In the past, Kosovo’s capabilities to develop a modern health care system were limited. Low GDP in 1990 worsened the situation even further. However, the establishment of the Faculty of Medicine in the University of Pristina marked a significant development in health care. This was also followed by launching different health clinics which enabled better conditions for professional development.

Nowadays the situation has changed and health care system in Kosovo is organized into three sectors including, primary, secondary and tertiary health care. Primary health care in Pristina is organized into 13 Family Medicine CentersQKMF. (2010-2014). Njesite me Adresa dhe Nr.Telefonit. Available: . Last accessed 23 February 2014. and 15 Ambulantory Care Units. Secondary health care is decentralized in seven Regional Hospitals. Though Pristina does not have a Regional Hospital, it instead uses the University Clinical Center of Kosovo for health care services. The University Clinical Center of Kosovo provides its health care services in 12 clinics, where 642 doctors are employed. At a lower level, home services are provided for several vulnerable groups which are not able to reach health care premises. Kosovo health care services are now focused on patient safety, quality control and assisted health.

Statistics

The Statistical Agency of Kosovo is a professional institution operating since 1948, located in Pristina, which collects, processes and publishes official statistical data. Since 2011, this agency functions under the Prime Minister's office. It is funded by the Kosovo Consolidated Budget and it is supported by donors. They have professional and technical cooperation with all ministries of Kosovo's Government, especially with the Ministry of Economy and Finance, the Central Bank of Kosovo, Eurostat, International Monetary Fund, World Bank, SIDA, DFID, UNFPA, UNDP, UNICEF and many other international institutions. According to a study made by Kosovo's Ministry of Public Administration, the number of female employees in Kosovo's health institutions was distinctly greater during the previous years. In 2010 there were 8,928 female employees and 4,282 males. This number had a minor increase in favor of male employees by one percent in 2012.

University Clinical Center of Kosovo (UCCK) had 870 doctors in 2010. In 2012 this number dropped to 642. The department of gynaecology had the most personnel throughout the previous three years, while neurosurgery had the lowest.

The mortality rate in 2009 was 836 patients in regional hospitals of which 39% were in Prizren's Regional Hospital, 21.5% in Peja, 20% in Gjakova, 17.7% in Gjilan, 1.0% in Vushtrri and 0.1% in Ferizaj. In 2010 the regional mortality rate was 806.

Health care divisions

After the 1999 war, there have been major improvements in health care. Medical services received several donations and international financial support raised dramatically. Many buildings have been constructed and renovated, the number of staff expanded, and the number of patients seeking medical services increased substantially. The highest health care authority in the Republic of Kosovo is Ministry of Health of Kosovo.

As in other countries, Kosovo's health care system is organized into three levels: primary, secondary and tertiary health care.

Primary Health Care (PHC)

Primary health care relates to the professional health care services offered to the community, usually from a nurse or general practitioner. It covers a wide range of health and preventative services such as supporting and taking care equally for all community, including those who have lower income, provide health education, counseling disease prevention, screening and promoting better living environments. Primary health care became a fundamental concept for World Health Organization as a result of the Alma Ata Declaration (1978). Since the Declaration of Alma-Ata, health situation at country level has gone through major changes. There have been many modifications in demographic profiles, socio-economic environment and reducement of risk exposure and common diseases. Primary health care is available for individuals and families, coming from different municipalities, with affordable costs that can be covered by the Government funds as well as community. Kosovo consists of an overall 36 municipalities, all of which have their own PHC medical centers. Kosovo Primary Health Care is organized in two separate levels such as: Family Medicine Centers (FM) and Ambulatory Health Care Units. Geographically isolated municipalities have established also some maternities, such as Women Welfare Centers, that serve for women emergency well-being cases.

Family Medicine Centers The table below shows main Family Medicine Centers in Prishtina and their locations. CENTERS LOCATION QKMF St."Fehmi Agani" Nr.20 QMF-I St."Ilir Konushefci" QMF-II Kodra e Trimave QMF-III St."Xheladin Kurbaliu" QMF-IV St."Xhemajl Ibishi" QMF-V St."Nena Tereze"-Dardani QMF-VI St."Hyzri Talla" QMF-VII Emshir QMF-VIII St. "Eduard Lir" QMF Hajvali QMF Besi Besi QMF Mat Matiqan DAT St."Fehmi Agani" Nr.20 Dental polyclinic St."Luan Haradinaj" Nr.20

Ambulatory Medical Units The table below shows Ambulatory Medical Units in Prishtina and their locations. CENTERS ADDRESS Ambulance Llukare Ambulance Keqekolle Ambulance Koliq Ambulance Dabishevc Ambulance Shkabaj Ambulance Barileve Ambulance Bardhosh Ambulance Kishnice Ambulance Slivove Ambulance Viti Ambulance Bullaj Ambulance Flotacion Ambulance Mramur Ambulance Rimanisht Emergency Ulpiana

Lack of family medicine specialists

Primary Medical Centers usually deal with problems such as short data on citizen registry, incorrect addresses and a large number of community migration from rural to urban areas. By 2013, the Ministry of Health had signed an agreement with a British college to train Kosovo graduated doctors in the UK. Family Health Care Centers in Kosovo were in need of 1,000 family medical specialists and had only half that number of doctors providing primary health care services.

Secondary health care Secondary health care refers to a higher level of health care system, in which patients from primary health care are referred for more specialized treatments. Secondary health care level includes medical services provided by a specialist or more advanced facilities, upon referral from a primary care physician that requires more specialized knowledge, skill or equipment than the primary care physician. Secondary prevention programs identify and treat asymptomatic people, who have already been exposed to different risk factors or have any pre-clinical diseases, without any clinical symptoms. These activities are focused on early screening of asymptomatic patients that are prone to develop the disease without any possible prevention or treatment. Screening tests are an example of secondary prevention activities, since they are performed even on patients who have not manifested any clinical symptoms of diseases, such as: hyperlipidemia, hypertension, breast, prostate cancer and many others. Secondary health care is offered by regional hospitals in municipalities such as Mitrovica, Peć, Gjakova, Prizren and Gjilan.

Regional hospitals

Besides University Clinical Center of Kosovo (UCCK), which is the only tertiary health care center, there are also seven regional hospitals that offer secondary health care services. Most of referred patients to UCCK come from regional hospitals. Regional hospitals in Kosovo are: Prizren’s regional hospital Peć’s regional hospital Gjakova’s regional hospital Ferizaj’s regional hospital Gjilan’s regional hospital Mitrovica’s regional hospital Vushtrri’s regional hospital

Tertiary Health Care

Tertiary health care is the highest specialized medical level, which offers more complex procedures and treatments performed by specialists. Tertiary activities involve treatment of already established diseases, manages to restore patients to their highest functional level, minimizes negative effects of disease and further complications.

Kosovo's tertiary health care specialized medical services are offered by medical institutions such as University Clinical Center of Kosovo, University Dentistry Clinical Center of Kosovo, National Blood Transfusion Center, National Institute of Labor Medicine, Medical Center for Sport and Recreation, National Institute of Public Health and Faculty of Medicine, University of Pristina. Many tertiary health care services are mistakenly used instead of primary and secondary health care services from Kosovo inhabitants.

University Clinical Center of Kosovo (UCCK) University Clinical Center of Kosovo is the main tertiary health care institution located in Prishtina, which offers most specialized medical services. It consists of Emergency Care Center, 12 clinics, National Institute of Public Health, Central Pharmacy, Private Pharmacies, and Institutes like Anatomy, Pathology, Physiology, Pharmacology and Toxicology.

UCCK Clinics - Human Resources

This table shows the overall human resources working in University Clinical Center of Kosovo, including specialized doctors and nurses for 12 clinics, Emergency Care Unit, National Institute of Public Health Kosovo and Central Pharmacy. UCCK Specialized Doctors Nurses Total Employees Pulmonary Clinic 11 36 47 Pediatric surgery Clinic 7 25 32 Neurosurgery Clinic 7 25 32 Urology Clinic 11 31 42 Surgery Clinic 52 164 216 Dermatology & Sexually transmitted diseases Clinic 18 25 43 Gynecology & Obstetrics Clinic 61 265 326 National Institute of Public Health 37 27 64 Anesthetic and Intensive Care Unit 44 154 202 Central Pharmacy 21 20 41 Psychiatry Clinic 16 47 63 Neurology Clinic 19 59 78 Pediatric Clinic 37 176 213 Orthopedic Clinic 37 103 140 Emergency Care Center 20 78 98

National Institute of Public Health in Kosovo

National Institute of Public Health (NIPH) was established on 5 June 1925 and it is the highest medical, professional, and scientific institution. The institution organizes and applies the strategy of public health hygienic-sanitary measures, prophylactic-epidemically measures, social-medical, health education, EPI (expanded program on immunization), health promotion, water, food and air quality controls, health policy, economy of health, and develops scientific research works in the territory of the Republic of Kosovo. Hence, the institute is known as the educational base of the Faculty of Medicine and is divided in five departments: Epidemiology, Human Ecology, Social Medicine, Micro-biology and Health Information System; Kosovo School of Public Health.

Development history of NIPH

The 1920s were characterized by very bad medical conditions in the Balkans. In general, based on the Kosovar health care condition and the overall public health situation, a decision was made to establish hygiene and epidemiological services in the city of Peć with the "Rockefeller" fund support from the US and on 5 June 1925 this service finally began to work. On the same day, basis were set for Preventive Medicine in Kosovo and 5 June is marked as a festive day for the founding of the Institute of Public Health. After that date, sanitary stations, hygienic and microbiological or epidemiological services were established in Pristina, Prizren and Mitrovica. In these units there was a great lack of specialized staff (except in Prizren), but health services were performed by health employees with medical school degrees. In ancient Prizren, during 1923/1924, was established a highly efficient bacteriological service which provided services to the entire territory of Kosovo (at that time a part of Sandžak and Montenegro). Yet, Dr. Isuf Dedushaj stated that it was only the bacteriological service which later developed into the hygienic-sanitary services in order to be later transformed into the Regional Institute of Public Health of Prizren.