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Kosovo Women’s Health Project – Doctors of the World

Focus:  Women’s Health

US Partner: Founded in 1990, Doctors of the World is a US-based non-profit international health, development, and human rights organization.  Since its inception, Doctors of the World has provided healthcare, training, and capacity-building assistance in more than 25 countries.  Currently, there are Doctors of the World projects in Kosovo, Mexico, Russia, South Africa, Thailand, the United States, and Vietnam.  Areas of special organizational expertise include: maternal and child health, primary healthcare, international public health, refugee health and medicine, street children, assessment and care of torture survivors, reproductive health and rights, health assessment missions, epidemiology, and the prevention and treatment of infectious diseases including tuberculosis and HIV/AIDS.

Partnership Objectives

The partnership’s overall goal is to develop two WWC models in Gjilan Hospital and Prizren MFMC, in Kosovo, to provide quality client-centered care throughout the life span for 32,000 women annually. Specific objectives are:

  • To establish space for, adequately furnish with appropriate medical equipment and health education material, and staff two WWCs in Gjilan Hospital and Prizren MFMC by July 2003.
  • To develop an easily replicable, holistic model of care that will address women’s specific health needs, and can be applied to both primary health care and secondary health care level facilities within Kosovo by December 2003.
  • To provide WWC sites with scheduled mentoring, consultation, and capacity building addressing human resource management, business plan design, clinical management and health promotion throughout the project, ensuring that women clients receive quality, evidence-based, holistic care in a safe and welcoming environment by December 2003.
  • To enhance the range of service possibilities of the WWCs by establishing community partnerships through the development of MOUs and referral mechanisms between WWCs and local NGOs, community organizations and health facilities already providing services to women in the Gjilan and Prizren regions by September 2003.
  • To develop an advocacy plan to sustain and replicate the WWCs using MoH funds for Kosovar sustainability by December 2003.

Achievements

Access/Capacity Building

  • An assessment of the Gjilan, Prizren, and Gjakova communities and medical facilities to determine the best location for establishing the Women’s Wellness Centers was completed. Using AIHA’s assessment form, DOW compiled demographic and health service information from the three municipalities and concluded that the Maternity unit at Gjilan Hospital in the city of Gjilan and the Main Family Medicine Center in the city of Prizren are the two best sites.
  • DOW initiated communications regarding training schedules, clinical protocols, and review of the site assessments with AIHA/Kosovo and WWC health professionals in Tirana, Albania.  Since October, DOW has liaised extensively with the Tirana WWC staff, and the Tirana WWC chose an activity/training coordinator to serve as liaison with DOW and sent clinical protocols to DOW for review and implementation.
  • DOW gained approval from the Kosovo Ministry of Health to coordinate with municipal and district health authorities for the WWC project.  DOW also visited local NGOs to discuss potential collaboration on promotion of WWC access, distribution of health education materials, and participation in health education campaigns.  So far, DOW staff reached tentative cooperation agreements with eight local NGOs, including the Center for Counseling for Women, Children, and Family and the Center for Women and Children in Prizren.  DOW will also work with the Center for Protection of Women and Children to train WWC healthcare staff on domestic violence issues as they relate to their patients/clients.
  • DOW and Dartmouth Medical School representatives in Kosovo met to discuss the WWC project and the Hanover/Gjilan partnership and explore opportunities for collaboration.  Potential avenues of collaboration include joint training and shared health information materials.
  • DOW developed job descriptions for the clinical protocol consultant and the women’s health technical advisor who will work on establishing the center.
  • Two DOW team members attended the Regional Breast Health Conference in Romania in October to meet, network and to exchange experiences with representatives of other WWCs.
  • Partners met with mentors from the Tirana WWC to discuss and select the core staff at each WWC site.
  • US partners assessed the general equipment and furnishing needs for each site. Many new furnishings are now in place. Both WWCs were also equipped with a phone and fax machine and a computer with internet connection.
  • Partners worked with Prizren WWC staff to implement a new patient flow system. The new system has already resulted in decreased patient congestion around the reception area.
  • Partners implemented an appointment system at the Prizren WWC. Women are given a reminder card with the time and date of their next visit and the WWC phone number and informed that they may call to change or cancel their appointment.
  • Rehabilitation of the WWCs began and will be completed by mid-August. Counseling rooms in both the Gjilan and Prizren WWCs were also completed.
  • The WWCs began using a computerized patient database and job descriptions were created.

Skills Building

  • DOW and Population Services International (PSI) agreed to train WWC staff on HIV testing and counseling.  DOW also contacted nine of the reproductive Health Information Centers (HICs) created by DOW under its USAID-funded Maternal Infant Health project to inform them about the WWC project and to seek referrals for cases that cannot be treated at those facilities (e.g., colposcopy, Pap smears, and domestic violence).  All HICs agreed to refer cases to the WWCs and to develop protocols for the referrals.
  • The US partners designed and administered two one-day workshops (one in Gjilan and one in Prizren) on holistic care that focused on design and development of mission statements, frameworks of action, patient charters, and job descriptions.
  • During February and March, the US partners provided a tutorial on survey methodology to the WWC staff. Afterwards, partners supplied 100 patient satisfaction surveys to be completed at each site for gathering baseline data. A midwife at each site was given the responsibility for data collection.
  • Midwives at both WWCs were trained to provide antenatal care to women. This is a first in Kosovo where the gynecologist usually provides this care.
  • Trainings were conducted at both WWCs by the Gender Training and Resource Center during June. WWC staff spent three days learning about communication methods, teamwork, and leadership.
  • In July, the Center for Protection of Women and Children trained WWC staff on patient rights, human rights, and violence against women.

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