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Decentralization in Albania

Decentralization in Albania. Pamela Wyville-Staples PHN SOTA 9 October 2002. Background on Albania. Former Communist Country (extreme isolationist form) with traditionally highly centralized government structures Changed government in early 1990s Approximately 3.5 million people

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Decentralization in Albania

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  1. Decentralization in Albania Pamela Wyville-Staples PHN SOTA 9 October 2002

  2. Background on Albania • Former Communist Country (extreme isolationist form) with traditionally highly centralized government structures • Changed government in early 1990s • Approximately 3.5 million people • 10,579 miles², $1,000 GNP/capita, and $63 GNP/capita spent on health expenditures

  3. Pre-1990s PHC Model

  4. Current Control and Financing of PHC

  5. Advantages of Decentralization • Albania has moved beyond an exclusively vertical structure • Decentralization has encouraged better governance throughout Albania, especially within the Ministries of Finance and Local Government • Greater interest by health care providers in participating in decision-making

  6. Current Issues • Competing donor interests • Timing • Decentralization in all social sectors • Flow of Funding • Specific health points • Fee payer system • Health information system • Pharmaceuticals

  7. Roles of USAID & others in PHC reform • Ministry of Health • Ministry of Local Government • Ministry of Finance • World Bank/IMF • USAID • PHR+ • AIHA Lezha/Pittsburgh Partnership

  8. Current Issues • Competing donor interests • Decentralization in all social sectors • Timing • Flow of Funding • Specific health related issues • Fee payer system • Health information system • Pharmaceuticals

  9. Next Steps • Engage MOF, MOH, MOLG, World Bank/IMF, USAID, & others donors regarding proper decentralized structure • Engage MOH in designing and implementing useful PHR+ PHC pilot sites including HIS, costing tools, etc. • Ensure coordination by all PHC players

  10. Thank you

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