Introduction to Institute of Public Health,

R&D and Innovation in Albania.IANPHI Meeting in Tirana, Albania on 24-25 April 2014

Genard HajdiniPartnership Specialist

Department of Health Information, Technology & Communication

Institute of Public Health (IPH) Albania

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INTRODUCTION

“The greatest wealth is health.”  ~Virgil

The Institute of Public Health presentation was developed in response to the IANPHI National Survey and “Evaluation Tool” preliminary data based on the…

1) National Program for Research and Development 2007-2009;

2) National Strategy for Health in Albania 2007-2013;3) National Strategy of Science, Technology and Innovation

of Albania; 4) National Background Report on Health for Albania; 5) Public Health Law; and6) Cross-sectional data gathered by different ministries in

the Albanian government and desk review process at Institute of Public Health (IPH) in Albania.

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Institute of Public Health (IPH) Founded on the basis of the Research Institute of

Hygiene and Epidemiology and Immune-biological Products (created in 1969).

In 1995, it became Institute of Public Health.

IPH Basic Functions: IPH supports technically the MOH with

information and advice. Researches and collects data on public health

issues. Performs continuous public health education for

healthcare professionals. Center of Laboratories of Expertise and

Reference. Administers Vertical Prevention Programs

delegated by MOH. National Epidemiological Observatory.

INTRODUCTION

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INTRODUCTION Public R&D institutions in Albania:

Institute of Public Health (IPH) Founded on the basis of the Research Institute of Hygiene

and Epidemiology and Immune-biological Products (created in 1969).

Faculty of Medicine at UT (Est. 1957). Mother Teresa University Hospital Center.

Private R&D institutions in Albania: Lady of Good Council (Catholic) University (accredited) U.F.O University (accredited). Kristal University (accredited). Medikadent (accredited).

Private R&D Clinics and Laboratories: Lady of Good Council Clinic Orthodox Clinic IKEDA Clinic Globus Clinic Didaktalba (Science Equipments Store), etc.

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INTRODUCTION Country:                          Albania General Population:       2,831,741

Regions:                          12

1) Berat 140,9642; 2) Dibër 136,6303; 3) Durrës 265,3304 4) Elbasan 296,0825; 5) Fier 310,9896; 6) Gjirokastër 75,1727 7) Korçë 220,4388; 8) Kukës 85,2399; 9) Lezhë 135,60910

10) Shkodër 217,375; 11) Tiranë 763,63412; 12) Vlorë 184,279

Urban: 53.7%  / Rural: 46.3%  = Ratio 1.16

Age Structure: 0-14 years: 30%,  15-64 years: 63%,  65 years and over: 7%.  (2000 est. Index Mundi)

Average Number of Household Members:  3.8

Age distribution according to ethnicity:  No complete data, since the ethnicity question was optional in Albania’s Census 2011.

(Source: Albanian Preliminary Data for Census 2011).Genard Hajdini

Health Systems Org. Chart in Albania

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Regional vs. District

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De Jure De Facto

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Health Care Expenditure

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The Public Health Law No. 10 138, date 11.5.2009. The role of Institute of Public Health (IPH) defined in

Chapter IV: Organization and Functioning of the Institute of Public Health (IPH) in Articles: 12, 13, 14, 15, 16… 40.

PUBLIC HEALTH LAW

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Article 12: The organization of the IPH

IPH is a public, budget institution, administratively under the Minister of Health.

IPH is a research center for public health, a reference center for the public health services, university training center for public health and information center for public health.

INTRODUCTION

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Article 13: Organizational structure

Leading bodies of IPH are: The director, The scientific council

Appointment and release from duty of the director of the IPH is done by the Minister of Health. The requirements and criteria for the appointment and release of the director are defined by an order of the Minister of Health

The scientific council is an advisory body of the PHI. Its establishment, organization and functions are approved by a decree of Council of Minister.

INTRODUCTION

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IPH Article 15: Functions

The Institute of Public Health performs the following functions:

a. Surveillance of communicable and non-communicable diseasesb. Management of national registersc. Scientific research in public health d. Following up the latest international health news including system and practicese. Training and education in public healthf. Reference center in public healthg. Informing population about public health issues.

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Financing IPH

Article 16: Financing

The Public Health Institute is funded by:

1 - State budget2 - Revenues from scientific and education activities3 - Grants, funds for scientific activities, development programs4 - Donations, gifts5 - Other legal sources.

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Reference Laboratory: IPH

Article 37: Reference laboratory The reference laboratories should assess the public health

laboratories within the regional structures of public health, according to the respective guidelines that are approved by the MoH.

The laboratories of the public health within the IPH are reference laboratories. One laboratory could be a reference laboratory for one or more analyses .

An independent institution should accredit the reference laboratories.The reference laboratories should provide support for laboratory activities, technical standards and analyses methods.

The reference laboratories should guide and guarantee the use of the system of internal management of the quality in each laboratory of public health. 14Genard Hajdini

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Article 40: Surveillance

The National Epidemiological Observatory and specific National Registries are in place for the surveillance of the risk factors and burden of diseases .

National Epidemiological Observatory of risk factors and specific national registries are located in the IPH.

Surveillance at IPH

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R&D Organizational Infrastructure of IPH in Albania

DIRECTOR IPH

MINISTRIOF HEALTH

Zv/Drejtor Shkencor

Zv/Drejtor Ekonomik

Sektori iAdministratës

Sektori i Burimeve Njerëzore

Sektori i Financës

Asistent i Drejtorit

Department of Control of Infectious Diseases 

Sektori Survejancës të Sëmundjeve

Infektive

Sektori Vaksinimit

Sektori Kontrollit të Vektorëve

Sektori Programit

Kombëtar të HIV/AIDS/SST

Qëndra e Këshillimit

Sektori Laboratorëve

1. Laboratori i Virologjisë2. Lab. i Imunologjisë (HIV/AIDS dhe hepatite)3. Lab. i Bakteriologjisë dhe Mykologjisë4. Kontrolli i Infeksioneve Spitalore5. Lab. i Biologjisë Molekulare6. Laboratori i Parazitologjisë7. Laboratori i Preparatorisë8. Lab. i Prodhimit të Antigeneve dhe Serumeve Diagnostike

Department of Sanitary Expertise

Seksioni i Ujit Sanitetit

Seksioni i Fizikës Sanitare

Seksioni i Kontrollit të Cilësisë së Ajrit

Seksioni i Shëndetit në Punë

Seksioni i Ujit Sanitetit

Seksioni i Laboratorëve

1. Zyra e Sigurimit dhe Kontrollit të Cilësisë; 2. Lab. i Mikrobiologjisë së Ushqimeve dhe Mykologjisë; 3. Lab. i Biokimisë; 4. Lab. i Kimisë së Ujit dhe Sanitetit; 5. Lab. i Kimisë së Ushqimeve; 6. Lab. i Kimisë Analitike Instrumentale; 7. Teknika Kromatografike; 8. Teknika e Absorbimit Atomik.

Department of Epidemiology and Health

Systems

Seksioni i Epidemiologjisë dhe

Indikatorëve Shëndetësor

Seksioni i Shëndetit Riprodhues

Sektori i Politikave dhe Sistemit Shëndetësor

Department of Education and Health Promotion

SCIENTIFIC COUNCIL

Seksioni i Shëndetit Komunitar

Seksioni i Shëndetit në Shkolla

Seksioni i Shëndetit Riprodhues

Seksioni i Shëndetit Mendor

Seksioni i Abuzimit me Substancat

Sektori i Merëmbajtjes së Kafsheve (Vivarium)

Sektori i Botimeve

Sektori i Radiombrojtjes

Qëndra e Trajnimit

Department of HI,TCH&COM

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HUMAN CAPACITIES

R&D Personnel Number

TOTAL FEMALE

1 Scientists 73 47

2 Technicians 38 22

3 Supporting Staff 84 50

TOTAL 195 119

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HUMAN CAPACITIES

Scientists + Technicians + Support Staff

Number TOTAL FEMALE

1 Engineering 1 1 2 Natural Sciences 39 25 3 Medical Sciences 53 32 4 Agricultural Sciences 4 2 5 Social Sciences 8 5 6 Humanitarian Sciences 8 5

TOTAL 113 70

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HUMAN CAPACITIESTitle/Grade Age Total

<30 31-40

41-50

51-60

61-65 >65

Academic - - - - - - 0

Academic w/o functions

- - - - - - 0

Professor 1 1 2 4

Prof. Assoc. 1 3 3 7

Dr. 5 6 1 12

Researcher & Assistants

7 24 10 9 1 51

Total Scientific 7 29 18 14 6 74

Assistant Scientists (Lab)a-university degreeb-high school degree

53

117

614

424

15

2753

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R&D Financing in Health

Sectors/Year2007

GDP (000 €)

(Sector GDP/Total GDP) %

National economy 15,000 0.2

I sector: Health 3,743 0.05

II sector: Education 5,240 0.07

III sector: Agriculture 4,491 0.06

IV sector: Environment 1,497 0.02

V sector: -- - -

Table 2. Performance of economy and sectors relevant for S&T field:

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R&D ProjectsTable 3. List of Completed and Continues Projects at Institute of Public Health (IPH) in Albania.

Title of Project: Financed ~(USD) Donor Organization

1. Demographic and Health Survey2. Behavioral & Biological Survey (HIV/AIDS)3. School Surveys (YRBS, ESPAD)4. Hepatitis Sero-prevalence Survey5. PHC Service Capacities and Gaps

a. Vaccinationb. Cancerc. CVD

6. Iodine Deficiency Survey 7. Nutrition and Obesity Surveys8. Stress and Mental Health at the Workplace9. Other Research (outbreak investigations, air & water

pollutions, health indicators)10. Virology Laboratory11. Molecular Biology Lab.12. Chemistry (iodine)13. Clinical Lab.14. Air Pollution15. New Vaccines16. Detection Programs STI (VCT)17. Detection Program Chronic Disease18. New Surveillance Systems (abortion, STI, birth defects)19. Family Planning 20. Food Safety Assessment

$1,800,000100,00030,00030,000

100,000/40,000/10,000

100,00020,00010,00050,000

100,000100,00030,00010,000

100,0001,000,000

50,00010,000

20,000 x 3 = 60,000100,00015,000

USAID/Swiss/UNFPAGlobal Fund (GF)UNFPAMASH (MOES)GAVI/UNFPA/MoH

UNICEFMASH (MOES)MoHMoH

World BankMoHMoHMoHWHOMoH + GAVIGlobal FundMoHUNFPAUNFPAMASH (MOES)

(Source: IPH) Genard Hajdini

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Health Research Priorities on the Basis

of the Country’s Readiness Health research priorities on the basis of the country readiness are:

1) Prevention of diseases and risk factors; 2) Mental health; 3) Non-infectious diseases with special importance; 4) Infectious disease; 5) Quality Assurance of Health Systems.

Also other points to be considered are:

6) Emergency alert and quick response toward natural and humanly caused catastrophes, accidents, and urgent situations;

7) Response to epidemics and pandemics in the country and region;

8) Allocation of resources toward public health research and response;

9) Clinical studies toward the most killing disease in the country both: infectious and non-infectious;

10) Accreditation and quality assurance of the laboratories and medical facilities in the country;

11) Public health and medical personnel capacities for country’s readiness;

12) Facility and infrastructure building with contemporary standards with a good health systems information network in Albania.

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Challenges & OpportunitiesS.W.O.T Analysis

StrengthsStrong laboratories infrastructure.Tradition and Knowledge Transfer.Some Human Capacities.Strong Logistics in the Field.Center of Information on PH.

WeaknessesFragile Quality Assurance SystemIn Process of National & International Accreditation.High Turnover Rate-Brain Drain.Lack of R&D Coordination Office.Low Absorption of Funds for R&D.

Opportunities

Strong National Network with DPH.Well-positioned between University and MOH.Supportive Legislation in Progress.International Networks & Partnerships.R&D has become a Priority: National & International Funds

ThreatsNew Governmental Structures overlapping with IPH Functions. PH Emergencies & Program Administration diverts energy & resources.Aid Funds & “Easy Money” create a dependency on low expectations and impedes competitiveness

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Health Research Priorities on the Basis of Future Potential

The health research priorities on the basis of future potential are:

1. Public Health (Genetic Screening); 2. Health Information Systems—the build up of Database Warehouses; 3. Biotechnology and clinical research; 4. Accreditation and Quality Assurance of all healthcare system:

hospitals, clinics, institutes through the national and international entities;

5. Establishment of high financial management of the Hospital and University Hospital Systems;

6. Albanian Centers for Excellence; 7. New Departments in Albanian Universities for PhD accredited

programs in health sciences.

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R&D and Innovation Examples

SURVEYS’ Research: Demographic and Health Survey.

http://www.measuredhs.com/ Behavioral and Biological Survey (HIV/AIDS). School Surveys (YRBS, ESPAD, etc.). Hepatitis Sero-prevalence Survey. PHC Service Capacities and Gaps (Vaccination, Cancer,

CVD). Iodine Deficiency Survey. Nutrition and Obesity Surveys. Stress and Mental Health at the Workplace Other research based on existing information systems

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R&D and Innovation Examples

Innovation Agenda of IPH New laboratories/technologies:

Virology Molecular Biology Chemistry (iodine) Clinical Lab. Air Pollution Monitoring new technologies

New Interventions: New vaccines Set up of early detection programs for STI (VCT) &

chronic disease New Surveillance Systems (abortion, STI, family

planning, birth defects, etc.). Social mobilization and healthy schools.

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R&D and Innovation Examples

TRAININGS: MPH (with the Faculty of Medicine at UT). Health Planning & Management. Field Epidemiology. Basics on Environmental Health. Occupational Health. Vaccination Programs.

International Partnerships. ASPHER (Joint-Member with Faculty of Medicine at UT). IANPHI (Member). Stability Pact Partnership. Other Joint-Project Collaborations with different

institutions. Conference Participations & Publications.

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2002 2003 2004 2005 2006 2007 2008 2009 20100.0

20.0

40.0

60.0

80.0

100.0

Circulatory System Disease (incidence per 10.000)

Meshkuj Femra

SDR, Disease of Circulatory Systemall ages per 100,000

29

30

SDR, Ischaemic heart disease, all ages per 100,000

31

32

SDR, Cerebrovascular Disease, all ages per 100,000

33

34

SKV Tumoret Simptoma e shenja të

sëmundjeve

Trauma, Helmime dhe

Aksidente

0

50

100

150

200

250

300

286.2

82.250.4

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Main Causes of Deaths per 100.000 inhabitants

35

2002 2003 2004 2005 2006 2007 2008 2009 20100.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Incidence of neoplasm by gender

Meshkuj

Femra

SDR, Malignant neoplasm female breast, all ages per 100,000

36

SDR, Malignant neoplasms, all ages per 100,000

37

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Albanian DHS 2008-2009

Indicator 2002 RHS 2008-09 Percentage of women with no education 0.3 Percentage of women with access to newspaper, television and radio 21.5 Total fertility rate (children per women) 2.6 1.6 Percentage of teenagers who have begun childbearing 6.4 2.8 Percentage of married women currently using any method of family planning 75.1 69.3 Percentage of married women currently using any modern method of family planning 8.0 10.6 Median age at first marriage for women age 25-49 (years) 21.8

Median age at first sex for women age 25-49 (years) 20.9 Percentage of married women who want no more children 72.8

Percentage of married women with an unmet need for family planning 12.8 Mean ideal number of children 2.6 Infant mortality rate (per 1,000 live births) 26.8 17.6 Under-five mortality rate (per 1,000 live births) 30.7 21.5 Percentage of live births receiving antenatal care from a trained health professional 97.3 Percentage of live births delivered at a health facility 94.0 96.7 Percentage of live births receiving assistance at delivery from a trained health professional 99.3

Percentage of children fully immunized 95.1 Percentage of children with acute respiratory infection or fever taken to a health facility 69.6

Percentage of children with diarrhea who received either ORS or RHS 67.8 Median exclusive breastfeeding duration (months) 3.6 Percentage of children underweight (-2 SD) 5.9 Percentage of children stunted (-2 SD) 15.6 Percentage of children wasted (-2 SD) 6.5

 

Conclusions

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Public Health Law in Albania is among the best in our country.

IPH has a research and education status. IPH is the technical support for MoH in Albania. It houses the best research scientists in the country.

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THANK YOU

To All IANPHI Directors and dedicated staff members.

To IPH Leadership: Director, Heads of Departments, Senior and Junior Managers.

Genard Hajdini

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Q&A

You have questions,

And I have answers…

Skype: genard1977

E-mail: genard_hajdini@yahoo.com

Work Cell: +355.67.20.52.947The End…