Among the demographic data of the 2023 Census for the Albanian population, there are two that stand out due to their continuous improvement. We are talking about the decreasing trend of maternal and infant mortality. This was also the topic of the fifth episode of the “Depopulation” series, produced with the support of UNFPA Albania.
In every 1,000 births, 6.1 Albanian babies lose their lives, and this is a very low figure and comparable to countries much more developed than Albania. Meanwhile, the figures for maternal mortality have decreased significantly, and in some maternity hospitals in the country they are even zero. One such is the “Queen Geraldine” maternity hospital in Tirana. Its director, Eliona Demaliaj, stated: “The very problems of pregnancy are also associated with major pathologies, which sometimes lead to the loss of the mother’s life, but we have wonderful results thanks to the experience and commitment and professionalism of doctors, as well as the implementation of clinical protocols, etc. Reducing infant and newborn mortality is not easy, it is not done in one day; it takes more work and many sacrifices, and we also need to have modern medical equipment and, above all, the experience of health personnel.”
In the studio of the “Depopulation” show, experts emphasized the importance of informing and raising awareness among new mothers, as the most efficient way to reduce morbidity and mortality. Even in this field, the principle “prevention is better than treatment” applies. Neonatologist Edi Tushe emphasized that attention should be focused on the first moments when babies are born, as they are decisive not only for their lives, but also for damages that can affect their health and well-being in the future.
Dr. Edi Tushe emphasizes that “The main problem of infant mortality is among newborns. About 70% of deaths occur in newborns. This shows that the life of the child in the first moments after birth is extremely endangered. The reasons that determine it are not only socio-economic causes, but also biological causes, the ratio of which is 1 to 1. Some of the causes can be avoided, especially those related to infections, malnutrition, the use of artificial milk compared to breast milk, etc.”.
If we look at the data published by INSTAT in 2023, 144 infant deaths were recorded: 52.1% are early neonatal deaths 0-6 days after birth, 18.0% are late neonatal deaths 7-27 days after birth and 29.9% are postneonatal deaths 28-365 days after birth, i.e. up to one year after birth.
But what are some measures that need to be taken in this regard? Dorina Toçaj, Program Analyst at the UNFPA Albania office, listed some of them:
"One of the main results that we want to achieve as UNFPA at the global level is zero preventable maternal deaths. It is extremely important to ensure equal access to health services for all women and girls, so that we also address the needs of marginalized groups. The quality of health services, i.e. strengthening the skills and knowledge of health personnel at every level of service, must be prioritized. Primary health care is of particular importance in addition to hospital care to strengthen the skills of personnel at this level of service for the best possible care for pregnant women. Likewise, work must continue to improve the level of knowledge and skills of health personnel in the country's maternity hospitals regarding the main diagnoses with high risk for the health of the mother and baby, such as Postpartum Hemorrhage, Eclampsia, Pre-Eclampsia, and others. Likewise, the drafting and unification of clinical guidelines and protocols should be prioritized, alongside clinical audit/supportive supervision to provide the necessary support towards continuous improvement of maternal and infant health indicators.”
The doctors in the studio also raised the alarm about the increase in the number of cesarean births (by surgery) in Albanian maternity hospitals.
Dr. Mirela Rista emphasizes that “Mothers, out of an inexplicable fear or from a non-combatant nature, make this decision. But they are also not sufficiently informed about natural birth and the fact that there are no consequences for her life or that of the baby, if the woman was followed during pregnancy by health personnel. Sometimes women choose a surgical birth as the fastest, perhaps without sacrificing those hours of pain to gain their most precious thing. In such situations, when the moment has not come, that is that biological hour of birth, a surgical birth can cause difficulties for the baby later in their life.”
Based on the analyses conducted, malnutrition is still evident among Albanian children, especially in underdeveloped rural areas and lower-income groups. The fact that there are inequalities in child health and nutrition requires prioritizing universal health coverage for mothers and children in difficulty in the planning process. The recommendations are that Albania should design specific programs to address the consequences of the dual problems of under- and overnutrition. Demographer Arjan Gjonça explained this phenomenon as follows:
“10 or 15 years ago, we had problems related to the child’s birth weight or height; both are indicators of malnutrition, closely linked to the mother’s pregnancy, and her malnutrition. These two indicators are very important and show us that one of the most important things to focus on is especially the period of pregnancy in the mother, because this is very important not only for the health of the mother but also for the children.”
Experts call for special attention to the implementation of interventions that focus on maternal and infant health. "Although maternal and infant mortality indicators are continuously improving at the national level, more needs to be done to reduce maternal and infant morbidity by improving the quality of services at every level of care, strengthening the skills of health personnel, and raising awareness among the population."
