Albania : country report

Project efforts were as follows: (1) Service delivery and training activities included establishing and training three regional FP/RH training teams; equipping seven training facilities; supporting a clinical study tour for trainers and public health officials; training 1,075 service providers (including obstetricians/gynecologists, family physicians/general practitioners, nurses, and midwives) in FP, sexually transmitted infections (STIs), and client counseling; training 93 providers in post-abortion/postpartum FP in Tirana city sites; and training 240 private pharmacists in FP and client counseling. (2) The information, education, and communication (IEC) component conducted and published the results of focus group research with women of reproductive age (WRA); produced and distributed reference materials on available FP methods for service providers and clients and a national quality FP services logo; and conducted a mass media campaign. (3) Logistics efforts included operationalizing a public-sector contraceptive logistics system; providing commodity storage equipment to service sites; and in-depth training in logistics management of senior Ministry of Health (MOH) personnel. SEATS provided basic clinical equipment and furnishings to 67 public-sector comprehensive service sites in four program districts. Despite limited local absorptive capacity and two periods of evacuation and ongoing civil instability, SEATS achieved its workplan and contributed significantly to establishing quality FP/RH services at 330 service sites (including hospitals, polyclinics, rural health centers, and ambulatory care sites) in the districts of Tirana, Durresi, Kruja, Kavaja, and Elbasani, having provided training to 1,571 service providers, including pharmacists, and public health officials. IEC activities helped increased provider and client knowledge of FP; and IEC and logistics management activities strengthened service delivery points and private pharmacies nationwide. SEATS training, IEC, and logistics activities with the public sector in four program districts generated 10,401 couple-years of protection, 15,521 new acceptors, and 19,618 revisits over 2 years of data collection. Through SEATS" provider training and improved logistics, the MOH was able to expand contraceptive provision to rural areas, including 45 new sites. Lessons learned were as follows: (1) By building capacity locally, SEATS was able to achieve success despite periods of evacuation, when planned external TA was impossible, and lengthy periods of social, economic, and political turmoil, when travel was dangerous. (2) Creation of the IEC coordination committee was the first in a number of successful collaborations between SEATS and other donors and cooperating agencies in the field of RH specifically, and public health more generally. This collaboration enabled SEATS and other agencies to achieve nationwide reach for their IEC materials despite the difficult and insecure travel conditions that characterized the last 3 years of the project. The success of these IEC materials was based on collaboration in their design and pretesting. Efforts such as the logo and mass media campaign were successful because SEATS sought the support of all relevant partners prior to implementation. (3) Facing evacuations and civil turmoil, SEATS" and USAID"s flexibility and ability to adapt activities and implementation plans to the circumstances were essential to program success. (4) Local staff have persevered through difficult and dangerous conditions, patiently yet persistently pushing activities forward. (5) Despite the evacuations, regional wars, and civil turmoil, USAID, in particular the Albania Mission, has remained committed to assisting Albania through its post-communist transition. USAID/Albania has remained consistently supportive of RH and SEATS" work. SEATS FP/RH activities will be continued and expanded through USAID/Albania funding to the Maternal and Child Health Technical Assistance and Support Contract (TASC).