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ALBANIAN MEDICAL JOURNAL SUPPLEMENTMortality patterns in Albania: An overall picture overthe period 2001-2009Eduard Kakarriqi 1,2 , Bajram Dedja 1 , Bukurie Gega 1 , Alban Ylli 1,2 ,Ervin Toçi 1 , Alba Merdani 1 , Dorina Çanaku 1 , Sonela Xinxo 1 ,Kozeta Filipi 1 , Miranda Hajdini 11Institute of Public Health, Tirana, Albania;2Faculty of Public Health, University of Medicine, Tirana, Albania.Aim: This study aims at displaying an overall pictureof mortality rates MRs (deaths per 100,000population) in Albania over the period 2001-2009.The huge amount of our data makes quite impossibleto portray in detail such an important issue into thecontext of a conference presentation.Methods: Mortality data (based on death certificates)are obtained by the official annual publications of theInstitute of Statistics (INSTAT), whose content doesnot provide the desirable outputs on the matter. Theavailable data were analyzed in order to obtain crudeand standardized (world population as standardpopulation) general (=all causes), gender-specific MRs,crude and standardized gender-specific cause-specificMRs, and crude and standardized gender-specific, agespecificand cause-specific MRs, all of them atdistrict, regional (prefecture) and country level overthe period from 2001 to 2009 (the last annualINSTAT publication on mortality in Albania).Results: Main findings include the following: (i) thetrends over the period 2001-2009 of the crude andage-standardized gender-specific general (=allcauses) MRs at prefecture and country level; (ii) theproportion of crude gender-specific cause-specificMRs towards the crude general gender-specific MRsat country level; (iii) the trends over the period 2001-2009 of the crude gender-specific cause-specificMRs at country level.Conclusion: The access of the Institute of PublicHealth (IPH), namely its National EpidemiologicalObservatory, to the INSTAT database as regardsmortality data (=individual death certificates), is theonly solution towards the production by the IPHof the detailed mortality indicators according to therequirements of the WHO, Eurostat, and ECDC.Otherwise, following the current modus operandi onthe matter, we will continue to fail.Keywords: INSTA T, mortality patterns, mortality rate.10 ALBANIAN MEDICAL JOURNAL SUPPLEMENT
INTERNATIONAL PUBLIC HEALTH CONFERENCE IN TIRANA, ALBANIAStrategies for prevention of non-communicablediseasesDoncho Donev 11Institute of Social Medicine, Faculty of Medicine Ss Cyril and Methodius University in Skopje,Republic of Macedonia.Aim: To present two basic strategies for preventionof non-communicable diseases (NCDs) andtheir strengths and weaknesses.Methods: Starting from the WHO EuropeanStrategy and Action Plan for prevention and controlof NCDs in the period of 2011-2015, an analysisof the relevant literature on experiences in manycountries in prevention of NCDs was conducted.Results: There are two basic strategies forprevention of NCDs: population strategy andstrategy for high-risk individuals. Population strategyis aimed at reducing the level of risk factors in allindividuals in the general population through creatingconducive environment that enables the adoption ofhealthy lifestyles and appropriate legislation, taxationand financial incentives from the government.Although the effect is small at the individual level,the strategy has a large impact on population level,in particular it does not require behavioral changesand can give quick effects. Such strategies are oftenvery cost effective and can even generate profit. Itoffers achieving good for all. Strategy for high-riskindividuals is aimed at detection and treatment ofhigh-risk individuals through screening (e.g. for highblood pressure) and treatment before complicationsoccur. It offers achieving large effects in a fewpeople, but has little impact on population level. Itrequires behavioral changes at the individual level(cooperation). Often the costs are high (drugs foryears for many patients), and it is possible to achievegood for some.Conclusion: The population strategy has severaladvantages, but in practice it is necessary to use acombined approach for the detection and treatmentof high-risk individuals, too. It is necessary for theimplementation of the strategies to be followed byappropriate action plans for communication of theeffects to the overall population.Keywords: non-communicablediseases, high-risk individuals, populaiton strategy, prevention.ALBANIAN MEDICAL JOURNAL SUPPLEMENT11
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