Ida Ismail
Home healthcare is a vital need for thousands of elderly and chronically ill people in Albania, who, due to health problems or difficult transportation conditions, find it impossible to reach health centers. “Together for Life” emphasizes through a comprehensive report that this service has significantly improved access to care for thousands of patients over the past few years, but warns that the lack of sustainable funding jeopardizes its continuity.
This service was first piloted in 2021 as a new type of healthcare in the country and aims to offer patients a wider range of Services at home, through trained nurses. The project has supported 150 health centers and in the last year alone, around 4800 patients have benefited from the home service. However, it is estimated that 15-20 thousand citizens need this care.
Older people face significant barriers to accessing Services
At today's meeting, during which the findings of the assessment were also presented, it was emphasized that a large proportion of the elderly in Albania face significant mobility problems. According to estimates, around 35% of people over 70 years old have difficulty moving, while this percentage increases significantly above the age of 85.
Diseases such as arthritis, osteoporosis, fractures from falls, stroke, and Parkinson's disease are among the most common causes that limit the mobility of the elderly. As a result, many of them are unable to reach health centers to receive Services.
To visit a health center, most patients need the help of family members or paid transportation, which is often unaffordable. This situation brings significant financial costs to families.
A patient from Dibra describes the difficulty in obtaining service as follows:
"The Health Center is an hour and a half away on foot. I don't have the strength to walk there and I have to use some vehicle here in the neighborhood that takes me for a fee because the car runs on diesel and diesel is expensive."
On the other hand, healthcare staff themselves face a lack of equipment for patients with special needs.
"We have two air mattresses and two wheelchairs at the health center. We have distributed them to patients. We have requests, but we cannot meet them," says a nurse from Dibra.
Data from the Health for All (HAP) project shows that only 8.9% of disabled patients report that they can ever visit the health center without assistance.
The main barrier for patients with mobility difficulties remains the inability to physically reach the health center. In 2023, 63.8% of patients reported that they could not walk to the health center and 38.7% stated that they could not afford the transportation costs.
Together for Life also highlighted problems with the shortage of doctors and nurses in rural and remote areas. In many cases, white-collar workers refuse to work in these areas, further limiting patients' access to Services.
According to the analysis, each new service requires dedicated funding. Currently, the minimum cost for a nurse providing in-home service is around:
- 2700 lek per month for materials,
- 3000 lek per month for transportation.
Mirela Rrumbullaku, from the Commissioner for Protection from Discrimination, said that patients with mobility impairments are among the most marginalized groups.
"Complaints become null and void because patients seek emergency solutions. According to the law, the procedure takes its own time and is no longer valuable."
She adds that many health centers lack even basic mechanisms for filing a complaint: "In health centers, you don't have a door if you want to file a complaint about the service there. The citizen shouldn't ask for the service, but it should be offered to him."
Institutions: Funding is possible
On behalf of the Mandatory Health Insurance Fund, Deputy Director Markens Shllaku stated that primary care financing has increased significantly in recent years,
"The funding of primary care from 2013, which was 50 million euros, in 2025 is 140 million euros. It has been funded approximately 3 times more," he said.
According to him, around 390 thousand primary care Services were provided in 2025 alone. He also emphasized that Albania has the financial capacity to support the service, so that it does not stop even after the project funding ends.
"The World Bank's recommendation for Albania is 50 euros/inhabitant. We have 75 euros/inhabitant in financing, so we have the financing possibilities."
The Together for Life report presented several key recommendations for state institutions, including the need for a more structured and sustainable approach to organizing and financing health Services, especially for the most affected categories of the population.
The Ministry of Health and Social Protection should consider funding the Home Health Care service, with the aim of guaranteeing access of elderly and disabled patients to quality and continuous Services.
At the same time, the importance of increasing transparency in the management of health sector finances is underlined. It is recommended to consolidate and publish health financial data, including all sources of financing and more detailed analysis of expenditures, so that the public and oversight institutions have a clearer picture of the use of funds.
Another problem identified is the lack of specialists in health centers. The report suggests supplementing the structures with professionals such as psychologists and physiotherapists, who are considered essential to more comprehensively address the needs of patients.
To improve the management of this service, experts also recommend that Home Health Care be included as a separate product in the Ministry of Health budget. This would enable clearer tracking of expenditures and investments dedicated to this service, increasing institutional accountability.
In terms of motivating healthcare personnel, Together for Life proposed the creation of a payment system that combines a basic salary with an additional bonus, linked to the number of patients covered by each nurse, and the need to increase transparency in the process of assessing the quality of medicines, as well as to raise citizens' awareness of their rights to receive quality medicines./acqj.al
