Occupational Health Kosovo
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The document discusses occupational health in Kosovo, noting that there are currently 31 active occupational health specialists in Kosovo who are concentrated in the capital city of Pristina. It outlines the laws and system governing occupational health in Kosovo, and identifies key issues such as the low number of occupational health specialists and lack of coverage in some municipalities. The future of occupational health in Kosovo is proposed to focus on increasing staff and developing preventative services through establishing a central institute and improving training.
Occupational Health Kosovo
- 1. Occupational Health Kosovo RilindZenelaj&Xhevat Shkodra法 族 法 Professor at Faculty of Medicine族Manager at Red Cross of Kosovo
- 2. Flag of Republic of Kosova The Republicof Kosovo is located in Balkan Peninsula in south-eastern Europe The Republic of Kosovo declared independence on 17 February 2008 Surface of Kosovo is 10,908 square kilometers. Population (2011 census) 1,733,872 Density 159/ Male50.4% 873,598 Female 49.6% 860,274 Life expectancy female,years 71 Life expectancy male,years 67 Population below of age 14 years 28% 15-64 years 65% >65 years 7% Employment Over 250,000 GDP per capita(2010),Euro 2,383
- 3. Labor force Employment During the period 1999- onward the Kosovar labor market wentthrough important changes and one of the main factor is the privatization process of the state-owned enterprises. The average number of employed persons in private sector has a tendency toward increasing. In 2010 the level of employment of the central age group(25-54) was 34%. The main branch of economy in 2009 has been tradingwith participation of employment 17.4% followed by education (13.4%),production(9.9%),administration (9.8%) and construction(7.9%). Figure 1.Level of employment Unemployment The male unemployment rate in 2009 was 37.4% of central age group (age 25-54) Female unemployment was 52.0% Analyzing the unemployment by demographic group,there is an increasing trend in the registered unemployment persons belonging to the age of 15-24
- 4. Figure 2.Level of unemployment Occupational Health and Occupational Health Legislation Occupational Medicine of Kosovo based on its activity is relatively new. This was organized through Occupational Medicine in local level of Health Houses (now Main Family Medicine Centre) or through services and units of occupational medicine at the other forms of institutional health organization in Kosovo. Being faced of occupation circumstances of last decade, this segment of health passed through important changes to its dysfunction. An important role had the Unit of Occupational Medicine at the National Institute of Public Health which also was stopped of working.Formally had also the Association of physicians of the Occupational Medicine. Before war (1999) Kosovo has had 65 specialist of Occupational Medicine. Nowadays of Occupational Medicine Todays in Kosovo are 31 active specialists of OM. This generation belongs to the age of 40-68 years, so it is old and not regenerated. Todays a few of them are working out of their field of specialization as a result of bad organization of OM. Currently, is considered that in Kosovo are employed over 250,000 workers, while quadruple is able and waiting to work. So the ratio of employees with a doctor is 1:8000, far away fromEuropean norms.
- 5. Regional specialists of OM in Kosovo 0% 3% 7% Prishtina (17) 16% Mitrivica (6) Prizren (5) Peja (2) 55% Gjilan (1) 19% Gjakove Figure 3. District distributed specialists Responsible body on OH 1. The Ministry of Health 2. The Ministry of Labor and Social welfare Main laws in force for OH The OH is part of public-public health system. The administrator of Health system is the Ministry of Health. The health system is organized on three levels, primary, secondary and tertiary. The Occupational health is part of tertiary level and is managed by two occupational health institutes, one located in Obiliq (10 km away from Capital city) and the second one in Gjakova (western part of Kosovo),and 7 local OM services. Presently all health system is ruled based on provisional health law which was adopted by United Nations Mission in Kosovo and Provisional Kosovo Self Governmental Institutions (Health law no.2004/4) which is under revision and very soon there will be a new law foreseen to be adopted by assembly by the end of this year. In the other hand there is not special legislation which regulates the aspect of occupational health as a specific entity. Fortunately, we have a new labor law (labor law No.03/L-212) which was approved in year 2010 and came into force in beginning of year 2011. This law talks about the safety in work and the rights of workers. Due to this law the employer is obliged to ensure the worker with proper protection in work and provide proper protective devices as well as it is obliged to undertake all measures to secure healthy and safe working environment. Novelties in this law are also the extension of sick leaves from 15 calendar days into 30 working days and extension of maternity leave from 3 months into 6 months. As I mentioned our health system is public-public we do not have health insurances fund and the government pays all health services. As both occupational institutes are part of health system workers-patients do not pay for services that they receive but due to lack of fund in some cases some of health services are limited.
- 6. The health insurances fund law is under preparation. Major part of it have been concluded but due to financial cost it has been postponed for approval in next year based on advises of World Bank and International Monetary Fund. The rights and obligations concerning labor relations are regulated in order of priority by the following sources: a) The constitution of Republic of Kosovo b) The collective contract of employment? c) The individual contract of employment d) Code of labor Occupational accidents and occupational disease The deficiencies on the accurate evaluation of the occupational accidents are conditioned by the following factors: 1. Lack of accident declaration 2. Lack of mild injuries 3. Lack of registration of the self employed persons or part time employers 4. The information about injured persons is deficient etc Reporting occupational diseases It is very difficult to report Occupational disease because of: 1. The partial coverage with health service of the enterprises 2. Deficient specialization of doctors engaged full time on health service in enterprises 3. The deficient of cabinets for Occupational disease For this reasons the numbers of Occupational injuries is far away from what is present in the field The most occupational diseases in Kosovo are Pneumoconiosis leads by Anthracosis. Occupational health education Faculty of Medicine There is a subject of Occupational Medicine at least 45 hours for Medical students,and specialization on Occupational Medicine that last 3.5 years. Moreover, there is no training for occupational health nurses. Occupational Health services
- 7. Both institutes provide professional services through diagnostic testing of patients. The services are /divided into following departments: Otorhinolaryngology Gynecology Medical laboratory Ophthalmology Internal Medicine Cardiology Neurology Psychiatry Dermatology Pulmology X-Ray Department Occupational Medicine Discussion 1. Low number of OM specialists 2. Urgent needs to increase the scientific and professional staff as: sanitary inspector, hygienists, psychologist etc. 3. Half of the municipalities does not have OM staff 4. More than half of OM specialists are concentrated in Prishtina The future of Occupational Medicine This should be based on: 1. The maximum utilization of existing human resources 2. Continual increasing of professional staff 3. Development of information system within health information system 4. Orientation from curative form to preventative one 5. The recovery of Association of physicians of the OM 6. Establishment of Central Institute of Occupational Medicine
- 8. Operating scheme of Occupational medicine DEPARTMENT OF SCIENTIFIC RESEARCH -scientific projects -scientific meeting -edition of scientific magazine MEDICINE FACULTY INSTITUTE OF OCCUPATIONAL HEALTH DEPARTMENT OF PROFESSIONAL PRISHTINE DEPARTMENT OF TRAINING AND DISEASES EDUCATION OF NEW GENERATION -hospital treatment -permanent education -examination -training -evaluation of working ability -specialization Figure 4. Operating scheme of Occupational medicine, done and presented to Government by Prof.Dr. XhevatShkodra
- 9. Main Problems? The main problems are: Health system and health financing. There is inadequate financing of health services and health needs, with other words lack of finances offered by government for health sector and there is not clear policy to develop health sector and produce proper legislation for regulate health financing. References 1. Shkodra ,Xhevat Prof.Dr.2002 Resurset e tanishmenjer谷zore,aktivitetet e tyren谷kuad谷rt谷Mjek谷sis谷s谷Pun谷sdhenevojatp谷rtrajnim 2. Ar谷nliu-Qosaj, Fatime and Ko巽inaj-Berisha,Merita 2010. Transition in Health and Health Care in Kosovo 3. Kosovo Agency ofStatistics,2009.SocialStatistics.Health Statistics. 4. ____.2011.Kosovo Census 5. ____.2009.Population Statistics 6. ____.2009. Economic Statistics. 7. ____.2009.Labour Market Statistics 8. UNDP.2012. Kosovo Human Development report 2012-Private sector and employment 9. Law No. 2003 / 19 On Occupational Safety, Health Andthe Working Environment 10. Law No. 2004/4 Kosovo Health 11. Law No.03/L-212 On Labor