Albania

As an initial step towards universal coverage, free accessibility to preventive services for the entire population, including uninsured people, was introduced in January 2017. 

The Ministry of Health remains the major funder and provider of health care. It has been reorganized and continues to assume the lead role in most areas of health care. Two public administration reforms in 1993 have affected the health care system: the creation of 12 regional prefectures, which have assumed some of the central government’s administrative authority; and the strengthening of the role of local government, a change which shifted some responsibility for primary health care to rural areas. The introduction of social health insurance in 1995 involved the establishment of the Health Insurance Institute, a national statutory fund, which is gradually extending coverage of services in planned stages. 

Provision of health care services differ between rural and urban areas. In rural areas, a typical health centre is staffed by up to three primary health care doctors plus nursing staff. Most of the doctors have not been trained in primary health care. In urban areas, large polyclinics provide specialist outpatient care and are also used by patients as the first point of contact with medical care. The referral system formerly in place is no longer functioning. Hospitals remain publicly owned, mostly by the Ministry of Health. Inpatient secondary care is provided mainly by district hospitals, which provide a minimum of four basic services: internal medicine, paediatrics, general surgery and obstetrics/ gynaecology.