The Health for All Project (HAP) has successfully concluded Year 2 of its Consolidation Phase (April 2024 – March 2025), making significant strides in the expansion of home care services, inter-professional collaboration, and capacity building among primary healthcare professionals.
Expanding the Reach of Home Care
Perhaps the most tangible achievement has been the dramatic increase in home care services. By the end of March 2025, 87 health centres across 17 Local Units of Health Care (LUHCs) were actively delivering home care, accounting for 24.3% of all health centres in Albania, and 32.8% of those in HAP-supported areas.
These services are provided by 845 nurses trained by HAP, who collectively conducted 43,925 home visits for 4,178 patients over the reporting year. On average, each patient received over ten visits, demonstrating consistent follow-up by PHC professionals. However, the inability of the Health Insurance Fund (HIF) database to disaggregate visits by patient vulnerability (those eligible for home care according to their Karnofsky score and others) makes it difficult to assess the care provided for the most at-risk groups.
Despite this progress, the home care system remains fragile. Not all supported health centres have initiated services, and the growing number of visits doesn’t necessarily reflect quality or frequency for the most vulnerable. Moreover, no additional government funds have yet been allocated to enhance the system’s sustainability.
Strengthening Collaboration in PHC
HAP has been instrumental in promoting inter-professional teamwork, particularly the integration of social workers and psychologists into PHC. A new set of operational tools for social workers has been developed and is awaiting Ministry of Health and Social Protection (MoHSP) approval. Meanwhile, a manual for psychologists is also currently under development.
Training a New Generation of Health Professionals
Capacity building has been central to HAP’s strategy. A total of 889 professionals were trained, including the 845 home care nurses and 44 LUHC staff members. The trained nurses constitute almost 20% of all PHC nurses in HAP-covered areas, forming a critical mass for the future scale-up of services.
Additionally, 190 physicians and nurses were trained as trainers on non-communicable disease (NCD) protocols during the reporting period. Since 2022, HAP has trained 985 professionals on NCD management, enabling 818 providers to participate in Peer Groups (PGs).
HAP also made substantial progress in elderly care and mental health, training 378 professionals in geriatric care since 2022, and 136 in mental health in the past year alone. At present, about 110 PGs are training on mental health disorders with the participation of over 1,000 professionals, including physicians, nurses, and psychologists.
Priorities for Year 3
Looking ahead, HAP will focus on:
- Advocating for dedicated public funding to expand and sustain home care services;
- Support the enhancement of the quality and sustainability of peer groups as a tool for continuing education;
- Strengthening regional capacities to autonomously manage the training of professionals and monitoring of services in PHC;
- Supporting inter-professional practices, especially the integration of psychologists and social workers in PHC;
HAP’s interventions during the second year continue to strengthen primary healthcare, improving the quality and access to health services for citizens, particularly vulnerable groups. Going forward, HAP will focus on securing sustainable funding for home care, strengthening peer groups, and building local capacities to ensure the sustainability of these interventions.