The results of the vulnerability study show that several factors impact accessibility of health services in Albania such as: 1) financial constraints, 2) poor health conditions and inability to go to the health center; 3) distance from the health centers and cost related to transportation; 4) lack of trust in the health care system; 5) constraints related to work or inability to leave the work. These factors impact to a larger extent specific vulnerable categories such as elderly people with limited mobility in the communities, mentally handicapped individuals living isolated in their families or other categories of patients with limited mobility (such as patients after surgery interventions or affected by cancer in terminal phase or other serious diseases) and finally, very poor and marginalized citizens. For these and other categories of patients, it is necessary to organize home-based services in order to avoid exclusion of these citizens from health service coverage.
HAP-2 will provide the technical expertise to develop a home-based care model adapted to the context of Albanian rural and urban areas. The proposed model will be discussed, elaborated and agreed in close collaboration with MoHSP, PHC personnel, professional orders and associations, local health authorities, LGUs and NGOs representing the interest of patients and consumers. The home-based care model needs to be appropriate and accepted by the PHC personnel, especially nurses operating at the level of the communities.