Today, with the aid of the international community [European Union (EU), World Bank (WB), World Health Organisation (WHO), United Nations Children's Fund (UNICEF), nongovernmental organisations (NGOs), Global Fund (GF), Stability Pact, etc.] the ministries of health in transitional countries in the South Eastern Europe (SEE) region are in the process of expanding the capacities and skills of the health workforce in order to achieve successful health care reform and accomplish necessary steps for EU integration. The aim of this paper is to review international community support to reconstruction of the health care in SEE countries, with main focus on the EU and WB donors and projects. Review was done on the basis of existing donor reports, Internet search (search of official Web sites and electronic databases, check of references from selected documents, and use of a generic Internet search engine) and authors' experience from different health projects. The governments of SEE countries, in order to create an effective and efficient health system, overcame a period of transition and soon or later became ready for the process of EU integration, and began working on the following issues: rehabilitation, reconstruction and equipping of health facilities; developing a health strategy and policy documents; legislation and financing framework; building institutional, human resource and management capacity; health care sector reform; support to public health development and restructuring of the pharmaceutical sector. In many SEE countries, the capacity of the Ministry of Health and Health Insurance Fund was strengthened, and policy and strategy documents were drafted to guide reorganisation and reorientation of health care services. The public health system was strengthened. A family medicine model was introduced and developed in most countries. Development of enabling legislation mostly followed proposed changes in the health system. Although progress on several important fronts in achieving transition and progress in the rehabilitation health sector in SEE countries is significant, a lot remains to be done. Experience in some countries can be used to stimulate, motivate and encourage professionals throughout the civil service to grasp with both hands the opportunities for positive change.
Background The vaccine hesitancy is a matter of global concern with inadequate global uptake postponing the moment of reaching herd immunity and bringing the COVID-19 pandemics under control. Countries in the Western Balkans struggle with vaccine hesitancy, trying to bring vaccine acceptance and ways to improve it into the focus. Methods A cross-sectional study on vaccine hesitancy was conducted from July to September 2021 and included adult population from Albania, Bosnia and Herzegovina, North Macedonia, Montenegro and Serbia (1605 individuals). Convenience sampling was applied using anonymized online questionnaire (shared through social media) measuring, among others, trust in societal factors, social responsibility and, the credibility of information sources about COVID-19 vaccines. Results The highest degree of trust in societal factors was found in North Macedonia (M = 3.65, SD = 1.06), followed by Montenegro (M = 3.50, SD = 1.19) and Serbia (M = 3.24, SD = 1.26). In Albania 44.7% respondents believed in reluctance of pharmaceutical companies to publish detailed research reports on the risks of adverse reactions to COVID-19 vaccines. The view that the health authorities when they encourage vaccination do so with the best intentions supported 66,3% respondents in North Macedonia and 49% in Albania and Serbia. The highest level of social responsibility (M = 4.12, SD = 1.09) was revealed in North Macedonia. Primary care physicians, health professionals in media, webpages of public health institutions, and scientific literature are the most trusted sources of information about COVID-19 in all countries. Conclusions The study demonstrated moderate trust in societal factors and moderately high level of social responsibility in all countries. The health professionals enjoy the greatest trust, which implies that medical doctors, especially physicians in primary health care should have a pivotal role in promoting vaccination and educating the general public in the Western Balkans.
Huge population migration, increasing unemployment and poverty and unhealthy lifestyles (stress, smoking, alcohol consumption, etc)
Background Introduction of vaccines against COVID-19 has not encountered expected acceptance. The uptake of COVID-19 vaccines in Western Balkans countries is lagging behind the European Union average. The aim of our study was to assess the intention to get vaccinated against COVID-19 in the population of unvaccinated adult citizens of five Western Balkans countries, and to explore factors that influence the vaccination intention. Methods Cross-sectional study was conducted in the period from July to October 2021. The questionnaire was shared through online social media. Intention to get vaccinated against COVID-19 was measured by a single item assessing the likelihood of getting vaccinated on a 5-points Likert scale. Linear regressions were conducted with socio-demographic characteristics, presence of chronic diseases and attitudes towards COVID-19 vaccination as independent factors. Results The largest proportion of unvaccinated respondents willing to get vaccinated in the future was observed in Montenegro and Albania (40.4% in each country), while in the Serbian sample, the willingness to get vaccinated was the lowest (22.6%). Socio-demographic characteristics were not significantly associated with the intention to get vaccinated against COVID-19 in most of the countries. In Albania, Bosnia and Herzegovina, North Macedonia and Serbia the strongest determinant of COVID-19 vaccination intention was the higher sense of social responsibility. Conclusions Vaccination interventions and campaigns aiming to improve the COVID-19 vaccine uptake should be focussed on specific set of factors in each country, appealing to social responsibility as most prevalent determinant of vaccination intention in Western Balkans.
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