Community Participation

• An advisory board consisting of staff and community members was created and advised the partnership on areas such as training, primary care model development, and determination of staffing and services. The board, which meets once a month, is composed of 10 people, including the director of the planned PHC clinic, a nurse who will work at the PHC clinic, an economist from the Prefecture, and a teacher.

Quality Assurance

• To further ensure quality care at the Lezha clinic, one partner from Lezha received training at the Region-wide Clinical Practice Guidelines Advisory Committee Meeting in Moscow in December.
• Twelve screening guidelines that were most relevant to the healthcare situation in Lezha were translated into Albanian for implementation at the Lezha clinic.
• To measure quality improvement, the Lezha partners administered 49 patient satisfaction surveys in two of the four city ambulatories. With the help of AIHA, another 110 patient satisfaction surveys were administered at the other two ambulatories. Two representatives in Lezha recommended by the Institute of Public Health in Tirana oversaw the survey process at the two sites where AIHA assisted with the survey process. Results of the surveys showed that satisfaction was extremely low in the areas of cleanliness and comfort of the clinics, helpfulness of signage in the clinics, registration process, friendliness and courtesy of the reception staff, and quality of the medical equipment at the clinics, all of which were addressed in the patient care model that was finalized in June 2003 to be posted in the renovated Center. The results of the patient satisfaction surveys will also be used as baseline data in measuring the improvement in patient satisfaction at the planned primary care center for women and children.

Access/Capacity Building

• The new primary health care partnership in Lezha commenced in October 2001 and a Memorandum of Understanding was signed in February 2002.
• Partners completed an initial community assessment and provided a written overview of the healthcare situation in Lezha.
• US and Albanian partners toured several PHC facilities in Lezha and the surrounding area. The partners also met with local authorities and other NGOs working in PHC to introduce the partnership and discuss areas for collaboration.
• Albanian partners identified key illnesses to focus on during the course of the partnership including: women’s health, children’s respiratory disease, allergies and environmental influences, diarrheal disease, infection control, health education and outreach, STIs, and HIV.
• In order to build capacity for improved primary care services, four physicians from Lezha received intensive training in obstetrics and gynecological care.
• Four midwifes were trained in intimate partner violence and clinical breast examination and were orientated on the role of midwifes in the US, OB care for women with disabilities, teen pregnancy, genetic testing, counseling, patient education, prenatal care, and quality measurement and implementation.
• Four nurses traveled to Pittsburgh to develop adolescent and women’s health education programs; observe, discuss, and develop staff/patient communication skills; develop a patient-centered care presentation for the Lezha Town Health Center; and observe consumer education classes.
• Five family physicians attended the health management training course conducted by the Tirana/Bucharest partnership in Lezha in July.
• The Lezha partners identified a site for the new Primary Care Center, had a blueprint drawn for the design of the new Center, and submitted the blueprint and funding request to the Ministry of Health for funding approval. All three floors of the clinic will be remodeled. Renovation is expected to begin in July and be completed by November. Written approval for the distribution of approximately $139,000 for the renovation of the Lezha Town Health Center was provided by the Ministry of Health in January 2003. The Ministry of Health accepted bids from contractors for the renovation of the Lezha Town Health Center, and a contractor was selected and a background check was completed.
• In January 2003, partners finalized the rehabilitation and service plan of the Lezha Town Health Center and submitted it to USAID. The plan included staffing, training, and equipment needs, as well as information on community participation and involvement in the development of PHC services.
• The renovated PHC clinic will be staffed by six general practitioners—including two general practitioners with training in obstetrics and four general practitioners with training in pediatrics—two midwives, eight nurses, one full-time social worker, one full-time lab technician, one full-time receptionist, and one half-time LRC Coordinator.
• Partners met with six NGOs operating throughout Albania, as well as representatives from the Tirana/Bucharest partnership and Tirana Women’s Wellness Center, to discuss possible collaboration. During the discussions, five family physicians from the Lezha Town Health Center were chosen to attend the health management training course that the Tirana/Bucharest partnership will conduct in Lezha in July and two physicians and two nurses will attend training on breast health at the Tirana Women’s Wellness Center during the fourth quarter of FY03.
• US partners conducted a workshop for the Lezha Town Health Center staff on developing a mission statement, vision, and patient care model. All ideas developed by the staff were compiled and given to the advisory board for review.