- - -

There is no content tagged with this country

Back to the previous page

Albania

Articles by Albania

Bruna Hylivu - Albania
07 April 2020

COVID-19 Impact: What we know so far – Albania

An interview with Bruna Hylviu, the Executive Director of Albania Center of Population and Development (ACPD) on the impact of COVID-19. How has Albania been affected by coronavirus? Albania has entered COVID-19 lockdown since 13 March. According to the government war law, there are restrictions that allow people and cars to only travel between 5am until 1pm from Monday to Friday. Essential activities are also limited only to these designated hours. As of 7 April, there are 377 infected people and 21 deaths. The state has limited budget, human resources and medical supplies to address the situation related to COVID-19, but recently a fund from the EU and donations from other countries have been dedicated to COVID-19 response. What impact is coronavirus having when it comes to sexual and reproductive health services? Following the containment strategy implemented for the entire country, for almost three weeks the government has announced today the introduction of mass testing for the most at-risk populations and contacts of confirmed cases in order to manage the virus outbreak. However, the government have to make public announcements related to financial plans to strengthen COVID-19 preparedness and response. The virus outbreak is stretching an already strained health system and raises question over whether everyone can get equal access to treatment. The entire healthcare system is somehow working within the timetable set by the government, limiting the ways to access healthcare services including sexual and reproductive health. Until now there have been no clear decisions/statements about the financial and operational measures taken or to be taken by the government to address the situation (for example, a dedicated budget, number of beds available/plans to buy kits, laboratories, respiration devices etc.).  Albania’s main strategy at the moment is the containment of the entire population, a poor system of case-finding, contact tracing management, and testing. What services have been the worst hit so far? HIV and STI tests, contraception, abortion care, cervical cancer screening and testing, gynaecological visits, and sexual and gender-based violence services are all in decrease. This is for several reasons, from limited opening hours, lack of precautions and protocols in place, lack of demand related to fear of people getting the virus, and lack of trust in the healthcare system protection measures in place. Are frontline staff still able to go into the community? There are frontline healthcare workers that provide COVID-19-related services for the entire population, but they continue to work in very challenging conditions; they are concerned about the shortage of personal protective equipment that might endanger their life. The service is centralized in capital city, Tirana. We have closed our static and mobile clinics for the safety of our healthcare staff, our vulnerable clients, and entire community. We are providing SRH (sexual and reproductive health) counselling via Skype and WhatsApp, and sensitization of the public about the effects of COVID-19 to SRH and gender inequalities through our website and social media. We are also providing information and articles about how coronavirus is affecting victims of gender-based violence, tips for pregnant women, how COVID-19 impacts people seeking abortion care etc. We are referring to the World Health Organization's website and to IPPF resources to disseminate messages among the community, partners through the web, social media and email. What are you doing to keep providing services to people in Albania? We are putting efforts to deliver SRH services for emergency situations, for women who have undergone abortions, and victims of gender-based violence. We are also focusing on contraceptive care, people who need HIV testing and counselling or pregnancy tests, as well distributing condoms for the most at-risk populations. These are offered by the nurses in the clinics or outreach people who schedule their time based on the demand of our beneficiaries and restrictions set by the government and respecting social distancing, equipped with masks and gloves. Otherwise all counselling and consultation services are transferred online via WhatsApp, Skype and phone provided by the gynaecologists of two ACPD clinics. What message do you have for people and your staff in Albania when it comes to sexual and reproductive health and rights (SRHR) and coronavirus? We are carrying on our work together through advocacy, information, and education to ensure access to SRH and to respond to gender-based violence at a time when women and girls need these services most. I want to thank staff and volunteers for making great efforts to enable SRH care even in the time of COVID-19.

Liljana

"I decided to do cryotherapy. It was the best decision I have made in my life."

With three children to raise on her own, Liljana’s health was the last thing on her mind but she could no longer ignore the feeling that something was wrong. Through speaking to her friends, she learnt about the  Albanian Centre of Population and Development (ACDP) clinic. “First, I had the gynaecological visit and after that, for 1 minute, the doctor did the VIA test. The response was immediate, but positive. I was so scared. The doctor was able to calm me down by explaining everything very simply. Everything was going to be all right because this disease was 100% curable.” Liljana underwent treatment for pre-cancerous lesions for two weeks, but the results of the test were still positive. The doctor suggested cryotherapy. “I decided to do cryotherapy, which is very simple and very comfortable. It was the best decision I have made in my life. After two years, I am completely recovered. I am very grateful to the ACDP clinic, they saved my life.” What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  A happier & healthier life Now Liljana is having routine checks following the advice of the doctor and maintains regular contact with the clinic. “I know that whenever I need advice, I can call the doctor or the nurse and always get a response.” Liljana told all her friends about the VIA procedure and recommended many of them to the clinic in Tirana. Since her successful treatment, Liljana has noticed the relationship with her children has also improved. “My 15 years daughter says that now I smile more than before. She has noticed that before the test I was sad, because I was thinking bad things about my life. This experience has helped me also to talk openly with my daughter about the reproductive and sexual life and teach her to take care of herself. The other two are boys, 13 and 10 years old, but I promise I will talk to them about the importance of having a healthy reproductive and sexual life.”

Eleanor* at the clinic

"Nowadays I feel much better and I am clean from signs of cancer”

Eleanor* is a mother of three children, she lives in Vlora, a city in south Albania. Eleanor and her children rely on her husband's modest income to survive. She is only too aware that her economic situation is a major barrier for her to access healthcare. Most treatments are referred to the capital, Tirana, or are at private clinics; incurring costs she simply cannot afford. When she heard about the Aulona Centre offering free PAP tests, she booked an appointment. “I have always admired women who take care of their health. Taking care of ourselves is decisive for our family wellbeing, children and relatives. But in our areas, it is difficult to get proper services, especially for reproductive health”, she says. Eleanor’s first pap smear was in 2012, the results came back negative. The doctor informed her that she had to come back in 3 years for another test.  In 2015 she returned to the center, convinced that the results would again be negative. The results came back positive. “I remember the doctor underlining my name with red pen. She said to go to Tirana for further treatment because they had better equipment and staff there.” The encouragement from the staff of Aulona center helped Eleanor decide on her next steps.  “While making my decision, I had this vision of my name underlined with red colour, which was an alert sign. So I contacted a doctor in Tirana and had the surgery in 2016. Nowadays I feel much better and I am clean from signs of cancer.” From a client to an activist  Her experience with Aulona center has made Eleanor an ardent activist of reproductive health for women. “Every cousin in my family knows about my case. I encourage them to have a PAP screening although they don’t have any concern. For some of them is a matter of shame, because they think if you don’t have any problem, why you should expose intimate parts of your body to the doctor? I challenge them asking what it is more difficult: when the doctor says: Madam, you have few years to live left or just booking a visit? They listen to me more now because they see I recovered.” Through her activism, Eleanor has recently become aware of the VIA testing method and is enthusiastic about it. “The most wonderful thing about this new method [VIA] is that I don’t have to wait 3 weeks for the response. I recall the waiting period for the second test with my eyes attached to the telephone screen. Why are they not calling? Is there anything wrong with my results? VIA avoid all this anxiety, and you can start the therapy immediately.”   Eleanor feels confident about her knowledge on sexual and reproductive health. Her own experiences allows her speak more openly with her 20-year-old old daughter, reminding her of the importance of regular screening. “The disease does not ask if you are rich or poor. I could have let myself at risk, but when interventions are at the right time, they save lives.” What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  *Name has been changed

21-year-old Artemisa Seraj volunteer and activist

"I do this work because I believe every girl and woman’s life counts.”

Scrolling through her social media page, 21-year-old Artemisa Seraj stumbled across a post from the Aulona Center offering seminars and workshops on sexual and reproductive healthcare for young people and students. Feeling like she had the opportunity to learn something about a subject that she and her friends rarely discuss, she decided to attend one of the seminars. “I found the information very interesting because we don’t talk very much about these things with my friends. It is still a taboo. On the other hand, we know that the sexually transmitted infections are being spread among youngsters, but we don’t know how to protect ourselves.” The first seminar went so well, Artemisa decided that she wanted to become a volunteer. “I like very much to pass the information on to others. So, I discussed with the Enela, the director of the center, to become a volunteer and here I am today.” Empowering women & girls Since becoming an activist Artemisa is now even more passionate about the importance of comprehensive sexuality education (CSE) for young people, gender equality and women’s rights. “I have known many other girls and women in our outreach activities that have no information about their reproductive and sexual life. Especially, girls from rural areas are the most deprived of this kind of information. The health centers have no staff or adequate equipment for gynaecological visits. Aulona center has high standards of friendly services for teenagers and youngsters, so you feel safe and not prejudiced against. Confidentiality is very high here and the doctors are very qualified. In the young groups, you feel like a community, you can speak openly about your concerns.”  Artemisa hopes that by distributing information to women and girls, it is empowering them as well giving them an opportunity to fight for their own rights. “I do think that even a single person can contribute to the improvement of the situation regarding CSE. It is an instinct now, whenever I meet a woman, I talk about the center.  My greatest satisfaction as an activist is seeing them coming to the center for a [health] visit or for counselling, because this means that my work has paid off. I do this work because I believe every girl and woman’s life counts.”

Hatixhe Gorenca is a nurse at the Albanian Centre of Population and Development (ACPD) clinic in Tirana

"Many of the women we work with have no health insurance"

Hatixhe Gorenca is a nurse at the Albanian Centre of Population and Development (ACPD) clinic in Tirana. She joined the center in 2013 with 39 years of experience working in gynaecology. During her time as a nurse, she has seen vast improvements in access and services for cervical cancer screenings. However, she says that there is a considerable number of women in rural areas that face difficulties in accessing healthcare, and some that cannot access it at all. Rural women & access “The ACPD clinic is crucial for these [rural] women, because the healthcare we offer through gynaecological visits, includes counselling, pap smears, colposcopies and recently VIA tests and cryotherapy. Services that are totally missing in their areas. What they appreciate most is the mobile clinic in the outskirts of Tirana, because they have an opportunity to meet with doctors and to get information about their health status. We do approximately 17-18 visits per day and the number is always increasing”, Hatixhe says.  The clinic has developed a reputation for offering youth-friendly healthcare and information. The confidential and open approach of the clinic is providing access for girls to comprehensive sexual education at an early age, without fear of discrimination or embarrassment. When the clinic first introduced VIA testing in 2017, as an alternative way for the screening of cervical cancer, it was welcomed by the women. “The reason is that compared to pap smears, VIA gives an immediate response on the health of the cervical cells,”  Hatixhe explains. “The other reason is economical. Many of the women we work with have no health insurance, as such they cannot benefit from the free tests at maternity hospitals. Furthermore, some of them are vulnerable women and they feel safe when they can get free information and healthcare at our clinic.” What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap smears. Results from VIA are available immediately so women can be screened and treated in one single visit.    ACDP outreach activities enable the staff to give the information where the women are: in the streets, in their workplace, in their homes. Hatixhe has witnessed a growing interest in women regarding their reproductive health in recent years. The number of women that walk through the clinic doors is proof of that. During the 2016-2017 over 3,000 women received healthcare services from the clinic.  Encouraging other women  “I myself am learning a lot in the clinic”, Hatixhe says. “VIA test was a new technique even for me, but it is so simple, I can now train the staff at the health centers. I can tell you that they are very enthusiastic and responsive because VIA is very easy to apply. Since many health centers have no gynaecological bed for their visits or low capacities to apply PAP tests which require specialized personnel, VIA is much more suitable for their conditions, because it can be done by the nurses or midwifes themselves.” Hatixhe is impressed by the reaction of women taking VIA tests. “As a nurse with long experience in the health sector, I have received many thanks from patients, but the hugs we get from these women are heartfelt. After 2-3 years of coming and going to different institutions, finally, they have found a method which can detect pre-cancer cells, get treatment for it and now they are totally healthy.”  Hatixhe says that many women have been encouraged to book a VIA test through hearing about it from a friend or relative who had a positive experience at the clinic. “After the first visit, the women return with other women who are interested to do the tests. This is wonderful.” 

Youth volunteers handing out information on sexual & reproductive healthcare in Albania.
19 December 2018

Revolutionizing access to cervical cancer screening in rural Albania

Albania is home to 2,870,324 people, approximately half are women and girls. The political events of the 1990s saw Albania become one of the poorest countries in Europe, leaving the nation to try and rebuild their fractured infrastructure. Including an ill-equipped healthcare system, that is still struggling to keep up with demand. Today, Albania benefits from a universal healthcare system, but not without its issues. Albania has the lowest proportion of doctors for its population in Europe - 115 per 100,000, meaning those that live in hard to reach and rural areas face additional barriers to life-saving healthcare. Barriers to healthcare Cervical cancer is the 4th most common female cancer in women aged 15 to 44 years in Albania. Although Albania has a national cervical cancer screening programme, it is not widely promoted, and the service is not always available. Relying on the traditional method of screening – the Pap smear – further complicates women’s access, as the majority of health centers lack basic equipment and resources including gynaecological beds and specialist gynaecologists. The long processing times from the initial test to receiving the results adds further complication to women seeking cervical cancer screening. The situation worsens when it comes to rural areas, where 45 percent of the population lives. Many women also face financial barriers when it comes to accessing healthcare.  Increasing women’s access In December 2015, IPPF’s Member Association, the Albanian Centre of Population and Development (ACPD), began a campaign to increase women’s access to healthcare in rural areas. An alternative, faster and cost-effective cervical cancer screening tool and treatment plan were developed – a method known as VIA and Cryotherapy. What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  Working with the Ministry of Health and Social Protection (MoHSP), ACPD advocated for the nationwide inclusion of VIA and cryotherapy to Albania’s national cervical cancer screening program. There are many benefits to VIA, that include:   Relatively inexpensive compared to pap smears A simple process that can be done with minimal equipment Results and treatment (cryotherapy) for pre-cancerous cells are immediate Quick turnaround time means fewer women lost in follow-up Can be performed by a wide range of medical professionals after training   Since the launch of the campaign in 2015, ACPD has reached over 1000,000 women and men through their clinics, mobile outreach, videos and social media.  520 were young people and 390 men and women were based in rural areas. Between 2016-2017 3,274 women were screened and 70 healthcare providers were trained to give VIA tests and Cryotherapy treatment. So far, the results have been encouraging. Mrs. Brunilda Hylviu, head of ACPD says that “this cost-effective cervical cancer screening tool is well-accepted, and most women were thrilled by the idea that the pre-cancerous lesions could be screened and eliminated at the same visit. We have seen tears of joy in women’s eyes and got heartfelt hugs from women who have been examined with VIA. Health professionals have a positive attitude regarding VIA because they can see in practice how effective it is with patients.” She says staff working at the health centers are very enthusiastic about VIA seeing the value it has added to the services they provide for their communities.   National action plan for cervical screening For the Albanian Centre of Population and Development, 2018 is the year of advocacy. “What we ask from the Government is first to prepare a National Action Plan for the Screening of Cervical Cancer as other countries in the region did. Second, to include VIA as an effective method proved for screening in rural areas. We do agree that Albania as a European country should aim for highest standards of screening such as HPV, but considering that we still have areas where women live without potable water or electricity, we see VIA as an alternative screening method based on evidence approved by WHO. Our motto is that not a single woman should die from cervical cancer and a good national screening program that reaches every woman can achieve this objective.” The challenges ahead are still big, but Brunilda is hopeful that they can make a difference.  “I am hopeful that we will have a positive result and we will succeed”, she says.

Girls Decide landing image
30 June 2016

Girls Decide

This programme addresses critical challenges faced by young women around sexual health and sexuality. It has produced a range of advocacy, education and informational materials to support research, awareness-raising, advocacy and service delivery.    Girls Decide is about the sexual and reproductive health and rights of girls and young women. Around the world, girls aged 10 to 19 account for 23% of all disease associated with pregnancy and childbirth. An estimated 2.5 million have unsafe abortions every year. Worldwide, young women account for 60% of the 5.5 million young people living with HIV and/or AIDS. Girls Decide has produced a range of advocacy, education and informational materials to support work to improve sexual health and rights for girls and young women. These include a series of films on sexual and reproductive health decisions faced by 6 young women in 6 different countries. The films won the prestigious International Video and Communications Award (IVCA). When girls and young women have access to critical lifesaving services and information, and when they are able to make meaningful choices about their life path, they are empowered. Their quality of life improves, as does the well-being of their families and the communities in which they live. Their collective ability to achieve internationally agreed development goals is strengthened. Almost all IPPF Member Associations provide services to young people and 1 in every 3 clients is a young person below the age of 25. All young women and girls are rights-holders and are entitled to sexual and reproductive rights. As a matter of principle, the IPPF Secretariat and Member Associations stand by girls by respecting and fulfilling their right to high quality services; they stand up for girls by supporting them in making their own decisions related to sexuality and pregnancy; they stand for sexual and reproductive rights by addressing the challenges faced by young women and girls at local, national and international levels.

Packard funding project in Benin
05 May 2016

IPPF funds youth-led projects to tackle abortion stigma

As part of our work in tackling abortion stigma, IPPF awards small grants to young people to create projects that would tackle the issue of abortion stigma in their communities. In 2015, small grants were awarded to promising projects submitted by young people in Ghana, Palestine, Spain, Macedonia and Nepal. In 2017, a further six grants were awarded to young people in Guinea, Kenya, Nepal, Puerto Rico, Sierra Leone and Venezuela. In 2019 five more grants were awarded to youth-led projects in Albania, Colombia, Nigeria, Spain and Tanzania. These documents give more information about what these projects set out to do, their methods and the results.

Albanian Center for Population and Development

ACPD is a non-for-profit organization, established in January 1993 that works for improvement of policies, legislation, the right of information and services for issues concerning population and development, including reproductive health. There are four strategic directions of ACPD work:  

  • Advocacy on further improvement of SRHR policies, gender equality including women and youth participation in decision making processes at central and local level.
  • Empowerment of women and youth on their SRHR rights through awareness and education, by promoting gender equality and broad society support
  • Qualitative and accessible integrated services, which are gender sensitive and address women and young people needs
  • ACPD maintains the leadership in promoting the broad partnership and cooperation on issues of SRHR through sustainable programmes and increase number of volunteers and supporters.

ACPD is led by a board of recognized experts in the field of SRHR, social issues, gender, migration etc. It has a permanent staff around 15 people, who are qualified specialists. The organization has three multi-functional centres located in (Centre of Albania) Tirana, (South) Vlora and (North) Shkodra with 206 active members and activists.

The SRH services include contraceptive care, cervical cancer prevention, HIV rapid test and counselling, pre and post abortion care, pre- and post-natal care, ultrasound examination and counselling, gender based violence counselling, sexual transmitted infections counselling, and relationships counselling and referrals. The organization has delivered a very extensive rights-based and gender-sensitive comprehensive sexuality education for children/young people in formal and informal setting. Approximately 1000 teachers and 1500 pupils are trained on CSE all over the country. ACPD and other NGOs have played an important role in advocating for sexuality education.

The ACPD also provides a gateway for dialogue, networking and cooperation among stakeholders and partners on regional, national and local levels.

Bruna Hylivu - Albania
07 April 2020

COVID-19 Impact: What we know so far – Albania

An interview with Bruna Hylviu, the Executive Director of Albania Center of Population and Development (ACPD) on the impact of COVID-19. How has Albania been affected by coronavirus? Albania has entered COVID-19 lockdown since 13 March. According to the government war law, there are restrictions that allow people and cars to only travel between 5am until 1pm from Monday to Friday. Essential activities are also limited only to these designated hours. As of 7 April, there are 377 infected people and 21 deaths. The state has limited budget, human resources and medical supplies to address the situation related to COVID-19, but recently a fund from the EU and donations from other countries have been dedicated to COVID-19 response. What impact is coronavirus having when it comes to sexual and reproductive health services? Following the containment strategy implemented for the entire country, for almost three weeks the government has announced today the introduction of mass testing for the most at-risk populations and contacts of confirmed cases in order to manage the virus outbreak. However, the government have to make public announcements related to financial plans to strengthen COVID-19 preparedness and response. The virus outbreak is stretching an already strained health system and raises question over whether everyone can get equal access to treatment. The entire healthcare system is somehow working within the timetable set by the government, limiting the ways to access healthcare services including sexual and reproductive health. Until now there have been no clear decisions/statements about the financial and operational measures taken or to be taken by the government to address the situation (for example, a dedicated budget, number of beds available/plans to buy kits, laboratories, respiration devices etc.).  Albania’s main strategy at the moment is the containment of the entire population, a poor system of case-finding, contact tracing management, and testing. What services have been the worst hit so far? HIV and STI tests, contraception, abortion care, cervical cancer screening and testing, gynaecological visits, and sexual and gender-based violence services are all in decrease. This is for several reasons, from limited opening hours, lack of precautions and protocols in place, lack of demand related to fear of people getting the virus, and lack of trust in the healthcare system protection measures in place. Are frontline staff still able to go into the community? There are frontline healthcare workers that provide COVID-19-related services for the entire population, but they continue to work in very challenging conditions; they are concerned about the shortage of personal protective equipment that might endanger their life. The service is centralized in capital city, Tirana. We have closed our static and mobile clinics for the safety of our healthcare staff, our vulnerable clients, and entire community. We are providing SRH (sexual and reproductive health) counselling via Skype and WhatsApp, and sensitization of the public about the effects of COVID-19 to SRH and gender inequalities through our website and social media. We are also providing information and articles about how coronavirus is affecting victims of gender-based violence, tips for pregnant women, how COVID-19 impacts people seeking abortion care etc. We are referring to the World Health Organization's website and to IPPF resources to disseminate messages among the community, partners through the web, social media and email. What are you doing to keep providing services to people in Albania? We are putting efforts to deliver SRH services for emergency situations, for women who have undergone abortions, and victims of gender-based violence. We are also focusing on contraceptive care, people who need HIV testing and counselling or pregnancy tests, as well distributing condoms for the most at-risk populations. These are offered by the nurses in the clinics or outreach people who schedule their time based on the demand of our beneficiaries and restrictions set by the government and respecting social distancing, equipped with masks and gloves. Otherwise all counselling and consultation services are transferred online via WhatsApp, Skype and phone provided by the gynaecologists of two ACPD clinics. What message do you have for people and your staff in Albania when it comes to sexual and reproductive health and rights (SRHR) and coronavirus? We are carrying on our work together through advocacy, information, and education to ensure access to SRH and to respond to gender-based violence at a time when women and girls need these services most. I want to thank staff and volunteers for making great efforts to enable SRH care even in the time of COVID-19.

Liljana

"I decided to do cryotherapy. It was the best decision I have made in my life."

With three children to raise on her own, Liljana’s health was the last thing on her mind but she could no longer ignore the feeling that something was wrong. Through speaking to her friends, she learnt about the  Albanian Centre of Population and Development (ACDP) clinic. “First, I had the gynaecological visit and after that, for 1 minute, the doctor did the VIA test. The response was immediate, but positive. I was so scared. The doctor was able to calm me down by explaining everything very simply. Everything was going to be all right because this disease was 100% curable.” Liljana underwent treatment for pre-cancerous lesions for two weeks, but the results of the test were still positive. The doctor suggested cryotherapy. “I decided to do cryotherapy, which is very simple and very comfortable. It was the best decision I have made in my life. After two years, I am completely recovered. I am very grateful to the ACDP clinic, they saved my life.” What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  A happier & healthier life Now Liljana is having routine checks following the advice of the doctor and maintains regular contact with the clinic. “I know that whenever I need advice, I can call the doctor or the nurse and always get a response.” Liljana told all her friends about the VIA procedure and recommended many of them to the clinic in Tirana. Since her successful treatment, Liljana has noticed the relationship with her children has also improved. “My 15 years daughter says that now I smile more than before. She has noticed that before the test I was sad, because I was thinking bad things about my life. This experience has helped me also to talk openly with my daughter about the reproductive and sexual life and teach her to take care of herself. The other two are boys, 13 and 10 years old, but I promise I will talk to them about the importance of having a healthy reproductive and sexual life.”

Eleanor* at the clinic

"Nowadays I feel much better and I am clean from signs of cancer”

Eleanor* is a mother of three children, she lives in Vlora, a city in south Albania. Eleanor and her children rely on her husband's modest income to survive. She is only too aware that her economic situation is a major barrier for her to access healthcare. Most treatments are referred to the capital, Tirana, or are at private clinics; incurring costs she simply cannot afford. When she heard about the Aulona Centre offering free PAP tests, she booked an appointment. “I have always admired women who take care of their health. Taking care of ourselves is decisive for our family wellbeing, children and relatives. But in our areas, it is difficult to get proper services, especially for reproductive health”, she says. Eleanor’s first pap smear was in 2012, the results came back negative. The doctor informed her that she had to come back in 3 years for another test.  In 2015 she returned to the center, convinced that the results would again be negative. The results came back positive. “I remember the doctor underlining my name with red pen. She said to go to Tirana for further treatment because they had better equipment and staff there.” The encouragement from the staff of Aulona center helped Eleanor decide on her next steps.  “While making my decision, I had this vision of my name underlined with red colour, which was an alert sign. So I contacted a doctor in Tirana and had the surgery in 2016. Nowadays I feel much better and I am clean from signs of cancer.” From a client to an activist  Her experience with Aulona center has made Eleanor an ardent activist of reproductive health for women. “Every cousin in my family knows about my case. I encourage them to have a PAP screening although they don’t have any concern. For some of them is a matter of shame, because they think if you don’t have any problem, why you should expose intimate parts of your body to the doctor? I challenge them asking what it is more difficult: when the doctor says: Madam, you have few years to live left or just booking a visit? They listen to me more now because they see I recovered.” Through her activism, Eleanor has recently become aware of the VIA testing method and is enthusiastic about it. “The most wonderful thing about this new method [VIA] is that I don’t have to wait 3 weeks for the response. I recall the waiting period for the second test with my eyes attached to the telephone screen. Why are they not calling? Is there anything wrong with my results? VIA avoid all this anxiety, and you can start the therapy immediately.”   Eleanor feels confident about her knowledge on sexual and reproductive health. Her own experiences allows her speak more openly with her 20-year-old old daughter, reminding her of the importance of regular screening. “The disease does not ask if you are rich or poor. I could have let myself at risk, but when interventions are at the right time, they save lives.” What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  *Name has been changed

21-year-old Artemisa Seraj volunteer and activist

"I do this work because I believe every girl and woman’s life counts.”

Scrolling through her social media page, 21-year-old Artemisa Seraj stumbled across a post from the Aulona Center offering seminars and workshops on sexual and reproductive healthcare for young people and students. Feeling like she had the opportunity to learn something about a subject that she and her friends rarely discuss, she decided to attend one of the seminars. “I found the information very interesting because we don’t talk very much about these things with my friends. It is still a taboo. On the other hand, we know that the sexually transmitted infections are being spread among youngsters, but we don’t know how to protect ourselves.” The first seminar went so well, Artemisa decided that she wanted to become a volunteer. “I like very much to pass the information on to others. So, I discussed with the Enela, the director of the center, to become a volunteer and here I am today.” Empowering women & girls Since becoming an activist Artemisa is now even more passionate about the importance of comprehensive sexuality education (CSE) for young people, gender equality and women’s rights. “I have known many other girls and women in our outreach activities that have no information about their reproductive and sexual life. Especially, girls from rural areas are the most deprived of this kind of information. The health centers have no staff or adequate equipment for gynaecological visits. Aulona center has high standards of friendly services for teenagers and youngsters, so you feel safe and not prejudiced against. Confidentiality is very high here and the doctors are very qualified. In the young groups, you feel like a community, you can speak openly about your concerns.”  Artemisa hopes that by distributing information to women and girls, it is empowering them as well giving them an opportunity to fight for their own rights. “I do think that even a single person can contribute to the improvement of the situation regarding CSE. It is an instinct now, whenever I meet a woman, I talk about the center.  My greatest satisfaction as an activist is seeing them coming to the center for a [health] visit or for counselling, because this means that my work has paid off. I do this work because I believe every girl and woman’s life counts.”

Hatixhe Gorenca is a nurse at the Albanian Centre of Population and Development (ACPD) clinic in Tirana

"Many of the women we work with have no health insurance"

Hatixhe Gorenca is a nurse at the Albanian Centre of Population and Development (ACPD) clinic in Tirana. She joined the center in 2013 with 39 years of experience working in gynaecology. During her time as a nurse, she has seen vast improvements in access and services for cervical cancer screenings. However, she says that there is a considerable number of women in rural areas that face difficulties in accessing healthcare, and some that cannot access it at all. Rural women & access “The ACPD clinic is crucial for these [rural] women, because the healthcare we offer through gynaecological visits, includes counselling, pap smears, colposcopies and recently VIA tests and cryotherapy. Services that are totally missing in their areas. What they appreciate most is the mobile clinic in the outskirts of Tirana, because they have an opportunity to meet with doctors and to get information about their health status. We do approximately 17-18 visits per day and the number is always increasing”, Hatixhe says.  The clinic has developed a reputation for offering youth-friendly healthcare and information. The confidential and open approach of the clinic is providing access for girls to comprehensive sexual education at an early age, without fear of discrimination or embarrassment. When the clinic first introduced VIA testing in 2017, as an alternative way for the screening of cervical cancer, it was welcomed by the women. “The reason is that compared to pap smears, VIA gives an immediate response on the health of the cervical cells,”  Hatixhe explains. “The other reason is economical. Many of the women we work with have no health insurance, as such they cannot benefit from the free tests at maternity hospitals. Furthermore, some of them are vulnerable women and they feel safe when they can get free information and healthcare at our clinic.” What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap smears. Results from VIA are available immediately so women can be screened and treated in one single visit.    ACDP outreach activities enable the staff to give the information where the women are: in the streets, in their workplace, in their homes. Hatixhe has witnessed a growing interest in women regarding their reproductive health in recent years. The number of women that walk through the clinic doors is proof of that. During the 2016-2017 over 3,000 women received healthcare services from the clinic.  Encouraging other women  “I myself am learning a lot in the clinic”, Hatixhe says. “VIA test was a new technique even for me, but it is so simple, I can now train the staff at the health centers. I can tell you that they are very enthusiastic and responsive because VIA is very easy to apply. Since many health centers have no gynaecological bed for their visits or low capacities to apply PAP tests which require specialized personnel, VIA is much more suitable for their conditions, because it can be done by the nurses or midwifes themselves.” Hatixhe is impressed by the reaction of women taking VIA tests. “As a nurse with long experience in the health sector, I have received many thanks from patients, but the hugs we get from these women are heartfelt. After 2-3 years of coming and going to different institutions, finally, they have found a method which can detect pre-cancer cells, get treatment for it and now they are totally healthy.”  Hatixhe says that many women have been encouraged to book a VIA test through hearing about it from a friend or relative who had a positive experience at the clinic. “After the first visit, the women return with other women who are interested to do the tests. This is wonderful.” 

Youth volunteers handing out information on sexual & reproductive healthcare in Albania.
19 December 2018

Revolutionizing access to cervical cancer screening in rural Albania

Albania is home to 2,870,324 people, approximately half are women and girls. The political events of the 1990s saw Albania become one of the poorest countries in Europe, leaving the nation to try and rebuild their fractured infrastructure. Including an ill-equipped healthcare system, that is still struggling to keep up with demand. Today, Albania benefits from a universal healthcare system, but not without its issues. Albania has the lowest proportion of doctors for its population in Europe - 115 per 100,000, meaning those that live in hard to reach and rural areas face additional barriers to life-saving healthcare. Barriers to healthcare Cervical cancer is the 4th most common female cancer in women aged 15 to 44 years in Albania. Although Albania has a national cervical cancer screening programme, it is not widely promoted, and the service is not always available. Relying on the traditional method of screening – the Pap smear – further complicates women’s access, as the majority of health centers lack basic equipment and resources including gynaecological beds and specialist gynaecologists. The long processing times from the initial test to receiving the results adds further complication to women seeking cervical cancer screening. The situation worsens when it comes to rural areas, where 45 percent of the population lives. Many women also face financial barriers when it comes to accessing healthcare.  Increasing women’s access In December 2015, IPPF’s Member Association, the Albanian Centre of Population and Development (ACPD), began a campaign to increase women’s access to healthcare in rural areas. An alternative, faster and cost-effective cervical cancer screening tool and treatment plan were developed – a method known as VIA and Cryotherapy. What is VIA & Cryotherapy? Show more + Visual inspection of the cervix with acetic acid (VIA) is a process of screening and examining the cervix. Pre-cancerous lesions on the cervix will turn white when the acid is applied.  This simple procedure can be done in a clinic setting without the use of a laboratory and allows for immediate treatment of any pre-cancerous lesions with cryotherapy. Cryotherapy is a gynaecological treatment that freezes and destroys abnormal, pre-cancerous cervical cells. Cryotherapy is not a treatment for cervical cancer. VIA has the potential to revolutionize cervical cancer prevention efforts, particularly in low resource settings, because it eliminates the need for laboratories, transportation of specimens and provides immediate test results.   VIA needs less equipment and fewer specialists than traditional cervical cancer screening methods like Pap tests. Results from VIA are available immediately so women can be screened and treated in one single visit.  Working with the Ministry of Health and Social Protection (MoHSP), ACPD advocated for the nationwide inclusion of VIA and cryotherapy to Albania’s national cervical cancer screening program. There are many benefits to VIA, that include:   Relatively inexpensive compared to pap smears A simple process that can be done with minimal equipment Results and treatment (cryotherapy) for pre-cancerous cells are immediate Quick turnaround time means fewer women lost in follow-up Can be performed by a wide range of medical professionals after training   Since the launch of the campaign in 2015, ACPD has reached over 1000,000 women and men through their clinics, mobile outreach, videos and social media.  520 were young people and 390 men and women were based in rural areas. Between 2016-2017 3,274 women were screened and 70 healthcare providers were trained to give VIA tests and Cryotherapy treatment. So far, the results have been encouraging. Mrs. Brunilda Hylviu, head of ACPD says that “this cost-effective cervical cancer screening tool is well-accepted, and most women were thrilled by the idea that the pre-cancerous lesions could be screened and eliminated at the same visit. We have seen tears of joy in women’s eyes and got heartfelt hugs from women who have been examined with VIA. Health professionals have a positive attitude regarding VIA because they can see in practice how effective it is with patients.” She says staff working at the health centers are very enthusiastic about VIA seeing the value it has added to the services they provide for their communities.   National action plan for cervical screening For the Albanian Centre of Population and Development, 2018 is the year of advocacy. “What we ask from the Government is first to prepare a National Action Plan for the Screening of Cervical Cancer as other countries in the region did. Second, to include VIA as an effective method proved for screening in rural areas. We do agree that Albania as a European country should aim for highest standards of screening such as HPV, but considering that we still have areas where women live without potable water or electricity, we see VIA as an alternative screening method based on evidence approved by WHO. Our motto is that not a single woman should die from cervical cancer and a good national screening program that reaches every woman can achieve this objective.” The challenges ahead are still big, but Brunilda is hopeful that they can make a difference.  “I am hopeful that we will have a positive result and we will succeed”, she says.

Girls Decide landing image
30 June 2016

Girls Decide

This programme addresses critical challenges faced by young women around sexual health and sexuality. It has produced a range of advocacy, education and informational materials to support research, awareness-raising, advocacy and service delivery.    Girls Decide is about the sexual and reproductive health and rights of girls and young women. Around the world, girls aged 10 to 19 account for 23% of all disease associated with pregnancy and childbirth. An estimated 2.5 million have unsafe abortions every year. Worldwide, young women account for 60% of the 5.5 million young people living with HIV and/or AIDS. Girls Decide has produced a range of advocacy, education and informational materials to support work to improve sexual health and rights for girls and young women. These include a series of films on sexual and reproductive health decisions faced by 6 young women in 6 different countries. The films won the prestigious International Video and Communications Award (IVCA). When girls and young women have access to critical lifesaving services and information, and when they are able to make meaningful choices about their life path, they are empowered. Their quality of life improves, as does the well-being of their families and the communities in which they live. Their collective ability to achieve internationally agreed development goals is strengthened. Almost all IPPF Member Associations provide services to young people and 1 in every 3 clients is a young person below the age of 25. All young women and girls are rights-holders and are entitled to sexual and reproductive rights. As a matter of principle, the IPPF Secretariat and Member Associations stand by girls by respecting and fulfilling their right to high quality services; they stand up for girls by supporting them in making their own decisions related to sexuality and pregnancy; they stand for sexual and reproductive rights by addressing the challenges faced by young women and girls at local, national and international levels.

Packard funding project in Benin
05 May 2016

IPPF funds youth-led projects to tackle abortion stigma

As part of our work in tackling abortion stigma, IPPF awards small grants to young people to create projects that would tackle the issue of abortion stigma in their communities. In 2015, small grants were awarded to promising projects submitted by young people in Ghana, Palestine, Spain, Macedonia and Nepal. In 2017, a further six grants were awarded to young people in Guinea, Kenya, Nepal, Puerto Rico, Sierra Leone and Venezuela. In 2019 five more grants were awarded to youth-led projects in Albania, Colombia, Nigeria, Spain and Tanzania. These documents give more information about what these projects set out to do, their methods and the results.

Albanian Center for Population and Development

ACPD is a non-for-profit organization, established in January 1993 that works for improvement of policies, legislation, the right of information and services for issues concerning population and development, including reproductive health. There are four strategic directions of ACPD work:  

  • Advocacy on further improvement of SRHR policies, gender equality including women and youth participation in decision making processes at central and local level.
  • Empowerment of women and youth on their SRHR rights through awareness and education, by promoting gender equality and broad society support
  • Qualitative and accessible integrated services, which are gender sensitive and address women and young people needs
  • ACPD maintains the leadership in promoting the broad partnership and cooperation on issues of SRHR through sustainable programmes and increase number of volunteers and supporters.

ACPD is led by a board of recognized experts in the field of SRHR, social issues, gender, migration etc. It has a permanent staff around 15 people, who are qualified specialists. The organization has three multi-functional centres located in (Centre of Albania) Tirana, (South) Vlora and (North) Shkodra with 206 active members and activists.

The SRH services include contraceptive care, cervical cancer prevention, HIV rapid test and counselling, pre and post abortion care, pre- and post-natal care, ultrasound examination and counselling, gender based violence counselling, sexual transmitted infections counselling, and relationships counselling and referrals. The organization has delivered a very extensive rights-based and gender-sensitive comprehensive sexuality education for children/young people in formal and informal setting. Approximately 1000 teachers and 1500 pupils are trained on CSE all over the country. ACPD and other NGOs have played an important role in advocating for sexuality education.

The ACPD also provides a gateway for dialogue, networking and cooperation among stakeholders and partners on regional, national and local levels.