Andeta Kapa
At the entrance to Health Center No. 8, the sign is clear: 7:30–20:30. A publicly posted schedule that promises service to citizens throughout the day. But at around 17:40, the door to the pediatrics is closed. There is little movement in the hallway. A nurse passes slowly, while several citizens wait without much information. The contrast between the advertised schedule and the real service is immediate and visible.
This phenomenon is not limited to a single center. During the field observation, 10 health centers and polyclinics in Tirana were visited, where in a significant part of them the same situation was evidenced: missing Services due to lack of personnel during the official afternoon hours. For citizens, this translates into insecurity and lack of real access to primary health care, despite the formal promise displayed at the entrance.
| Health Center No. 1 | Health Center No. 3 | Health Center No. 4 | Health Center No. 7 | Health Center No. 8 | Health Center No. 14 | Polyclinic no.2 | Polyclinic no.5 | Polyclinic no.9 | Polyclinic no.10 |
| 7:30-20:00 | 7:30-20:10 | 8:00-20:00 | Open 24 hours | 7:30-20:10 | 7:30-20:10 | 8:00-16:30 | Open 24 hours | 8:30-19:15 | 7:30-20:45 |
According to the quality standards for the accreditation of primary health care institutions:
“There is a structured, organized and functional system for the 24-hour emergency service. The institution ensures and guarantees the presence of qualified personnel for 24 hours every day. The number of assigned personnel must meet the requirements of the flow of cases in the emergency service.”
But the reality on the ground shows a different situation.
The first center visited was Health Center No. 3. In the lobby, Mirjeta, 70, holds some tests in her hand. She had a scheduled visit and was expecting to receive treatment for the next three months.
“They told me: come tomorrow, because today the doctor is not present for personal reasons,” she says. “I came according to the schedule, I had spoken to the doctor earlier and we decided to meet today. I don’t know why the doctor wasn’t there. I need a check-up, not an explanation,” she says.
For him, this means returning home without service and another day of waiting.
A few minutes later, a young mother approaches the reception desk. Albana, 35, has with her 6-year-old son with a high fever.
“I came several times in the afternoon and couldn’t find the pediatrician,” she says. “I had to take him to a private hospital. When a child has a fever, you can’t wait until tomorrow.”
She sees this not as a choice, but as an obligation:
“It’s a cost you don’t plan for.”
According to market rates, a pediatric visit in the private sector ranges from 2,000 to 5,000 lek. At Hygeia Hospital, a pediatric visit costs 6,000 lek, while at the American Hospital it costs 3,500 lek, an amount that for many families constitutes an immediate financial burden, especially when the situation recurs.
Another citizen, waiting outside the family doctor's office, talks about the uncertainty after 17:00 PM.
"Either you find the doctor, or you don't. Sometimes they tell you to come tomorrow. The problem is that we come according to the schedule that is written and we have no way of knowing when the doctor is, because there is no notice or replacement. We can't come in the morning, because we are at work," he says.
He adds that in some cases he has been forced to turn to the QSUT due to the influx and lack of service.
This does not appear to be an isolated case. Even at Polyclinic No. 9, which provides Services on Kavaja Street, citizens report similar difficulties.
“I only got two hours off work,” Albani says. “I risked my job just because the service wasn’t available during office hours.”
At Health Center No. 7, which serves the Lapraka area, at around 17:45 PM, Xhoana, a young mother, reports that her newborn son's vaccination has been delayed due to a lack of staff.
"I came several times and there were no nurses. Even when they were present, they didn't give us any information. I don't understand how this can happen," she tells ACQJ.
“Why is there no one here?”
The citizen's voice echoes in the lobby. No one answers.
Public health expert, Erion Dasho, explains that the lack of service at the predicted time has direct consequences.
"The citizen who does not receive service will be directed towards other alternatives. They will either overload the emergency rooms of hospitals, or they will go to private ones. The consequences are not only individual, they affect the entire system," he explains.
According to him, primary care is the foundation of the health system and any failure at this level creates pressure on the entire structure.
"This is one of the many indicators that prove that healthcare has never been and is not a priority for the governing political force," adds Dasho.
From a legal perspective, lawyer Ledio Braho considers the situation a possible issue of administrative violation.
"Failure to provide service within official hours can be considered a violation. If there are concrete consequences for the citizen, it can also lead to further liability," he underlines.
However, according to the State Health Inspectorate, no complaints have been registered so far about the premature closure of the centers.
This raises a fundamental question: Why are official complaints lacking? Is the problem a lack of effective reporting mechanisms or a lack of confidence and awareness among citizens to report?
Findings from the organization Together For Life show that the absence of complaints does not mean the absence of problems.
According to a report on the functioning of the health system, citizens often choose not to report the problems they encounter, treating them as a normal part of everyday life. This creates a gap between official data and the reality on the ground, where difficulties in accessing Services remain largely undocumented.
During their stay at Health Center No. 3, there is no public announcement explaining the doctor's absence or change in schedule. Citizens rely only on the posted sign.
In theory, primary care should absorb common cases and avoid overloading hospitals.
It's past 18:30 PM. According to the schedule, service for most of the centers we visited that afternoon should continue for another two hours.
But for many of the citizens we met, the posted hours did not match the service provided in practice.
The schedule was there. The doctor, no.
The Ministry of Health and Social Protection did not respond to a request for comment by the time of publication.acqj.al
