WHO Operations in Kosovo: Action Plan for 2000

EXECUTIVE SUMMARY
WHO Goal and Strategy

Background

WHO has been active in the province of Kosovo since 1997. Activities stopped during the recent hostilities but, since 14 June 1999 following the peace agreement, WHO has built up a substantial humanitarian and development presence focusing on health sector planning, reform and development. The WHO office in Pristina serves as the major technical support in health to the United Nations Mission in Kosovo (UNMIK), working alongside the UNMIK staff in a coordinating and advisory role.

Kosovo has a young population with health indicators that are the worst in Europe. The existing health system has a tradition of centralized institutional and specialist approaches rather than one comprehensive, horizontal primary care approach. In addition, the past ten years have seen much disruption and discrimination due to political instability. Parallel systems of service delivery and training were developed but most of these have been destroyed or abandoned.

WHO will sustain its work in Kosovo through its humanitarian assistance team and will strive to provide the local population, UNMIK and the international governmental and non-governmental organizations with the support needed to health sector
rehabilitation, reconstruction and development. Interim health policy guidelines have been developed which call for the emergency health effort to be organized in a manner that will contribute to a longer term process of health sector reform and
sustainability in the health sector. The goal is an efficient, effective, accessible and affordable public health care system. Organization will be through primary health care based on catchment areas with referral onwards to secondary and tertiary care as needed, while maintaining key public health interventions. The core WHO activities are:

• Improving and strengthening primary health care (PHC)
• Improving and strengthening secondary health care
• Decreasing the burden of disease through targeted public and environmental health interventions
• Improving the management system of pharmaceuticals
• Strengthening the capacity for health policy, planning and financing
• Coordination of humanitarian assistance.

WHO Core Activities

Improving and strengthening primary health care

PHC activities aim at providing advisory, coordination and capacity building support to UNMIK and other partners in establishing modern primary health care services.

There will be five programme areas.

1. Training and human resource development

WHO Operations in Kosovo 4

2. Design of the Kosovo Primary Care/Family Medicine Centres

3. Maternal and child health

4. Mental health coordination and strengthening

5. Integration of violence prevention programme into Primary Health Care

Improving and strengthening secondary health care

WHO will provide technical assistance to provide the people of Kosovo with access to efficient, safe and rational specialist and hospital services. Activity areas will include:

1. Structural planning for the rehabilitation of secondary care

2. Planning for the functional rehabilitation of secondary care

3. Technical guidance and standards for rationalization of staffing in secondary care.

Decreasing the burden of disease through targeted public and environmental health interventions WHO will provide technical assistance and support in four areas. The emphasis will be on integration of public and environmental health into horizontal primary care, where feasible. Activity areas for provision of technical assistance and selected material support include:

A. Public health

1. Immunization

2. Communicable disease control

3. Re-establishment of health information systems

B. Provision of District Public Health Advisors to all five districts

C. Environmental health

1. Water quality and supply

2. Solid waste collection and removal

3. Sewage and sanitation arrangements

4. Food safety

D. Decreased morbidity and mortality due to tuberculosis (TB)

1. Re-establishment and strengthening of the TB programme

2. Detection and treatment of TB cases

3. Community participation and social mobilization for TB control.

Improving the management system of pharmaceuticals

There has been much disruption of the pharmaceutical sector and there is no sustainable structure for pharmaceutical supplies to the public sector. WHO will work in five major areas:

1. Availability and access

2. Quality assurance

3. Rational use of drugs

4. Regulation and control

5. Human resource development.

Strengthening the capacity for health policy, planning and financing

A combination of factors including political instability, shrinking economies and the collapse of the state systems of eastern Europe, have led to an extreme flux in areas relating to health policy and financing. WHO seeks to provide UNMIK and other
partners with realistic options and strategies in these areas for appropriate decision making. Areas of activity will include:

1. Technical support to budgeting and financial management plans

2. Technical support in developing options for health financing

3. Testing of innovative strategies in health care financing.

Coordination of humanitarian assistance

In line with the World Bank/European Union request, WHO will continue and enhance its humanitarian assistance coordination efforts in the health sector at central and peripheral level. This involves the participation of all partners in health
and includes information exchange, joint implementation activities and joint planning.

Health-related communications will continue to play an essential part of WHO's coordinating role. It will ensure effective planning and monitoring of the health status and health problems of the population, alert the international community on priority health issues and serve as a platform for information exchange.

Budget Summary (US$)

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