Despite continuous improvements in most health indicators, the situation regarding morbidity and mortality remains alarming. Infant and maternal mortality are both among the highest in Europe. In 2005 Lulaj reported a perinatal mortality of 22.82 ‰ (≥ 500 grams) or 17.4 ‰ (≥ 1000 grams) and a maternal mortality of 6.8 per 100,000 live births. This means a clear improvement compared to the situation in 2000 (29.1 ‰ perinatal mortality ≥ 500 grams, maternal mortality of 23 per 100,000 live births). In 2010 the values stabilized at the 2005 level. Child mortality in 2015 was 36.44 ‰, the highest value in Europe. According to the United Nations Children’s Fund If every third child under 5 years of age does not have enough vitamin A, 20% of children under 5 years of age have stunted growth, 5% of children in Kosovo are undernourished, and around every 10th child under 5 years of age suffers from chronic malnutrition. The immunization rate has recently increased to over 90%, but remains low among the RAE minorities.
The extent of environmental pollution and the handling of addictive substances, especially tobacco, pose an enormous risk to the health of the Kosovar population.
According to THERELIGIONFAQS, the health system in Kosovo is organized on three levels. The first level includes primary care, a total of 422 practices and care centers. Secondary care includes specialists and the seven hospitals, while tertiary care includes the university clinics in Prishtina and state institutes. The number of licensed private hospitals in Kosovo was 23 hospitals in 2019. In 2017, around 14,000 people were employed in the public health system. Public spending of € 108 million (about 60% of total public health expenditure) corresponds to 1.8% of GDP, a very small proportion, even in regional comparison. The share of private health expenditure corresponds roughly to the level of public expenditure. The long-standing debates about reforming the tax-financed health care system have essentially concentrated on the introduction of statutory health insurance. However, the socio-economic framework conditions have so far hindered the implementation of this reform option. A contribution rate of 10% would therefore generate only 40% of current public expenditure, which makes the sustainability of this approach appear questionable. Despite many successfully implemented reforms in the Kosovar health system, there are many challenges to be solved in addition to financing. The focus is on the following aspects: The gatekeeper function of general practitioners is not being implemented efficiently. Despite improvements in recent years, the demand for (vital) drugs cannot be fully satisfied, which is a breeding ground for the development of black and gray markets. Kosovo and Albania have the highest rate of intra-hospital infections compared to other European countries, which is mainly due to hygienic problems. Stray dogs and cats have been observed repeatedly in the university clinics in Prishtina! The medical infrastructure in Kosovo remains patchy despite considerable investment. Together with the lack of medical expertise, this leads to the problem that certain diseases (e.g. leukemia, kidney failure) cannot be treated in Kosovo. An efficient information processing system is completely lacking. Anecdotal evidence underscores the widespread problem of corruption in the health sector. The dual function of medical staff who work in public and private institutions at the same time leads to substantial conflicts of interest. Decisions about budget allocation sometimes seem to be clearly politically motivated and are hardly evidence-based. Finally, the financial barriers make access to the health system more difficult, which leads to serious inequalities.
The Health Policy Institute, Citizen’s Network for Peace, Reconciliation and Human Security, and Swiss Refugee Aid offer an overview of the medical care situation.
The challenges of the corona pandemic
The corona pandemic represents an extreme challenge for the backward Kosovar public health system. As for most countries in the world, the first problem was the lack of protective equipment and corona tests, but especially the very limited capacity limits of intensive care medicine. At the beginning of the crisis there were barely a hundred ventilators in all of Kosovo.
The measures taken by the former health minister Vitia, who was highly praised by the international community for his crisis management, and the entire government focused on the procurement of ventilators, through purchases and donations, as well as protective equipment and tests. Overall, the number of ventilators available increased to over 200 in the 2nd quarter of 2020. A wage bonus in the health sector was also decided. Student dormitories at the University of Pristina have been converted into quarantine facilities for citizens returning from abroad. A tragic incident occurred there in May when a student who had returned from Germany with the help of the Kosovar embassy fell suicidally to his death. About the question
As a result of the surge in the number of infections, the Kosovar health system came under considerable pressure in the summer of 2020. A significant part of the Prishtina Clinic and most of the most important regional clinics have almost completely switched to treating corona patients.