Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo.

The aim was to describe health literacy among the older population of Kosovo, an Albanian speaking post-war country in the Western Balkans, in the context of self-perceived health status and self-reported chronic morbidity. A cross-sectional study was conducted in Kosovo in 2011 including 1753 individuals aged ≥ 65 years (886 men, 867 women; mean age 73.4 ± 6.3 years; response rate: 77%). Participants were asked to assess, on a scale from 1 to 5, their level of difficulty with regard to access, understanding, appraisal and application of health information. Sub-scale scores and an overall health literacy score were calculated for each participant. Information on self-perceived health status, presence and number of chronic diseases and socioeconomic characteristics was also collected. Mean values of the overall health literacy score and all sub-scale scores (access, understanding, appraisal and application) were lower among older people who reported a poorer health status or at least one chronic condition compared with individuals who perceived their health status as good or had no chronic conditions (p < 0.001 for all). Our findings provide valuable evidence on the independent and inverse association between health literacy levels and self-perceived health and chronic morbidity in this post-war European population. The putative link with chronic morbidity and lower adherence to health services is hard to establish through this cross-sectional study. Prospective population-based studies should be conducted in Kosovo and other transitional settings to replicate these findings and properly address the causal relationship between health literacy and health status.

Functional health literacy among primary health care users in transitional Kosovo.

AIM: Adequate functional health literacy is considered as a basic prerequisite for a proper health-seeking behavior of adult individuals. Our aim was to assess the levels and socioeconomic correlates of functional health literacy among adult primary care users in transitional Kosovo. METHODS: A cross-sectional study was conducted in Kosovo in November 2012-February 2013 including a representative sample of 1035 primary health care users aged > or = 18 years (60% females; overall mean age: 44.3 +/- 16.9 years; overall response rate: 86%). The cross-culturally adapted long version of TOFHLA test (an instrument assessing reading comprehension and numerical abilities) was used to assess functional health literacy among study participants. TOFHLA scores range between 0-100 with higher scores implying better functional health literacy. The analysis of variance (ANOVA) was used to assess the association of functional health literacy with demographic and socioeconomic characteristics. RESULTS: Mean score of the functional health literacy was significantly higher among younger participants, in men, in highly educated individuals and participants with better self-reported income level. CONCLUSION: Our findings indicate that vulnerable socioeconomic individuals exhibit lower functional health literacy levels in post-war Kosovo. Health care professionals and particularly policy makers in Kosovo must be aware of the excess risk among the low socioeconomic groups and should tailor intervention programs accordingly.

Factors associated with fatal traffic accidents in Tirana, Albania: cross-sectional study.

AIM: To assess the prevalence of fatal road traffic accidents in Tirana, Albania, and describe their determinants. METHODS: This cross-sectional study included all road traffic accidents recorded by the Traffic Police Department of Tirana district for the period 2000-2005. A structured questionnaire included information about the type of traffic accident (fatal vs non-fatal event), year of event, age and sex of the responsible party, reason of accident, location and time of event, and the type of vehicle involved. Multivariable-adjusted binary logistic regression analysis was used to assess the predictors of fatal road traffic accidents. RESULTS: Overall, there were 1578 recorded road traffic accidents in Tirana district during 2000-2005. Of these, 272 (17%) were fatal. Multivariable-adjusted models showed that younger age (OR, 3.97; 95% CI, 2.28-6.91), high speed (OR, 2.54; 95% CI, 1.62-3.98), and especially alcohol consumption (OR, 6.15; 95% CI, 3.54-10.66) were strong and significant predictors of fatal accidents. Fatal accidents were more prevalent on intercity roads (OR, 4.25; 95% CI, 3.11-5.82) and involved especially vans and trucks (OR, 4.12; 95% CI, 2.34-7.24). CONCLUSION: Young age, high speed, and alcohol are predictors of fatal road traffic accidents in Tirana district. These findings can serve as a basis for health care professionals and policymakers to create preventive measures for traffic accidents.

Magnitude and fatality from road accidents among children in Tirana, Albania.

PURPOSE: To describe the prevalence of road accidents among children 1-14 years in Tirana, the capital city of Albania. WORK METHOD: A cross-sectional study was conducted including all recorded road accidents of children 1-14 years at the Directorate of Road Police in Tirana for the period 2000-2005. Information about type of accident (fatal vs. non-fatal event), year of event, age, sex and type of road user (i.e. injured children), reason of accident, and time of event was collected. Fisher's exact test was used to assess the associations of covariates with fatal road accidents. WORK RESULTS: Overall, there were 177 recorded episodes of road accidents among children 1-14 years in Tirana during 2000-2005. Of these, 31 (17.5%) were fatal events. Fatal accidents were more prevalent among children aged 1-4 years compared with children 10-14 years (38.5%vs. 9.1%, respectively; P=0.007). There was no difference in fatality rates with respect to children's sex (18.7% in boys vs. 14.0% in girls; P=0.645), reason of accident (P=0.670), time of event (P=0.497), or year of accident (P=0.247). DISCUSSION: Children aged 10-14 years are at a particularly high risk for fatal road accidents in Tirana. Furthermore, the exceptionally high fatality rate among pedestrian children points to the urgent need for working with parents, schools and local authorities in order to improve pedestrian skills and environments. CONCLUSION: In Albania, immediate actions should be undertaken in order to enforce current legislation about mandatory use of child restraint and bicycle helmets.

Building public health associations in the transition countries of south-eastern Europe: the example of Albania.

The Albanian Forum of Public Health (AFPH), an umbrella organization including different public health associations operating in Albania, was established in March 2004 with the support of the European Public Health Association (EUPHA) and the Open Society Institute (OSI). Ever since its establishment the AFPH has been an open arena wherein opinions and options for rational health policies comprising all relevant issues of the New Public Health are discussed, formulated, and documented near the Albanian Ministry of Health. Notwithstanding the laudable mission of the AFPH, there is an emerging need to establish a regional Public Health Forum in south-east Europe as a basic prerequisite for sustainable development of public health in these countries. Most conveniently, this regional umbrella organization should have a supporting Secretariat based in one of the south-east European countries. Nevertheless, there is a clear call for international funding with participation of different agencies and bodies (OSI, EUPHA, Canadian International Development Agency, and the Stability Pact). A regional association in the south-east Europe would enable the organization of annual conferences in the most renowned institutions in the region. Also, a regional collaboration among public health associations would be a suitable start for the development of research in south-east Europe. Furthermore, the existence of a regional public health association would make feasible the establishment of a scientific public health journal for south-east Europe in the English language.