Medical Sciences
Permanent URI for this collectionhttps://repository.aab-edu.net/handle/123456789/59
The Medical Sciences community showcases scholarly publications and research outputs authored by faculty and researchers in the Faculty of Medical Sciences. This collection includes journal articles, working papers, conference proceedings, and other academic works that contribute to the understanding of theory, policy, and practice. It aims to promote open access to high-quality economic research conducted within the institution.
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Item Nursing Assessment and Management in Multiple Incidents in Emergency Clinic at the University Clinical Centre of Kosovo(AAB College, 2025-07-17) Beqiri, LirijeMultiple incidents are a large number of casualties caused in a short period of time, usually as a result of a single event such as a military plane accident, hurricane, flood, earthquake, road traffic accident or armed attack that does not exceed the logistics capabilities of emergency clinics. Developing countries including Kosovo are at high risk due to many factors such as: population growth in urban areas, climate change, technology, road traffic accidents, earthquake, etc. All of these cause losses of life. The aim of this paper is to analyze nursing assessment and management to multiple incidents at the Emergency Clinic at the University Clinical Centre of Kosovo (UCCK) and to evaluate nurses' knowledge of their readiness to handle these cases. To conduct this topic, a quantitative method was used where I conducted surveys with 40 nurses from this centre. In addition to the quantitative method, desk research has also been used, a method for conducting desk research and reviewing previous research findings. As a result of this research paper is found that nurses have sufficient confidence in their knowledge to manage all emergency cases at Emergency Clinic at the UCCK and it is considered that the workload of nurses at Emergency Clinic at the UCCK does not affect the most professional evaluation of multiple incidents.Item MEASURING THE PERCEPTION OF QUALITY MANAGEMENT PRIMARY HEALTHCARE SERVICES THROUGH SERVQUAL MODEL(AAB College, 2025-07-17) Rexhepi, Ilir; Shabani, Gezim; Ismajli, NaimThe quality of healthcare is more difficult to identify than other services because it is the clients themselves and their quality of life that gets evaluated (Eiriz & Figueiredu, 2005). The main aim of this study is to investigate people’s perceptions and expectations regarding the quality of services in primary health care (PHC) in Kosovo. A national level survey provides baseline findings intuitively understandable to policymakers on the expectations — perceptions of the quality of services at the PHC level and identifying the quality gap between the expectations and perceptions in all dimensions of different facilities. This comparative test will show the differences between the level of quality services provided by each PHC provider in Kosovo. This research seeks to improve the access and the quality of the priority services at PHC, including maternal and child health (MCH) and non-communicable disease (NCD). This research showed that at the national level the patients have higher expectations toward PHC services. Whereas, in specific, this study showed that there is a significant gap in expected and perceived services of the PHC system between different ethnic patients and different levels of citizen education. Therefore, the result of this study will contribute to enhancing the sustainability of the mandatory health insurance reform and raise the alarm of relevant institutions to reshape the policy-making in order to improve the population health outcome.Item Why There is No Health Insurance in the Republic of Kosovo?(AAB College, 2025-07-17) Mustafa, MyberaAlthough the legal basis for an adjustment and legal definition can be found in the Constitution of Kosovo, namely in Section 51.2, since 1990, Kosovo could not guarantee a provision of Healthcare Insurance (HI) for its citizen. While it is the recent statistics that have been showing a high degree of unemployment and poverty, the importance of functionalizing of a Health Insurance Fund (HIF) has been considered as a very important issue, particularly in regard to a most vulnerable layer of the local population Along the previous 10 years, since the first Law on Healthcare Insurance has been initially drafted in 2004, attempts were made by the Ministry of Health (MH) to establish different working groups for the purpose of defining the legislation, which should lead to its adoption and creating the legal basis for the establishment of the Health Insurance Fund. Despite the efforts, to date, these attempts have proved unsuccessful due to the lack of the serious approach to the issue by the changing government. Furthermore, in consultation with International Monetary Fund, a study worth mentioning is also the one which has been developed by the World Bank in 2008 (for the purpose of studying fusibility regarding the macroeconomic involvement), which also brought important recommendations for the Government of Kosovo. In the section where the results are presented, different views from the Government of Kosovo, Ministry of Health and World Bank are portrayed in the manner of creation, financing and fund management. Further discussions should aim to define the causes and key problems behind the question: “Why there is no Health Insurance in Kosovo?”.Item Reforms and Challenges of Post-conflict Kosovo Health System(AAB College, 2025-07-17) Mustafa, MyberaBefore its collapse, Kosovo’s healthcare system was an integrated part of the Former Yugoslav Republics System (known as relatively well advanced for its time). Standstill had begun in the last decade of the twentieth century as the result of political disintegration of the former state. The enthusiasm of the healthcare professionals and the people of Kosovo that at the end of the conflict healthcare services will consolidate did not prove just right. Although we can claim that reorganization of Kosovo healthcare was a serious push (especially in the first years after the conflict), the intensity of development begun to fall at the latter stages. Although the basic legislation for the operation of the Healthcare System today in Kosovo does exist, the largest cause for the reform stagnation is where the law is not implemented properly and measures are not set as to a meaningful system of accountability. Twelve years have passed by since the 1999 war-conflict and, although, Kosovo has made progress in many other spheres, it has not yet reached to consolidate a health system comparable to those of other European countries. Intending to get out of difficult situation, several healthcare strategic plans have been developed in the past decade in Kosovo, but attempts in this direction have not been particularly fruitful. This script describes the actual Healthcare complexity of a situation in Kosovo 12 years after the end of the 1999 war-conflict. Interconnection and historical background is also looked upon and is described in the flow of events. Finally, the description of transfer competencies from international administrators to the local authorities as well as the flow of strategic planning that took place since 1999 has also been analyzed.Item MANAGING THE QUALITY OF BEHAVIOR ON HIV AMONG INJECTING DRUG USERS IN PRISHTINA(AAB College, 2025-07-17) Rexhepi, IlirAlthough Kosovo is a country with low HIV prevalence, the exposure to HIV among injecting drug users (IDUs) may be considerably higher. To assess the quality behaviors of HIV, HBV, HCV and Syphilis, as well HIV-relevant behavioral risks, a bio-behavioral RDS study was carried out in this key population in Prishtina in 2011. The study was a part of the second wave of HIV surveillance among most-at-risk populations. (The first wave was completed in 2006.) In total, 205 IDUs (of whom five were seeds) were tested and interviewed in the July-August 2011 period. Age range in the sample was 19-54 (Mean age = 31.0; SD = 7.14). Most participants were men (179/200; EPP1 = 88.7%). In regard to education, the largest percentage of recruited IDUs had completed secondary education (EPP = 49.3%). Slightly less than a third of respondents have been married at the specific time the study have been carried on (EPP = 30.9%). Permanent employment was reported by 35.1% (EPP) of IDUs in the sample. No HIV+ cases were found. Four IDUs were infected with Syphilis (EPP = 2.0%; 95% CI = 0.3-4.3), 16 with HBV (EPP = 6.0%; 95% CI = 3.0-10.5) and 96 with HCV (EPP = 37.4%; 95% CI = 28.9-46.8). Of the HBV+ individuals, two were diagnosed as having an acute and nine as having chronic infection. A majority of IDUs were alone the last time they injected drugs (EPP = 63.0%). In the past week, 187 of 197 participants (EPP = 97.3%) did not share injecting equipment. A majority of IDUs (158/198; EPP = 83.8%) stated that they always use sterile injecting equipment. Slightly over a half of participants (EPP = 51.8%) were ever treated for drug abuse. In regard to sexual behaviors, a majority of recruited IDUs were sexually active in the month preceding the study (EPP = 74.1%), of which about a quarter had multiple sexual partners (EPP = 27.1%). A minority of participants had regular sexual partner who was also injecting drugs (EPP = 8.5%). Less than a third of the surveyed IDUs used condoms consistently in the past month (EPP = 30.3%). About one fifth of participants (EPP = 22.0%) answered correctly to all five standard UNGASS HIV knowledge indicators. Although the study met all basic requirements of RDS methodology (Johnston et al., 2009), generalizability of the findings should be approached with caution due to a relatively small sample size and the fact that a majority of recruited IDUs have used Labyrinth drop-in and needle-exchange services in the past. The findings point to low levels of injecting equipment sharing, although the prevalence of HCV infection suggests that this is a recent development. Relatively infrequent and inconsistent condom use, coupled with low HIV risk self-assessment, emphasizes a need for a stronger promotion of condom use in the population. Overall, the observed changes in the levels of risk-taking behaviors in this key population confirmed the importance of repeated high-quality bio-behavioral HIV surveys in this key population (Zaba et al., 2005; Brown, 2003).Item The Joint Initiative for Teaching and Learning on Global Health Challenges and One Health experience on implementing an online collaborative course(AAB College, 2025-07-17) Arenliu Qosaj, FatimeThe “Joint Initiative for Teaching and Learning on Global Health Challenges and One Health” piloted the online course “Global Health Challenges and One Health in 2021. The present work documents this experience, lessons learned, and the future outlook of the course. A descriptive study was conducted based on the evaluations performed with the enrolled students and course coordinators. Of 30 enrolled students from graduate programs of six institutions from Brazil, Germany, Mozambique, and Kosovo, two unenrolled, and nine failed for not completing the activities. Therefore, 19 (63%) students completed the course. Some challenges identified were language and technology access barriers, difficulty scheduling group meetings due to different time zones, and high workload per credit in some institutions. Activities in groups conducted synchronously, such as debates, journal clubs, and case studies, were highlighted as those with higher impact in the learning process, having more participation of students when carried in small groups. Some students reported the establishment of research and work partnerships with other participants from partner institutions. The experience reinforces the importance of international exchange to improve collaboration between institutions and the impact of working in small interprofessional groups to develop technical, intercultural, and interdisciplinarity competencies necessary to human resources working with the One Health approach. The success of such international educational initiatives depends on overcoming barriers to implementation, which can be detected in institutional and course levels. Therefore, continuing evaluation of the course and improvements must be performed and involve all participants.Item Creating a platform to enable collaborative learning in One Health: The Joint Initiative for Teaching and Learning on Global Health Challenges and One Health experience(AAB College, 2025-07-17) Arenliu Qosaj, FatimeThe “Joint Initiative for Teaching and Learning on Global Health Challenges and One Health” targets education and training in Global Health Challenges and One Health, focusing on surpassing issues that affect One Health training programs. The present work describes the planning, implementation, and challenges to develop an international educational initiative among six partner institutions from four different countries, to build a collaborative teaching and learning environment. The course applies collaborative online international learning principles and is addressed to graduate students of universities from Brazil, Germany, Mozambique, and Kosovo. A pilot curriculum was developed with modules on intercultural competence, interprofessional and collaborative practice in One Health; One Health; healthcare, surveillance, and One Health; bioethics in One Health and careers in Global Health. The course combines synchronous and asynchronous activities developed in groups by mixing students from different institutions and countries. Forty-four experts from 22 institutions of the Americas, Africa, Europe, and Asia collaborated with the course content. Some challenges to implementing the course were the different criteria to assign credits across institutions, the lack of bibliographic material across all partners, limited overlap hours and periods for synchronous activities, and short semester overlap across institutions. Despite the challenges for implementation, the entire process of planning and delivering the course involves intense international collaboration, contributing to the curriculum internationalization, benefiting all institutions involved, promoting exchange even in the challenging scenario of the pandemic of coronavirus disease 2019 (COVID-19).Item Health policy developments in the Western Balkan Countries 2000–19: towards European Health and Health Care Policies(AAB College, 2025-07-17) Arenliu Qosaj, FatimeBackground: Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia have committed to becoming European Union (EU) member states. This, among others, implies that candidate/potential candidate states adopt legally authorized EU policies, including health. The study aims to identify the main country-specific health policy areas critical to the EU accession health policy dimension and present the change in associated selected health indicators from 2000 to 2019. Methods: The study draws on published reports and analyses of official statistics over time and cross-country. Health care policy adherence to the European Commission’s recommended country-specific health actions was classified into five health policy areas: financing, payment, organization, regulation and persuasion. Key health policy areas for Western Balkan countries (WBCs) were identified. Health progress or lack thereof in catching up to the EU15 population health, health expenditure and the number of health professionals are measured. Results: The European Commission prioritized financing and regulation for all WBCs in the five policy areas. Nine of the 18 analyzed selected health indicators showed divergence, and the other nine converged towards the EU15 averages. WBCs continue to face diverse public health challenges in improving life expectancy at birth, death rates caused by circulatory system diseases, malignant neoplasms, traffic accidents, psychoactive substance use, tuberculosis incidence, tobacco smoking prevalence and public-sector health expenditure. Conclusions: By 2019, there is limited evidence of WBCs catching up to the average EU15 health levels and health care policies. Closer attention towards EU health and health care policies would be favourable.Item Prevalence of Perceived Stress, Anxiety, and Depression in HCW in Kosovo during the COVID-19 Pandemic: A Cross-Sectional Survey(AAB College, 2025-07-17) Arenliu Qosaj, FatimeA pandemic may have a negative impact on healthcare workers’ (HCW) mental health. In this cross-sectional study, we assess the self-reported prevalence of stress, anxiety, and depression and identify their predictive factors among HCW in Kosovo. The online questionnaire collected data on socio-demographics (sex, age, occupation, education, workplace) and the presence and severity of depression, anxiety, and stress through the 21-item Depression, Anxiety, and Stress Scale (DASS-21) questionnaire. Descriptive statistics, t-test, and linear logistic regression were used to analyze the data. Of the 545 respondents, the majority were male (53.0%), under 60 years of age (94.7%), and married (81.7%). Most of them were physicians (78.2%), while the remaining were nurses, midwives, and other health professionals (22%). Prevalence rates for moderate to extremely high stress, anxiety, and depressive symptoms were 21.9%, 13.0%, and 13.9%, respectively. The nurses reported significantly higher mean scores for depression and anxiety than the physicians (p < 0.05). Being married, having poor health, not exercising, and reporting “burnout” from work significantly predicted higher levels of depressive, anxiety, and stress symptoms among health workers (p < 0.05). Most HCWs (71.6%) reported a mild, moderate, or severe mental health burden, and certain factors predicted higher levels of such burden.Item Prevalence of hypertension and diabetes in the population of Kosovo(AAB College, 2025-07-17) Sopjani, IdrizObjectives: To observe the prevalence of arterial pressure and glycemia in Kosovo and to provide free screening service through health promotion. Methods: This prospective study was conducted over a 3-year period, during 2017–2019. All data were collected by AAB College staff in 11 Kosovo cities prior to a random sample with 7254 observations. Data included demographic information as well as blood pressure and glycemic level measurements. Results: The overall prevalence of arterial pressure was registered at 27.6% and diabetes mellitus at 9.2%. Arterial pressure in females had a tendency to increase with age (r = 0.3552, P < 0.001), as well as the glycemic index (r = 0.1997, P < 0.001). Nevertheless, age had a stronger impact on males than in females, with regard to higher arterial pressure in the year 2017 (P < 0.001). In the following years, 2018 and 2019, the ratio had reversed. Glycemia had strong correlation with systolic arterial pressure value (P < 0.001). For a 1 mmol/L increase in glycemia, the diastolic value increased by 0.19 mmHg on average. Conclusions: This study concluded that at younger ages the values of arterial pressure and glycemia remain within the commonly observed range, but over the years the probability for higher blood pressure or glicemia increases. Through continuous control of arterial pressure and glycemia at an early age, it is possible to identify abnormal diagnostics, in order to address them in time. Educational initiatives and screenings should take place in order to increase awareness of the citizens for checking themselves regularly.