in Albania - Instituti i Shendetit Publik

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ALBANIAN MEDICAL JOURNAL SUPPLEMENTCommunication for behavior change for improvedhealth and nutrition outcomes of children in AlbaniaDaniela Nika 1 , Mariana Bukli 2 , Jeta Lakrori 1 , Gentiana Qirjako 1,31Institute of Public Health, Tirana, Albania;2UNICEF Tirana Office, Tirana, Albania;3Faculty of Public Health, University of Medicine, Tirana, Albania.Aim: Design and implementation of a communicationcampaign to promote sustainable change inthe behavior of families and communities forimproved care and feeding practices for mothersand children.Methods: Communication Strategy to ReduceMalnutrition in Children in Albania was prepared in2011 as one of the main components of NutritionJoint Program. It was developed collaboratively bya Group of National Experts, and an internationalcommunication consultant, supported by UNICEFoffice in Albania. This Strategy was developed usinga systematic Audience-Centered CommunicationPlanning Process. It was based on Diffusion ofInnovations, and the change model was based in the7 Steps of Change: awareness, knowledge, attitudesfavoring the new behavior, decision to try, trial,confirmation and advocacy. Development ofcommunication products was based on formativeresearch and pretesting.Results: An exciting, colorful campaign, targetingwomen, new and future mothers and mothers-inlawwas developed, promoting and modeling acoherent package of infant and young child feedingpractices. This campaign uses a variety of massmedia and interpersonal channels, and is unified bycentral character, a logo, a tagline and a musicaltheme. This is a behavior change campaign, makingeffective use of information, evidence, attitude andimage change messages, and modeling to promotechange. Health professionals were also targeted toimprove their communication and nutritioncounseling skills.Conclusion: Communication for behavior changeis a new culture for Albania, and requires adequatebudget allocations and experts trained in social andbehavior change communication for health andnutrition. Spreading information does not necessarilybring changes in attitudes and behaviors. It isimportant to find the right balance between massmedia communication and interpersonalcommunication activities especially in view of budgetrestrictions and limited social responsibility frommedia.Keywords:communication strategy, healthynutrition social and behavioral change.94 ALBANIAN MEDICAL JOURNAL SUPPLEMENT
INTERNATIONAL PUBLIC HEALTH CONFERENCE IN TIRANA, ALBANIAPotentially inappropriate prescribing among olderpeopleDriton Shabani 1,2 , Zejdush Tahiri 2 , Besnik Jucja 21Department of Pharmacy, Faculty of Medicine, University of Pristine, Kosovo;2University of Medicine, Tirana, Albania.Older people often experience multiple diseases and,therefore, this is inevitably associated with multipledrug use. This phenomenon, being referred to aspolypharmacy, is related to the concurrent use of atleast five different medications. It has beenconvincingly demonstrated that multiple usage ofmedications may lead to inappropriate prescribingand a decrease in the therapeutic response. Accordingto the vast international literature on this matter,potentially inappropriate prescribing in older peopleare considered those drugs which do not haveevidence-based indications for use, those which beara high risk for side effects in older people comparedwith younger adults, or those drugs which have notbeen shown to be cost-effective in clinical settings,but particularly in epidemiological (populationbased)studies.From this perspective, inappropriate prescribing inolder people is a common and serious healthcareproblem in most of the countries worldwide, butespeciallyso in transitional countries of the WesternBalkans including Kosovo and Albania where thereare no clear and strict regulations related toprescriptions of medications. Therefore, similar toother countries, the polypharmacy phenomenon issupposedly linked to an increased risk of adversedrug reactions and inappropriate prescribing inKosovo and Albania too.Although inappropriate prescribing is a vastphenomenon in many countries, this condition isalmost fully preventable and, thus, there have beendeveloped specific screening instruments forinappropriate prescriptions including Beers Criteriaand the Inappropriate Prescribing in the Elderly Tool(IPET).In the international literature, Beers Criteria consistof the most frequently reported screening instrumentfor inappropriate prescribing notwithstandingsome major criticism which has been evoked mostlydue to the fact that several drugs are rarely prescribedcurrently, there exists a lack of structure in thepresentation of the criteria and omission of severalimportant and common inappropriate prescribinginstances.These internationally validated instruments arecurrently being cross-culturally adapted andsubsequently will be administered to a nationwiderepresentative sample of older people in Kosovo.Keywords: Beers Criteria, inappropriateprescribing, InappropriatePrescribingin theElderlyTool (IPET), older people,polypharmacy.ALBANIAN MEDICAL JOURNAL SUPPLEMENT95
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