Gaining health : analysis of policy development in European ...

are published or even accessible for public discussion and
debate.
Attempts to reform the health information system have begun.
The leadership was provided mostly by foreign donor
agencies such as USAID (United States Agency for International
Development). A comprehensive information system
is far from being set up, and there is a lack of appropriate
coordination between competing actors in the field.
4.4. Development of research and expertise
The Ministry of Education and Science is responsible for
funding and coordinating research. Public health has not
been a priority area until recently.
In 2002, the Government decided to significantly increase
research funding in the health field. Following this decision,
the Ministry of Health and IPH prepared the first National
Research Strategy. A committee of professionals was set
up to lead this process. The Strategy includes a number of
priorities, serving as a basis for providing funding to various
projects. In this process, indicators such as mortality, trends
in the burden of diseases and the efficacy of interventions
were taken into consideration.
Nevertheless, the majority of research in health is carried
out outside the National Research Strategy. This is due to
the fact that, for almost a decade, most of the research has
been financed by different donors and very often carried
out by civil society organizations. Even if formally most of
the donors try to coordinate their research-type activities
with government-based health agencies, donor-driven
research is not always in line with the priorities expressed
in long-term policies and strategies, including the National
Research Strategy.
Research in Albania has been going through a process of
transformation. Traditionally, research in the health field has
focused mainly on infectious diseases, occupational medicine
and child health. Recently, the range of issues has broadened
substantially to include a focus on such aspects as risk
factors for chronic diseases, healthy ageing, reproductive
health, adolescent health, mental health, and new dangers in
environment health. Nevertheless, evidence for NCD prevention
is still weak and inconsistent with the development
of a comprehensive, long-term NCD prevention strategy.
The biggest barrier to the development of multidisciplinary
research on NCD prevention is the lack of coordination of
existing resources and the lack of adequate funds.
There is an increasing general awareness in health policymaking,
at least in theory, that strategies and interventions
should be based on evidence supported by valid research
results. In the health sector, the outcomes of long-term
policies are not monitored and evaluated by sound scientific
research.
The Second Albanian Conference on Public Health in
December 2006 (4) clearly demonstrated an increasing
interest by the whole public health community in research
results and the further development of a research base in
NCD morbidity, mortality and risk factors. This reflects a
general acceptance that steps have been taken to develop
health policy analysis in the field of health promotion and
disease prevention.
5. Conclusions and lessons learnt
• Considering the double disease burden in the country, it
is a real challenge for Albania to initiate policies to tackle
NCD. In the present situation, despite the existence of
the Strategy on Health Promotion and Disease Prevention,
the characteristic political feature is an opportunistic
day-to-day management of NCD prevention that is
fragmented and inefficient.
• The status of policy development to tackle NCD in
Albania is one of the lowest in Europe. Public health
Chapter 4
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Case studies: policy development in countries for tackling noncommunicable diseases