South Eastern European Journal of Public Health (SEEJPH) <p>The South Eastern European Journal of Public Health (SEEJPH) is an open-access international peer-reviewed journal involving all areas of health sciences and public health. Devoted to the global health SEEJPH welcomes submissions of scientists, researchers, and practitioners from all over the world, but particularly pertinent to southern and eastern countries in transition.</p> en-US (Prof. Genc Burazeri PhD) (OJS-Team of Bielefeld University Library) Wed, 17 Mar 2021 00:00:00 +0000 OJS 60 Scenario planning: An alternative approach to European Commission for combating antimicrobial resistance by 2050 <p><strong>Aim</strong>: Antimicrobial resistance (AMR) is one of the major health challenges of the future, but the concrete impact of counteracting measures is still unclear. To study possible outcomes within the European Union, a scenario analysis for the year 2050 was performed on the possible influence of the European Commission (EC).</p> <p><br><strong>Methods</strong>: Scenario planning and development of strategies based on different scenarios.</p> <p><br><strong>Results</strong>: Rational use of antimicrobials in animals and humans, surveillance and monitoring, new antimicrobial therapies, travel and globalization, exposure to the environment, and awareness were recognized as the main driving elements. Four Scenarios were developed: An efficient and impli-cated EC sorts out AMR; An implicated but unsuccessful EC withstands AMR; AMR is managed regardless of the EC disinterest; and A neutral and inefficient EC fails to manage AMR.</p> <p><br><strong>Conclusion</strong>: All the strategies developed on the basis of the four scenarios probe for an increase in European Union's dedication to achieve positive outcomes. These include the development of effective legislation and international coordination.</p> <p><br><strong>Acknowledgment</strong>: Peter Schröder-Bäck, Helmut Brand and Kiranjeet Kaur’s contribution is co-funded through a grant of the European Commission within the Erasmus+ programme (Project: Prevent it. Project reference: 598515-EPP-1-2018-1-IN-EPPKA2-CBHE-JP).</p> <p><br><strong>Conflict of interests:</strong> None declared.</p> Laura Patricia Orellana García, Kiranjeet Kaur, Helmut Brand, Peter Schröder-Bäck Copyright (c) 2021 Laura Patricia Orellana García, Kiranjeet Kaur, Helmut Brand, Peter Schröder-Bäck Tue, 06 Apr 2021 00:00:00 +0000 Assessment of the prevalence and risk factors of low back pain in operating room health workers: An observational study in Italy <p><strong>Aim</strong>: The aim of this study was to assess the prevalence of low back pain (LBP) among health<br>professionals and the possible risk factors.</p> <p><br><strong>Methods</strong>: The study was carried out from April 2018 to October 2018 among all health workers of the <br>Orthopaedic Clinic and the Emergency Department of “Policlinico Umberto I” in Rome. LBP was <br>assessed using the Nordic Questionnaire Musculoskeletal Disorders in the section on lumbar pain. <br>The type of physical activity carried out as prevention was investigated by use of the <br>International Physical Activity Questionnaires. The overall state of health and lifestyle was <br>deter- mined by the Short Form 12-item Health Survey. Job satisfaction and perceived work stress <br>were assessed through the 15-questions of Karasek’s Questionnaire. The intensity of the low back <br>pain was assessed using a Numerical Rating Scale. A univariate analysis was conducted to assess the <br>associations between socio-demographic and working variables. Multiple logistic regression mod- els <br>were used to assess independent correlates of LBP.</p> <p><br><strong>Results</strong>: One hundred thirteen subjects were enrolled, 52 women and 61 men. The annual period- <br>prevalence of lumbar musculoskeletal disorder was found on 79.6% of participants with LBP. <br>Mean value evidence of NRS was 2.66. The highest LBP risk over the 12 months was found in groups <br>with high job demand (OR = 1.18; 95%CI: 1.01 – 1.38), low decision-making opportunities (for <br>decision latitude OR = 0.87; (0-76 – 1.0), and low levels of physical activity (OR = 0.75; 95%CI: <br>0.64 – 0.89).</p> <p><br><strong>Conclusion</strong>: The working environment is a potential risk factor for the development of LBP and is <br>suitable for prevention programmes. The protective effect of physical activity and work-related <br>stress management indicate room for improvements for the prevention of LBP in these HCWs.</p> <p><br><strong>Conflicts of interest</strong>: None declared.</p> Stefano Brauneis, Enza Sorrentino, Vincenza Di Lisa, Gabriella Galluccio, Barbara Piras, Francesca Carella, Edoardo Palozzi, Carmela Generali, Simona Maggiacomo, Silvia D’Aurelio, Insa Backhaus, Filippo La Torre, Ciro Villani, Giuseppe La Torre Copyright (c) 2021 Stefano Brauneis, Enza Sorrentino, Vincenza Di Lisa, Gabriella Galluccio, Barbara Piras, Francesca Carella, Edoardo Palozzi, Carmela Generali, Simona Maggiacomo, Silvia D’Aurelio, Insa Backhaus, Filippo La Torre, Ciro Villani, Giuseppe La Torre Wed, 17 Mar 2021 00:00:00 +0000 How to minimize negative health effects in the European Union due to the Economic recession caused by the COVID-19 Pandemic <p><strong>Aims: </strong>The article aims to analyze what can be learned from the last Financial Crisis from 2008 on to minimize the negative health effects in the European Union due to the Economic recession caused by the Covid-19 Pandemic.</p> <p><strong>Methods: </strong>Systematic literature reviews were conducted to analyze the interventions taken to combat the last Financial Crisis and their consequences on health. Parallel to this, a&nbsp;qualitative document analysis&nbsp;of the&nbsp;ongoing&nbsp;discussion about the measures taken or to be taken in the Covid-19 Pandemic to fight the current economic recession&nbsp;was conducted using institutional websites and international media.</p> <p><strong>Results: </strong>The main methods taken to combat the Financial Crisis from 2008 were, bailing out banks, austerity measures, and the European Stability Mechanism. There is evidence that the Financial crisis had negative effects on the European Health Systems in general. Austerity measures in some countries, led to an increase in psychological disorders. Overall mortality was not affected but the decrease of avoidable mortality slowed down. Various economic interventions such as bailing out essential industries e.g., the Aviation sector, cash injections, tax relief, short-work salary compensation, modified ESM, and the Pandemic Emergency Purchase Program (PEPP) were taken during the Covid-19 Pandemic to help stabilize the economy.</p> <p><strong>Conclusion: </strong>The current recession is not caused by internal failures of the financial system as it was in the financial Crisis of 2008, but by an outside event - the Covid-19 pandemic. Measures were taken by the governments and the European Union to avoid an economic crisis, and by these, the negative health effects were created during the Financial Crisis in 2008, but the lockdown phase seems to lead to similar negative health effects regarding psychological disorders and delay of planned screening and treatment.</p> <p><strong>Conflict of interest: </strong>None declared.</p> Adhitya Satyamoorthy, Helmut Brand, Robin van Kessel Copyright (c) 2021 Adhitya Satyamoorthy, Helmut Brand, Robin van Kessel Wed, 02 Jun 2021 00:00:00 +0000 Factors influencing the choice of facilities among enrolees of a prepayment scheme in Ibadan, Southwest Nigeria <p><strong>Aims:</strong> Factors that influence the personal choice of a health care facility among health care consumers vary. Currently, what influences the choice of health facilities among enrollees under the National Health Insurance Scheme (NHIS) is not known. This study aimed to as-sess what influences the choice of facilities in the NHIS of Nigeria.</p> <p><br><strong>Methods:</strong> This was a descriptive cross-sectional study conducted among enrollees in selected NHIS facilities in the 11 Local Government Areas (LGAs) of Ibadan, Nigeria. A total of 432 enrollees were selected and were interviewed. A WHO-USAID semi-structured interviewer-administered questionnaire was used to obtain relevant data. Data collection was between Oc-tober and December 2019. Data were analyzed using STATA version 12.0 (α =0.05).<br>Results: At unadjusted OR, older respondents (OR 3.24, CI = 2.52-4.18, p = &lt;0.0001), and those who had attained the tertiary level of education (OR 3.30, CI 2.57-4.23, p &lt;0.0001) were more likely to make a personal choice of health care facilities. A similar pattern was ob-served among respondents who were in the high socioeconomic group (OR 4.10, CI 3.01-5.59, p = &lt;0.0001). However, at Adjusted OR, only high socio-economic status was a predic-tor of personal choice of health care facility (OR 1.92, CI 1.21-3.05, p = 0.005).</p> <p><br><strong>Conclusion:</strong> This study is suggestive that a need for and the ability to afford the cost of care influence the choice of health facilities. Policies that promote health literacy in the general populace will enhance the capability of individuals to make a personal choice of health facili-ties. Stakeholders should prioritize this for policy.<br>Recommended citation: David A. Adewole, Temitope Ilori. Factors influencing the choice of facilities among enrolees of a prepayment scheme in Ibadan, Southwest Nigeria</p> <p><br><strong>Acknowledgments:</strong> The authors wish to acknowledge study participants for permission to interview them in the course of the data collection of this study.<br>Authors' contributions: David Adewole conceived and designed the study. Temitope Ilori did data collection and analysis. Both authors contributed equally to the manuscript write-up. The two authors also read through the manuscript draft the second time and agreed to the final manuscript.</p> <p><br><strong>Conflict of interests:</strong> None declared.</p> David Ayobami Adewole, Temitope Ilori Copyright (c) 2021 David Ayobami Adewole, Temitope Ilori Tue, 11 May 2021 00:00:00 +0000 Two sides of a broken medal: Disease prevention and health promotion in schools of public health <p><strong>Aim</strong>: Disease prevention and health promotion are closely related through the lifestyle concept and teaching modules on them should be a part of the postgraduate curriculum of every School of Public Health (SPH) in the European Region and beyond. We aimed to determine to which degree the European SPH offer modules on Disease Prevention and Health Promotion in their postgradu-ate programs, but also the delay in full implementation for the target year 2030 that has been set at 100% for all SPHs.</p> <p><br><strong>Methods</strong>: The Association of Schools of Public Health in the European Region (ASPHER) con-ducted two surveys on the activities of its members in 2011 and 2015/16. A group of 48 SPH responded in both surveys. Questions were related to the content offered by SPHs, the types of teaching methods that are in use and presentations of the modules at social networks.</p> <p><br><strong>Results</strong>: For both modules, the 2nd survey in 2015/16 shows slightly less positive results as com-pared to the 1st Survey in 2011 (72.9% vs. 77.1% and 81.3% v. 87.5%). The only exception is the use of social media which increased for disease prevention from 20.8% to 37.5% of all SPH and for health promotion from 22.9% to 39.6%. Referring to the set target of 100%, delays between 4 and 13.5 years accumulate for the target year 2030.<br>Conclusion: With the exception of the use of social media, progress towards 2030 is slow or even negative. Serious efforts have to be made by ASPHER to revert this process.</p> <p><br><strong>Acknowledgments</strong>: The authors would like to thank all members of ASPHER for their commit-ment in responding to the survey questionnaire and providing examples of good practices in edu-cation, training and research for public health.</p> <p><br><strong>Conflict of interest:</strong> None declared.</p> Zeljka Stamenkovic, Helmut Wenzel, Janko Jankovic, Vesna Bjegovic-Mikanovic Copyright (c) 2021 Zeljka Stamenkovic, Helmut Wenzel, Janko Jankovic, Vesna Bjegovic-Mikanovic Sun, 09 May 2021 00:00:00 +0000 Preventive check-up programme for strengthening people-centred primary health care services in Albania: Case study and lessons learnt <p>Non-communicable Diseases (NCDs) in Albania are increasing, yet the country has a low number of outpatient visits per inhabitant per year. A primary health care (PHC) based programme of medical check-ups, with a focus on prevention, was set up in the country in 2015 aiming to address this issue, among others. This manuscript describes the development and status of the programme at key time points after its implementation, and considers some of its outcomes.<br>The current analysis was based on data gathered from the check-up programme information system and the registry of diseases at PHC centres, and guided by the European Framework for Action on Integrated Health Services Delivery.<br>Based on PHC registered cases, a 13% and 34% increase in the prevalence of elevated blood pres-sure and diabetes were observed in 2015 respectively, following the introduction of the check-up programme compared to the previous year. Three years after implementation, about 60% of the population aged 35–70 years old had used the programme at least once, with 61% of the total 954 667 visits provided to women.<br>Overall, the check-up programme in Albania has identified a substantial number of new cases of NCD as well as their associated risk factors in its population. The early detection of NCDs is expected to contribute to the prevention of complications, premature mortality and their associated costs. Albanian politicians and decision-makers should regularly revise and introduce appropriate changes to the check-up programme in the future. In particular, the issue of sustainability and long-term resource mobilization is of particular concern and warrants careful consideration.</p> <p>&nbsp;</p> <p><br><strong>Conflict of interests:</strong> None declared.</p> Alban Ylli, Arnoldas Jurgutis, Genc Burazeri, Gazmend Bejtja, Nazira Artykova, Tetine Sentell Copyright (c) 2021 Alban Ylli, Arnoldas Jurgutis, Genc Burazeri, Gazmend Bejtja, Nazira Artykova, Tetine Sentell Sat, 17 Apr 2021 00:00:00 +0000 Chocolate intake is associated with a lower body mass index in adult men and women in transitional Albania <p><strong>Aim: </strong>In light of the controversial evidence regarding health effects of chocolate intake, we aimed to assess its association with body mass index (BMI) among adult individuals in Albania, a transitional post-communist country in South Eastern Europe which has traditionally employed a Mediterranean dietary pattern.&nbsp;&nbsp;</p> <p>&nbsp;</p> <p><strong>Methods:</strong> A cross-sectional study was conducted in 2003-2006 involving a population-based sample of 737 Tirana residents aged 35-74 years (469 men, 268 women; overall response: 70%). Of these, 565 individuals (373 men and 192 women) provided data on chocolate intake and anthropometrics (77% of the sample). A 105-item food frequency questionnaire, including chocolate consumption, was administered to all individuals. Nine categories were used to assess the average frequency of intake of each food item in the past 12 months. In the analysis, chocolate intake was dichotomized into: consumption of &lt;1/month vs. ≥1/month. A physical examination included measurement of weight and height. Furthermore, information on socio-demographic characteristics and classical risk factors was collected. Multivariable-adjusted general linear model was used to calculate the mean BMI values by chocolate intake groupings.</p> <p>&nbsp;</p> <p><strong>Results:</strong> Upon simultaneous adjustment for socio-demographic characteristics, classical risk factors and nutritional factors, there was an inverse association between BMI and chocolate intake in both sexes (sex-pooled mean BMI: 26.1 among participants who consumed chocolate &lt;1/month vs. 27.0 in those with an intake of ≥1/month; P&lt;0.001).</p> <p>&nbsp;</p> <p><strong>Conclusions:</strong> This study points to a beneficial effect of moderate chocolate intake on lowering BMI, which deserves further vigorous investigation and replication in prospective studies in Albania and other populations.</p> Iris Mone, Bledar Kraja, Jolanda Hyska, Genc Burazeri Copyright (c) 2021 Iris Mone, Bledar Kraja, Jolanda Hyska, Genc Burazeri Wed, 07 Apr 2021 00:00:00 +0000 Pharmaceutical policies in post-communist Albania: Progress and challenges toward European Union membership <p><strong>Aim:</strong> Shifting from a communist regime to a democratic system has affected health system fundamentally in most of the Western Balkan countries including Albania. Albania became a European Union (EU) candidate country in 2014. Since then, one of the main concerns has been to approximate the legislation with the EU framework. The aim of this paper is to review the evolvement of pharmaceutical legislation in Albania and challenges toward achieving full approximation to the EU’s respective legislation.</p> <p>&nbsp;</p> <p><strong>Methods:</strong> We used qualitative techniques, especially means of conventional content analysis and two sources to collection data. First, we consulted the Albania’s National Publications Office webpage and analysed all available legislation regarding “pharmacy”, “medicine” and “pharmaceutical products” from 1994 to 2021. Then, we analysed the National Integration Plans that have been published by the Government of Albania from 2014 to 2021.</p> <p>&nbsp;</p> <p><strong>Results:</strong> The decrease of the price margin system goes in parallel with the increase of the pharmaceutical expenditure, including out-of-pocket expenditure on medicines and lack of adequate and sensitive reimbursement policies. The main pillars of the pharmaceutical sector in Albania are well-covered legally but not fully in concordance with the EU framework.</p> <p>&nbsp;</p> <p><strong>Conclusion:</strong> There is a need to foster laws implementation that regulate the opening of pharmacies; a detailed regulation on pharmacovigilance; and a regulation on medicinal products for paediatric use. Also, the existing legal framework should be aligned with the European one. Medicine pricing methods should go in the same line with the decrease of out-of-pocket expenditure.</p> Dajana Roshi, Eni Tresa, Alessandra Lafranconi, Genc Burazeri, Katarzyna Czabanowska, Helmut Brand Copyright (c) 2021 Dajana Roshi, Eni Tresa, Alessandra Lafranconi, Genc Burazeri, Katarzyna Czabanowska, Helmut Brand Mon, 19 Jul 2021 00:00:00 +0000 Hepatitis C in several risk groups: Literature review <p><strong>Aim: </strong>The objective of this study was to assess the distribution of hepatitis C in selected risk groups such as haemodialysis patients, pregnant women, healthcare workers, HIV-HCV co-infected patients, patients with mental health diseases and piercing and tattoo procedures. Furthermore, it aimed at evidencing common transmitting routes and highlighting the importance of preventive measures among these groups.</p> <p><strong>&nbsp;</strong></p> <p><strong>Methods: </strong>The literature review was conducted using online databases (Medline) with search query involving the keyword “hepatitis C” in conjunction with keywords describing risk groups such as "dialysis", or "haemodialysis", or "pregnancy", or "pregnant", or "mental health", or "tattoo", or "piercing", or "HIV", or "health professionals”.</p> <p>&nbsp;</p> <p><strong>Results: </strong>After assessing all the retrieved publications, 39 of them were considered for inclusion: 17 on haemodialysis patients, 7 on pregnant women, 8 on HIV-HCV co-infection and 7 publications on health professionals, patients of mental health wards and piercing and tattoo procedures. The high rate of hepatitis C is still a high problem and in some cases it is considered as a new issue, as in the case of pregnancy. Some of the transmission routes have been identified earlier, such as the HIV-HCV co-infection but some, such as piercing and tattoo, are becoming new transmission routes. Health professionals are still identified as high risk group while mental health patients are a potentially high risk group.</p> <p>&nbsp;</p> <p><strong>Conclusion: </strong>Even though some patients are routinely screened for hepatitis C, there are indications for performing such a routine test in other groups. In almost all of the risk groups, it is advocated to use stricter preventive measures and to disseminate knowledge on risks of hepatitis C.</p> <p>&nbsp;</p> <p><strong>Conflict of interest: </strong>None declared.</p> Albiona Rashiti-Bytyçi, Naser Ramadani, Ariana Kalaveshi, Sefedin Muçaj, Luljeta Gashi, Premtim Rashiti Copyright (c) 2021 Albiona Rashiti-Bytyçi, Naser Ramadani, Ariana Kalaveshi, Sefedin Muçaj, Luljeta Gashi, Premtim Rashiti Mon, 31 May 2021 00:00:00 +0000 COVID -19 Pandemic - Increasing the African Access to Vaccination Tewabech Bishaw Copyright (c) 2021 Tewabech Bishaw Fri, 23 Jul 2021 00:00:00 +0000 Survey exploring the opinion of corresponding authors of articles published in the South Eastern European Journal of Public Health during 2014-2021 <p>The aim of this survey was to assess the intentions of corresponding authors for publishing again in the South Eastern European Journal of Public Health (SEEJPH), the aspects that they like most about the jour- nal, and things which can be improved by SEEJPH in order to be more attractive to potential contributors. A three-item questionnaire was sent out by email to all corresponding authors (N=89) who published in the 16 volumes of the SEEJPH journal between 2014 and 2021. Among 84 eligible corresponding authors, we collected 26 answers, or 31%.</p> <p>There were generally favourable and constructive comments, which is encouraging. The wide array of coun- tries of the corresponding authors represents the successful global orientation of SEEJPH. Also, more than half of all related articles are classified as original papers, and the average of four authors per represented paper is satisfying. Furthermore, all corresponding authors would publish again in SEEJPH (“definitely”, or “probably”), and their numbers are almost equally distributed throughout 2014-2021.</p> <p><strong>Acknowledgments: </strong>We express our gratitude to our Publisher Dr. Hans Jacobs, Sebastian Wolf, and all our supporters in the University of Bielefeld/Germany, our Boards of Editors, and our authors, friends, and colleagues.</p> Kreshnik Petrela, Meri Roshi, Ulrich Laaser, Genc Burazeri Copyright (c) 2021 Kreshnik Petrela, Meri Roshi, Ulrich Laaser, Genc Burazeri Sat, 10 Jul 2021 00:00:00 +0000 Easter Eggs & ‘Easter Eggs’: Alcohol Branded Chocolate Eggs & Intoxigenic Environments in Ireland <p>Alcohol branded Easter Eggs were observed in a mainstream Irish supermarket. The Public Health (Alcohol) Act, 2018 fails to deal with such child-friendly marketing. An amendment to the current legislation to counter this deficit is urgently required. The absence of such legislation is particularly notable given the longstanding inclusion of clauses to this effect in tobacco control legislation in Ireland.</p> <p><strong>Conflict of interests: </strong>None declared.</p> <p>&nbsp;</p> Frank Houghton Copyright (c) 2021 Frank Houghton Wed, 05 May 2021 00:00:00 +0000 How can we champion young women working in public health? Ines Siepmann, Tara Chen, Petra Andelic Copyright (c) 2021 Ines Siepmann, Tara Chen, Petra Andelic Mon, 10 May 2021 00:00:00 +0000