USAID Director Featured in Vitrina Mjekësore

In an exclusive interview in this month's popular health magazine, Vitrina Mjekësore (A Window to Your Health), USAID/Albania Mission Director, Roberta Mahoney, talks about USAID/Albania's heatlh programs that are helping Albanian women learn how to take care of their reproductive health.  Coinciding with the launch of USAID's mass-media campaign, Happy Moments, the article discusses the importance of using modern contraceptives to not only protect young women and girls from unplanned pregnancies but also as an important tool to improving the overall health and well-being of young people in Albania.  The program is supported by the Ministry of Health and will launch its second phase in the coming months.

Transcript of the Vitrina Mjekësore Interview with Roberta Mahoney, April 9, 2009

Vitrina Mjeksore: Would you prefer to mention any successful achievement of USAID?

Mahoney: Well you know that USAID has programs in number of different areas and has some specific programs in the health sector. Working with the Ministry of Health, one of our programs is aimed at helping better understand the situation of health care and health performance Albania. In order to do so, we’ve undertaken some very successful surveys with the Ministry. It is hard to decide where you need to go unless you know what the current status is. Over the years we have done numerous studies and preliminary work on a number of demographic health surveys. We recently launched the first nation-wide, the first complete demographic health survey that, when completed later this year, will give a very good picture of healthcare in the country. It will give data on infant mortality, neo-natal mortality, how many women die in childbirth, what is life expectancy, what are the major health problems that different age cohorts face, and provide information about the overall health status of Albanians. All of this data helps give us and the Ministry of Health the context of which they can develop programs. USAID’s contribution to information gathering is one very important success.

Another has been the work that we have done on family planning activities, as well as on maternal and child health activities.
Through our largest health program, the ProShëndetit program, USAID has focused on various policy elements of the problems that relate to how services are delivered.  We try to help Albanians use the resources that it has to address the health problems that it faces. Our purpose is not to come in and tell you what we do or tell you how we did it, or even to provide the resources to deliver a particular system, rather we are interested in how we can work together to better target populations or health issues, deploy the right resources to address health problems.

USAID has helped establish a comprehensive health information system, provided support for the creation of quality certification boards for doctors and nurses, and helped expand family planning services nationwide down to commune level. Albania you ha skilled people and has some facilities, but the management of the certain commodities, some of the people, some of the facilities may be an area where we can help make sure things are used and managed better. This has been a big focus.

We are designing a new activity in the health sector because ProShëndetit, the primary health care activity, is finishing this year. USAID sees opportunities to continue working in the health sector and, over the course of the next couple of months, we will be designing this activity.

We are also trying to work with neighbors in the region, with Kosovo on a new telemedicine activity to help link the hospitals throughout the country. Albania is a small country, and phenomenally beautiful country, but it is not always easy to get from Rrëshen to Tirana. So we hope this will help improve communications and patient care.

Vitrina Mjeksore: Regarding the actual situation of Albania, do you think that our country has walked with the right and required rhythm, paces?

Mahoney:  I think each country has to find its own way and develops at its own natural pace. Albania can help learn from other countries, but each country is independent, is sovereign, and has its own pace of evolution. What I see as extremely positive is that the people whom I’ve met in Albania are very willing to learn from neighboring countries and that may speed up the process of development.  There seems to be a natural competitiveness of many Albanians, so perhaps there is a willingness to take some risks.  For instance, I see this campaign as a little risky to talk about sexuality and intimacy of young people. I know my mother would have been thinking, not my daughter.

Vitrina Mjeksore: Our mother’s would think the same. What do you think about the heath care system in Albania?

Mahoney: Exactly, so it’s a little risky doing this so I think that shows that Albania is saying we are a modern country, we know what people do, and contemporary methods of contraception, contemporary methods of health care, we want to be a part of the European Union, we want to be a European country, which you are, at the same time Albania doesn’t have the best health statistics in the region. It has good life expectancy, it has good mortality statistics but it seems to be because it is a beautiful country, the food is fresh, the food is clean, the air is relatively clean, people walk everywhere, so there is a healthy lifestyle, and health diet. These factors contribute greatly to longevity.

Could there be improvements in the health care system, in the health care delivery systems? Absolutely. Recently I visited Rrëshen and met people in the hospital there as well as people in a health clinic. The people I met were committed to doing a good job; they were committed to delivering services to the people in the region. But they also had very few materials to do their work. Medicines and medical equipment and supplies, these were lacking. This experience is not unique and it reinforced USAID’s approach there are opportunities in Albania to improve the management of health issues and delivery of health care services.

Vitrina Mjeksore: Which are your near projects in the field of medicine?

Mahoney: As I mentioned the ProShendetit program is coming to an end so we will be designing with the Government of Albania a new activity for primary health care. Secondly we have just launched the C-Change activity to improve communication on family planning and contraceptive use. And third will work to improve telecommunication linkages between Albania and neighboring countries through a telemedicine project.

Vitrina Mjeksore: It's some time now you are living in our country. How do you like this experience?

Mahoney: So I have only been here since September 2008, about 7 months, so it hasn’t been too long. But I love Albania. I live a little ways from the office but I walk everyday to the office and I feel perfectly safe. Most places I’ve lived, I couldn’t walk. So the idea that I can get up in the morning, look out and see Mt. Dajti, walk to the office, and see people that I know, and have people recognize me on my walk everyday is really very nice. So I say hello to my green grocer, I say hello to the kids going to school, it’s just very representative and characteristic of Albania. It’s friendly, it’s welcoming, it’s warm, its people getting up and going to work and going to school to help make themselves better, to help make Albania better. It is a place that has promise. It has promise internally and Albania has promise in the region. It is a stable partner in the region and has a bright future. For me, I like being here.

I’ve travelled; I went first to Elbasan, Progradec, and to Korça. So far, the Korça pumpkin byrek (byrek me kungull) is just fabulous. So then I went to Theth and Shkodra. The people, the places, are all so different. The family I stayed with had their own cow and they gave us fresh milk, fresh yogurt, quince preserves. I’ve been to Fier, Berat, most recently to Vlora, Himara, to Saranda, and around to Gjirokastër and back up through Ballsh, and Ardenica and Apollonia in Fieri. And I have eaten well everywhere. It’s beautiful in the south; it’s beautiful in the north.

My mother is staying with me in Albania for a while, she’s 83, and she also loves it. People are friendly, the food is great, the weather is fabulous, she loves looking at the mountains, and she has plans to come back next year. I haven’t invited her back, but she is making plans to come back. It’s a great place.

Vitrina Mjeksore: Would you like to add anything?

Mahoney: The United States and Albania have a very special relationship. We all feel very warmly welcomed here, we feel we can work together on very important problems and make very important progress on those issues. We share a similar attitude and we share in successes. I am particularly associated with USAID, but it’s the whole U.S. Mission that feels very warmly welcomed and feels we have a very good working relationship here. Albania is a great place for us to be.