Public Health in South Eastern Europe

Healing the Crisis: A Prescription for Public Health Action in South Eastern Europe

An annotated bibliography presented by LSHTM, the Open Society Institute, UNICEF, and DFID.

The annotated bibliography comprises key documents identified in the course of the project, including bibliographic information and annotations.

A searchable database, with access to many of the documents, is available here: [Database]

3rd Conference on Public Health Training and Research Collaboration in South Eastern Europe (PH-SEE) (2002). Conference programme. Tirana. Countries, territories and regions: South Eastern Europe

Aarva, P., V. Bjegovic, et al. (2002). Assessment of the Institute of Public Health Network in Serbia, Belgrade. Countries, territories and regions: Serbia and Montenegro
This publication presents the assessment of the quantity and the quality of services rendered by the institutes of public health (IPH) network, the current state of financing and recommendations for the improvement of public health work in Serbia. The data collected by three types of questionnaires, the qualitative interviews during the field visits of 9 IPHs and routine health statistics were validated through triangulation. The results indicated several challenges, such as the absence of the integrated public health policy in Serbia, out of date service structure of the IPHs, the lack of multi-professional personnel and the unclear mechanisms for financing of public health. The key recommendations are related to the development of the national public health strategy, needs for revision of legislation and development of sustainable financing mechanisms based on the clear and transparent principles such as using the performance and the outcomes indicators. The IPHs network sh ould reorient their services to better meet the needs of new public health and strengthen health promotion in the region. The overstaffing of the IPH personnel should be solved by reducing especially the number of administrative staff and the laboratory services of the IPHs should be rationalized. Furthermore there is a need to re-examine the existing programmes of education in public health, while the introduction of the school of public health would positively support the research and development in the public health of Serbia.

Abu-Qare, A. W. and M. B. Abou-Donia (2002). "Depleted uranium - the growing concern." J Appl Toxicol 22(3): 149-52.
Countries, territories and regions: Serbia and Montenegro
Recently, several studies have reported on the health and environmental consequences of the use of depleted uranium. Depleted uranium is a heavy metal that is also radioactive. It is commonly used in missiles as a counterweight because of its very high density (1.6 times more than lead). Immediate health risks associated with exposure to depleted uranium include kidney and respiratory problems, with conditions such as kidney stones, chronic cough and severe dermatitis. Long-term risks include lung and bone cancer. Several published reports implicated exposure to depleted uranium in kidney damage, mutagenicity, cancer, inhibition of bone, neurological deficits, significant decrease in the pregnancy rate in mice and adverse effects on the reproductive and central nervous systems. Acute poisoning with depleted uranium elicited renal failure that could lead to death. The environmental consequences of its residue will be felt for thousands of years. It is inhaled and passed throug h the skin and eyes, transferred through the placenta into the fetus, distributed into tissues and eliminated in urine. The use of depleted uranium during the Gulf and Kosovo Wars and the crash of a Boeing airplane carrying depleted uranium in Amsterdam in 1992 were implicated in a health concern related to exposure to depleted uranium. Copyright 2002 John Wiley & Sons, Ltd.

Adeyi, O. (1998). "Priorities for medium-term development in the health sector of Bosnia and Herzegovina." Croat Med J 39(3): 285-7.
Countries, territories and regions: Bosnia and Herzegovina
In the medium term, the World Bank will work with the Government of Bosnia and Herzegovina, non-government organizations, and international development agencies to complete the reconstruction work already begun. There will be an increased emphasis on developing sustainable health finance regime and establishing a basic health system.

Agani, F. (2001). "msJAMA: mental health challenges in postwar Kosova." JAMA 285(9): 1217.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Agovino, T. (1998). "Dodging bullets while searching for health care in Kosovo." Lancet 352(9141): 1687.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Agovino, T. (1999). "Caring for ethnic Albanians in Macedonia's refugee camps." The Lancet 353: 1701-3.
Countries, territories and regions: Macedonia

Agovino, T. (2001). "Democracy and health care in Serbia." Lancet 357(9262): 1121-2.
Countries, territories and regions: Serbia and Montenegro

Albania Health Reform Project (2001). Towards a healthy country with healthy people. Draft public health and health promotion strategy. Countries, territories and regions: Albania

Albanian Government (2001). National Strategy for socio-economic development. Tirana, Albanian Government. Countries, territories and regions: Albania

Albanian Institute of Health Insurance (2002). Statistical data. Countries, territories and regions: Albania

Albanian Red Cross and French Red Cross (2002). Project on HIV/AIDS prevention in Albania during 2002, Albanian Red Cross, French Red Cross,. Countries, territories and regions: Albania

Alexiev, S. and G. Onchev (2001). "Social, psychological, ethical and cultural aspects of psychiatric practice in Bulgaria." Social Medicine Journal 3: 14-16.
Countries, territories and regions: Bulgaria
The article represents the research of the present state of psychiatric practice in the country. Main results are: low levels of professional interest about the problem, generally positive attitude towards guidelines for GCP among respondents, lack of awareness, concerning some basic psychiatric aspects as supervision, nonhomogeneous views about ethical aspects as informed consent and confidentiality, differences concerning the type of psychotherapy used in the practice - cognitive - behavioral in the group of "juniors" and psychodynamic in the group of "seniors", lower ethical sensitivity of "juniors" concerning diagnostics of psychiatric illness.

Ambor-Hutz, M. M. and K. Knipler (2001). "Stepping back, stepping forward. Woman's health care in Bosnia-Herzegovina." AWHONN Lifelines 5(84): 80-3.
Countries, territories and regions: Bosnia and Herzegovina

American National Red Cross (2000). Technical report on the program "Technical Advisor for measles - Rubella catch up vaccination campaign, November 2000. Tirana, American National Red Cross,. Countries, territories and regions: Albania

Ashford, M. W. and U. Gottstein (2000). "The impact on civilians of the bombing of Kosovo and Serbia." Med Confl Surviv 16(3): 267-80.
Countries, territories and regions: Kosovo, Serbia and Montenegro
Before the 1999 bombing, Kosovo was among the poorest regions in Europe, with low scores on indices of health care. After the war, housing for much of the population is below even basically acceptable standards and health care is disrupted, with serious risk of epidemic diseases. Societal disintegration has led to high levels of stress. In Serbia, also a poor country, which already suffered from high levels of pollution before the war, large amounts of several highly toxic chemicals were liberated into the environment by the bombing. Targeting of electrical generating plant, water treatment facilities, Danube bridges, railways and roads has adverse effects on civilian life, endangers health and seriously affects health care. The military strategy of attack on civilian infrastructures is a war on public health.

Association for Support of Persons with Psychosis "Welcome" ( 2001). FOSIM Annual Report. Psychological and Legal Integration of Handicapped Individuals and their Families into the Society. Annual Project Report. (in Macedonian and English) -. Skopje, Association for Support of Persons with Psychosis "Welcome",. Countries, territories and regions: Macedonia
Short-term and long-term goals (for the whole project duration): emotional support and understanding of individuals suffering from mental illness and their families; solving their social status for successful reintegration and acceptance of those individuals by the society; improvement of ethical principles for providing human rights for the users of psychiatric service; humanization and improvement of the social, psychological and medical treatment for the mentally disabled individuals, creating partnership between the families of the mentally disabled individuals and the mental health professionals, organizing psychoeducation for disabled individuals and their families, organizing crisis situation self-help groups, improvement of the mental health legislation, public information and education for acceptance of this group of individuals by the community, that would contribute to the improvement of their social status. Summary of the present activities: public information and education about the problems of the mentally disabled and their families, education of volunteers for helping mentally disabled individuals. education for users of psychiatric service for selfhelp and for protection of their human rights in all fields, education for families in order to help their mentally disabled member, as well as for selfhelp, systemic family therapy with the families included in the project, legal protection of the benefitiaries of the project, organization of cultural, entertaining and recriational activities. The activities that have been undertaken in the framework of this project, generated obvious changes for the users and their families as well as for the professionals. The obvious results from the Project are also confirmed by the fact that durring the work in the whole therm of the Project none of the users has been hospitalised or treated in the hospital. Due to the publicity given to the Project, the number of the membership of this NGO has evidently encreased. As a particular progress we would lilke to stress that the association established a social club, where mentally disabled persons and their families for the first time have direct contact with the public in general.

ASTRA (2003). Sexual and Reproductive Rights and Health in Central and Eastern Europe (http://www.astra.org.pl/linki-raport.htm, ASTRA. Countries, territories and regions: Eastern Europe

Ayotte, B. (1999). "The crisis in Kosova: systematic attacks on health professionals." J Ambul Care Manage 22(4): 81-5.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Azzam, H. (2000). An Analysis Of Laboratory Needs In The Europe & Eurasia Region, USAID, E&E, EEST, HRHA Division. Countries, territories and regions: Romania, Eastern Europe
The aim of this report is to analyze existing laboratory infrastructure and capacity within the E&E Region based on: three interviews with CAR deputy health ministers; several interviews with other donor agencies such as UNICEF, WHO and the Red Cross in the CAR Region; forty clinical and public health laboratory assessments carried out in four CAR countries (Turkmenistan, Uzbekistan, Kazakhstan and Kyrgyzstan) on TB, STIs, HIV and hepatitis, and eleven clinical laboratory assessments carried out in Romania on both STIs and cervical cancer; looking at national, oblast (region) and rayon (district) level laboratories, and using an assessment tool developed by the author.
The report assesses health systems' and individual laboratory functions, and provides recommendations for USAID. It begins with an overall enumeration of the structure and role of clinical and public health laboratory systems, describing sources of funding, allocation of resources, and procurement mechanisms. The report then analyzes the current situation of clinical infectious disease laboratories highlighting difficulties in human resources, technical expertise, availability of quality reagents and functioning equipment, management, quality control measures, and policy guidelines, ending with recommendations.

Babic-Banaszak, A., L. Kovacevic, et al. (2002). "Impact of War on Health Related Quality of Life in Croatia: Population Study." Croat Med J 43(4): 396-402.
Countries, territories and regions: Croatia
AIM: To present health-related quality of life in post-war Croatia, focusing on the population as a whole rather than on the specific group of people. METHOD: The study was conducted in six Croatian counties in the 1997-1999 period. Three of those counties had been directly affected by the 1991-1995 war. The sample consisted of 1,297 randomly selected respondents aged 18 years and older. The questionnaire was anonymous, consisting of questions on sociodemographic characteristics of respondents and Medical Outcome Study 36-item short-form health survey (SF-36). SF-36 comprised the following nine subscales: physical functioning (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role-emotional (RE), mental health (MH), and health transition (HT). RESULTS: Mean subscale scores for the areas directly affected by war were PF 64.21; RP 52.70; BP 59.35; GH 49.02; VT 49.52; SF 68.29; RE 63.02; MH 57.95; HT 41.28; and for the areas not affected by war were PF 65.35; RP 62.01; BP 61.79; GH 50.45; VT 49.40; SF 71.41; RE 74.11; MH 60.33; HT 45.14. The two areas differed significantly in RP (p<0.001), SF (p=0.035), RE (p<0.001), MH (p=0.038), and HT (p=0.003). Respondents living in the areas directly affected by war achieved lower total health-related quality of life scores. Younger respondents, respondents with secondary education, and those with lower income were the groups mostly affected by war. CONCLUSION: War affects self-perceived health, physical ability, and emotional and mental health of the entire population affected by war, especially younger age groups, those with lower education, and lower income.

Babic-Bosanac, S., L. Kovacevic, et al. (2001). "The Croatian health survey - patient's satisfaction with medical service in primary health care in Croatia." Coll Antropol 25(2): 449-58.
Countries, territories and regions: Croatia

The aim of the study was to investigate patient satisfaction with nurses and general practice organization in Croatia. A total of 2,252 patients 18 years of age and over from 47 randomly selected general practices were included in the study. 72.1% of patients were satisfied with nurses and general practice organization. Older and less educated patients were generally more satisfied. Patients were more pleased with nurses' behavior (81.9%) than with practice organization (62.3%). Factor analysis revealed two underlying discriminates of patient satisfaction--"positive attitude towards the nurse" and "inaccessibility of practice". The former discriminate emphasized a great potential of nursing, which should be taken into consideration in the transformation of health care system in Croatia.

Bagaric, I. (2000). "Medical Services of Croat People in Bosnia and Herzegovina during 1992-1995 War: Losses, Adaptation, Organization and Transformation." Croat Med J 41(2): 124-140.
Countries, territories and regions: Bosnia and Herzegovina
During the 1992-1995 war in Bosnia and Herzegovina (BH), Croatian people in BH had 19,600 (2.6%) killed and 135,000 (17.6%) displaced persons, and 222,500 (28.9%) refugees. They lost around two thirds of both physicians and other health personnel, and were left with 8. 5% of prewar patient beds. Fortunately, the organized defence against Serbs was initiated in time and Croats defended the territories where they formed majority. The first defense unit established was the Medical Corps Headquarters (MCH), caring for soldiers and civilians alike. The MCH was soon incorporated in the Croatian Defense Council (CDC, armed forces of Croatian people in BH).The MCH had two chains of command. One went through the district commanders of medical services and their subordinated physicians to paramedics in military units, and the other directly to the commanders of 14 war hospitals. After its formation in 1993, the Ministry of Health took the jurisdiction over the civilian medical services and after the Washington Peace Agreement (April 1994) over the war hospitals, too, whereas the medical services within military units remained under control of the Ministry of Defense. Dayton Peace Agreement divided BH into the Federation of BH and Republic Srpska, each with their own army. The Federation of BH Army is composed of the CDC and Bosniac-controlled Army of BH, with overall numerical ratio 1:2.3 for Bosniacs, and organized in accordance with NATO standards. Military medical services are provided by the Logistics Sector of both Ministry of Defense and Military Corps Headquarters (Joint Command).

Bakran, Z., A. Bobinac-Georgievski, et al. (2001). "Medical Rehabilitation in Croatia - Impact of the 1991-1995 War: Past Problems, Present State, Future Concerns." Croat Med J 42(5): 556-64.
Countries, territories and regions: Croatia

Balabanova, D. and M. McKee (2002). "Access to health care in a system transition: the case of Bulgaria." Int J Health Plann Manage 17(4): 377-95.
Countries, territories and regions: Bulgaria
Throughout the 1990s, the Soviet-style model in central and eastern Europe that provided free health services has been subject to radical reforms. Socio-economic inequalities have also increased but there is little information on inequalities in health care utilization. This paper examines the pattern of illness behaviour in Bulgaria, seeking evidence of inequalities in access to services and eliciting users' pathways to care. DESIGN: Analysis drew on a representative population survey in Bulgaria (1997). The financial determinants of service use were tested in a multivariate model adjusted first for age, and then for age, marital status and self-reported health. In-depth interviews with users and providers addressed pathways to care, use of connections and other informal strategies to obtain care. RESULTS: As expected, rates of illness vary with income, with highest rates among the poor. After adjustment for illness, consultation rates are relatively equal across income leve ls, with the exception of worse-off women who tend to consult more. For first contact, there are few differences according to income, with the better off preferring secondary level. Pathways slightly differ, with women more often treated in primary care. Private sector utilization is low. Qualitative research reveals well-established strategies to obtain more advanced care, including use of connections, informal payments and use of emergency services. CONCLUSIONS: An apparent lack of inequalities in access to care conceals a more complex picture in which income and gender influence the pathways taken through the system.

Balabanova, D. and M. McKee (2002). "Understanding informal payments for health care: the example of Bulgaria." Health Policy 62(3): 243-73.
Countries, territories and regions: Bulgaria
Throughout the 1990s, in response to funding deficits, out-of-pocket payment has grown as a share of total expenditure in countries in transition. A clear policy response to informal payments is, however, lacking. The current study explores informal payments in Bulgaria within a conceptual framework developed by triangulating information using a variety of methodologies. OBJECTIVE: To estimate the scale and determinants of informal payments in the health sector of Bulgaria and to identify who benefits, the characteristics and timing of payments, and the reasons for paying. DESIGN: Data were derived from a national representative survey of 1547 individuals complemented by in-depth interviews and focus groups with over 100 respondents, conducted in Bulgaria in 1997. Informal payments are defined as a monetary or in-kind transaction between a patient and a staff member for services that are officially free of charge in the state sector. RESULTS: Informal payments are relatively common in Bulgaria, especially if in the form of gifts. Informal cash payments are universal for operations and childbirth, clear-cut and life-threatening procedures, in hospitals or elite urban facilities or well-known physicians. Most gifts were given at the end of treatment and most cash payments-before or during treatment. Wealthier, better educated, younger respondents tend to pay more often, as a means of obtaining better-quality treatment in a de facto two-tier system. Since the transition, informal payments had become frequent, explicit, solicited by staff, increasingly in cash, and less affordable. Informal payments stem from the low income of staff, patients seeking better treatment; acute funding shortages; and from tradition. Attitudes to informal payments range from strongly negative (if solicited) to tolerant (if patient-initiated), depending on the circumstances. CONCLUSIONS: The study provides important new insights into the incidence and nature of informal p ayments in the health sector in Bulgaria. Payments were less than expected, very complex, organised in a chaotic, although adaptive, system, and relatively equitable. The timing of payment and the presence of compulsion is a key factor in distinguishing between informal payments given in gratitude or as a bribe, and the latter are seen as problematic, needing to be addressed. Paying informally appeared to be a product of socio-economic reality rather than culture and tradition. The study showed that the principle of comprehensive free coverage existing in Bulgaria until 1989 has been significantly eroded. Initiating a public debate on informal payments is important in a health care reform process that purports to increase accountability.

BAPID and Inclusion Europe (2001). Human Rights for Persons with intellectual Disability. Country Report. Bulgaria. Brussels, BAPID
Inclusion Europe. Countries, territories and regions: Bulgaria

Bara, A.-C., W. J. A. van den Heuvel, et al. (2002). "Reforms of Health Care System in Romania." Croat Med J 43(4): 446-452.
Countries, territories and regions: Romania
AIM: To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. METHOD: We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of the health care system. RESULTS: The reforms of the health care system in Romania have been realized in a rather difficult context of scarcity of financial and human resources. The Gross Domestic Product spent on health care in 2000 was 4% and the number of physicians in 1999 was 42,975. The main changes due to the legislative reforms have been the introduction of a new social health insurance and strengthening of the position of family physicians. Negative effects of the reforms have been the decrease in health care accessibility and growing inequity in utilization of health care services. Health care users still pay physicians under-the-table, and have more out-of-pocket health car e expenses. CONCLUSION: Future reforms in Romania should encourage the positive effects of current reforms: free choice of physician, autonomy of the primary health care system, and increasing financial resources for the health care system.

Barath, A. (2002). "Children's well-being after the war in Kosovo: survey in 2000." Croatian Medical Journal 43(2): 199-208.
Countries, territories and regions: Kosovo, Serbia and Montenegro
To assess special health and psychosocial needs of Albanian children in Kosovo shortly after the dramatic ethnic conflict in this part of former Yugoslavia in 1999. METHODS: The survey included representative samples of school-age children (n=813), parents (n=41), and teachers (n=31) from six public schools in Prishtina and surrounding area. The measuring instruments included a standardized inventory of children's coping behavior in stressful situations (Ryan-Wegner Coping Style Inventory, SCSI), and survey questionnaires for children, parents, and school teachers, which were also used in a parallel study in Bosnia and Herzegovina (Sarajevo) on comparable survey samples. The study was accomplished in April 2000, ie, only a few months after the crisis in Kosovo. RESULTS: At the time of the survey, many children in Prishtina and surrounding area lived in unhealthy and dangerous physical environment. There were frequent lack of electricity (74%), lack of safe drinking water (68% ), garbage on the streets (63%), and firearms, explosive devices, and mine fields in close environment (45%). Many of them showed signs and symptoms of ill health, including frequent headaches (60%), stomach ache (41%), frequent high fever (32%), and sleeplessness (18%). Most of them felt unsafe on the streets (61%). Many of them had rather unhealthy eating habits, such as not having breakfast regularly (16%) or not having a morning snack (60%). Three major groups of stressors were identified as having impact on children's health and psychosocial well-being in Kosovo, as follows: 1) lack of cultural and social security resources at home and in the community at large (20% of common variance explained); 2) poor physical and mental health conditions (14% of common variance); and 3) school-related stressors (11% of common variance). Similarly, parents and teachers also lived and worked under stressful life conditions. Many parents feared the impact of traumatic war experiences o n children's health (54%), and school teachers noticed high rates of children's learning and behavioral disorders (84%). Factor analysis of the SCSI proved the hypothesis that in stressful situations children tend to use two major coping strategies: either active, ie, object-focused coping (13% of variance explained) or passive, ie, self-focused coping (10% of variance explained), the later being more typical for younger children. The pattern of stressors and coping behaviors were similar to stressors impacting physical and mental health of children in Sarajevo, although there were a number of culture-specific differences. CONCLUSION: Environmental, educational, and social conditions must be respected in assessing impact of war and conflict on children. Promotion of solidarity, tolerance, and mutual support among children from different ethnic and cultural backgrounds should be encouraged.

Barath, A. (2002). "Psychological Status of Sarajevo Children after War; 1999-2000 Survey." Croat Med J 43(2): 213-220.
Countries, territories and regions: Bosnia and Herzegovina
AIM: To make a survey of children's health and psychosocial needs after the 1992-1995 war in Sarajevo, Bosnia and Herzegovina. METHODS: Representative samples of school-age children (n=310) from 6 public schools in the Sarajevo Canton, their parents (n=280), and teachers (n=156) were surveyed by means of self-administered questionnaires and standardized psychometric scale (Ryan-Wengers Schoolagers Coping Strategies Inventory). The survey was conducted in October-November 1999, approximately four years after the war. RESULTS: At the time of survey, well-being of children in Sarajevo was still heavily impacted by many various unhealthy life conditions and psychosocial stressors. Many school-age children lived in unhealthy and dangerous environment, including overcrowded living conditions (40%), unsafe playgrounds (68%), and no access to sports fields (52%). Most felt unsafe on streets (74%), many (73%) coped with one or more school problems, and even 84% were ill at least once during the past 12 months. General poverty was the prime stressor (common variance explained: 23.5%), followed by school- and health-related risks (common variance explained: 17.0%). At the third place were family-associated risk factors impacting children's health and development, such as overcrowded living conditions and lack of social support within their own family (common variance explained: 10.5%). Parents and teachers also lived and worked in stressful life conditions and were concerned for both their children's and their own well-being. Despite all that, most children tended to use healthy strategies in coping with stressful events in their everyday lives. CONCLUSION: The reinforcement of children with positive (healthy) coping skills and strengthening of their social support networks seems to be the most important intervention strategy to help the war-traumatized children in Bosnia and Herzegovina.

Bardehle, D. (2002). "Minimum health indicator set for South Eastern Europe." Croat Med J 43(2): 170-3.
Countries, territories and regions: South Eastern Europe
AIM: The Stability Pact includes a program for the development and reconstruction of training and research in public health for the countries of South Eastern Europe (PH-SEE). One of the identified priorities of national public health development is the definition of a Minimum Indicator Set for all countries of SEE. METHODS: A Task Force of the PH-SEE Network (www.snz.hr/ph-see) has proposed a Minimum Indicator Set on the basis of the list of the 224 indicators of the World Health Organization (WHO) Health for All (HFA) 21 strategy. The indicators selected follow the selection criteria as defined by expert groups of WHO and the European Commission. A meta-database describing the indicators should be established soon. RESULTS: A list of 32 indicators was agreed at a workshop in Ohrid, Macedonia, in September 2001. All indicators are included in the WHO HFA 21 indicator set. Some indicators are related specifically to the SEE post-war situation, such as indicators on suicide an d homicide, literacy rate, average number of calories per person a day, and average number of persons per room. CONCLUSION: After principal agreement of the expert group on the list of indicators, further practical steps are necessary, especially testing the indicators and building a logistic network for realizing the Minimum Indicator Set. This includes a pilot phase, a revision of the Minimum Indicator Set after testing, responsibilities and timelines for data collection and data analysis, and transfer of the project into a continuous surveillance and monitoring system.

Barnabus Foundation (2000). Need Assessment of District (Lagjia) 16 of Tirana, Albania (Presented by Barnabas Foundation for Community Development, February), May 2000. Tirana, Barnabus Foundation for Community Development. Countries, territories and regions: Albania

BASYS and Romanian MInistry of Health (1997). REPEDE - Health Care Reform (Report available in English and Romanian). Countries, territories and regions: Romania
The main goals of this project were to develop and design a coherent mid term strategy of the implementation of the social health insurance law in Romania. The main objective was to define the roles and responsibilities of health system within legislative and regulatory framework.
To meet the challenge of the reform objectives the foreign experts are requested to assist the responsible and authorized actors in the MoH and working groups. Four areas of expertise support were envisaged: institutional reform, financing reform, reimbursement of health services and costs and restructuring health care services.
Additionally the final version of the SOP 97 was reviewed and prepared according to the last changes in the policy of the EU- PHARE and MoH plus the preparation of the TOR for the PHARE future activities.

Beganovic, M., B. Lagerkvist, et al. (1999). "Rehabilitation of war victims in the Federation of Bosnia and Herzegovina with special reference to physical injuries." Med Arh 53(3): 179-80.
Countries, territories and regions: Bosnia and Herzegovina
The number of war victims in need of physical rehabilitation in Bosnia and Hercegovina is not exactly known but less than one per cent of the population. Anyhow physical rehabilitation services needs to be reorganized in the community taking care of about 70-80% of the patients. The rest are partly in need of institutional care, which is also important for training and research purposes. The reorganization of services for the mentally ill is aimed at both war victims and others and reorganized at Community Mental Health Centers. The number of mentally ill war victims is definitely exceeding the number of physically injured from the war.

Belevska, D. (2000). Project implementation report, annual report: Project title: Social and Psychological integration of handicapped individuals and their familites into the Society, Association for Support of Persons with Psychosis "Welcome". Countries, territories and regions: Macedonia

Berdaga, V., S. Stefanet, et al. (2001). Access of the Population of the Republic of Moldova to Health Services. Chisinau. Countries, territories and regions: Moldova
The information presented in the Report is based on the results of a survey conducted in 2000 and contains the description of the access of the population of the Republic of Moldova to health services. This Report contains three main sections: access to health services, costs for the treatment of the last episode of illness and population's willingness to participate in funding health. The first two sections refer to different aspects of the geographic and financial access to health services and to the level of financial protection of the Moldovan population when health problems arise. The last section describes the population's willingness to participate in funding health services, capacity to pay and the preferred methods of payment, reveals the conditions in which the population would agree to pay and the population's attitude toward health insurance. The survey was conducted based on a probability sample of 10,370 households organized in clusters. The collection of data w as realized based on a special questionnaire. The document contains a glossary of specific terms and annexes where methods and results are described.

Bino, S., E. Kakarriqi, et al. (2002). Measles-Rubella Mass Immunization Campaign in Albania, November 2000. Countries, territories and regions: Albania

BIS Healthcare Group (2001). Development of Neonatal Intensive Care Services - Scoping Study, Republic of Macedonia Ministry of Health,. Countries, territories and regions: Macedonia

BIS Healthcare Group and Ministry of Health-World Bank (2001). Review of the obstetric-gynecological services in Macedonia. Health Sector Transition Project. (in Macedonian and English). Countries, territories and regions: Macedonia
This Report has been prepared as part of the Health Sector Transition Project in the Component Basic Health Services as subcomponent for the Perinatal Program with the main objectives: to do situation analysis, needs assessment and to give recommendations for the model of the highest level of obstetric care available for women at all levels in Macedonia. It is important in this regard that the full spectrum of care for women's health is provided and taught in the Clinic for Obstetric and Gynecology at Clinical Center. Cur-rently this includes high-risk obstetrics and gynaecological surgery, oncology, urologic care for women, and reproductive endocrinology and infertility including in vitro fertili-zation. All these services (and training of residents in these specialties) are now provided at a high level of competence and should continue to be supported. The Report gives key observations and recommendations for addressing the main observed priorities; develop patient centred care during labour (patient respect, comfort, support and privacy), patient education, childbirth preparation; organisational and structural change: to establish a sin-gle coherent mechanism for clinical governance, to redistribute resources according to population need, to ensure that there is a clear career path established and that this has solid lines of accountability, to provide the infrastructure policies and procedures and the processes for review of these; nursing education; establish clear standards of care and validation systems (accreditation/re-accreditation), continuous medical education, devel-opment of institutionally suitable, evidence-based protocols, form perinatal protocol committee, protocols for outpatient and in-patient care, improve practices of obstetric ul-trasound; standardized equipment, consumable supplies and maintenance; develop clini-cal governance; improvement of perinatal sata and statistical analysis (maternal mortality data). Chapter 5 ide ntifies the implementation plan and next steps.

BIS/NICARE, Ministry of Health, et al. (2002). Continuous Medication Education (CME) Project for PHC doctors: pilot and rollout phase - Health Sector Transition Project, BIS/NICARE, Ministry of Health, World Bank,. Countries, territories and regions: Macedonia
CME Project (1999-2001) was part of Health Sector Transition Project (HSTP) imple-mented by International Project Unit (coordination, management and procurement of equipment), Ministry of Health, World Bank (Credit IDA No.2889-MK), and BIS/NICARE (technical assistance). The objectives of the CME pilot phase November 1998 - October 2000 were to prepare doctors for the coming reforms and to introduce and establish a deep vocational commitment to the concept of life long learning. The fol-low up program 2000-2001 was designed with three projects within it: a) CME stream: with objectives: to produce a team of Educators who will be able to provide CME to all PHC doctors; to establish permanent institutional arrangements for the continuation of CME. b)Primary Care Specialist Training stream: with objectives: to design a program for primary care specialist training to be approved by the Faculty of Medicine and to pro-duce a plan for its implementation. c)Accreditation and licensing reform stream: the ob-jectives were: to produce a plan for accreditation for the Basic License; for the accredita-tion of specialist training; and for the revalidation of doctors. Major Achievements: "A Strategy for CME for Primary Care Doctors", Memorandum of Understanding Regarding the Development of Primary Care Standards, Program for primary care specialist training approved by the Faculty of Medicine", produced plan for its implementation and Strategy for the School of the PHC and CME. Decision for the establishment of the School for PHC within the Medical School was made, the Memorandum of Understanding has been signed by the Minster of Health, Health Insurance Fund Director and the Dean of the Medical Faculty on 26 December 2001, the by-law for specialisation has been amended. Strategy for accreditation and licensing of the doctors, amended Health Care Law and regulation for the Doctor's Chamber are produced within the accreditation stream. Quan-titati ve indicators: 4 CME Centers, 31 educators, 15 guidelines, 15 short guides, 7 bro-chures, 45 teaching days, 15 day foundation course, 12 second year modules, 15 OSCE stations, web site, 678 foundation course graduates 408 second year graduates, individual equipment delivered to 678 CME foundation course graduates and 110 sets for the clinics (total value 3 million USD $). Conclusion: The concept of life long learning was ac-cepted and institutionalized in Macedonia through the newly established School for PHC.

Bjegovic, V., V. Cucic, et al. (2000). Sexual behaviour of school children and AIDS prevention. Social Science. Rights, Politics Commitment and Action. Proceedings of the 13th World AIDS Conference. Monduzzi. Bologna, International Proceedings Division: 295-298.
Countries, territories and regions: Serbia and Montenegro
This paper represents a part of the results obtained from health behaviour study among school children in Belgrade. Years of life under severe stress and trauma-ridden environment have brought hopelessness, confused values and distrust in future, followed by general negligence towards health and increased risk behaviour of school children, including unsafe sexual practice, higher consumption of alcohol and tobacco. The overall environment of Serbian school children show that there is a strong need for health promotion and education intervention directed to both risk behaviour and psychosocial side of children's lives involving both their parents and school. The objective of this paper was to present attitudes and actual sexual behavior of school children as initiative step of AIDS preventive intervention. There were 2.582 boys and 2.557 girls in the total random sample of children aged 11, 13 and 15 years in Belgrade (1.642, 1.715 and 1.782 respectively). Standardized questio nnaire, as research instrument from WHO research protocol for cross-national survey "Health Behavior in School-Aged Children", contains annex of questions highlighting sexual behavior and attitudes in this field. Obtained data were analyzed by means of descriptive statistics and Chi square test in calculation sex and between age differences. Multiple logistic regression, stepwise method, was used to predict which independent variables characterized the children that already had sexual relations. The results of this study have shown that sexual experience is increasing with age of school children, with presence of gender differences. General attitude toward the reason to start having sex is love, while AIDS and unwanted pregnancy are the main fears to postpone sexual relations. This information is practical indicators and will serve as base for future preventive actions. Analysis of logistic regression model have shown that children answered that they had sexual rel ations are usually boys, more smoking cigarettes, drinking alcohol and have the bigger number of evening coming outs, but less engage in physical activity during their leisure time than their peers.

Bjegovic, V. and B. Metejic (2002). Needs assessment among elderly population in Kragujevac - Baseline study. Belgrade, Progetto Svilupo & Ministry of Social Affairs of the Republic of Serbia. Countries, territories and regions: Serbia and Montenegro
The report presents the baseline study as the first step towards the quality integrated care for elderly population in Serbia. The objective of assessment was the quality of life among elderly, their health behaviour, self-reporting health status, utilization of social and health care services and the level of social cohesion and support. Cross-sectional study was done in 2002, with a questionnaire designed according to the similar international researches. The 5% quota sample adjusted for the age and sex was consisted of 176 elderly from 6 selected local communities in Kragujevac (Central Serbia). According to the marital status there were equal numbers of those respondents who were married or widower/widows, predominantly with primary and secondary education. The commonest problems regarding their health status, organization of everyday life, their functioning, and ways to obtain necessary help they considered as connected to their living conditions in single households, wi th low income from pensions, bad living conditions, low scale of physical activities, low level of health status according to their self-assessment with usually more then 3 diseases which are diagnosed and feeling of dissatisfaction with every day life under condition of low social support. The first five diseases presented among respondents are hypertension, disorders of peripheral circulation, chronic rheumatism, heart failures, kidney and urethra troubles. Utilization of health care services was very low in the last year in the light of the fact that their needs are very high, especially with regards to the home visits by physicians, nurses or social workers.

Bogdanov, L. and A. Jonkova (2002). Evaluation for Effectiveness of Health Insurance in Bulgaria (www.ime-bg.org. Buglaria, Institute for Market Economics. Countries, territories and regions: Bulgaria

Borissov, V. and T. Rathwell (1996). "Health care reforms in Bulgaria: an initial appraisal." Soc Sci Med 42(11): 1501-10.
Countries, territories and regions: Bulgaria

Bulgaria is in the process of re-structuring its health care system from one based on command and control to one founded on pluralism. This paper explores the way this transformation is taking place from the comparative perspective of the health care reforms being implemented in Britain and elsewhere. It draws out the lessons that there may be for Bulgaria based on western European experience and concludes with an assessment of the applicability and desirability of relying on the experience of other countries as a precursor for policy development and formulation in another.

Borrel, A., A. Taylor, et al. (2001). "From policy to practice: challenges in infant feeding in emergencies during the Balkan crisis." Disasters 25(2): 149-63.
Countries, territories and regions: South Eastern Europe
This paper focuses on the health intervention developed in a camp of Albanian-Kosovar refugees, displaced as a consequence of the Balcans war in Kosova. Between May and June 1999, the camp of Kavaje in Albania, received 1,700 refugees, with an average age of 24 years old. During this period, 1904 cases were registered at the primary health care centre settled in the camp. The most frequent causes of consultation were respiratory infections (22%), external causes (21%), skin infections and intestinal diseases (12%). A part of the psychological damage, the population attended didn't present with relevant health problems. Most of the visits to the doctor, related to the difficulties suffered on their way to the camp and to the conditions they were living on.

Bosnjack, D. and A. Marusic (2000). "Croatia: legal regulation of doctors." The Lancet 14(356): 1349-50.
Countries, territories and regions: Croatia
Accompanying changes in the way health services in Croatia are organised has been a significant change in the way the medical profession is regulated. In 1995 the Croatian Medical Chamber was established, with legal powers. The responsibilities of physicians to their patients are spelled out in considerable detail. Most of these responsibilities are matched by provisions in Croatia's criminal law. Croatia has about 10,000 doctors and dentists and since 1998 19 cases have been resolved by the Medical Chamber and its commissions. Public health providers offer protection in medical negligence cases but this could change as more market-oriented health-care provision is introduced. In 1997 and 1998 only 60 malpractice claims under the criminal law were brought and most of those were dismissed.

Bower, H. (1999). "Kosovo to shift emphasis to a primary care system." BMJ 319(7215): 941.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Boyadjiev, M. (2001). Legal Arrangements on Healthcare Institutions in Bulgaria, The European Union and the United States. Comparitive Analysis. Sofia, Open Society Foundation. Countries, territories and regions: Bulgaria

Bozicevic, I. (2002). "Looking beyond the candidate countries. The Stability Pact countries and health." Eurohealth 8(4): 45-6.
Countries, territories and regions: South Eastern Europe

Bozicevic, I. (2002). Report on literature search on health promotion in Croatia and plans for its future development, Health Development Agency. Countries, territories and regions: Croatia

Bozicevic, I. (2003). Consequences of and policy responses to tobacco epidemic in South East Europe - DRAFT. Countries, territories and regions: South Eastern Europe

Bozicevic, I. (2003). Report on the launch of the World Report on Violence and Health in the countries of the Stability Pact. Countries, territories and regions: South Eastern Europe

Bozicevic, I., S. Oreskovic, et al. (2001). "What is happening to the health of the Croatian population?" Croatian Medical Journal 42(6): 601-5.
Countries, territories and regions: Croatia
AIM: To describe the problems in the interpretation of Croatian mortality data and explore possible reasons for the recorded increase in mortality in the 1990-1999 period, particularly related to different methods of collection and estimation of data on deaths and population. METHODS: Numbers of recorded deaths and population estimates were first obtained from the Croatian Institute for Public Health and examined in detail. The Institute used population estimates supplied by the Croatian Statistics Bureau, which included de jure population data (including all Croatian citizens wherever they live) until 1996 and de facto population data (including only population living in Croatia at least for a year, irrespective of citizenship) since 1996. A different set of population estimates based on de facto estimates since 1992 was obtained from the Croatian Bureau of Statistics. We examined trends in age- and sex-specific death rates from major causes in 1990-1999 period, using the mo rtality data from the Croatian Institute for Public Health and both sets of population estimates. Lung cancer as a cause of death was examined in more detail, since it is relatively stable over short periods of time. Interviews were undertaken with key informants to identify the reasons for any discrepancies. RESULTS: In Croatia, relatively stable death rates from lung cancer in men ranged from 84/100,000 in 1990 to 79/ 100,000 in 1995. In 1996, a marked discontinuity appeared in the Croatian data, with a 14% increase compared to 1995 (from 79/100,000 to 91/100,000) and a further increase in 1999 (94/100,000), which is not credible on the basis of the natural history of lung cancer. Analysis of mortality rates with de facto population estimates showed more gradual increase from 1992-1996. Methods used to estimate population and mortality during the 1990s were inconsistent and misleading. At present, it is impossible to be certain about the true level of mortality in Croatia during 1990s, as the numerator (deaths) and denominator (population) were incompatible until 1998. CONCLUSION: Major problems in data collection would have been identified if the investigation of unexpected mortality trends in Croatia in the 1990s had been done. Systematic analysis of health patterns should be done as soon as data from the 2001 census become available. Capacities in public health should be strengthened to make this possible. This issue has received little recognition from the international donor organizations, particularly those that use health data.

Bray, I., P. Brennan, et al. (2000). "Projections of alcohol and tobacco related cnacer mortality in Central Europe." Int J Cancer 87(1): 122-8.
Countries, territories and regions: Eastern Europe
Central European mortality rates for cancer sites related to tobacco and alcohol have increased rapidly in recent decades. From a public health point of view, it is of considerable interest to know whether these past increases in cancer mortality will continue into the future. Cancer mortality rates for the period 1965-1994 in Bulgaria, Czech Republic and Slovakia (analysed together), Hungary, Poland, and Romania were analysed for cancers of the larynx, oral cavity and pharynx, oesophagus, bladder, kidney, and pancreas. Using a Bayesian age-period-cohort approach, we have calculated smoothed observed rates. The effects of period and cohort were extrapolated to estimate mortality projections for 1995-99, 2004-09, and 2005-09. Mortality rates for all sites are projected to increase in most countries. Hungary has the highest projected rates for most sites, and particularly rapid increases are expected for cancers of the oral cavity and pharynx and of the larynx in Hungarian men. The smoothed 1990-94 male mortality rates for these two sites of 16. 32/100,000 and 8.70/100,000, respectively, are projected to reach 35. 17/100,000 for cancer of the oral cavity and pharynx and 14.12/100, 000 for cancer of the larynx by the period 2000-04. For kidney cancer, former Czechoslovakia has the highest observed and projected mortality rates. The smoothed 1990-94 rate of 8.37/100,000 is expected to increase 24% to 10.38/100,000 by 2000-04. Our results indicate that further increases may be expected on top of the already high cancer mortality levels in Central Europe. Policies to reduce alcohol consumption and prevent smoking in younger generations are necessary to reduce mortality as these cohorts age. Copyright 2000 Wiley-Liss, Inc.

Brecher, C., E. Schall, et al. (1998). "Health Management education partnerships: more than technology transer." J Health Adm Educ 16(2): 169-79.
Countries, territories and regions: Albania
This article presents the reflections of three faculty members from New York University based on more than two years of experience in a health management education (HME) partnership with institutions in the Republic of Albania. The most significant point to be shared with colleagues considering similar initiatives in other countries is that aiding other professionals in developing health management education programs involves much more than the transfer of technical information among professionals. Based on experience in Albania, we argue that the development of viable management and policy analysis programs will require assistance to counterparts in Central and Eastern Europe in: (1) building constituencies for these activities among influential leaders and sustaining this support through changes in government; (2) providing models of and motivations for using styles of pedagogy that vary significantly from those now common in this part of the world; and (3) reconciling conf licts between pressures for investments in the largely hospital-based activity of health management and the largely public-health-based needs of relatively poor countries.

Brennan, R. J., C. Vaderrama, et al. (2001). "Rehabilitating public health infrastructure in the post-conflict settling: epidemic prevention and preparedness in Kosovo." Prehospital Disaster Med 16(4): 244-51.
Countries, territories and regions: Kosovo, Serbia and Montenegro
The war in Kosovo in 1999 resulted in the displacement of up to 1.5 million persons from their homes. On the subsequent return of the refugees and internally displaced persons, one of the major challenges facing the local population and the international community, was the rehabilitation of Kosovo's public health infrastructure, which had sustained enormous damage as a result of the fighting. Of particular importance was the need to develop a system of epidemic prevention and preparedness. But no single agency had the resources or capacity to implement such a program. Therefore, a unique six-point model was developed as a collaboration between the Kosovo Institute of Public Health, the World Health Organization, and an international, non-governmental organization. Important components of the program included a major Kosovo-wide baseline health survey, the development of a province-wide public health surveillance system, rehabilitation of microbiology laboratories, and the dev elopment of a local capacity for epidemic response. While all program objectives were met, important lessons were learned concerning the planning, design, and implementation of such a project. This program represents a model that potentially could be replicated in other post-conflict or development settings.

Brown, V. J. (1999). "The worst of both worlds: poverty and politics in the Balkans." Environ Health Perspect 107(12): A606-13.
Countries, territories and regions: South Eastern Europe
The Balkan region has a grim history in terms of environmental health. Obedience to imperatives to develop heavy industry, factory farming, and militarization led to pollution of air, water, and food by heavy metals, radioactivity, pesticides, and fertilizers. Yet the benefits of modernization and technological sophistication, such as a higher standard of living and progressive health care, have largely eluded these nations. In this sense, they embody the worst of both worlds, suffering from both diseases of industrialization and those of rural poverty. The crumbling of communist governments has left the Balkan countries in great confusion. Reduction in public health funds, shortages of medicine and food, poor working conditions, and the consequences of poverty and war are causing death rates to rise. Respiratory health is considered by many experts to be the region's worst environmental health problem, primarily because of tobacco consumption and very poor air quality. The e nvironmental health impacts of the last spring's bombing and refugee exodus in the former Yugoslavia and Albania are still being debated.

Brown, V. J. (2000). "Brown's response: difficulties with "the Balkans"." Environ Health Perspect 108(11): A494.
Countries, territories and regions: South Eastern Europe

Budeva, S. (2001). "A Survey of Drug Addicts' Behaviour in the District of Veliko Turnovo." Social Medicine Journal 2: 22-23.
Countries, territories and regions: Bulgaria
The results of a survey among 170 respondents aged 13 - 24 in the district of Veliko Turnovo have been presented. The purpose of the study was to find out the level of knowledge about drugs and the attitudes of the young people towards their use. The method of data collection was individual inquiry. The questionnaires consisted of 20 questions (both open-ended and close-ended). As main source of information about drugs, 47% of the respondents pointed out their friends, 17.1% - the media, 14.1% - their parents and only 5.9% - the teachers and specialists ( narcologists, psychologists, physicians ). In connection to the use of drugs, 30 (17.6%) reported they had tried any type of drug and 18 (10.6%) reported that they were using drugs regularly i.e., every 6th young student in Veliko Turnovo have used drugs. The most risky age appeared to be 15-16 years (56.6%). 36.7% of the respondents have tried drugs above this age and the beginning in younger age was an exception - 6.7% of the pupils. Among the motives to receive psychoactive substances were: curiosity (56.6%), the feeling of loneliness and boredom (30%), the peer pressure (26.6%), a way to escape from the problems (20%), lack of perspectives (13.3%) and lack of knowledge about drug influence (10%). Prevention and a model of social intervention are needed to deal with the problem of drug abuse.

Bulgarian Council of Ministers (2000). National Programme for prophylaxis of inherited diseases, diatheses and congenital diseases and malformations in Republic of Bulgaria for the period 2000-2005
(www.mh.government.bg/program_and_strategies.php). Countries, territories and regions: Bulgaria
On 10th of November, the year 2000, Council of Ministers of Republic of Bulgaria has accepted Resolution No 735 on creation of operative program for endorsement of a National Program for prophylaxis of inherited diseases, diatheses and congenital diseases and malformations in Republic of Bulgaria for the period 2000-2005.
On the basis of article / clause 3, paragraph 1 of the Act on Public Health, Council of Ministers has taken the decision to approve a program for prophylaxis of inherited diseases, diatheses and congenital abnormalities. According to Resolution No 735, Ministry of Health had to provide funds, necessary for program implementation within the specified by State Budget Act budget resources designated for the respective year in order to:

- purchase kits and reactives for prenatal and postnatal diagnostics and screening tests;
- purchase modern diagnostic devices / apparatuses.

Minister of Health had to envisage and recommend to medical universities of higher education and to colleges enlargement of the programs for students' education and postgraduate training of health specialists at the expense of increase of classes in the field of contemporary / up-to-date prophylaxis and diagnostics of congenital diseases and malformations.
Resolution has been signed by the then prime-minister Ivan Kostov and the Secretary General Eliana Maseva.

Bulgarian Health Insurance Company Ltd (2003). Bulgarian Health Insurance Company Ltd. Zakrila. http://zakrila.dir.bg/. Countries, territories and regions: Bulgaria

Bulgarian Ministry of Health Medical standard 'Immunology'
www.mh.government.bg/standards.php. Countries, territories and regions: Bulgaria
Immunology is basic / fundamental medical specialty and a scientific discipline, consisting of the following components:

1. Examination of human immune system both in norm and in pathology-specific diagnostic process, based on anamnesis data, present health status and the treatment applied to the present moment, carried out by immunologist on the purpose to determine the nature of disease and to prescribe the necessary examinations and treatment.
2. Examination / check-up of the immune system of the individual in norm and pathology through the application of specific immunological methods and their interpretation.
3. Determination of the indications for immunomodulating therapy, medicinal monitoring, monitoring of the activity of the disease process, affecting the immune system.
4. Definition of disease prognosis. Dispanserization and continued observation /follow - up/ of the patient.
Main purpose of the specialty, according to the standard, is the provision of up-to-date, reliable information for an early diagnosis of the damages of the immune system, follow-up the effect of the applied treatment and control over the dynamics of the diseases process, effective prevention, assessment of the level of health recovery and labor efficiency / working capacity.

Immunology is interdisciplinary specialty, interacting with all the other medical specialties. At the same time, specificity of immunological methods and the large contingent of patients determine / lay down some specific characteristics of its general / common normative base. The national Standard Immunology regulates:

1. Common / universal validity of the compulsory norms of the specialty, regardless of the place and the level of the health care establishment.
2. Participation of the immunologist at all stages of patient's check-up - carrying out of the examination, diagnosis, choice of treatment, follow-up the effect / outcome of the therapy.
3. Obligatory /minimal/ amount / scope of items and equipment for the immunological laboratories, providing specialized outpatient and inpatient care in Bulgaria. Some of the labs with great experience and established programs for preparation and analysis, are allowed to exceed that minimal amount.
4. The recommended methodological and analytical principles for fulfillment of the activity to achieve quality of examination to the highest degree, reproducibility of the outcomes and unification of their interpretation.

The medical standard in Immunology is worked out by the Council of Experts in immunology to the Ministry of Health, accepted and approved by the Council on 'Standards on the quality and effectiveness of the curative and preventive activity' and is confirmed by an order of the Minister of Health of Republic of Bulgaria.
The standards have been implemented on the purpose to ensure precise realization of the immunological tests, conformable to the modern development of the technological procedures and the availability of reagents.
The standards define the minimum criteria and rules, that all laboratories are obliged to observe and follow and which can be usedin the process of their accreditation.
The procedures, applied in the tests, usually have a multitude of acceptable versions. The accuracy and the reliability of each procedure has to be identified, proved documented in the laboratory or proved through published data received from other labs.
For some of the procedures, their effectiveness and successful application in the clinic has been proved even when these procedures are difficult of access and are not compulsory for all the laboratories.

Bulgarian Ministry of Health Medical standard 'Clinical microbiology'
www.mh.government.bg/standards.php. Countries, territories and regions: Bulgaria

The clinical microbiology is a medical specialty and a scientific discipline which provides the necessary information about the etiological diagnosis of the infections and infectious diseases with the help of quantitative and qualitative methods. It identifies the anti-microbial activity / effect of the medicines, controls the dynamics of the disease process, effectiveness of the treatment, effective prophylaxis and the assessment of the degree of recovery of health. The clinical microbiology is the clinical specialty, defining the etiological diagnosis and determining the prognosis according to clinical and laboratorial criteria. It sets the etiotropic therapy and prophylaxis of all the infectious diseases.
Clinical and microbiological analyses / tests are objective by their nature, which is one of the reasons for the continuous increase in the number of the completed / accomplished examinations. The rapid development of the laboratorial technology and the clinical microbiology as an etiological and diagnostic specialty, lead to ceaseless implementation of new indicators as well as methods and equipment for examination and analysis.

The Medical Standard 'Clinical Microbiology' regulates:

1. The compulsory (optimal) number of examinations (indicators) and appliances for the clinical microbiological laboratories on the various levels of specialized outpatient and inpatient care in Republic of Bulgaria.
The compulsory (optimal) number of examinations (indicators) and appliances for each type of laboratory might be extended if necessary in order to be up to the requirements of quality.
2. The recommended analytical principles for the performance / accomplishment of the activities of the clinical microbiological laboratories in the Republic of Bulgaria.
3. The exercising of the internal laboratorial control.
4. The participation in the National system for external control over the quality, exercised by the National Center of Infectious and Parasitic Diseases in Bulgaria.
5. The participation of all microbiological laboratories in the National system for control and monitoring of the antibiotic resistance carried out and coordinated by the National Center of Infectious and Parasitic Diseases in Bulgaria .
6. The participation of the National advising / referee laboratories in the internationally recognized external non - mercantile / non - commercial laboratorial control.

The Medical Standard 'Clinical Microbiology' has been elaborated by the Section / Department of Microbiology to the National Center of Infectious and Parasitic Diseases in Bulgaria. The Standard has been discussed by a large circle of specialists in Clinical Microbiology in the health network in Republic of Bulgaria, it has been accepted by the Council of Science and Education to the National Center of Infectious and Parasitic Diseases in Bulgaria, The Association in Medical Microbiology, The Bulgarian mycological association and has been approved by the Bulgarian Minister of Health.
The standards set the minimum criteria, which ought to be observed by all the clinical microbiological laboratories.
The standards have been implemented in order to guarantee precise microbiological diagnostics, conformable to the level of the microbiological laboratory and the modern development of the technological procedures.
The procedures specified in the standards usually have different versions, whose reliability has to be documented in the laboratory after giving a proof in the same laboratory or by data published by another laboratory.
The requirements specified in the standard are subject to optimization and development.
The procedures for good laboratorial practice for examination of various clinical materials as well as all the instructions for work are discussed and afterwards accepted by the National Center of Infectious and Parasitic Diseases in Bulgaria as a member of the National Committee for Clinical Laboratory Standards in the USA (NCCLS). They are periodically published.
The National Standard regulates the requirements for quality of the work of the laboratories, according to the NCCLS.
The laboratory has to keep data documentation for the materials tested, the reagents used, the data of examination and the person who has carried out the examination.

Bulgarian Ministry of Health Medical standard 'Medical parasitology'
www.mh.government.bg/standards.php. Countries, territories and regions: Bulgaria
Medical parasitology is a scientific discipline which guarantees the provision of medical care of patients with parasitosis - primary and secondary examination, etiological diagnosis, necessary manipulations and additional / supplementaery examinations, carrying out of a therapy and a dispanserization, anti - epidemic control and prophylaxis of the parasitosis, promotion of health, methodical and consultative activities and scientific research in that area.
In the Republic of Bulgaria prasitology is treated both on the level of outpatient and patient care. As a medical specialty, it is a part of the program of studies for the students in the medical faculties and colleges and for postgraduate qualification of medical doctors and microbiologists in the bases for specialization. According to the program for postgraduate training in the basic specialty 'Medical Parasitology'at least three years of work on probation is required, including both individual and course education in the specialty. Training in Medical Parasitology is also carried out for General Practitioners, (GPs), pediatricians, specialists in internal diseases, infectionists, etc.
The Medical Standard in the field of Parasitology regulates: the activities, connected to the early etiological diagnosis, therapy, control over the dynamics of the disease process, the effect of the treatment, anti-epidemic, control and preventive measures, dispensary observation of patients with parasitosis and former parasitosis cases and promotion of health.
Parasitological examinations are objective in their character, which is one of the reasons for ceaseless increase of the spectrum of examinations. The rapid development of the Medical parasitology as science (both theory and practice) and of the laboratory technology, result in continuous introduction of new indicators, as well as of methods and equipment for their analysis, new therapeutic approaches and up-to-date theoretically substantiated measures for fight against Parasitosis.

The Medical Standard on Parasitology is created also on the purpose to control:

1. The compulsory (optimal) set of indicators and obligatory equipment for accomplishment of Medical Parasitology on different level of primary and secondary level.
The compulsory (optimal) amount of indicators and appliances for each type of section / unit in Medical Parasitology could be expanded, if necessary, following the regulations for quality.
2. The recommended analytical principles for carrying out of the activities needed in the sections in Medical Parasitology in the Republic of Bulgaria.
3. Exercising the internal laboratory control.
4. The participation in the national system for external quality control, exercised by the National Center of Infectious and Parasitic Diseases in Bulgaria.
5. The participation of the National referential laboratories in an internationally recognized external non-commercial laboratory control.

The medical standard 'Medical Parasitology' is worked out by the Department 'Parasitology and Tropical Medicine' to the National Center of Infectious and Parasitic Diseases in Bulgaria. It has been discussed by the Expert Council in Medical Parasitology of the Ministry of Health (MH), by a broad circle of specialists in Medical Parasitology in the health network in the Republic of Bulgaria. It is accepted by the Council of Science and Education of the National Center of Infectious and Parasitic Diseases in Bulgaria and by the scientific Association in Medical Parasitology and is approved by the Minister of Health in the Republic of Bulgaria.

Bulgarian Ministry of Health Medical standard 'Virology'
www.mh.government.bg/standards.php. Countries, territories and regions: Bulgaria
Medical Virology is an independent, separate medical specialty and scientific discipline, providing the knowledge and scientific data needed to clarify the etiology of diseases with viral genesis among people, by means of qualitative and quantitative methods. Its object of study includes the large number of pathogenic agents / viruses /, capable only of intracellular reproduction, which distinguishes them from all the other pathogenic microorganisms.
In Bulgaria, Medical Virology is practiced in the outpatient as well as in the inpatient care. It is included in the programs of studies of the universities and in the programs for postgraduate qualification for the individuals who have graduated in medicine and biology.
The National Standard in Medical Virology contains requirements and indicators for activities, related to the etiological diagnosis of the human viral infections, follow up the progress and the effect of the treatment of the viral infection and make an assessment of the anti-viral vaccines.
The National standard in Medical Virology has been elaborated by the Department 'Virology' of the National Center of Infectious and Parasitic Diseases in Bulgaria, it has been discussed by Bulgarian specialists in virology, accepted by the Council of Science and Education of the National Center of Infectious and Parasitic Diseases in Bulgaria and the Association in Medical Virology and by the Council on 'Standards for quality and effectiveness of the curative and preventive activity' to the Ministry of Health. It has been approved by the Minister of health of the republic.
This standard regulates the requirements which should be suited by a laboratory in virology in order to be recognized as competent in doing serological and virusological analysis. The standard covers the examinations / tests, carried out in the laboratory, using standardized methods, methods uncovered by the standardized and methods worked out in the laboratories.
This standard is applicable to all the virological laboratories, regardless of the range and scale of the activity and the number of the personnel working in the laboratory. If a laboratory does not perform one or more activities regulated by that standard, for example development of new methods, then the requirements for these activities are inapplicable.
The standard is designed in order to answer the needs of laboratories, working out their systems on quality. It may be used by laboratory clients and authorities on accreditation as well.
The laboratory bears responsibility for the activities carried out by it in a way, satisfying the requirements of the standard and the needs of the clients and the legal authorities completing accreditation.
The laboratory has to guarantee its independence of completing the examinations both of inside and outside pressure / commercial, financial, etc./, which would have a negative effect over the activities accomplished.
The laboratorial policy and procedures have to avoid actions, which would reduce the faith in its competence, independence and objectivity. The personnel of the laboratory should be appropriate for that work and should have suitable qualification, practical experience and skills in the field of Virology. The leadership should be taken by a legally competent medical doctor who is specialist in Virology. The laboratory is obliged to use permanent staff. When hiring additional personnel, the hired people must be ones of appropriate qualification for the job. The virological laboratory is a medical and diagnostic section within the boundaries of the medical institution or the Hygiene and Epidemiological Inspection. It could be also a self-dependent / separate laboratory, but only if it is able to answer to the requirements specified in the standard.

Bulgarian Ministry of Health Strategy of Republic of Bulgaria on food safety
(www.mh.government.bg/program_and_strategies.php). Countries, territories and regions: Bulgaria
Bulgarian policy on food safety is based on the working legislative and sublegislative normative order. Main legislation includes: Act on Foods, Act on Health, Act on veterinary-medical activities, Act on protection of plants and Forage Act. All these normative acts regulate requirements on foods, duties of food producers, manufacturers, tradesmen, the order for exercise of state control over the entire food chain. There are lots of sublegislative normative acts - regulations, based on the aforesaid acts. They work out the requirements on the specific fields in details and introduce the achievements of the European Law on food safety in the national legislation. A National Council on food safety has been established to the Council of Ministers for the purpose to coordinate the state/public policy on food safety, according to the Act on Foods.

State authorities, applying the legislation on food safety in practice, are:
?/ Ministry of Health, through:
1. Directorate "Health prevention and state sanitary control";
2. 28 hygienic epidemiologic inspections, which are regional authorities for state control on foods;
3. National Center on radiobiology and radiation protection.

?/ Ministry of Agriculture and Forestry, through:
1. Main / Head administrative body of the National Veterinary - Medical Service with 48 sections in the country
2. National Service on Plant Protection, Quarantine and Agrochemistry
3. Head Directorate on Forage Control to the National Service on grain with a Central and regional laboratories on exercising control over the animal foods. The coordination on implementation of the European legislation is accomplished by the Directorate "?uropean Integration and Relations with the International Financial Institutions" to the Council of Ministers and particularly on working groups level.
Direct control on food safety is accomplished by 28 Hygiene and Epidemiological Inspections in the country.

There is an Executive Committee on Food Safety established to the National Council on Food Safety and 5 interdepartmental expert working groups with participation / representation of the branch organizations as well.

Bulgarian Ministry of Health (2000). National strategy and working program on prophylactic oncological screening in Republic of Bulgaria, 2001-2006
(www.mh.government.bg/program_and_strategies.php). Countries, territories and regions: Bulgaria
Spread of oncological diseases among Bulgarian population is an issue of growing importance. It has become a health, social and psychological problem. The number of fresh cancer cases has doubled for less than 2 decades and would probably reach 30 000 people. About 20,000 Bulgarian citizens die from neoplasms annually. Cancer and CVD (Cardio - Vascular Diseases) are the most frequent causes for death among women of working age. Neoplasms are also the most frequent cause for invalidization at that age. Oncological diseases and their treatment consume a lot of resources in modern health care and cause both direct and indirect expenses. All these are serious reasons to search for rational ways and approaches to decrease burden on individual, society and state caused by oncological diseases.
One of these approaches of proven effectiveness is early diagnosis of disease. Practice has shown that the best way to diagnose disease at an early stage and to carry out a successful treatment, is population screening. It has already taken the first place in all international and national programs for fight against oncological diseases. Its presence or absence in health care system of a country is an important indicator for assessment of system effectiveness.
Bulgaria is among the countries with the highest morbidity of cervical cancer in Europe. Probably one of the reasons for growing morbidity and mortality of cervical cancer is restricted application of mass screening with pap - smears. Incidence and prevalence of breast cancer among females and cancer of prostate among males is also high. About 50 % of fresh cases of breast cancer are among women who are below the age of 60. There is clear tendency for rapid increase in the incidence of women in working age. The situation with cervical cancer is even more disturbing - approximately 70 % of all cases are registered in the age groups below 60 years.

The purpose of the National Strategy is:

" To increase percentage of detected cases with cervical cancer, breast cancer and cancer of prostate and cure them in preclinical and earlier stage and in such a way decrease mortality caused by these diseases by 30 %;
" To increase health knowledge and culture of population and to form strong habits for periodical observation and examinations by the family doctor.

Underlying / Basic principles of the Strategy:

" Choice of oncological diseases which are subject to prevention through early detection would be completed / accomplished on the basis of international standards and norms;
" The only activity for early detection of cancer is organized screening of the entire (liable for a certain territory) population group and / or coverage of risk contingents;
" Screening would take place only when fast and adequate examination and treatment of signalized patients has been guaranteed;
" Screening as practical activity would be accompanied by prospective scientific research for analysis and evaluation of its health and economic effectiveness.
" Full interaction should exist between prophylactic program and National Cancer Register, which would register and signalize changes on time;
" Prophylactic screening is realized completely on program principle;

The Programme begins with a general preliminary / preparatory period, including: - training of specialists / skilled workers; establishment of network of health care establishments / medical institutions and laboratories for examinations, conformed with the National Health Map; directing of signalized cases for diagnostics and treatment; construction of Screening Register, guaranteeing implementation and control over the program; - organization and control of prophylactic screening /carried out by the Management / Guidance of the program/.

After the end of the program, its activities become an integral part of Bulgarian Health Care System - specialized Oncological medical institutions being the most closely connected to it.

Target groups include:

for cervical cancer - all females between 25 and 60 years of age (screening interval - 3 years);
for breast cancer - I group: females from 40 to 49 years of age (screening interval - 1 year), II group: females from 50 to 69 years of age (screening interval - 3 years);
for cancer of prostate - males who are hereditarily tainted between 45 and 69 years of age (screening interval - 1 year);

It is expected that for various localizations which are subject to prophylactic screening, signalized cases would be approximately 10 % of all examined individuals. Organizations, involved in the process of realization of the strategy, include: governmental and non-governmental institutions, whose activities are related to the problem 'Neoplasms' - Ministry of Health, National Health Insurance Fund, Ministry of Finance, Parliamentary Commission for Health Care Services ??, Ministry of Labor and Social Policy, Medical Universities, Institutes and Colleges, authorities of municipal administration, international programs, 'Fight Against Cancer' Foundation, etc. ??

Bulgarian Ministry of Health (2001). National program on nephrology and dialysis
(www.mh.government.bg/program_and_strategies.php). Countries, territories and regions: Bulgaria
Over 80 % of chronic renal disorders progress to chronic renal insufficiency and cause disability. Modern medicine suggests to patients, suffering from chronic renal insufficiency the opportunity to live by the means of extra renal methods for blood purification and mostly to receive a transplanted kidney. When treating the terminal chronic renal insufficiency, in spite of the continuous improvement of the outcomes of renal replacement therapy, the survival of the patients is still 20 to 40 % of the survival of the overall population in the same age group. Simultaneously, the costs of this treatment as well as of the cost of renal transplantation are extremely high. 63 clinics and wards for haemodialysis function in Bulgaria, equally distributed on its territory. According to data recorded in the year 2000 the number of people under haemodialysis was 2683. Among those, 524 were suffering from acute renal failure and 2159 from chronic renal failure. The methods of extra ren al blood purification included haemodialysis, applied to 2159 patients and continuous ambulatory peritoneal dialysis (CAPD), applied to 114.
The object of the National program on nephrology and dialysis are the system of prophylaxis, diagnostics and therapeutic methods in nephrology:

" Outpatient and inpatient care for nephrological patients and pre-dialysis stage of chronic renal insufficiency
" Extrarenal methods of blood purification
The purpose of the program is to construct a rational approach to fight against renal diseases, subordinate to a uniform doctrine, as follows:
" Early diagnosis and treatment of nephritic disorders and prevention of chronic renal failure;
" Effectiveness of extrarenal methods of blood purification and adequate rehabilitation of the ill people;
" Creating conditions for accelerated development of renal transplantation.
The objectives are:

" Component 1: Outpatient and inpatient health care in nephrology for nephrological patients and pre-dialysis stage of chronic renal insufficiency

" Creation of an integrated approach for early diagnostics, rational treatment of renal disorders and chronic renal insufficiency in pre-dialysis stage.

Component 2: Extra renal methods of blood purification

" Optimizing the expensive treatment using extra renal methods for blood purification, regulating of financing and more rational approach towards it.
" Improvement of the quality of the treatment to a higher level in order to meet the world standards. This is likely to result in decrease of the expenses for treatment of chronic renal insufficiency and of dialysis treatment, and would hopefully lead to improvement in quality of life of the patients and the chances for accomplishing a successful renal transplantation.

Participants in the program are: Ministry of Health, Ministry of Labor and Social Policy, Ministry of Education and Science, National Health Insurance Fund, Bulgarian Physicians' Union, Bulgarian Nephrology Association, Union of Scientific Medical Associations in Bulgaria, Medical Universities or faculties in Sofia, Plovdiv, Varna, Pleven and Stara Zagora, Foundations and Programs fighting against infections caused by hepatitis virus, AIDS, etc.
Funding of program activities will be performed purposefully from the State Budget with the Act on annual budget, on the basis of an annual plan, worked out by the Executive Council and approved by the governing body of MH and NHIF.

Bulgarian Ministry of Health (2001). National programme 'MEDICAL STANDARDS IN REPUBLIC OF BULGARIA (2001-2007)'
(www.mh.government.bg/program_and_strategies.php). Countries, territories and regions: Bulgaria
Health Care Reform in Bulgaria is characterized by change in the health priorities - from secondary level of prevention (hospitalization, extensive care) to primary level of prevention (promotion of health and prophylaxis) and quality of diagnostic and curative care. This is one of the main reasons for implementation and application of medical standards. Their purpose is to guarantee quality to every Bulgarian citizen in the process of delivery of medical services.

Medical standards are needed in the following aspects:
" Modernization of normative basis for each medical specialty.
" Structuring the large amount of information
" Communication, collaboration and funding of medical care according to the principles and rules, applied in the countries integrated to the EU.
" Medical standards are necessary to protect both the rights of medical specialists and the rights of the patients on theoretically substantiated normative basis.

Purpose of the program
The purpose of the Program is to establish an institutional framework and conditions to work out and apply medical standards of national concern in reality.
Priority goals:
1. To guarantee standard quality of prophylactic, diagnostic and curative medical activities as a main factor to reduce morbidity and mortality of Bulgarian population.
2. To achieve balance between continuously growing number of new technological methods in modern medicine, rise in their prices, and scanty financial, material and human resources in Bulgarian health care system.
3. To create updated normative basis / legal ground for each medical specialty, with a view to:
- An impartial evaluation / assessment, analysis and financing of medical care;
- Impartial accreditation assessment and efficacious control of health care establishments for hospital care and Diagnostic-Consultative Centers.
4. To ensure compatibility of medical practice in Bulgaria to medical practice in the EU countries and to form a joint / universal communication environment for co-operation, experience exchange and funding.
5. To build up a theoretically substantiated normative / legal basis for identification of actual 'medical error'.

The stages of realization of the Programme include: Preliminary stage (2001); Stage of program implementation (2002 - 2006), which includes achievement of priority goals and objectives; Final stage (2007), which envisages analysis of the program outcomes / outputs. Necessary funds have to be provided for the most part by Republican / State budget. In the process of program implementation an increase in the percentage of financial resources provided by other organizations will be needed.

Bulgarian Ministry of Health (2002). Medical standard 'Clinical Pathology'
www.mh.government.bg/standards.php. Countries, territories and regions: Bulgaria
Bulgarian Ministry of Health issued Decree No 18 on 6th of August 2002 to approve Medical Standard 'Clinical Pathology', which has to be observed by all hospital wards in the country, developing activities in clinical pathology.
Medical Standard outlines morphologically-diagnostic examinations in the hospital / inpatient and outpatient care, structure of the sections, in which it is being accomplished and professional qualification of the specialists practicing that job.
Medical standard is meant to guarantee optimal and adequate accomplishment of pathomorphological diagnosis, to create basis for proper organization of pathologoanatomical activities, to outline the algorhythms by nosological entities and to minimize the risks of medical error.
General and Clinical pathology is basic medical specialty, clarifying structural and functional interactions in the organism through examination of morphological changes in the tissues and organs on various structural levels and creates a conceptually-methodological base of the medical logics. Analysis of morphological changes allows to be revealed etiological factors and pathogenesis of diseases.
Clinical pathology has the purpose to find out the two most basic characteristics of diseases-type and localization of pathological process.

Bulgarian Ministry of Health (2002). Medical standard 'Maxillofacial surgery'
www.mh.government.bg/standards.php. Countries, territories and regions: Bulgaria
The subject of the present standard is the basic / fundamental stomatological and medical specialty 'Maxillofacial surgery'.
The present standard has been worked out in conformity with the existing in the Republic of Bulgaria legislation on the basis of already approved standards for the specialty 'Surgery' (National Framework, Ordinance No 09-109/18.03.2002 for approval / ratification / confirmation of medical standards for Surgery, Official Bulletin, Vol. 3/2002).
The surgical therapy in that specialty is being conducted in medical institutions for outpatient care and mostly in surgical ward/clinic/specialized hospital with isolated / detached operating zone /sector, operating rooms / halls, block/. The amount of the surgical activities carried out in them, depends on:

- multiprofile or profiled /specialized/ character of the surgical ward/clinic/hospital;
- number, specialization, competence of the medical doctors/dentists - surgeons, working on the pay-roll in the unit/the hospital;
- capacity and resources of the hospital to carry out preoperative, intraoperative and postoperative diagnostic check-ups;
- equipment of the surgical ward/clinic/hospital and of the operating rooms / halls;
- abilities to provide interdisciplinary consultations, including profiled /specialized/ surgical consultations and formation of compound / mixed surgical teams.

All these factors determine the amount and complexity of the surgical care delivered on the following levels:

?. Health care establishments for outpatient care /ambulatory clinic for individual and group practice; for specialized medical and stomatological care; medical, stomatological, medical and stomatological and Diagnostic and Consultative Center/;
B. Multiprofile and specialized hospital for active treatment /authorized for practice in the field of the Medical specialty 'Surgery'/;
C. Specialized hospital for active treatment in 'Maxillofacial surgery'/ranked as a university hospital /.
The Medical Standard 'Maxillofacial surgery' has been worked out on the purpose to formulate norms, concerning the surgeons, working in the medical institutions for outpatient and inpatient stomatological / medical care, mentioned above, irrespective of the amount of the operative activities, carried out by them.

Bulgarian Ministry of Health (2002). National program on development of invasive cardiology in Republic of Bulgaria 2002-2008
(www.mh.government.bg/program_and_strategies.php). Countries and Regions: Bulgaria
National program on development of invasive cardiology in Republic of Bulgaria 2002-2008 was worked out in conformity with the requirements of WHO, taking into account national peculiarities and the existing constellation of socio-economic factors and the progress of the Health Reform. The morbidity of cardio-vascular diseases for the period 1997-1998 was: arterial hypertension- 617 272; ischemic heart disease - 149 484; cerebrovascular disease - 80 282; rheumatic valvular defects - 4 512; diseases of the vessels - 22 467. 115 087 people have died in the year 2000, including 76 297 or over 66 % of all deceased who died from diseases of cardio-vascular system. The leading role of cardio-vascular diseases as a main cause for death, disability and diminishing of quality of life, generator of negative social trends and recessive economic parameters, defines them as a priority in the field of national health policy. The invasive cardiology is one of the modern methods and techn ologies of effective treatment of these diseases. The purpose of the program is to reduce the morbidity of acute myocardial infarction, to prevent the complications with ischemic heart disease, rhythm aberrations in heart function, congenital or acquired valvular disease/lesion/defect, as well as to reduce the frequency of fatal complications with arteriosclerosis of the aorta and the coronary arteries, through application of invasive diagnosis to greater number of patients and interventional treatment of these diseases at earlier stage.

Bulgarian Ministry of Health (2002). National programme on restricting tobacco-smoking
(www.mh.government.bg/program_and_strategies.php). Countries, territories and regions: Bulgaria

According to statistical data from 1996, the distribution of tobacco-smoking in the country can be characterized by:
" High percentage - 35,6% of regular smokers in the age group over 15 years with respectively 49, 2% among males and 23,8% among females;
" Very high percentage - 64.9% of male smokers in the age group from 20 to 45, i.?. two out of every three men in this active age are smokers;
" Increase in the percentage of female smokers - from 16.7% in 1986 to 23.8% in 1996.
Surveys conducted by Ministry of Health and the National Center of Public Health have shown even higher values of tobacco-smoking distribution - 42,9% for the over-all population and respectively 56,5% for males and 31,2% for females. Alarming tendency is the distribution of tobacco-smoking among the Bulgarian pupils. The findings of a representative study conducted in 1999 by the WHO and the National Center of Public Health among pupils aged 15-16, revealed that tobacco-smoking was widely distributed - 49,8% prevalence among girls. There was a decrease in the low age limit of smoking commencement. According to the study, 39 % of the pupils who were smokers, started at the age of 13 years.
The conclusions that can be made about the main characteristics of tobacco-smoking in Bulgaria are:
1. Smoking in the country is widespread.
2. The dynamic of dissemination among men is at lower rate than among women.
3. The low age limit of smoking commencement is continuously decreasing.
As a result, there is a 20 % increase in the frequency of lung cancer from 1980 up to now. Over 90% of the diseased males and 20% of the diseased females are smokers. Bulgaria is in one of the leading positions in the world by stroke mortality. Every 5th male and 4th female dies from stroke. Both brain strokes and heart infarctions form 46% of the overall mortality at the present time. The increase in smoking frequency is at the expense of females and especially young ones ( 20 - 35 years - old). Smoking among children is characterized by an early start and predominance among girls. There is a continuous monotonous increase in the smoking curve.
The strategic purpose of the program is to decrease the morbidity and mortality of tobacco-related diseases and to improve the health status of the population.
The operative purpose is to provide the basis for a systematic national policy, orientated to restriction of tobacco-smoking through application of legislative, administrative and social measures and to diminish the unfavorable after-effects on health.
The objectives are:
1. To evaluate the measures taken by the working legislation in the country against tobacco-smoking and to improve their effectiveness
2. To increase the level of information and knowledge of the population on health and economic consequences of smoking and to create conditions for development of intolerance in the society towards smoking
3. To provide conditions for giving up smoking and treating the nicotine addiction through establishment of a network of consulting services and increasing the professional competence of the medical specialists.
The target groups include: children and pupils, pregnant and breastfeeding / nursing women, soldiers and cadets, parents, health workers, teachers and pedagogues, employers.

Buonomo, E., A. Godo, et al. (2000). "Child malnutrition in north Albania: results from an anthropometric survey." Ann Ig 12(6): 505-11.
Countries, territories and regions: Albania
In order to assess child malnutrition, an anthropometric cross-sectional survey of children aged 0-36 months was conducted in selected rural, urban and mountainous areas of Northern Albania in May 1997. The results showed a high prevalence of low anthropometric indices in rural and mountainous areas with a trend of similar magnitude in northern rural areas. In Northern Albania child malnutrition is a public health priority. As the main risk factor for underweight we found a recent history of diarrhoea (OR = 2.45) together with female gender (OR = 2.28), rural (OR = 2.09) or mountain (OR = 1.61) residency. Absence of sanitation, marker of poor housing conditions, also showed a significant association (OR = 1.55) with underweight. Low birthweight (OR = 1.12) was confirmed as an important risk factor for underweight condition. In conclusion these findings underline the importance of support appropriate mother and child health and nutritional programmes in rural areas of Northern Albania.

Buonomo, E., M. C. Marazzi, et al. (1998). "Infant nutritional and health status, feeding practices in rural and urban Albania." Ann Ig 10(3): 163-71.
Countries, territories and regions: Albania

C.S.Mott Foundation (2003). Increasing the level of advocacy skills and experiences in Southeast Europe. An assessment of needs., C.S.Mott Foundation. Countries, territories and regions: South Eastern Europe

Cain, J., A. Duran, et al. (2002). Health Care Systems in Transition: Bosnia and Herzegovina, European Observatory on Health Care Systems.
Countries, territories and regions: Bosnia and Herzegovina

Canadian International Development Agency (CIDA) (2003). Website. http://www.acdi-cida.gc.ca/index-e.htm
Countries, territories and regions: Eastern Europe, South Eastern Europe

Carlson, E. and S. Tsverstarsky (1996). Rising Bulgarian infant mortality: fact or artifact. Sante et mortalite des enfants en Europe: inequalities sociales d'hier et d'aujourh'hui. G. Masuy-Stroobant, C. Gourbin and P. Buekens. Louvain-la-Neuve, Academia-Bruylant.
Countries, territories and regions: Bulgaria

Catipovic-Veselica, K. (1998). "Socioeconomic changes associated with medical indices in the Democratic Republic of Croatia." Psychol Rep 83(1): 129-30.
Countries, territories and regions: Bulgaria
In Croatia after the demise of socialism, unemployment and poverty have risen dramatically. Associated health problems have increased in prevalence. Examples are mortality from cardiovascular disease and use of illicit drugs. At the same time, the number of live births and abortions have significantly decreased. The extreme and protracted stress reactions are associated as triggers of great health problems.

CDC, IMCC, et al. (1993). "Reproductive Health Survey - Romania."
Countries, territories and regions: Romania
The principal goals of the survey RRH-93 was to obtain data on reproductive behaviors and other selected women's health issues in order to assist policy makers and program managers in assessing health needs and providing comprehensive health care services.
The survey used a stratified sample design and the 1992 census was used as sampling frame. Based on the percent of households with at least one women 15-44 years of age and on a projected response rate of 90%, a sample of 12,387 households was selected from which to obtain complete interviews for approximately 5,000 women.
The nationwide reproductive health survey conducted in Romania in 1993 (93RRHS), showed that the use of modern contraceptives was very low and reliance on traditional methods, which are prone to high failure rates and subsequent unintended pregnancies, was high. Women reported frequent use of traditional methods (withdrawal, calendar), high rates of abortion, general lack of awareness and poor quality of information about reproductive health issues, and a high level of mistrust of some modern contraception methods.

CEE-HRN (2002). Injecting Drug Users, HIV/AIDS Treatment and Primary Care in Central and Eastern Europe and the Former Soviet Union. Vilnius, International Harm Reduction Development Program of the Open Society Institute, WHO, UNDCP. Countries, territories and regions: Eastern Europe

Central and Eastern European Health Net (CEEHN) (2000). Multicountry study on formal and informal out-of-pocket payments in health (unpublished). Central and Eastern European Health Net (CEEHN). Countries, territories and regions: Eastern Europe
The Central and Eastern European Health Net (CEEHN) is a joint venture between the universities and research institutes of four countries of the region and the USA. CEEHN was established in 1999 by the Harvard School of Public Health, Boston, USA, the Jagellonian University, Krakow, Poland, the Masaryk University, Brno, Czech Republic, and the National Institute for Research and Development in Health, Bucarest, Romania and the Semmelweis University, Budapest, Hungary.
The main purpose of this study is to: understand the extent of out-of-pocket payments (OPP) and, where possible, try to separate formal and informal parts of it; understand OPPs' consequences, especially on access and perceived quality, for the recipients of health care services; identify possible associations between OPP, and particularly the informal payment component, and households' demographic and socio-economic (SES) characteristics; identify people's attitude towards OPP and informal payments; and identify the extent of OPP for pharmaceuticals, and estimate people's willingness to pay for drugs in the different countries.
This joint report builds upon the four country individual reports. It singles out a few key findings from the individual reports and it points at some contrasting and other unifying features of the phenomenon of out-of-pocket payments in the four countries.
This study is intended to contribute to cover our knowledge gap concerning the phenomenon of OPP in FSE of Central and Eastern Europe by applying a common methodology and study design in four different countries, Czech Republic, Hungary, Poland and Romania.

Cerbu, A. (2002). Public Health of the Nation as a Sum of Individual Healths. Study carried out in the frame of the project "UNDP NHDR: Moldova 2002".
(http://www.ipp.md/publications/3.4.%20Sanatatea%20publica(engl)1_Banaru.pdf), Scientific Practical Center for Public Health. Countries, territories and regions: Moldova

In 2002 the Institute for Public Policy in Moldova carried the project "UNDP National Human Development Report. Besides other studies on civil society, mass media as a governance factor, cultural values and education system, a particular study was performed to analyze the public health sector in the Republic of Moldova. The "Public health of the nation as a sum of individuals healths" publication presents comments on the main indexes that reflect the state of the public health in Moldova, based on the data of the Scientific and Practical Center of Public Health and Sanitary Management. This is an analytical study aimed to approach health not just like an individual problem but as a complex one that refers to the whole society. The conclusions given at the end of this document underline the main health related problems, such as continue increase of mortality indicators, actual medical-demographic tendencies and unfavorable modifications, insufficient financing, market of medical services. The basic factors and directions that would positively change the development of public health sector are briefly highlighted.

Ceric, I., S. Loga, et al. (2001). "Reconstruction of mental health services in Bosnia and Herzegovina." Med Arh 55(1 Suppl 1): 5-23.
Countries, territories and regions: Bosnia and Herzegovina
Psychiatric services in Bosnia-Herzegovina before the war disaster was fairly developed and one of the best organized services amongst the republics of the former Yugoslavia. The psychiatric care system was based on psychiatric hospitals and small neuropsychiatric wards within general hospitals, accompanied by psychiatric services in health centers. The onset of war in B&H brought devastation and destruction in all domains of life, including the demolition and closing of numerous traditional psychiatric institutions, together with massive psychological suffering of the whole civilian population. Already during the war, and even more so after the war, the reconstruction and reorganization of the mental health services was undertaken. The basis of mental health care for the future is designed as a system where majority of services is located in the community, as close as possible to the habitat of the patients. The key aspect of the system of the comprehensive health care i s primary health care and the main role is assigned to family practitioners and mental health professionals working in the community. Large psychiatric institutions were either closed or devastated, or have their capacities extensively reduced. There will be no reconstructions or reopening of the old psychiatric facilities, nor the new ones will be built. The most integrated part of the psychiatric system are the Community based mental health centers. Each of these centers will serve a particular geographic area. The centers will be responsible for prevention and treatment of psychiatric disorders, as well as for the mental health well being. Chronic mental health patients without families and are not able to independently live in the community will be accommodated in designated homes and other forms of protected accommodation within their communities. The principal change in mental health policy in B&H was a decision to transfer psychiatric services from traditional fac ilities into community, much closer to the patients. Basic elements of the mental health policy in B&H are: Decentralization and sectorization of mental health services; Intersectorial activity; Comprehensiveness of services; Equality in access and utilization of psychiatric service resources; Nationwide accessibility of mental health services; Continuity of services and care, together with the active participation of the community. This overview discusses the primary health care as the basic component of the comprehensive mental health care in greater detail, including tasks for family medicine teams and each individual member. 1. Comprehensive psychiatric care is implemented by primary health care physicians, specialized Centers for community-based mental health care, psychiatric wards of general hospitals and clinical centers in charge of brief, "acute" inpatient care; 2. Primary mental health care is implemented by family practitioners (primary care physici ans) and their teams; 3. Specialized psychiatric care in community is performed professional teams specialized mental health issues' within Mental health centers in corresponding sectors; 4. A great deal of relevance is given to development of confidence and utilization of links between primary health care teams and specialized teams in Mental health centers and psychiatric in patient institutions; 5. Psychiatric wards within general cantonal hospitals, departments of psychiatric clinics in Sarajevo, Tuzla, and Mostar, and Cantonal Psychiatric hospital in Sarajevo (Jagomir) shall admit acute patients as well as chronic (with each new relapse). Treatment in these facilities is brief an patients are discharged to return to their homes, with further treatment referral to their family practitioner or designated Mental health center; 6. Chronic mental patients with severe residual impairment in social, psychological, and somatic functioning, shall live in the community with their families or independently. Those chronic patients without families and economic and other resources to live independently shall be placed in supervised Homes in the communities where they live. The above delineated strategy of mental health care program in B&H has several fundamental and specific objectives, among which the most important are: Reduction of incidence and prevalence of some mental disorders, particularly war stress-related disorders and suicide; Reduction of level of functional disability caused by mental disorders through improvement of treatment and care of individuals with mental health problems; Improvement of psychosocial well being of people with mental health problems, through implementation of comprehensive and accessible service for community mental health care; and Respect of basic human rights of individuals with mental health disabilities. The program has been updated since 1996, after the two-year pilot program. The main goals for current two - and five-year period are: Implement the mental health care reform program by launching all 38 Mental health centers in the Federation of BiH by 2002; Complete the 10-day education and re-education of at least 50% of all professionals employed in mental health services in FB&H by 2002; and Achieve that 80 percent of all mental health problems are treated by family medicine teams (primary care practitioners) and specialized mental health services (Community mental health care centers) by 2005.

Ceric, I., S. Loga, et al. (1999). "Reconstruction of mental health services in the Federation of Bosnia-Herzegovina Article in Serbo-Croatian (Roman)." Med Arh 53(3): 127-30.
Countries, territories and regions: Bosnia and Herzegovina
The war in Bosnia and Herzegovina has caused severe suffering of the population, and left behind destruction and misery. Hundreds of thousands were killed, ten thousands were severely injured, and almost the whole population has endured severe psychological traumas. The consequences today are numerous stress related psychical disorders, and especially PTSD. The war has almost destroyed the system of psychiatric services, and lead to lack of professional staff. Because of this, after the war, Federal Ministry of Health of Bosnia and Herzegovina has decided to carry out a complete reconstruction of psychiatric services based on new principles. Comprehensive care for improvement of mental health; prevention of mental illness, treatment and rehabilitation of mentally ill, should be transferred from institutions into the community. Consequently Ministry of Health have designed 38 Community Mental Health Centers in the Federation of Bosnia and Herzegovina in connection with already existing Primary Health Care centers (Dom zdravljas). Each of these centers is responsible for mental health in general within a catchment area of 50,000-80,000 inhabitants. A network of Community Mental Health Centers has started to operate. An efficient and useful training of the staff going to work in these centers have been carried out. Nevertheless, there is still significant resistance towards this new approach to mental health services and treatment of people with mental illness in the community. However, many problems related to this new program of community psychiatry have been identified and are under consideration.

Chen, M. and M. Mastilica (1998). "Health care reform in Croatia: for better or for worse?" American Journal of Public Health 88(8): 1156-60.
Countries, territories and regions: Croatia
Along with the rest of Central and Eastern Europe, Croatia has begun to dismantle its long-standing socialist health care system and to replace it with a market-based approach. Marketization's advocates maintain that the market will bring efficiency and quality to the Croatian health care system. Nevertheless, data from consumer surveys and official statistics reflect the reform's hidden costs: limited access to care, heightened costs, growing inequality, and the deemphasis of preventive and proactive care in favor of costly therapeutic medicine.

Chenet, L., M. McKee, et al. (1998). "Alcohol and cardiovascular mortality in Moscow; new evidence of a causal association." J Epidemiol Community Health 1998 Dec;52(12):772-4.
Countries, territories and regions: Eastern Europe

Chiritoiu, B. M. (2001). An evaluation framework for health social insurance. Comparative study on Romania, Hungary and the Czech Republic, Open Society Institute. Countries, territories and regions: Romania, Eastern Europe
This paper is based on the research funded by an International Policy Fellowship from the Open Society Institute. The literature on health policy employs four wide criteria for policy evaluation: macro-efficiency, micro-efficiency, freedom choice and responsiveness to the needs of patients, and finally equity.
The paper's conclusions are: In spite of the different paths to reform they have chosen, the three countries analysed here, the Czech Republic, Hungary and Romania, have shown a marked convergence in the way the reformed healthcare system is governed. The more competitive Czech model has grown more similar to the more dirigiste Romanian and Hungarian ones. This evolution has resulted from the restrictive regulation introduced by the Czech government, but also from the inability of the health funds to deal with the information problems that mar the health sector. Theoretically a competitive system, Czech social health insurance is in all but name a market with a dominant player, and little competition. There are of course differences in health status between these three countries, and there are differences in the quality of healthcare. But these differences are explained by factors outside our framework of analysis. The convergence in governance is mirrored by the similarity i n performance according to our 'effective purchaser' indicators. What little differences there are from this point of view, are not resulting from the institutional structure of social insurance.

Cholokova, T. (2000). "On some basic problems of women's health in Bulgaria." Social Medicine Journal 4: 5-6.
Countries, territories and regions: Bulgaria
Based on official statistical data for Bulgaria and the EU countries, a 10 years analysis of the principal characteristics of women's health in Bulgaria is performed. Trends in health status of women are alarming and require taking targeted measures on behalf of the health care system.

Chomsky, N. (1999). Kosovo Peace Accord. http://www.zmag.org/chomsky/articles/z9907-peace-accord.htm
Countries, territories and regions: Kosovo, Serbia and Montenegro

Christos, H., P. MI, et al. (2000). "Surveillance of communicable diseases in the Balkans. Committee of the Balkan Network for Surveillance of Communicable Diseases." Lancet 355(9213): 1465.
Countries, territories and regions: South Eastern Europe

Ciubota, I. O., L. Botezat, et al. (2000). "Romanian perspective on health reporting." Stud Health Technol Inform 77: 153-5.
Countries, territories and regions: Romania
Since 1990 the Romanian healthcare system has been crossing a stage of dramatic change. The healthcare reform, which is in progress, has structural, organizational and functional implications at the country level. The Ministry of Health is now preparing for the big IT changes. A Healthcare Management Information System (HMIS) will assure in the very next future automate data collection on health status of the population and on resource allocation and consumption. It is not an easy way towards the use of the Data Warehouse concept and On Line Analytical Processing technology for creating and accessing the data repository. Therefore we decided to integrate existing applications related to health system indicators until the HMIS will assure a high performance analysis and data interpretation.

Ciupagea, M. (2002). "Twenty years and now advocacy." Harm Reduction News. Newsletter of the International Harm Reduction Development Progam of the Open society Institute 3(1).
Countries, territories and regions: Eastern Europe

Clinical Center - Skopje, Department of Obstetrics and Gynecology, et al. (2002). Perinatological Data in the Republic of Macedonia 2001. Skopje, Clinical Center - Skopje, Department of Obstetrics and Gynecology, Human Reproduction Center. Countries, territories and regions: Macedonia
Content: cases per type of pregnancy and delivery, deliveries per place of delivery and living place, number of deliveries and births, types of deliveries, neonates per weight, irregular pregnancies, pregnancy with anemia, drugs used during pregnancy, deliveries with caesarea, antenatal and ultrasound controls, uncontrolled pregnancy, smoking and pregnancy, mortinatality, early neonatal and perinatal mortality

Coffin, P. and A. Strodaha (2001). Overdose in Central and Eastern Europe and the former Soviet Union. A survey and report. New York, MIA
International Harm Reduction Development Program of the OSI. Countries, territories and regions: Eastern Europe

Cohen, J. C., Human Development Department, et al. (1996). An assessment of the Romanian Pharmaceutical Sector, July 1996, Cohen,Julien Clare, Human Development Department, World Bank. Countries, territories and regions: Romania
From June 12-22, a fact-fiding mission was conducted in Romania to assess the pharmaceutical sector in general and the impact of the World Bank`s Health Reabilitation Loan (3409 RO)
The rationale for financing pharmaceutical procurement under this loan was to ensure the supply of essential drugs (and contraceptives and vaccines) for population during the initial years of Romania`s tranzition from a centralized to market economy. Throughtout the project, however, the procurement process has had many problems which has delayed the drugs, contraceptives and vaccines from being distributed. Generally, the procurement problems have been related to the lack of clarity on the respective roles of the Ministry of Health and UNICEF in the procurement process.
From the point of view of the economy, the pharmaceutical sector stands out as an exceptional sector in Romania because it has undergone a rapid degree of privatization, particulary in the areas of drug supply and distribution. The only area where the private sector has not been involved is in local production.
The recommendation of this report put forward in this report include the creation of an authonomous national drug authority, with a critical mass capable of enforcing regulations: drug pricing and reimbursement reforms, review meetings to address procurement issuess under the World Bank loan; and the implementation of activities related to information, education and communication (IEC) which will support cost contaiment measures and promote the regional use of drugs

Commission of the European Communities (2002). Commission Staff Working Paper. Federal Republic of Yugoslavia, Stabilisation and Association Report. Brussels, Commission of the European Communities. Countries, territories and regions: Serbia and Montenegro

Constantin, A., C. Neagu, et al. (1999). "Eight years of experience in the first Romanian center of family planning and contraception." Eur J Contracept Reprod Health Care 4(2): 57-60.
Countries, territories and regions: Romania
This study describes 8 years of experience (1990-97) in the first Romanian center for family planning and contraception, which started in Bucharest at the Clinic Hospital of Obstetrics and Gynecology 'Prof. Dr. P. Sirbu' on 27 February 1990. A total of 14,258 women had attended the clinic by 1 January 1998. Trends in the use of contraceptives and the number of births and abortions at the center are described. During the 8 years, the induced abortions decreased by 65% and the uncompleted abortions (illegal abortions) by 45%. Hormonal contraception was the most commonly used contraceptive method (61.5%), followed by intrauterine devices (28.8%) and local contraception (barrier methods: condoms, diaphragms, spermicides) (9%).

Corrao, M. A., E. G. Guindon, et al. (2000). The 11th world Conference on Tobacco OR Health. Tobacco Control country Profiles, Atlanta, Georgia, American Cancer Society.
Countries, territories and regions: Worldwide

Costa, J. (2002). Social Health Insurance in the Balkans. Prepared for DFID Health Insurance Workshop. London, DFID. Countries, territories and regions: South Eastern Europe

Cotanda, F. L. (1998). Estudoi Comparado de las Reformas de los Sistemas Sanitarions de Espana y Bulgara. Tesis Doctoral Dirigida Por El Professor Juan Del Rey Calero, Universidad Autonoma de Madrid. Countries, territories and regions: Bulgaria

Council of Europe (2001). South East Europe Strategic Review on Social Cohesion. Health Network, Country Report - Albania. Tirana, Council of Europe. Countries, territories and regions: Albania
The country report is a review of the health situation in Romania done in 2001 under the Stability Pact Process. This report has four parts. In part 1 - "Background information" present the most recent development related to access to health care, highlight current weakness in providing health care and identify the reasons behind these weaknesses, and provide actual figures of as many as possible of the health comparative indicators. Part 2 present the access to health: poverty and marginal groups. Part 3 and 4 are focused on participation of vulnerable and marginalised groups in decisions related to health and methodologies in the health sector: from data collection to policy development.

Council of Ministers (2003). Project for Act on Transplantation of Organs, Tissues and Cells. Bulgaria, Council of Ministers. Countries, territories and regions: Bulgaria

Croatian Ministry of Health (2003). Report on Donation and Transplant Activities in Croatia in 2002, Ministry of Health. Countries, territories and regions: Croatia

Croatian Ministry of Health (2003). Donor Action National Training Course in Transplantation, Croatia, Ministry of Health.
Countries, territories and regions: Croatia

Croatian Ministry of Health (2003). HIV/AIDS Situation Analysis. Countries, territories and regions: Croatia

Croatian Ministry of Health (?). Diabetes in Croatia, Ministry of Health. Countries, territories and regions: Croatia

Croatian National Institute of Public health (2001). Croatian Health Service Statistical Annual 2000, Croatian National Institute of Public health,. Countries, territories and regions: Croatia

Croatian National Institute of Public Health (2002). Croatian Health Service Yearbook 2001. Zagreb, Croatian National Institute of Public Health.
Countries, territories and regions: Croatia

CSEED health team (2002). Health in the Balkans: a case of blurred boundaries and narrow interpretation, CSEED health team, DFID. Countries, territories and regions: South Eastern Europe

Cucic, V., V. Bjegovic, et al. (2000). Health Behaviour of School children. Executive Summary of the Research Project, FR Yugoslavia. Belgrade, UNICEF. Countries, territories and regions: Serbia and Montenegro

Cucic, V., V. Bjegovic, et al. (2000). AIDS Preventitive Indicator Monitoring. First Evaluation. Belgrade, UNICEF, Institute of Social Medicine, Statistics and Health Research, School of Medicine, Belgrade University,. Countries, territories and regions: Serbia and Montenegro

Dafoe, G. H. (2001). "New endeavours for HIV prevention in the Balkans." Can J Public Health 92(4): 244.
Countries, territories and regions: South Eastern Europe

David, H. P. and A. Baban (1996). "Women's health and reproductive rights: Romanian experience." Patient Education and Counseling 28: 235-245.
Countries, territories and regions: Romania

Davies, L. (2000). "Balkans briefing 6. Picking up the pieces: reflections on the initial stages of the reconstruction of the health care system in Kosovo, July 1999." J Epidemiol Community Health 54(9): 705-7.
Countries, territories and regions: Kosovo, Serbia and Montenegro

De Clercq, L., B. Lagerkvist, et al. (2001). "Assessment of community mental health care in the Federation of Bosnia-Herzegovina (FBH) after the 1992-95 war." Med Arh 55(2): 105-12.
Countries, territories and regions: Bosnia and Herzegovina
Bosnia-Hercegovina is in the process of reforming its health care system. One realises that this is a complex matter that will cost a great deal of time and effort. The findings suggest that the highest priority now is the development of the 'mental health strategic and action 'plan', which includes (as a component of the overall PHC strategy) legislation, financing mechanisms, a clear statute for the CMHCs and staff, and to define the relationship with other PHC services. In addition, it is recommended that the authorities should take a more decisive co-ordinating and leading role. To this end, a special Mental Health Task Force assisted by a professional advisory group on mental health and/or professional consultants could be established. In order to realise a real cost-effective community-based care, it is inevitable to allocate enough funds to these primary mental health care services and initiatives such as sheltered living and family support initiatives (eventually to r eallocate funds from expenditures on hospital-based care). A mental health reform does not happen in a vacuum and therefore can not be accomplished without 'negotiating' with other sectors/ministries, e.g., Ministries of Finances, Social Affairs/Displaced Persons and Refugees, International Trade and Economy. A multi-sector approach is considered indispensable. Overall management of CMHCs should be strengthened. In addition, it is important that CMHCs exchange information and promote standardised protocols and procedures to enhance comparability and structured referral. The planned Management Information System is a good example, but should be implemented as soon as possible in all CMHCs. Other initiatives to improve professional networking might include (community mental health) newsletters, round table conferences, etc. Further skills training of CMHC staff and management might be difficult to define as long as it is not clear what practical skills are required. Technical Assistance to the (mental) health sector should primarily focus on the overall framework and policy. Training should be tailored to the actual needs and focus primarily on local capacity building via training-of-trainers. Health prevention and promotion, i.e. information provision to the general public and community participation in terms of support for self-help groups and consumer groups, deserve more attention than it has received so far.

de Ville de Goyet, C. and E. Sondorp (2001). Internal Evaluation of WHO Response in Kosovo (June to December 1999), WHO. Countries, territories and regions: Kosovo, Serbia and Montenegro

Dehne, K., L. Kohodakevich, et al. (1999). "The HIV/AIDS epidemic in Eastern Europe: recent patterns and trends and their implications for policy-making." AIDS 13(7): 741-9.
Countries, territories and regions: Eastern Europe

Delcheva, E. (2000). The Health Sector Reform - Economic aspects. Baics of Hospital Management. N. H. I. F. Ministry of Health. Sofia, Bulgaria.
Countries, territories and regions: Bulgaria

Delcheva, E. (2002). "Implementing EU tobacco legislation in Bulgaria. Challenges and opportunites." Eurohealth 8(Special issue): 34-5.
Countries, territories and regions: Bulgaria

Delcheva, E. and D. Balabanova (2001). "Hospital sector Reform in Bulgaria: First Steps." Eurohealth 7(3 Special Issue).
Countries, territories and regions: Bulgaria

Delcheva, E., D. Balabanova, et al. (1997). "Under-the-counter payments for health care: evidence from Bulgaria." Health Policy 42(2): 89-100.
Countries, territories and regions: Bulgaria
Against a background of falling revenues and increasing expectations, health care systems in central and eastern Europe are facing increasing budgetary gaps. There is extensive anecdotal evidence that these gaps are being filled by informal or 'under-the-table' payments. These are important because of their implications for estimates of future funding requirements, for equity, and for the possible perverse incentives they introduce for those providing and managing health services. There is, however, relatively little information on either their scale or how they are perceived in these countries. We report the results of a small survey from Bulgaria that begins to address these issues. Data were collected by means of an interviewer-administered household survey in which those who had used state-provided health services in the preceding 2 years were identified. The survey took place throughout Bulgaria in 1994. One thousand people were approached and 706 (70.6%) provided inform ation suitable for analysis; 42.9% had paid for services that were officially free. Payments had been for a wide range of services and to differing groups, including medical, nursing and ancillary staff. Payments to individuals during consultations were between 3% and 14% of average monthly income but the average cost of an operation was 83% of mean monthly income. There were large differences in the amounts paid by individuals. Most people were in favour of both official user fees and health care reform, except among the old, the poor, and those in poor health. Despite certain limitations, this study gives some indication of the scale of informal payments in Bulgaria. Several possibilities exist to address them. Contrary to what is often argued, there seems to be a popular willingness for them to be converted into formal co-payments. Before this can be done, there is a need for more research on the impact that this would have on equity and affordability.

Dencheva, R., G. Spirov, et al. (2000). "Epidemiology of syphilis in Bulgaria, 1990-1998." Int J STD AIDS 11(12): 819-22.
Countries, territories and regions: Bulgaria
There have been great political, social and economic changes in Bulgaria since 1990 with higher incidences of syphilis when compared with the previously controlled morbidity of syphilis. There has been a 7-fold increase in 1998 compared with 1990. The male/female ratio remained the same 1.2:1. A higher number of cases was reported in cities than in villages and small towns, 80.68% in 1990; 73.4% in 1998. The number of employed patients with syphilis has decreased during the years--from 75.5% in 1990 to 44% in 1998, with a corresponding increase in syphilis in the unemployed. The age group at highest risk is 20-24 years, 28.7% in 1991; 24% in 1998. The least affected group are those older than 55--the incidence being 6.34% in 1990; 2.6% in 1997 and 4% in 1998. The prevalence of the different stages of early infection remained the same. The incidence of congenital syphilis increased from 1 in 1990 and 1991 to 21 in 1996, 29 in 1997 and 35 in 1998.

Department of Health and Social Welfare (2000). Health Policy, Kosovo, Department of Health and Social Welfare. Countries, territories and regions: Kosovo, Serbia and Montenegro

Development and Aid Coordination Unit (DACU) (2001). Working Paper, Health Sector in Serbia, DACU. Countries, territories and regions: Serbia and Montenegro

DFID (2001). Kosovo. Health Briefing Paper, DFID. Countries, territories and regions: Kosovo, Serbia and Montenegro

DFID Health Systems Resource Centre (2001). Serbia, Country Health Briefing Paper. Countries, territories and regions: Serbia and Montenegro

DFID Resource Centre (1999). Bosnia Health Briefing Paper, DFID. Countries, territories and regions: Bosnia and Herzegovina

Diabetes Education Program in Bulgaria (DEPB) Project Group (2001). "Diabetes Education program in Bulgaria." Patient Education and Counseling 43(1): 111-4.
Countries, territories and regions: Bulgaria
The objective of the Diabetes Education Program for Bulgaria (DEPB) was to introduce a large-scale unified structured educational program for insulin-treated diabetic patients. A total of 52 university and regional educational centers for people with diabetes and four centers for education of children with diabetes were organized. The educational course includes 10 sessions, 45min each, in 3-5 consecutive days for groups of 8-12 insulin-treated patients. To assess the effect of the DEPB on diabetes-related parameters data collection was organized in seven centers. It included 2055 patients who were allocated to education (intervention group) or not to be educated (control group). Diabetes-related parameters were measured at baseline, and patients will be followed at 6 months. Measuring the biochemical parameters, self-estimated knowledge, treatment satisfaction, burden and handling of diabetes before and after education would give the opportunity to evaluate its impact on the metabolic control and on psychological factors.

Ditiu, L. (1999). "National Tuberculosis Programme in Romania 1997-2000: how it works." Cent Eur J Public Health 7(4): 189-90.
Countries, territories and regions: Romania
Romania displays one of the highest epidemiological parameters of tuberculosis among European Countries, territories and regions: the incidence reached 113.3 per 100,000 in 1998, the prevalence of chronic cases was 18.9 and mortality 11.5 per 100,000 in 1996. A National Tuberculosis Programme aimed at decreasing the present burden of the disease has been elaborated according to the WHO strategy in 1997 and for its implementing. The National Committee on Pneumophtisiology and the Central Unit of the National Institute of Pneumophtisiology were made responsible. Tuberculosis managers and supervisors were nominated in each of the 48 counties and a total of 18,000 family doctors were involved in this programme at the primary health care level. Tuberculosis has been declared the second health priority in Romania and the following budget providers for its effective control were acquired: Ministry of Health, World Bank, Open Society Foundation, Funds of Romania and World Health Organization. The following a chievements can be mentioned so far: A technical manual on the National Programme has been published, WHO modules on DOTS strategy were translated into Romanian, a training course on the WHO-DOTS strategy was organized for tuberculosis managers and laboratory chiefs, a pilot project on the WHO-DOTS strategy started in lasi, first control visits in counties and pneumophtisiologists were implemented, training for family doctors was organized and a project for health education with video shots was presented on the national TV channel.

Dizdarevic, Z. (1999). "Basic characteristics of the National tuberculosis Program in Bosnia-Herzegovina (Article in Serbo-Croatian - Roman)." Med Arh 53(3 Suppl 1): 5-8.
Countries, territories and regions: Bosnia and Herzegovina
National TB Programme (NTP) in Bosnia and Herzegovina was approved on 24th May 1994. Following the recommendations of WHO Working Group we revised and supplemented NTP of Bosnia and Herzegovina for 1996 and 1998/99. The objective of the programme was provide practical guidelines on implementation of TB control to all lung diseases and TB specialists over the territory of Bosnia and Herzegovina in accordance with WHO Global Program. TB control through NTP is implemented on the following health care levels: primary health care, General practitioner and family doctor, dispensary of Lung Diseases & TB, Hospitals (Cantonal and Regional), Clinical for Lung Diseases & TB. The effects of this NTP are the following: high sputum smear conversion rates at the end of the initial phase, high cure rates decreased prevalence of chronic excretors of tubercle bacilli, decreased transmission of infection, prevention of drug-resistance. Very good results were achieved in the last three years in TB control with stable incidence through by passive case findings, active finding of contacts, proper and controlled treatment using DOTS strategy as the best TB prevention.

Dizdarevic, Z. (1999). "Reproductive health care situation in Bosnia-Herzegovina." Med Law 18(2-3): 213-5.
Countries, territories and regions: Bosnia and Herzegovina
The law legalizing abortion and implementing family planning, passed in former Yugoslavia in 1952, is still in effect in the newly created state of Bosnia-Herzegovina. This law has helped eliminate illegal, i.e. criminal, abortions, but existing arrangements providing family planning and promoting reproductive and sexual health are not effective enough, because too few people know enough about the rights to individual choice in family planning. The primary objective for the next twenty years is to educate the people--women, men and the young--about their rights to reproductive choice and sexual health, and about how to exercise those rights as fully and effectively as possible. Legal and financial assistance from WHO will be welcome, because the post-war Bosnian society and state lack funds for such initiatives.

Dolea, C., E. Nolte, et al. (2002). "Changing life expectancy in Romania after the transition." Journal of Epidemiology and Community Health 56: 444-449.
Countries, territories and regions: Romania

Donev, D., U. Laaser, et al. (2002). "Skopje Declaration on Public Health, Peace and Human Rights, December 2001." Croat Med J 43(2): 105-6.
Countries, territories and regions: South Eastern Europe

Donev, D., S. Onceva, et al. (2002). "Refugee crisis in Macedonia during the Kosovo conflict in 1999." Croatian Medical Journal 43(2): 184-9.
Countries, territories and regions: Macedonia
The Kosovo refugee crisis in the Macedonia in 1999 was unique in terms of its unprecedented magnitude against its short duration (sharp increase and sudden decrease in refugee population), its high visibility in the world media, and attention received by donors. In the late March 1999, after the launch of the NATO air campaign against the Federal Republic of Yugoslavia, refugees from Kosovo began to enter Macedonia. Within 9 weeks, the country received 344,500 refugees. Aiming to provide an emergency humanitarian relief, United Nations, and international and national organizations together with the host country, donors, and other concerned parties coordinated and provided immediate assistance to meet the needs of refugees, including shelter in collective centers (camps) and accommodation in host families, nutrition, health care, and water/sanitation. The morbidity and mortality rates remained low due to the effective action undertaken by a great number of humanitarian organiz ations, backed up by strong governmental support. No significant epidemics developed in the camps, and there were no epidemic outbreaks during the crisis. Mortality rate of refugees was lower than in other emergency situations.

Donev, D. M. (1999). "Health insurance system in the Republic of Macedonia." Croat Med J 40(2): 175-80.
Countries, territories and regions: Macedonia
The current health insurance system of the Republic of Macedonia was introduced by the Health Protection Law, which was adopted in 1991 and modified and supplemented by the amendments in 1993 and 1995. According to this Law, health insurance was established as an obligatory, supplementary obligatory, and voluntary insurance for certain kinds of health care. This report gives an insight into the specificities and practice of all three types of insurance in the Republic of Macedonia. A person can become an insured to the Health Insurance Fund on the basis of 23 modalities. More than 80% of the citizens are eligible to the obligatory health insurance, which provides a broad scope of basic health care rights. Payroll contributions are equal to 8.6% of gross earned wages and more than 70% of health sector revenues are derived from them. Besides some other basic resources and contributions for health financing, co-payments for health care expenses by users were introduced in 1993. Health financing and reform of the health insurance system are of high importance within the ongoing health care reform in the Republic of Macedonia. It is expected that the new Law on health insurance will strengthen the mechanisms for collecting revenues and introduce new methods of co-payment and risk-adjusted reallocation of the funds related to age structure and health status of the population.

Duff, C. H. (1999). "Balkan briefing. Reflections on the health of a refugee population (Part 1)." J Epidemiol Community Health 53(9): 578-9.
Countries, territories and regions: South Eastern Europe

Durakovic, A. (2001). "On Depleted Uranium: Gulf War and Balkan Syndrome." Croat Med J 42(2): 130-4.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Dybdahl, R. (2000). "Traumatic expeiences and psychological reactions among women in Bosnia during the war." Med Confl Surviv 16(3): 281-90.
Countries, territories and regions: Bosnia and Herzegovina
Internally displaced women (N = 77) in Bosnia were interviewed before and after participating in group psychotherapy during the war in 1994 and 1995 to gain background information and assess stress exposure and stress reactions. Nearly all the women had experienced loss of family members, many acts of violence and mental health impairment. The participants had high scores on a symptom scale, in terms of intrusive, avoidance and arousal symptoms and somewhat lower on depression/powerlessness items. After participating in short-term group therapy they reported significant reduction in symptoms. The women who had experienced most traumatic events and had most symptoms, reported greatest reduction in symptomatology. Some of the implications of the findings are discussed and it is concluded that group therapy may be helpful in war conditions, even though traditional preconditions for psychotherapy are not present.

Dybdahl, R. (2001). "Children and mothers in war: an outcome study of psychosocial intervention program." Child Dev 72(4): 1214-30.
Countries, territories and regions: Bosnia and Herzegovina
The present study was designed to evaluate the effects on children (age: M = 5.5 years) in war-torn Bosnia and Herzegovina of a psychosocial intervention program consisting of weekly group meetings for mothers for 5 months. An additional aim was to investigate the children's psychosocial functioning and the mental health of their mothers. Internally displaced mother-child dyads were randomly assigned to an intervention group receiving psychosocial support and basic medical care (n = 42) or to a control group receiving medical care only (n = 45). Participants took part in interviews and tests to provide information about war exposure, mental health, psychosocial functioning, intellectual abilities, and physical health. Results showed that although all participants were exposed to severe trauma, their manifestations of distress varied considerably. The intervention program had a positive effect on mothers' mental health, children's weight gain, and several measures of children' s psychosocial functioning and mental health, whereas there was no difference between the two groups on other measures. The findings have implications for policy.

Dzeletovic, A. and R. Popovic (1999). "Yugoslavia: preventing the spread of HIV and STDs." Entre Nous Cph Den Spring(42): 15-6.
Countries, territories and regions: Serbia and Montenegro

ECHO (2001). Vulnerable groups, annual report, ECHO. Countries, territories and regions: South Eastern Europe

ECHO, WHO, et al. (2001). Communicable disease surveillance System - Albania, ECHO, WHO, MOH. Countries, territories and regions: Albania

ECOHOST (1998). Childhood Injuries. Final Report, UNICEF, WHO, London School of Hygiene and Tropical Medicine. Countries, territories and regions: Eastern Europe

Editor (1999). "The disease problems of Kosovan refugees in Albania." Commun Dis Rep CDR Wkly 9(18): 155.
Countries, territories and regions: Albania

Editor (2001). "Harm Reduction News." Newsletter of the International Harm Reduction Development Progam of the Open society Institute 2(1).
Countries, territories and regions: Eastern Europe

Editorial (1999). "Vaccination campaign for Kosovar Albanian refugee children - former Yugoslav Republic of Macedonia, April - May 1999." MMRW Morb Mortal Wkly Rep 48(36): 799-803.
Countries, territories and regions: Macedonia
Extensive ethnic conflict within the Kosovo region of the Federal Republic of Yugoslavia and an organized bombing campaign by the North Atlantic Treaty Organization led to mass population displacement in 1998 and early 1999. In April 1999, approximately 500,000 Kosovar Albanians fled into the Yugoslavian Republic of Montenegro and the neighboring countries of Albania, Bosnia-Herzegovina, and the Former Yugoslav Republic of Macedonia (FYROM). Of the estimated 130,000 refugees who fled to FYROM, approximately 65,000 were housed in seven refugee camps. A major public health concern in these camps was the prevention of vaccine-preventable diseases, particularly measles. In response, the FYROM Ministry of Health (MOH) in collaboration with the United Nations Children's Fund (UNICEF) and International Medical Corps, a nongovernmental organization, planned and implemented a mass vaccination campaign. This report describes the first campaign (April 26-May 10, 1999), its results, and follow-up activities.

Eliades, M. J., J. Lis, et al. (2001). "Post-war Kosovo: Part 2. Assessment of emergency medicine leadership development strategy." Prehospital Disaster Med 16(4): 268-74.
Countries, territories and regions: Kosovo, Serbia and Montenegro
Since the return of the refugee population to Kosovo, attempts at development of an emergency medical system in Kosovo have met with varied success, and have been hampered by unforeseen barriers. These barriers have been exacerbated by the lack of detailed health system assessments. A multimodal approach of data collection and analysis was used to identify potential barriers, and determine the appropriate level of intervention for emergency medicine (EM) development in Kosovo. The four step, multi-modal, data collection tool utilized: 1) demographic and health systems data; 2) focus group discussions with health-care workers; 3) individual interviews with key individuals in EM development; and 4) Q-Analysis of the attitudes and opinions of EM leaders. Results indicated that Emergency Medicine in Kosovo is under-developed. This method of combined quantitative and qualitative analysis identified a number of developmental needs in the Kosovar health system. There has been little formal training, the EMS system lacks organization, equipment, and a reliable communication system, and centralized emergency centers, other than the center at Prishtina Hospital, are inadequate. Group discussions and interviews support the desire by Kosovar health-care workers to establish EM, and highlight a number of concerns. A Q-methodology analysis of the attitudes of potential leaders in the field, supported these concerns and identified two attitudinal groups with deeper insights into their opinions on the development of such a system. This study suggests that a multi-modal assessment of health systems can provide important information about the need for emergency health system improvements in Kosovo. This methodology may serve as a model for future, system-wide assessments in post-conflict health system reconstruction.

Enachescu, D. (1998). "External cooperation for the professional management of health services in Romania." J Health Adm Educ 16(2): 145-56.
Countries, territories and regions: Romania
Political change in Romania in 1989 played a crucial part in new health system leadership in the country. However, this new leadership had limited managerial experience and knowledge, with trainers using outdated cultural models. External assistance and cooperation from officials in Western Europe and the United States was needed to train a new leadership and reject the socialist system of health care. This article details Romania's external cooperation experience, including descriptions of the need for such training, development of the training project, work with universities in Europe and North America, critical review of the project and realization of external cooperation for the professional training of managers.

Etty, T. and B. Rechel (2002). Social Policy Issues in Bulgaria Against the Background of Accession: The Partial Closure of the Kozloduy Nuclear Power Plant and the Minority (Roma) Issue, European Economic and Social Committee, Seventh meeting of the EU-Bulgaria Joint Consultative Committee. http://www.esc.eu.int/pages/Enlarg/ccm/bulgarie/ meeting7_16_04_02/di_ces39-2002_fin_di_en.pdf
Countries, territories and regions: Bulgaria

European Agency for Reconstruction (2003). "Website."
Countries, territories and regions: South Eastern Europe

European Bank for Reconstruction and Development (2000). Transition report 2000, Employment, skills and transition: Economic transition in central and Eastern Europe, the Baltic States and the CIS, European Bank. Countries, territories and regions: Eastern Europe

European Commission (2001). CARDS Assistance Programme. Former Yugoslav Republic of Macedonia 2002-2006, European Commission. Countries, territories and regions: Macedonia

European Commission (2001). Albania - the European contribution. http://europa.eu.int/comm/external_relations/see/albania/index.htm
Countries, territories and regions: Albania

European Commission (2001). The EU's relations with the former Yugoslav Republic of Macedonia, June 2001. http://europa.eu.int/comm/external_relations/see/fyrom/index.htm
Countries, territories and regions: Macedonia

European Commission (2001). Bosnia and Herzegovina, Country Strategy Paper, 2002-2006, European Commission. Countries, territories and regions: Bosnia and Herzegovina

European Commission (2001). Federal Republic of Yugoslavia, Country Strategy Paper, 2002-2006, European Commission. Countries, territories and regions: Serbia and Montenegro, Kosovo

European Commission (2001). Albania, Country Strategy Paper, 2002-2006, European Commission. Countries, territories and regions: Albania

European Commission (2001). Croatia, Country Strategy Paper, 2002-2006. Countries, territories and regions: Croatia

European Commission (2002). Civil Society Drug Demand Reduction. Phare networking facility programme. Guidelines for applicants to call for proposals 2002, European Commission. Countries and Regions: Eastern Europe

European Commission (2002). Ensuring Minority access to health care. Summary project fiche. Desiree Number BG 0104.02. Bulgaria, European Commission. Countries, territories and regions: Bulgaria

European Commission (2002). Narrative final Report on operation: Social Integration and new alternative support of persons with mental illnesses. Skopje, WHO, Regional office for Europe, Humanitarian Assistance Office, the Former Yugoslav Republic of Macedonia. Countries, territories and regions: Macedonia

European Commission (2002). The EU's relations with Bosnia & Herzegovina, Latest update: March 2002. http://europa.eu.int/comm/external_relations/see/bosnie_herze/index.htm
Countries, territories and regions: Bosnia and Herzegovina

European Commission (2002). 2002 Regular Report on Bulgaria's Progress towards Accession. Countries, territories and regions: Bulgaria

European Commission (2002). Croatia - the European contribution, Latest update: March 2002. http://europa.eu.int/comm/external_relations/see/croatia/index.htm
Countries, territories and regions: Croatia

European Commission (2002). "The EU's relations with Moldova, Latest update: March 2002."
Countries, territories and regions: Moldova

European Commission (2002). The EU's relations with Romania, Latest update: October 2002. http://europa.eu.int/comm/enlargement/romania/
Countries, territories and regions: Romania

European Commission (2003). Supply contract forecast - Roma Population Integration location. Bulgaria. Countries, territories and regions: Bulgaria

European Commission (2003). Supply contract forecast - Ensuring minority access to health care. Bulgaria. Phare programme, European Commission. Countries, territories and regions: Bulgaria

European Commission (2003). Service contract forecast - Ensuring minority access to health care. Bulgaria. Phare programme, European Commission. Countries, territories and regions: Bulgaria

European Commission (2003). European Union relations with Southeast Europe. http://europa.eu.int/comm/external_relations/see/index.htm
Countries, territories and regions: South Eastern Europe

European Commission (2003). The Western Balkans in transition, Directorate General for Economic and Financial Affairs. Countries, territories and regions: South Eastern Europe

European Commission (2003). European Union relations with Southeast Europe. http://europa.eu.int/comm/external_relations/see/index.htm
Countries, territories and regions: South Eastern Europe

European Commission (2003). The Western Balkans in transition, Directorate General for Economic and Financial Affairs. Countries, territories and regions: South Eastern Europe

European Commission (2003). The EU's relations with the state of Serbia & Montenegro, Latest update: January 2003. http://europa.eu.int/comm/external_relations/see/fry/index.htm
Countries, territories and regions: Serbia and Montenegro

European Commission, ECHO, et al. (2001). Management of TB among refugees and host population in Albania and FYR Macedonia in support of the national TB programmes (1999-2000), European Commission, ECHO,WHO,. Countries, territories and regions: Macedonia
The objective was to assist the national TB programmers in the two countries in implementing TB control strategy - DOTS, and was based on the five-year plan of both countries. Implementa-tion timetable was 01/08/99-31/10/00. Three main operations were on the agenda of the project: Emergency rehabilitation aiming to create a sustainable infrastructure in order to facilitate the implementation of DOTS strategy in Albania and FYROM. Operation II named Medical had the objective of providing NTP with necessary amount of drugs, equipment, laboratory supplies and consumables necessary for diagnosis, treatment and follow up of TB patients, according DOTS strategy. Operation III named Training was addressed to strengthen NTP by increasing an updat-ing the knowledge of all categories of health staff involved in TB programme; to increase the awareness in general population and TB patients with regard to TB diseases and DOTS strategy. The target groups involved in the trainings were: the specialists in lung diseases, family doctors; laboratory technicians; nurses etc.

European Commission, ECHO, et al. (2002). Strengthening of the national TB Programme of WHO TB Control strategy in FYROM. Emergency Preparedness and Response: Support Health activities in Albania, FYR Macedonia and FR Yugoslavia, European Commission, ECHO, WHO. Countries, territories and regions: Albania, Macedonia, Serbia and Montenegro
In the scope of the project special designed interventions were implemented, related to rehabilitation of TB dispensaries, procurement of TB drugs and consumables/equipment for TB diagnosis and follow-up, training of different levels of health staff, baseline and monitoring surveys as well as health education/visibility activities (including printing and multiplication of the national TB Guideline and procurement of the medical literature for the Central Unit). All these activities are considered essential for the implementa-tion/expansion of DOTS strategy in the country and, in terms of funding were not cov-ered from the usual budget (the salaries of the staff, the costs of the hospitalization of the patients, BCG vaccination campaigns). As a total the number of direct beneficiaries from the project were 700 TB patients, who are beneficiaries of the TB first, line drugs and re-agents and consumables for diagnosis and follow up.

European Union (1997). Treaty of Amsterdam, amending the Treaty on European Union, the Treaties establishing the European Communities and related Acts. Countries, territories and regions: Europe

Fabianova, E., N. Szeszenia-Dabrowska, et al. (1999). "Occupational cancer in central European countries." Environ Health Perspect 107(2): 279-82.
Countries, territories and regions: Romania, Bulgaria, Eastern Europe
The countries of central Europe, including Poland, the Czech Republic, Slovakia, Hungary, Romania, and Bulgaria, suffer from environmental and occupational health problems created during the political system in place until the late 1980s. This situation is reflected by data on workplace exposure to hazardous agents. Such data have been systematically collected in Skovakia and the Czech Republic since 1977. The data presented describe mainly the situation in the early 1990s. The number of workers exposed to risk factors at the workplace represent about 10% of the working population in Slovakia and 30% in Poland. In Slovakia in 1992 the percentage of persons exposed to chemical substances was 16.4%, to ionizing radiation 4.3%, and to carcinogens 3.3% of all workers exposed to risk factors. The total number of persons exposed to substances proven to be carcinogens in Poland was 1.3% of the employees; 2.2% were exposed to the suspected carcinogens. The incidence of all certified occupational diseases in the Slovak Republic was 53 per 100,000 insured employees in 1992. Cancers certified as occupational cancers are skin cancer caused by occupational exposure to carcinogens, lung cancer caused by ionizing radiation, and asbestosis together with lung cancer. Specific information on occupational cancers from Romania and Bulgaria was not available for this paper. It is difficult to predict a trend for future incidences of occupational cancer. Improved control technology, governmental regulatory activity to reduce exposure, surveillance of diseases and risk factors, and vigilant use of preventive measures should, however, ultimately reduce occupational cancer.

Faculty of Public Health (?). Reproductive behavior and primary stage of new-born children in conditions of socio-economic transition, Department of Social Medicine, Faculty of Public Health, Medical University of Varna, Bulgaria. Countries, territories and regions: Bulgaria

Farcas, D. D. (1999). "The Health Management Information System of Romania." Stud Health Technol Inform 68: 140-5.
Countries, territories and regions: Romania
In Romania a Health Management Information System (HMIS) project is in progress. The project covers the main activities of the Ministry of Health (MoH), of the 42 District Health Authorities and more than 250 other health care units. The first applications will be implemented at the middle of 1999. The paper shows the context of the HMIS among other Health Information Systems in Romania, its main parts and some organizational issues of the HMIS project, achievements and difficulties encountered.

Fatusic, Z. (2001). "Perinatal mortality in the Federation of Bosnia and Herzegovina." J Perinat Med 29(3): 247-9.
Countries, territories and regions: Bosnia and Herzegovina
AIM: The aim of the study was to investigate the most frequent causes of perinatal mortality in Bosnia and Herzegovina. METHODS: We analyzed in a retrospective study over a one year period (1999) the following cantons: Sarajevo, Mostar, Tuzla, Bihac, Gorazde, Travnik, Zenica, which represent about one half of the population of Bosnia and Herzegovina. RESULTS: Perinatal mortality in the analyzed regions within Bosnia and Herzegovina was 19.55@1000, which is unacceptable in comparison with developed countries. Early neonatal mortality (9@1000) was lower than late fetal mortality 10.55@1000. The most frequent causes of death were: premature birth, 6.32% of all deliveries; EPH gestosis with a rate of 9% of all deliveries and fetal anomalies with 0.68% of all deliveries. In Bosnia and Herzegovina, prematurity is the cause of early neonatal mortality in 78.5% of cases, while fetal anomalies are the cause in the early new-born period in 10.70% of cases. CONCLUSION: The results of pe rinatal mortality analyses in Bosnia and Herzegovina confirm that perinatal mortality directly depends on the development of the health care system, economic sustainability, and living conditions. Our results show that Bosnia and Herzegovina fall into the category of developing country with a perinatal mortality rate of 19.55@1000.

Federal Republic of Yugoslavia (2002). Interim Poverty Reduction Strategy Paper. http://poverty.worldbank.org/files/12563_Yugoslavia_IPRSP.pdf
Countries, territories and regions: Serbia and Montenegro

Fimka, T. G. (2002). Social-medical aspects of traffic accident traumatism in childen and youth in the republic of Macedonia (Macedonian language). Department of Social medicine. Skopje, University Ss Cyril and Methodius. Countries, territories and regions: Macedonia

Florian, B. (2003). Montenegro in Transition: Problems of Identity and Statehood.
Countries, territories and regions: Serbia and Montenegro
This book is closing an important gap in the literature on the former Yugoslavia, as the first overview over political, historical, and economic developments in Montenegro during the past decade in English. Researchers from Montenegro and outside cover all major aspects for understanding contemporary Montenegro; from its historical origins and the identity of Montenegrin to political, economic studies and an overview of minority-majority relations. Contents: Preface (Florian Bieber), Montenegrin politics since the disintegration of Yugoslavia (Florian Bieber), The dispute over Montenegrin independence (Beáta Huszka), The Belgrade agreement: robust mediation between Serbia and Montenegro (Wim van Meurs), Who are Montenegrins? Statehood, identity, and civic society (Srdja Pavlovic), A short review of the history of Montenegro (Serbo Rastoder), The economic development of Montenegro (Dragan Djuric), National minorities in Montenegro after the break-up of Yugoslavia (Frant isek Sistek and Bohdana Dimitrovova), Bibliography.

Forey, B., J. Hamling, et al. (2002). International Smoking Statistics. A collection of historical data fro 30 economically developed countries. Oxford, Oxford University Press,Wolfson Institute of Preventitive Medicine.
Countries, territories and regions: Worldwide

Fuenzalida-Puelma, H. L. (2002). Healthcare Reform In Central and Eastern Europe and In the Former Soviet Union. A Literature Review. Budapest, Hungary, Open Society Institute.
Countries, territories and regions: Eastern Europe

Gardemann, J. (2002). "Peace and public health: 1999 Kosovo experience." Croatian Medical Journal 43(2): 103.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Gardemann, J. (2002). "Primary Health Care in Complex Humanitarian Emergencies: Rwanda and Kosovo Experiences and Their Implications for Public Health Training." Croat Med J 43(2): 148-155.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Garfield, R. (2000). Economic sanctions, health and welfare in the Federal Republic of Yugoslavia 1990-2000, UNICEF, OCHA. Countries, territories and regions: Serbia and Montenegro

Gaspar, F. (2000). Regional Monitoring of Child and Family Well-being: UNICEF's MONEE project in CEE and the CIS in a comparative prespective. Florence, UNICEF Innocenti Research Centre. Countries, territories and regions: Eastern Europe
The paper outlines the goals, organization and methodology of one of the most authorita-tive attempts to monitor the situation of children and women in countries undergoing rapid social and economic change. UNICEF's "Public Policies and Social Conditions: Monitoring the Transition in Central and Eastern Europe and the Commonwealth of In-dependent states", known as the MONEE project, has been gathering and sharing data on the situation since 1992. The project, through a series of reports on child and family well-being, has had remarkable impact on policy makers, academics, politicians and members of the public. One of the keys to its success has been the comprehensive set of demo-graphic and social indicators and related policy and informational information collected via a wide network of experts. By drawing a comparison with similar analytical efforts, this paper highlights the distinctive features of the project, including a holistic and re-gional perspective based on a systematic mix of statistical and analytical investigations. This approach offers some comparative advantages relative to UNICEF's global surveys and national situation analyses in terms of its capacity to grasp key patterns of change and the role of institutional factors. While proposing a greater role for regional monitor-ing in development work, the paper envisages that similar efforts will not always take the same path. It concludes, however, that the MONEE project also provides valuable lessons for social monitoring in other countries and regions.

Geary, J. (1994). "Birth of a nation: family planning in Albania." ORGYN 2: 2-8.
Countries, territories and regions: Albania

Geddes, J. (2000). "Bosnia and Herzegovina. The challenge of change." Can Fam Physician 46(276): 278-80.
Countries, territories and regions: Bosnia and Herzegovina

Georgiev, D. B. and A. R. Goudev (2001). "Bulgaria's health-care reforms - there may be trouble ahead." Lancet 357(9257): 695.
Countries, territories and regions: Bulgaria

Georgieva, L. (2002). "Some troublesome tendencies in the dynamics of tobacco smoking among the population of Bulgaria." Social Medicine Journal 4: 24-27.
Countries, territories and regions: Bulgaria
The serious socio-economical and demographic changes in Bulgaria after 1989 year have made it well-known as a country with one of the most higher death rate from cardiovascular diseases (CVD). The paper presents wide picture of the prevalence of the smoking in Bulgaria in comparison with the results from MONICA and a stage of the epidemic of smoking in England. It analyzes the tendencies for its development and suggests measures for its restriction. Sofia Heart Study (SHS) has been conducted in Bulgarian capital in 1994. The analysis of the main characteristics of smoking 'epidemic' in Bulgaria proved that it was one of the last European countries showing tendency towards increase in the number of smokers. The portion of male smokers was continuously growing, reaching its maximum of 74%. There was also an alarming increase in the number of female smokers although it was still low compared to the number of male smokers. The percent of Bulgarian citizens who quitted smoking was comparatively low and there was a great outbreak of tobacco-smoking among highly educated people. Another survey has been carried out in Sofia five years after SHS 94. The outcomes were: slight increase in the percent of smokers in comparison with the respondents interviewed in 1994 in the age group 25 - 54 (more than 50.0% of the people < 45 years were smoking) and slight decrease in the group 55 - 74 for both genders (about 10.0% of the people > 64 were smokers). Another tendency was the increase in frequency of smoking among the youngest age groups and lower threshold of taking to smoking (from 13 to 14 years of age among adolescents).

Georgieva, L., J. Powles, et al. (2002). "Bulgarian population in transitional period." Croat Med J 43(2): 240-4.
Countries, territories and regions: Bulgaria
In the transition period from a communist to market-oriented economy, Bulgaria faces several public health challenges. One of them is the decline in population (estimated fall from current 8.25 million to around 6 million in 2045), mainly due to emigration and pronounced fall in fertility. Infant mortality is still relatively high (over 15/1,000 live births), and the incidence of tuberculosis is on the rise. Total mortality shows a steady upward trend from 12.1/1,000 in 1990 to 14.3/1,000 in 1998. Trends in ischemic heart disease are comparable to those in other Central and Eastern European countries, but stroke mortality is notably higher. This calls for detailed epidemiological studies of risk factors, such as salt consumption, as well as preventive programs for detection and control of high blood pressure. The problems of smoking and alcohol abuse should be addressed by a coordinated public health and legal measures.

Georgivea, K. and I. Dimitrova (2000). "Sexual behavior of heterosexual undergraduates." Social Medicine Journal 1: 8-11.
Countries, territories and regions: Bulgaria
Two hundred and nine heterosexual undergraduate medicine and dentistry students, mean age 20.5 + 0.1 years, 52.6%-male, completed a self-reported questionnaire about AIDS-related sexual behavior. 78.5% were coitally experienced and mean age of sexual debut is 17.7+0.1. Two or more lifetime sexual partners have had 62.9% of them. The condom use of sexually active students is inconsistent& 64.1% had at least one unprotected vaginal intercourse; 68.7% - unprotected and intercourse and 90.1% - unprotected fellation in the last 3 months before survey. Men are significantly more likely than women to engage in HIV-risk behavior. These results clearly support the need of an urgent campaign promoting proper sex education for young people.

Ginter, E. (1997). "Recent trends in health status of the male population in postcommunist Europe." Cent Eur J Public Health 5(4): 174-6.
Countries, territories and regions: Eastern Europe
At the time of the collapse of the Soviet bloc in 1989-1990, male life expectancy in Central and Eastern Europe was significantly lower than that in Western Europe. Recent trends in health status in this region are very different: steady improvement in the Czech Republic, first signs of improvement in the Slovak Republic and Poland, slight aggravation in Hungary and Bulgaria and health collapse in the Russian Federation. Male life expectancy at birth in the Czech Republic reached in 1995 70.0 years, while in the Russian Federation it decreased in 1994 to 57.7 years. The increase in life expectancy in the Czech Republic is attributable to the decline of infant mortality and of cardiovascular mortality in middle-aged males. The decrease in life expectancy in the Russian Federation is attributable to the increase of cardiovascular mortality and to an extremely high increase of mortality caused by accidents, suicides and homicides. Pandemic of alcoholism plays a significant role in the unfavourable health trends in the Russian Federation.

Gjonca, A. and M. Bobak (1997). "Albanian paradox, another example of protective effect of Mediterranean lifestyle?" The Lancet 350(December 20/27): 1815-17.
Countries, territories and regions: Albania

Gjonca, A., C. Wilson, et al. (1999). Can Diet and Life Style Explain Regional Differences in Adult Mortality in the Balkans? Rostock, Max-Planck-Institute for Demographic Research. Countries, territories and regions: South Eastern Europe

Gjorgov, A. N. and V. Lazarevik (2001). A Knowledge, attitude and practice (KAP) study of Roma Women, in reproductive and sexual health, family planning and cancer screening, in Shuto Orizari, Skopje, Macedonia. Countries, territories and regions: Macedonia

Gjorgov, A. N. and V. Lazarevik (2002). Reproductive profiles of redisent and refugee Roma women in Macedonia. Skopje, National Health Insurance Fund
Ministry of Health. Countries, territories and regions: Macedonia

Glaros, D., C. Lionis, et al. (2001). "Health care in Albania: what of the future?" Lancet 357(9261): 1047.
Countries, territories and regions: Albania

Glasper, E. A., L. Robertson, et al. (1998). "Hospital vs community care: a Romanian perspective." Br J Nurs 7(17): 1027-32.
Countries, territories and regions: Romania
In the Summer of 1997, two Romanian charities which provide financial support to care for children with human immunodeficiency virus (HIV) living in Romania invited a team of healthcare professionals to conduct an independent audit of care for children nursed in hospital and community settings. The primary objective of the mission was to: witness hospital and community care of HIV positive children; work with Romanian healthcare professionals in the development of a simple user friendly audit tool for use in a variety of child care settings; and utilize the tool to audit and produce a written report related to care provision in the hospital and community home setting. The results of the audit exercise demonstrate that the provision of care for HIV positive children in the community homes exceeds that of similar children cared for in a tertiary hospital setting.

Gledovic, Z., M. Jovanovic, et al. (2000). "Tuberculosis trends in Central Serbia in the period 1956-1996." Int J Tuberc Lung Dis 4(1): 32-5.
Countries, territories and regions: Serbia and Montenegro
OBJECTIVE: To estimate tuberculosis incidence and mortality trends in Central Serbia (excluding Kosovo and Vojvodina provinces) in the period 1956-1996. DESIGN: The incidence and mortality data of tuberculosis in Central Serbia in the period 1956-1996 were analysed based on the annual reports of the Institute for Lung Diseases and Tuberculosis in Belgrade and the official data of the Republic Health Institute. RESULTS: During the period under observation, tuberculosis incidence decreased from 324.0 to 34.8/100 000 population, fitting the exponential model (y = 389.066e-(0.0689); F = 847.60; P = 0.000). Mortality rates decreased from 76.0 in 1956 to 0.9/100000 in 1982. Over the whole period (1956-1996) the decrease in mortality rates fitted the exponential model (y = 66.83e-(0.0922); F = 150.95; P = 0.000). The increase in mortality rates in the period 1982-1996 fitted cubic model (y = 7.647 - 2.674x + 0.359x(2)-0.013x(3); F = 12.17; P = 0.001). CONCLUSION: Decreasing trends i n tuberculosis incidence are the result of good control programmes. Changes in mortality trends are related to migration from war zones and poor economic conditions which hinder the detection and treatment of tuberculosis.

Glenny, M. (1999). The Balkans 1804-1999: Nationalism, War and the Great Powers, Granta Books.
Countries, territories and regions: South Eastern Europe

Godwin, M., G. Hodgetts, et al. (2001). "Primary Care in Bosnia and Herzegovina. Health care and health status in general practice ambulatory care centres." Can Fam Physician Feb(47): 289-97.
Countries, territories and regions: Bosnia and Herzegovina
OBJECTIVE: To assess the health care and health status of patients attending primary care clinics in Bosnia and Herzegovina. DESIGN: Assisted administration patient survey. SETTING: Two ambulatory care clinics (ambulantas) in each of three cities in Bosnia and Herzegovina: Tuzla, Mostar, and Banja Luka. PARTICIPANTS: Patients attending the ambulantas during a 1-week period in March 1999; 885 answered questionnaires. MAIN OUTCOME MEASURES: Each patient listed demographic characteristics and answered questions on satisfaction with health care and with the physical and financial accessibility of health care services and medications. A validated health status questionnaire (EuroQoL), previously used in parts of the former Yugoslavia, was administered. RESULTS: Only 22% of patients were employed; 57% could not pay the nominal fee to see a physician; 71% walked to the clinic; mean distance from patients' homes to the clinics was 2.3 km; 63% could not get the medications prescribed (in 85% of cases because of cost, not availability); 80% to 90% of answers to satisfaction questions suggested high satisfaction with the care patients received from their doctors; 67% of the time patients were referred to a specialist by general practitioners; 33% had problems walking; 17% had problems with self-care; 36% had problems with usual daily activities; 72% had at least some pain or discomfort; and 62% described at least some anxiety or depression. The three cities showed significant differences; patients in Tuzla generally had lower health status and more problems with health care. CONCLUSION: Unemployment and financial considerations reduced health care access in Bosnia and Herzegovina. While only one third of patients had physical difficulties, two thirds had emotional problems or pain. Satisfaction with physicians' care was high.

Goldman, R. L. (1999). "Primary health care in the reforms of the health care system: an analysis of reformation schemes of emerging and developing countries as applied to the Republic of Macedonia." Health Mark 17(2): 87-93.
Countries, territories and regions: Macedonia

Goldstein, R. D., N. S. Wampler, et al. (1997). "War experiences and distress symptoms of Bosnian children." Pediatrics 100(5): 873-8.
Countries, territories and regions: Bosnia and Herzegovina

Golusin , Z., M. Poljacki, et al. (2001). "Occurence of sexually transmitted diseases in Vojvodina during the last 20 years." Med Pregl 54(11-12): 543-6.
Countries, territories and regions: Serbia and Montenegro
INTRODUCTION: Sexually transmitted diseases are the most often registered communicable diseases in a great number of countries. The aim of this study was to analyze dynamics and distribution of gonorrhea, syphilis and scabies in Vojvodina region during the last twenty years. MATERIAL AND METHODS: Epidemiological characteristics of gonorrhea, syphilis and scabies were analyzed on the basis of data obtained from the Section of Epidemiology of the Institute of Public Health in Novi Sad. The research included the period between 1980 and 1999, with sex and age distribution of patients. Morbidity rates were given per number of inhabitants of Vojvodina. RESULTS: In the period between 1980-1999 there were 454 registered patients with the diagnosis of syphilis in Vojvodina. The morbidity ratio was highest in 1980 (3.41/100.000), and lowest in 1991 (0.24/100.000). In the twenty-year period there were more patients with gonorrhea, than patients with syphilis. There were 44.621 registere d patients with gonorrhea. The maximum morbidity ratio was in 1980 (25.09/100.000), but the minimum was in 1998 (1.68/100.000). Within the examined period scabies was recorded in 56.490 patients. The highest morbidity ratio was in 1984 (232.37/100.000) and the lowest was in 1992 (73.56/100.000). DISCUSSION: The average morbidity ratio of syphilis in USA, between 1992-1994, was 11.8/100.000 and at the same time in Vojvodina it was only 0.42/100.000. In Vojvodina most patients with this disease were 20-39 years old. In the same period in USA the ratio of gonorrhea patients was 309/100.000 and in Vojvodina it was 2/100.000. In this group also, most patients were 20-39 years old. However, scabies mostly appeared at the age of 7-14. CONCLUSION: According to the obtained results, the number of registered patients with these three diseases in Vojvodina stagnates or it decreases. In order to deal with real data, it is necessary to report these diseases regularly.

Government of Bosnia and Herzegovina (2000). National Report on Follow-up to the World Summit for Children Bosnia and Herzegovina, Government of Bosnia and Herzegovina. Countries, territories and regions: Bosnia and Herzegovina

Government of Bulgaria (1999). "Act on Control of Drugs and Precursors, Bulgaria."
Countries, territories and regions: Bulgaria

Government of Bulgaria (2000). National Programme on Suicide Prevention. Countries, territories and regions: Bulgaria
Every year 1500 people die from suicide in Bulgaria, namely 3-4 people per day. During the last few years their number exceeded the number of people who died in motor vehicle accidents; this ranked suicide mortality first in the structure of mortality which is due to the so called 'external causes / reasons', i.e. lethal cases, not caused by disease. According to official data, in the year 2000 suicide mortality amounts to 17 out of 100 000 people, and the mortality caused by motor vehicle accidents - to 15.2. Two contrary tendencies have developed since 1989 (the year in which the political and socio - economic changes have started in Bulgaria): decrease in mortality caused by motor vehicle accidents and increase in the suicide mortality. Suicide mortality among young Bulgarian citizens aged 15-35 (according to the criteria of the EU) figures out at 9,5 to 100 000 people in the year 2000. Growth in this indicator is apparent.The increasing tendency of suicide mortality amo ng teenagers (15-19 years - old) is very alarming. The attempted unsuccessful suicides are repeatedly / much more. 2935 suicide attempts have been registered in the country in the year 2000. Namely, 8 individuals make attempts to take away their lives daily. About half of the registered parasuicides (47%) belong to the younger age groups. 165 children 14 years old and younger have ever attempted suicide which means that a child makes such an attempt every two days. Most of the people attempting suicide have been somatically and mentally healthy. The comparatively high number of the unemployed stands out in the social structure. On one hand, this emphasizes the social determination of the suicide actions, on the other hand it gives a direction to the activities aiming to prevent suicide.
In 2000 medical specialists have treated about 4300 persons who performed a suicide action. Respectively 2612 out of these have received hospital care, meaning that 7 beds per day have been occupied by such patients. The average length of stay is 3 days. The greatest was the work-load of the toxicologic wards. A team for suicide prevention has been established to the National Center of health prophylaxis in 1994, uniting specialists from different offices and departments, working in that field. The team has prepared a project and initiated its approbation in five pilot areas in the country: the regions of Sofia-city, Elin Pelin, Bourgas, Dobritch and Plovdiv in the period from 1996 to 1998.
The surveys carried out in the field of suicides during the last 50 years and the information provided, have been insufficient. After the successful approbation of the program, it has been accepted at collegiums in the Ministry of Health. The realization of the activities has been entrusted to the National Center of Public Health, The National Center of Health Information, the Hygiene and Epidemiological Inspections and the Regional Centers for Health. The Centers for Mental Health, as well as the other psychiatric services on a regional level have been also entrusted with the accomplishment of the suicide prevention activities. The program started in the year 2000.
Strategic purpose: Improvement of the health and demographic status of the Bulgarian population
Main purpose: Decrease in the frequency of the suicidal attempts and in the suicide mortality.
Aims:
1.Restricting the influence of the factors, determining suicide behavior 2. Increasing the protective factors
3. Forming psychological skills, adequate to the social environment

Approaches: high risk approach and population approach

The successful suicide prevention supposes / involves a combination of these two approaches with a view to achieve an optimal effect.

Objectives:

1. Assessment of the initial situation in the country before the implementation of the program
2. Construction and maintenance of data base for monitoring of suicides and attempted suicides on national and regional level and for an evaluation of the effectiveness and efficacy of suicide prevention activities.
3. Elaboration and application of health-educating programs and projects
4. Elaboration and application of programs and projects in primary, secondary and tertiary suicide prevention
5. Formation and maintenance of an environment that is supportive for the realization of the program
6. International collaboration

Financing of the program activities is expected to be purposefully fulfilled by the budget of Ministry of Health

Government of Bulgaria (2002). Act on blood, blood products and their application (www.mh.government.bg/program_and_strategies.php). Countries, territories and regions: Bulgaria
This act regulates the order and conditions of donation, diagnosis, processing, preservation and usage of blood and blood components; assurance of high quality and safety of blood and blood products; planning the type and quantities of blood and blood products to satisfy the needs of the medical institutions delivering health care as well as financing of the activities concerning provision with blood and blood products. Minister of Health organizes, coordinates and controls the activities mentioned above in order to observe the principles of free will when donating blood; protection of the donors' rights and health; equity of patients and protection of their health; rational use of blood and its components and self-sufficiency of the country with blood and blood products. All able bodied persons aged 18-65 can become donors unless they have any medical contra-indications.

Government of Bulgaria (?). "Health Care Institutions/Establishments Act."
Countries, territories and regions: Bulgaria

Government of Bulgaria (?). "Health Insurance Act."
Countries, territories and regions: Bulgaria

Government of Bulgaria (?). "Act on Pharmaceuticals."
Countries, territories and regions: Bulgaria

Government of Bulgaria (?). "Act on Professional Associations (Medical)."
Countries, territories and regions: Bulgaria

Government of Bulgaria (?). "Act on Public Health."
Countries, territories and regions: Bulgaria

Government of Bulgaria (?). Act on foods. Countries, territories and regions: Bulgaria

Government of Romania (2001). The governing program for 2001-2004 - Improving the health of the population and child welfare (www.guv.ro), Government of Romania,. Countries, territories and regions: Romania
The major goals for the health system are: development of an integrated health care services; fostering the institutional capabilities for health care reform implementation; prevention and control of transmissible diseases; prevention and control of chronic diseases; decrease of infant morbidity and mortality; and increase the equity, and responsivity.
The governing program has three components:
a) Health care
The governmental program in this fields proceeds from the fact that health care must be a collective social asset, accessible to all citizens of Romania, irrespective of their solvency, on the background of free and balanced access to health care services.
In establishing the actions and measures to be taken toward the strategic goal "A healthier Romania, with low morbidity and less premature deaths," account was taken of the discrepancy between the population's health care needs, the structure and orientation of health care services. Also considered was the fact that the current health care system has too many units where certain services are overstrained while others are inefficient and that there is an overemphasis on hospital services to the detriment of outpatient and community care services.
b) Policy regarding the family
The policy regarding the family focuses on three main directions: families with small children, marriage and family relations, and the balance between work and family.
c) Child welfare
Protection of all children's rights in Romania has to be backed firmly and unequivocally. Thus the health and well being of children will be a priority of the Government Program. To this end, a global, unitary, modern and durable system will be promoted, in tune with European standards.
See web page: www.guv.ro

Government of the FR Yugoslavia (2001). National Report on Follow-Up to the World Summit for Children. Federal Republic of Yugoslavia. Countries, territories and regions: Serbia and Montenegro

Government of the Republic of Macedonia (2000). Poverty reduction strategy paper (interim version). Skopje, Government of the Republic of Macedonia. Countries, territories and regions: Macedonia

Government of the Republic of Serbia (2002). Health Policy, as adopted in February 2002. Countries, territories and regions: Serbia and Montenegro

Government of the Republic of Serbia and Ministry of Health (2001). Brussels donors conference paper, Health Section. Countries, territories and regions: Serbia and Montenegro

Greek EU Presidency (2003). Policy Paper for the GreeK EU PResidency - Western Balkans. An Agenda for stability, development and integration, Greek EU Presidency. Countries, territories and regions: South Eastern Europe

Gunby, P. (1998). "Medical care echoes regional fragmentation in the Balkans." JAMA 280(19): 1645-6.
Countries, territories and regions: South Eastern Europe

GVG and European Commission (2002). Study on the Social Protection Systems in the 13 Applicant Countries. Romania Country Report. Second Draft, GVG
European Commission. Countries, territories and regions: Romania

GVG and European Commission (2002). Study on the Soocial Protection Systems in the 13 Applicant Countries. Bulgaria Country Report. Second draft, GVG
European Commission,. Countries, territories and regions: Bulgaria

Hadzihalilovic, J. and R. Hadziselimovic (2001). "Growth and development of male children and youth in Tuzla's region after the war in Bosnia and Herzegovina." Coll Antropol 25(1): 41-58.
Countries, territories and regions: Bosnia and Herzegovina
A four-year aggression on Bosnia and Herzegovina was extremely unfavourable period for growth and development of children and youth. In spite of that, it is established that ontogeny of male children and youth (between 10.5-19.5 years) on the observed region is going well, and it is within the limits at the average European standards. By parallel analysis of growth of domestic and expatriate persons, it is established that the average (sum) values of almost it's all indexes are significantly bigger for domestic (object) inhabitants. However, after the end of growth, they become approximately the same. By comparison of indexes of growth and development of the tested sample and samples from 1980 (of the same population), the soft acceleration trend for majority (indexes) of parameters is established, what is mostly seen in postpuberty age. The tested persons in pre-puberty and puberty age had the same or even less average values comparing to the tested persons from 1980. This i s probably a direct result of negative influence of exogenous factors (war vital conditions), which caused temporary stoppage in growth and development in that period of growth when growth is the most intensive. Despite the fact that war life conditions have negatively affected the growth and development of the subjects studied, it has been found that the development of male children and youth, meaning the growth of different parameters on the studied area were in synchrony.

Hajioff, S., G. Pecelj, et al. (2000). Health Care Systems in Transition: The former Yugoslav Republic of Macedonia. Copenhagen, European Observatory on Health Care Systems.
Countries, territories and regions: Macedonia
This Report present the major changes (planned and planned) through which the health care sys-tem in Macedonia has undergone in the last decade, facing enormous challenges linked with the transition to independence. economic blockades, embargoes and refugee crisis. The Report is structured following the recommendations in the guidelines for this type of country report: Gov-ernemnt and recent political history; demographic indicators; resent history of the health care system; organisational structure of health care system; planning, regulation and management; health care finance and expenditure; main system: health insurance and scheme; health care benefits and rationing; complementary sources of finance; health care expenditure; health care delivery system (primary, secondary, tertiary, public health services); social care; human re-sources; pharmaceuticals, investing in technology, financial resource allocation, payment of hos-pitals, payment of professionals; health care reforms. Reform trends were to shift from a service dominated by secondary care to one led by primary care. It is difficult to measure the success of the reforms under such extreme circumstances and difficult context and to implement standard setting and performance assessment. Health reforms despite all obstacles had a few successes. Still some inequalities remain, especially in rural area and financial inequalities. The health sys-tem offers to improve efficiency and with improved economic situation in the country the needed changes can be carried forward.

Harris, M. (1997). "One hell of a trip." Ment Health Care 1(2): 48-50.
Countries, territories and regions: Romania
In 1989 the uprising against the Ceausescu regime blew the lid off the hidden horrors of Romania's mental hospitals. Aid poured in from western agencies and charities. Eight years on, with attention switched elsewhere, how much has changed?

Harxhi, A., L. Pernaska, et al. (2002). Rapid Assessment and Response on HIV/AIDS among especially vulnerable young people in Albania. Countries, territories and regions: Albania

Hayes, O. W. and H. Novkov (2002). "Emergency health services in Bulgaria." Am J Emerg Med 20(2): 122-5.
Countries, territories and regions: Bulgaria
The emergency care system in Bulgaria is evolving as a hybrid of the former "Soviet-style" health service and western-style emergency medicine. Bulgaria like other "Eastern bloc" Communist nations has undergone a sweeping socioeconomic transformation during the past 10 years. These changes have had profound consequences including the development of emergency services and the recognition of emergency medicine as a specialty in Bulgaria. Copyright 2002, Elsevier Science (USA). All rights reserved.)

Health Canada (2002). Rapid Assessment of Serbia HIV/AIDS/STI Surveillance System. Field Investigatio Report, Health Canada. Countries, territories and regions: Serbia and Montenegro

Health Canada (2002). Rapid Assessment of Montenegro HIV/AIDS/STI Surveillance System. Field Investigation Report. September 28 - October 2, 2002, Health Canada. Countries, territories and regions: Serbia and Montenegro

Health Development Agency (2002). Public Health and Health Promotion Strategy, Reference document, DRAFT. Countries, territories and regions: Albania

Healthy Options Project Skopje (2003). Profile of Health Options Project Skopje. Annual report. Skopje, Foundation Open society Macedonia. Countries, territories and regions: Macedonia
HOPS is a non-governmental, non-profit and non-partisan organization that started operating as a project supported by The Lindesmith Center and The Open Society Institute Macedonia in 1997. During this period it has successfully implemented programs for reduction of drug related harm, prevention of HIV/AIDS and other sexually transmitted and blood-borne diseases, as well as programs for social reintegration and re-socialization targeting young people and vulnerable groups (drug users and their families and sex workers and their families) in Skopje, Macedonia. HOPS raise funds from governments, charitable foundations, companies and individual donors. HOPS is Member of the Technical Working Group within the UN Theme Group for HIV/AIDS in R. Macedonia; Coordinator of the Harm Reduction Working Group within the City Coordinative Body for Fight Against Drugs in Skopje; Co-founder of the Harm Reduction Coalition for South-Eastern Europe and organizer of the First Harm Reduction Con ference for South-Eastern Europe, held in Skopje, 10 December, 1999. In the year 1999, HOPS developed and organized the Second National Campaign for HIV/AIDS prevention in Macedonia. In the year 2000 HOPS implemented the first project for HIV/AIDS prevention and social assistance for women involved in prostitution and their families. In 2001/2002, HOPS has expanded its activities in three other cities in Mace-donia (Tetovo, Kumanovo and Ohrid), starting outreach activities for HIV/AIDS preven-tion among drug users. It has also initiated the establishment of Macedonian Harm Re-duction Network. HOPS has already spun off four NGO's as a result of it's implemented projects: "Health Education and Research Association", "RONDO - Music School", "LIM-PID - Association for Development of Urban Subcultures" and "PASSAGE - Ma-cedonian Association of Drug Users".

Healy, J. (1999). "Croatia: sustainable health services." Euro Observer 1(3): 8.
Countries, territories and regions: Croatia

Healy, J. and M. McKee (2001). "Implementing hospital reform in Central and Eastern Europe." Health Policy 61: 1-19.
Countries, territories and regions: Eastern Europe

Heath, I., A. Haines, et al. (2000). "Joining together to Combat Poverty." Croat Med J 41(1): 28-31.
Countries, territories and regions: Croatia

Hertzman, C. and A. Siddiqi (2000). "Health and rapid economic change in the late twentieth century." Social Science & Medicine 51(6): 109-19.
Countries, territories and regions: Eastern Europe

Heymann, M. (2001). "Reproductive health promotion in Kosovo." J Midwifery Womens Health 46(2): 74-81.
Countries, territories and regions: Kosovo, Serbia and Montenegro
Relief agencies that specialize in postwar emergency relief and then work to contribute to sustainable development as the crisis ends are increasingly recognizing the positive impact of midwifery care and training on reproductive health outcomes. Midwives are finding work and developing new roles in postwar reconstruction and refugee health care. This article describes the experiences of a nurse-midwife who worked for Mercy Corps International in Kosovo and launched the Kosovo Women's Health Promotion Project. A short history of the conflict in Kosovo, the effects of the war on its people and the health care system, a description of women's health care, and the status of women in Kosovo are included.

Hinkov, H., S. Koulksuzov, et al. (1999). Health Care Systems in Transition: Bulgaria. Copenhagen, European Observatory on Health Care Systems.
Countries, territories and regions: Bulgaria

Hofmarcher, M. M. (1998). "Is public health between East and West? Analysis of wealth, health and mortality in Austria, Central and Eastern European Countries and Croatia relative to the European Union." Croatian Medical Journal 39(3): 241-8.
Countries, territories and regions: Croatia, Eastern Europe
To provide a conceptual framework for health planning activities in the "middle income" transition countries. METHOD: Economic, demographic, and disease-related data in Central and Eastern European (CEE) countries, including Croatia and Austria, were compared to the Europen Union (EU) average. Data were selected from the databases provided by the World Health Organization, Organization for Economic Cooperation and Development, World Bank, United Nations, and the European Bank of Reconstruction and Development. Life expectancy and mortality were extrapolated until the year 2000 by using an exponential growth model for the WHO time series data, starting in 1994. Death rates due to ischemic heart diseases (18%) and cerebrovascular diseases (13%) were selected to show frequent causes of death. RESULTS: Relative to the EU average, the gross domestic product (GDP) share of health expenditures in transition countries was disproportionate to wealth and premature death. The population in CEE-countries was younger and the share of people aged >65 was predicted to remain about 15% below the EU average and Austria. For Croatia, the share of people aged 65 would be on the increase, similar to the share predicted for Austria (slightly above the EU average). Mortality of selected non-communicable, chronic diseases is predicted to increase and remain relatively high. Mortality rates due to infectious diseases have been declining but remained comparatively on a high level. CONCLUSIONS: Coexistence of demographic and epidemiological transition along with high mortality rates due to infectious diseases creates a "double burden". Economic transition has the potential to comprise both the increase in wealth, and life and health expectancy.

Horton, R. (1999). "Croatia and Bosnia: the imprints of war -1. Consequences." The Lancet 353(June 19): 2139-44.
Countries, territories and regions: Croatia, Bosnia and Herzegovina
As Serbia and Kosovo emerge from yet another European war, their people's health and the region's health care, scientific research, and medical education have been seriously damaged and disrupted. There are lessons to be learned from recent Balkan wars, lessons that might help doctors, international relief organisations, and governments to do better than they have done elsewhere during the long reconstruction period that will follow this recent savage conflict. An analysis of the medical legacies of war may also raise issues for doctors worldwide to consider as part of their role in a larger public-health community. For a week in May, 1999, I travelled to Croatia and the Croat-Muslim Federation of Bosnia-Herzegovina to meet doctors working in peace but next to war. In the first part of this essay, I briefly survey some of the medical consequences of the Croatian and Bosnian conflicts. In the second part, to be published in the June 26 Issue, I consider plans for and limitatio ns to restoration, and try to identify possible opportunities for prevention of the adverse health effects of war in a newly enlarged Europe.

Horton, R. (1999). "Croatia and Bosnia: the imprints of war - II. Restoration." The Lancet 353(June 26): 2223-8.
Countries, territories and regions: Croatia, Bosnia and Herzegovina

Hrabac, B., B. Ljubic, et al. (2000). "Basic package of health entitlements and solidarity in the Federation of Bosnia and Herzegovina." Croat Med J 41(3): 287-93.
Countries, territories and regions: Bosnia and Herzegovina
The aim of this report is to provide an overview of the methodology for designing a basic package of health entitlements and solidarity in the Federation of Bosnia and Herzegovina which will, respecting the principles of solidarity and equity, guarantee equal rights to all citizens of the Federation. After the analysis of the situation, we specified the reasons for the reform, listed the objectives, and described the basis of the basic package design, the establishment of federal solidarity, and the plan of realization. We discussed the background ethical theories of our policy choice, explicitly stated the normative and technical criteria for priority setting, and deliberated Federal financing solidarity policy and allocation methodology, as well as criteria for "risk equalization" among cantons.

Hristova, L. and I. Dimova, M (1997). "Projected cancer incidence rates in Bulgaria, 1968-2017." Int J Epidemiol 26(3): 469-75.
Countries, territories and regions: Bulgaria
BACKGROUND: Incidence predictions are applicable when planning preventive or screening health care programmes, diagnostic, treatment and rehabilitation facilities. The aim of this study was to predict future (1993-2017) incidence rates of the most common sites of cancer in Bulgaria: breast, cervix and corpus uteri in females, and lung, prostate and stomach in males. METHOD: Observed numbers of incident cases in the period 1968-1992 and observed (predicted) population size were employed. Age-cohort and age-cohort-period log-linear models were fitted to the observed data, assuming no change in the observed trends. RESULTS: The incidence rates for all the studied primary sites, except stomach cancer, were predicted to increase. The observed rates in the period 1988-1992 and the predicted rates in the period 2013-2017 per 100000 were in females: breast-from 38.8 to 64.6, cervix-from 12.8 to 19.3, corpus uteri-from 12.4 to 26.5. In males similar rates were: lung-from 41.0 to 73.8, prostate-from 10.1 to 15.0 and stomach-from 17.5 to 10.2. Due to the increasing incidence rates and ageing of the population the predicted number of new cases in the studied sites of cancer in the period 2013-2017 is 62% higher than that observed in the period 1988-1992.

IHRD International Harm Reduction Development and Open Society Institute (2001). Drugs, AIDS and Harm Reduction. How to slow the HIV Epidemic in Eastern Europe and the Former Soviet Union. New York, IHRD International Harm Reduction Development, Open Society Institute. Countries, territories and regions: Eastern Europe

Iliev, Y., V. Akabaliev, et al. (2001). "Acute poisoning mortality rate in Plovdiv Region, Bulgaria." Arh Hig Rada Toksikol 52(3): 307-13.
Countries, territories and regions: Bulgaria
The severe recession in Bulgaria which followed the collapse of the totalitarian regime in 1989 had an unfavourable impact on the health status of the population. Systematic studies of acute poisoning mortality rate in the transitional period (1990-98) are scarce in the post-totalitarian Eastern European countries and are lacking in Bulgaria. This retrospective study analysed 1,150 deaths due to acute poisoning in Plovdiv Region for the period 1961-98. Acute poisoning mortality rate was moderately high in the period between 1990 and 1998 with respect to the average of 4.99 per 100,000 a year. It grew steadily during rapid socialist industrialization (1961-90) and showed a trend of slight decrease during transition (1991-1998). The decrease may largely be accounted for by the foundation of the regional toxicological centre and to a certain degree by a drop in industrial and agricultural production and exposure to hazards.

Illieve, I., B. Chalukova, et al. (2000). Project on Development of Prevention Strategy for the Young People at the Age of 10-24 from Psychoactive Substance Use, risk Sexual Behaviour, HIV/AIDS and STD. Varna, Bulgaria. Countries, territories and regions: Bulgaria

IMF-IDA (2000). Former Yugoslav Republic of Macedonia :Interim Poverty Reduction Strategy Paper. Countries, territories and regions: Macedonia
The Documents presents a short overview on the poverty data and analysis in the country; poverty reduction policies ( in the economic, health and social safety sector, education, labor market, rural and regional development);preparation plans for the strategy, support and coordination by partners, risks to the strategy, overall staff assessment. In the Health care policy it is emphasized a need for more accurate data on the issue of the access to the health care services for the poor people. There is also a need for more public health pro-grams beyond those already in operation and a need to move as quickly as possible on problems such as : too many doctors with too little training, inefficient hospitals, lack of access to subsidized drugs, uninsured individuals and a lack of financial management and public accountability of the Health Insurance Fund. As an attachment the Interim version of the paper has been enclosed.

Inclusion Europe and Republic Centre for Helping Persons with Mental Handicap (2002). Human Rights of Persons with Intellectual Disability. Country Report Republic of Macedonia. Brussels, Inclusion Europe, Republic Centre for Helping Persons with Mental Handicap,. Countries, territories and regions: Macedonia

INSTAT (2001). The population of Albania in 2001, INSTAT. Countries, territories and regions: Albania

INSTAT (2003). Preliminary Results of the General Census of Population and Housing, April 1, 2001, http://pages.albaniaonline.net/repoba/zyra_shtypit/prel_eng.htm. Countries, territories and regions: Albania

Institute for Health Protection (2001). Report for Realization of AIDS Preventitive Program of the Population in the Republic of Macedonia for 2001. Skopje, Institute for Health Protection. Countries, territories and regions: Macedonia

Institute for Health Sector Development (2002). Contract Consulting Services for Health Care Financing Development. Report to the Ministry of Health of the Provisional Self-Government of Kosova, Institute for Health Sector Development. Countries, territories and regions: Kosovo, Serbia and Montenegro

Institute for Mother and Children (2002). Report on Program for mothers and children (annually). Skopje, Institute for Mother and Children. Countries, territories and regions: Macedonia
Content: demographic characteristics (woman in reproductive period, mothers and chil-dren), infant mortality, health care for woman in reproductive period (antenatal, during and after delivery), health care for children (preventive and curative), health status of children at age 0-6, health care of school children

Institute for Public Policy (2002). The Republic of Moldova and European Integration. Chisinau, Cartier.
Countries, territories and regions: Moldova
The issue of European Integration became of high interest for the Republic of Moldova immediately after the breakup of the Soviet Union and the proclamation of the independence of Moldovan state. However, the society doesn't clearly know what the EU integration would mean for the country. The Institute for Public Policy (IPP) has leaded an evaluation of the current situation of the process of integration of the Republic of Moldova in the European Union and has analyzed some ideas, whose accomplishment would contribute to the acceleration of this process. As an outcome of this evaluation and analysis, the current publication has concentrated a collection of analytical reports carried out by an expert group of IPP. The materials on Moldova's European integration are concluded with a synthesis of all elaborated studies that summarize the present situation, as well as the measures that should be undertaken in order to accelerate the process of integration of the Republic of Moldo va in European Union. This book has been developed, in the most part, in the second part of the year 2000.

Institute for Public Policy and Central European Initiative (2002). New Borders in South Eastern Europe. The Republic of Moldova, Ukraine, Romania. Stiinta, Institute for Public Policy, Central European Initiative.
Countries, territories and regions: Moldova
The Institute for Public Policy (Chisinau, Moldova) has developed and implemented a research project funded by Central European Initiative and Open Society Institute, which aimed to develop studies on various aspects of border operation and make suggestions on how to reduce negative impacts and improve border operation under the new conditions. Studies were developed by three expert groups from Moldova, Romania and Ukraine, representatives of authorities involved in frontier management, as well as political analysts. The activities were coordinated by three policy institutions from the countries involved, which, together with the Ministry of Foreign Affairs of the Republic of Moldova, have organized the international follow-up conference "New Borders in South-eastern Europe and their Impact on the Stability in the Central European initiative region" on May 17-18, 2002. This publication includes both studies developed by experts and presentations held during the Con ference. Positive and negative aspects of new Schengen border for the Republic of Moldova, Romania and Ukraine are highlighted in conclusions to this publication. The recommendations focus on elaborating common measures to be undertaken by EU countries, its future members and new neighbors in order to minimize the negative effects of Schengen border.

Institute for Sociological and Political - legal research (2001). Project: Public opinion about reforms in health services. Skopje, Institute for Sociological and Political - legal research. Countries, territories and regions: Macedonia

Institute of Public Health (2001). "Bulletin, No1."
Countries, territories and regions: Serbia and Montenegro

Institute of Public Health (2001). "Bulletin, No 2."
Countries, territories and regions: Serbia and Montenegro

Institute of Public Health of Kosova (2000). The AIDS Situation in Kosova, Institute of Public Health of Kosova. Countries, territories and regions: Kosovo, Serbia and Montenegro

Institute of Public Health of Serbia (2000). Health status, health needs and utilisation of health services - in 2000. Report on the analysis for adult population in Serbia: Differences between domcile population, refugees and internally displaced persons, WHO. Countries, territories and regions: Serbia and Montenegro
The main objectives of the health survey, presented in this publication, were to assess the health status of the population of Serbia, identify major health problems and needs, and determine utilization of health care and satisfaction with services. The health survey was cross sectional study with representative sample of 4.500 households (in total 11.741 persons were interviewed). In addition refugees and internally displaced persons (IDP) living in private accommodation and in collective centers were analysed and compared with general population. Households and individual questionnaires were the main research instruments for data collection health behaviour, risk life styles (smoking, alcohol consumption, substance abuse) and health care utilisation, while the prevalence of certain risk factors was estimated from blood pressure measurements, anthropometry, laboratory analyses (hemoglobin) and calculating body mass index. Based on analyses of data collecting in this survey, quality of nutrition and living condition were recognized as immediate problems for the refugees and IDP population. The survey results also pointed the low level of moderate physical activities and high prevalence of smoking (60%) especially among refugees and IDPs. The highest percentage of underweight persons was discovered among the refugees / IDPs in collective centers, while anemia was discovered in more than a quarter of the refugees.

International Organization for Migration (IOM) (2002). IOM and The Stability Pact for South Eastern Europe, IOM. Countries, territories and regions: South Eastern Europe

IPH (1998). An Overview on the main health data in Albania. Countries, territories and regions: Albania

IPH (2000). "Epidemiology of health inequity in Albania."
Countries, territories and regions: Albania

IPH (2000). Report on the project: Public Information Advocacy. The Albanian Public's Perceptions of the Health Care System. Second phase. Countries, territories and regions: Albania

IPH (2002). Lot Quality Assessment. Countries, territories and regions: Albania

IPH (2002). Diarrhoeal Diseases in Albania 1996-2001. Tirana, IPH. Countries, territories and regions: Albania

IPH and Department of Environment & Health (2001). Quality of natural waters in the cities of Tirana, Durres, Elbasan, Fier, Vlore, Sarande, Lezhe, Shengjin and Shkoder. Tirana, IPH,
Department of Environment & Health,. Countries, territories and regions: Albania

IPH and World Bank (2000). Public Opinion about Health Care Systems in Albania. Questionnaire. Tirana, IPH, World Bank. Countries, territories and regions: Albania

Isjanovska, R. (?). Comments of EUROHIS - testing in Republic of Macedonia. Skopje, University St Kiril and Metodij. Countries, territories and regions: Macedonia

Isjanovska, R. (?). EUROHIS programme questionnaire, Macedonian version, Institute of Epidemiology, Biostatistics with Medical Informatics. Countries, territories and regions: Macedonia

Ivankovic, A. and Z. Rebac (1999). "Financing of Dental Health Care in the Federation of Bosnia and Herzegovina." Croat Med J 40(2): 166-174.
Countries, territories and regions: Bosnia and Herzegovina
Financing dental health care in the Federation of Bosnia and Herzegovina (FBH) over the last 10 years was analyzed with respect to time before the war, during the 1992-1995 war, and after the war. In the first period (until 1991) the system was centralized, well structured, financed through the communities of interest, and burdened with a lack of financial discipline and high inflation. By the end of 1991, all citizens in the territory of BH Federation had the right to dental health insurance and participated in the price of dental service with 10-50%. During the 1992-1995 war, insurance and financial institutions ceased their work until the establishment of civilian governing authorities. The system of dental services was legalized within the health system as its integral part, yet, because of insufficient financial support, the rights of the insured were not fulfilled. Following the Dayton Peace Agreement in 1995, two systems (Croat and Muslim) were in function in FBH, each based on different legal grounds, and dental care stagnated considerably. The 1997 FBH Law on Health Care and Health Insurance and the Law on the Privatization of companies introduced a unique health system, widening the sources of financing and categories of health insurance. The process of health care privatization has been legalized, but not yet implemented. Lack of definitions of ownership diminish foreign investments, and without foreign financial support the improvements will be slower than needs. The process of health care restructuring will thus directly depend on the solving the political crisis in the country.

Ivanovska, L. and I. Ljuma (1999). "Health sector reform in the Republic of Macedonia." Croat Med J 40(2): 181-9.
Countries, territories and regions: Macedonia
AIM: To evaluate the results of current reforms in Macedonian health sector. METHOD: Description and situation analysis, covering the period 1991-1997, are focused on demographic and vital indicators, morbidity and mortality data, elements of health care system, legislation, health insurance, health care financing, and elements of health care reforms. RESULTS: The Republic of Macedonia experienced changes in the social and economic situation, similar to those in other countries in transition. The growing number of dependents (young and old persons) impact high health expenditures. High priority health problems were infant and premature adult mortality. As an inheritance of the former political system, the development of different parts of health care services was unbalanced and insurance and local network of health facilities were highly decentralized. The reforms addressed health financing and reimbursement, organization and management of health services, and pharmaceutical policies and supply. The legislation was revised, but new revision is needed. CONCLUSIONS: Health care reforms were needed in Republic of Macedonia in order to overcome the problems associated with early phase of transition. The disadvantages of the current reforms are: lack of proper political will for the implementation of activities according to the planned schedule, initial over-utilization of hospital care, and no significant changes in financing of the public sector facilities. The advantages are that the health system did not disintegrate, universal access to health services was maintained, free choice of physician was promoted, and public/private mix of services was established and financed by the Health Insurance Fund.

IZBOR (2002). Project report: Improvement of the health status and decrease of the health risks from Hepatitis B, C and HIV of intravenous drug users, Macedonia. Strumica, IZBOR. Countries, territories and regions: Macedonia
Target population: 2200-2500 drug users, injecting drug users (heroin, methadone, cocctails of methadone and diazepam) from Strumica and incidently Gevgelija, Bogdanci, Valandovo and Radovish. Major achievements in the last two years: distribution of 216000 needles and 107000 syringes; distribution of 40000 condoms, distribution of eduactional material (4000 brochures), providing health services, health promotion and councelling, social services. With HOPS and Via Vita have established the Macedonian Harm Reduction Network working in the field of advocacy for Harm Reduction and resource mobilization and development of the civil sector in R. Mace-donia. Close cooperation with Orthodox Church in Strumica resulted with opening the professional clinic for drug users treatment. The Project for the opening of the first treat-ment commune is in the final phase.

Jakubowski, E. and H. Hajrulahovic (2000). "Bosnia and Herzegovina: Health System reform implementation at a critical stage." Euro Observer 2(3): 3-4.
Countries, territories and regions: Bosnia and Herzegovina

James, J. (1999). Albania, Country health briefing paper. London, Department for International Development. Countries, territories and regions: Albania

Jamrozik, K. (1995). "Eastern Europe in transition: the dilemmas of health." The Medical Journal of Australia 163: 643-5.
Countries, territories and regions: Eastern Europe

Janjanin, M. (2001). "Program of oral health as a part of the public health program in Republic Serbia." Med Arh 55(1): 29-30.
Countries, territories and regions: Serbia and Montenegro
Special attention is given by the health legislation for protection of vulnerable groups and those who are exposed to high risk. The system of health care service is restructured and expanded in the way that accessibility, efficiency and effectiveness are improved. Public health insurance programme has priority and funds are ensured from the budget and the national health service for its execution. The programme of oral dental health is the component of the Public Health programm. This Programme has been continually implemented for more than 5 years. This Programme defines particular aims which are realized through following: systematical health educations, fluor protection, oral hygiene, proper nutrition, systematical sanitation. It is realized in the whole Republic but with different success. Regional and communal health centers are included in executing this Programme, particularly dentistry as the bearer of these activities, then pediatrics, gynaecology, community-health service, etc. One part of the Programme is directed to include other society segments to give it support (education, water supply, food producers, mass media, etc.). The results show that the Programme is effective and that the oral dental health of the inhabitants in Serbia has been considerably improved for the last 5 years.

Jedrychowski, W., U. Maugeri, et al. (1997). "Environmental pollution in central and Eastern European countries; a basis for cancer epidemiology." Rev Environm Health 12(1): 1-23.
Countries, territories and regions: Eastern Europe
The main objective of this paper is to discuss the environmental issues in the countries of central and eastern Europe (CCEE) and to show their significance for cancer epidemiology. Of known cancer risk factors that may be related to environmental exposure in the CCEE, tobacco smoking is probably the most important. The worsening trends in cancer mortality noted in middle-aged men in the CCEE can be attributed to smoking. Other lifestyle factors that interact with environmental hazards include high alcohol consumption and unhealthy nutrition. Among other factors, the most common environmental exposure in the CCEE that has potential adverse effects on health in terms of cancer incidence is related to high levels of ambient and indoor pollutants exceeding the air quality guidelines of the World Health Organization. Millions of people, usually in urban areas, are estimated to be exposed to such levels of pollution. Outdoor air pollution is a substantial environmental problem in many areas of the CCEE, where heavy industries are concentrated without adequate technology for emission control. Chemically contaminated drinking water provides a major route of exposure for many potential environmental health hazards. The pollution of water resources, including groundwaters, by industrial and agricultural wastes is a widespread problem in both the CCEE and the former USSR. An estimated 13% of treatment plants in the Russian Federation lack the necessary equipment to treat drinking water, particularly for disinfection, to meet the required standards. Many countries in the region have problems in rural areas, where the networks are small or consumers depend on private wells, and treatment of drinking water is either poor or nonexistent. Consequently, because the standards are difficult to meet, drinking-water accumulates high levels of arsenic and nitrates. The main concern is nitrate, arsenic, fluoride, and pesticides. In countries like Bulgaria, Hungary, R omania, and Slovakia, locations are known where nitrate concentration in drinking water are high enough to cause methemoglobinemia. Lack of appropriate data hamper valid estimates of the extent of unhealthy working conditions or of poor housing conditions. Unsafe industrial installations are potential environmental health hazards, the possible scale of which is difficult to estimate reasonably.

Jeffery, H. (1999). Report on Perinatal Health Services in Macedonia. (in English and Macedonian), Ministry of Health, World Bank, Royal Prince Alfred Hospital, Sydney. Countries, territories and regions: Macedonia
The National Perinatal Program in Macedonia was part of the Health Sector Transition Project financed by World Bank IDA Credit 2889-MK and managed by the International Project Unit (IPU) from the Ministry of Health (MOH) with technical consultancy of Prof. Heather Jeffery. The objectives of the MOH and the World Bank were: situation analysis, needs assessment and to define Strategy at National level which will enable to decrease the perinatal mortality rate. This report was prepared by Prof. Jeffery, with the support of the IPU/MOH and the World Bank during the period July - October 1999. The aim of the report is to recommend a national strategy for perinatal care. It will be used by the Macedonian MOH, health professionals and international agencies as a framework through which they will contribute to decreasing the perinatal mortality rate. The overall strategy is reliant on the Perinatal Committee taking a major role in ensuring continuing education of medical and nursing undergraduates and postgraduates, improving commu-nication and networking between primary, secondary and tertiary units caring for mothers and babies, ensuring accurate reporting and analysis of perinatal statistics in order to tar-get preventive and curative strategies. The implementation of the recommendations is dependent on a number of priorities. Recommendations for action: Prevention and Health Promotion; Training and Education; Infrastructure (O&G clinic, Paediatric clinic, Spe-cial Hospital for O&G, refurbishing of level II or III units, labor wards, rooming in fa-cilities); Institutional and Organisational Change. Implementation Plan: Stage 1 (to be completed 6-12 months: Organise CME for Level II and III training of doctors and nurses; Install equipment in level IIa and II units in Skopje; Structural changes concurrent with educational implementation; Implement registrar and resident paediatric rotations between the 3 units in Skopje. Stage 2 (to be co mpleted after education and structural changes, ideally within 12 months, although full NICU functioning bed capacity will take upto 3 years): Install equipment in level III units; Implement a Neonatal Transport Ser-vice; Implement a multidisciplinary team to assess all high-risk neonates and decide ap-propriate timing of testing in relation to age and type of psychometric and neurodevel-opmental / sensory testing.: Form a Perinatal Committee and Maternal, Perinatal and In-fant Mortality Committee.

Jeffery, H. and J. Polverino (2002). Evaluation of the National Perinatal Program in Macedonia. Health Sector Transition Project, Ministry of Health in Macedonia, World Bank. Countries, territories and regions: Macedonia
Evaluation of the National Perinatal Program (part of the overall Health Sector Transition Project financed by World Bank IDA Credit (2889-MK) occurred during 3 weeks in January 2002, exactly 2 years after the commencement of implementation when educa-tion of trainees commenced at Royal Prince Alfred Hospital in Sydney. The major com-ponent of the strategy to date has been education. The primary aims of this evaluation were fourfold: (i) Evaluation of the National Perinatal Program with emphasis on out-comes, especially perinatal mortality before and after commencement of intervention. (ii) Current organisational framework for the National Perinatal Program (iii) Examination of equipment (iv)The long term strategy for Perinatal Services in Macedonia. The evalua-tion was done by: 2 overseas consultants both of whom were intimately involved with implementing the program from its inception; 2 members of the International Project Unit (Project-Coordinator and procurement officer) ; 2 observers Professors from the Paediat-ric Clinic who were not directly involved with the implementation; 1 neonatologist - co-ordinator of the CME centre in Cair. Five outcomes were thus assessed and the specific methodology for each of these has been used. 1. Perinatal Mortality Rate in Macedonia for 3 years before intervention compared with 2 years after intervention for 16 hospitals with > 93% births: Overall a decrease of 21% in the PMR, before intervention 1997-99 with 2 years after starting intervention 2000-01 (27.4 to 21.5 per 1000 births) and De-crease of 36% in early neonatal deaths in babies >1000g (12.0 to 7.7 per 1000 live births); 2. Assessment of Teachers at CME Centre and Assessment of Trainees in Sydney and in Skopje: The educational methods used have been based on evidence of effective-ness and the content emphasised four themes, namely perinatal skills, educational theory, change management and basic epidemiology with an evidence-based approach t o prac-tice. The educational program is sustainable providing it is funded; 3. Evaluation of im-plementation of evidence based practice in these hospitals and 4. Response of trainees to the educational program in Sydney and in Skopje: These striking results are consistent with the high penetration of implementation of evidence into practice that was observed at the 12 maternity units and 2 paediatric units that were assessed. They are consistent with the rigour of the assessment techniques required for certification of the 115 success-ful trainee doctors and nurses. In all, 50% of doctors and 25% of nurses who care for neonates in Macedonia have been certified; 5. Achievements and failures compared with the original recommendations of the report dated September 1999: The environment for change is ripe to rapidly gain improved health outcomes for mothers and babies from fur-ther investment. This is a National imperative and should be part of the National Health Strategy.

Johnson, B. R., M. Horga, et al. (1996). "Women's perspectives on Abortion in Romania." Social Science & Medicine 42(4): 521-30.
Countries, territories and regions: Romania

Johnston, T. (2002). Supporting A Healthy Transition. Lessons from Early World Bank Experience in Eastern Europe, World Bank. http://lnweb18.worldbank.org/oed/oeddoclib.nsf/ DocUNIDViewForJavaSearch/607F8AB6557C0C4585256C5500696DFA/ $file/eca_health_wp.pdf
Countries, territories and regions: Eastern Europe

Johnstone, P. (1999). "Kosovo: the challenge to public health." J Epidemiol Community Health 53(8): 450.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Jones, L. (2002). "Adolescent understandings of political violence and psychological well-being: a qualitative study from Bosnia Herzegovina." Soc Sci Med 55(8): 1351-71.
Countries, territories and regions: Bosnia and Herzegovina

Jones, L. and K. Kafetsios (2002). "Assessing adolescent mental health in war-effected societies: the significance of symptoms." Child Abuse Negl 26(10): 1059-80.
Countries, territories and regions: Bosnia and Herzegovina

JSI/TASC (2002). Albania, Contraceptive Security report (Working group),. Countries, territories and regions: Albania

Juresa, V., D. Ivankovic, et al. (2000). "The Croatian Health Survey - SF 36-1 General quality of life assessment." Coll Antropol 24(1): 69-78.
Countries, territories and regions: Croatia
The objective of the Croatian Health Survey was the assessment of population health related quality of life in the transitional environment of Croatia. Health status measures incorporate dimensions such as physical, psychological, and social functioning, role performance and perception of wellbeing. In order to assess health status, "The medical outcome study 36-item short-form health survey (SF-36) model" was used. A total sample of 5048 inhabitants (1983 males and 3065 females), 18 years and over, represents approximately 1% of the general population of Croatia. Mean scores were as follows: physical functioning (PF) 69.94, role-physical (RP) 63.01, bodily pain (BP) 64.51, general health (GH) 53.40, vitality (VT) 51.85, social functioning (SF) 72.96, role-emotional (RE) 72.42, mental health (MH) 61.71 and health transition (HT) 44.79. Results of the SF-36 health survey in Croatia are very much like the results in other European countries with indication that genera l quality of life is lower in Croatia.

Kabakchieva, A. (2002). Research on Knowledge, Attitudes and Behavior of the Bulgarian CSWs towards AIDS and venereal diseases. Sofia, Bulgaria, Health and Social development Foundation. Countries, territories and regions: Bulgaria

Kabakchieva, E., Y. A. Amirkhanian, et al. (2002). "High levels of sexual HIV/STD risk behavior among Roma (Gypsy) men in Bulgaria; patterns and predictors of risk in a representtive community sample." International Journal of STD and AIDS 13: 184-191.
Countries, territories and regions: Bulgaria
Studies on HIV and STD risk factors among vulnerable minority groups in Eastern Europe are underrepresented in the literature. The rapid increase in HIV and STD rates observed throughout the region may quickly affect impoverished, stigmatized, and underprivileged communities. Roma (or Gypsies) constitute such a vulnerable group. A total of 324 men aged 14-37 years were recruited during June-July 2001 in a Roma community neighborhood in Sofia, Bulgaria. HIV/STD risk behaviors were widespread. Men reported a mean of 2.4 female partners in the past 3 months and 77% did not use a condom during their most recent vaginal intercourse. 72% of Roma men said they had engaged in anal intercourse with women in the past 3 months and almost 75% of these heterosexual anal intercourse occurrences were unprotected. 27% reported having sex with other men during their lifetimes, 10% had same-sex anal intercourse partners in the past 3 months, and 58% of the most recent anal intercourse acts by these men were not condom-protected. 16% of men reported selling sex, and 32% paid someone for sex. Positive condom-use attitudes, intentions, norms and self-efficacy, as well as younger age and condom availability, were factors associated with lower sexual risk. These factors should be targeted in rapid, comprehensive, and culturally sensitive prevention interventions for Roma communities.

Kanavos, P. (1999). "Financing Pharmaceuticals in Transition Economies." Croat Med J 40(2): 244-59.
Countries, territories and regions: Eastern Europe

Kapetanovic-Bunar, E. (2001). "Development of the health service for treatment and prevention of alcoholism in Bosnia-Herzegovina (Article in Serbo-Croatian)." Med Arh 55(3): 175-6.
Countries, territories and regions: Bosnia and Herzegovina
In this paper author analyzed and described development and improvement of health service for prevention and treatment of alcoholism of population in Bosnia and Herzegovina.

Kavaldzhieva, B. and S. Popova (2002). "The prevalence of risk factors among women in neoplasms in Varna city." Social Medicine Journal 1: 13-15.
Countries, territories and regions: Bulgaria
A telephone interview was carried out with 342 women with neoplasms registered at the Oncological dispansery in Varna. The questionnaire involved factors of life style, professional activities, heredity and sexual behavior. According to the location women were divided into three qroups: Ist group - 148 women with breast cancer; IInd - 98 women with genital cancer; IIIrd - 96 with other sites. The factors related to hormonal balance showed significant variation between groups: In Ist group dominated women with late first and last deliveries, more abortions and sexual dissatisfaction. Women in the IInd group were characterized by early first deliveries, greater number of deliveries, early menarche and late menopause

Kazakova, G. (2000). "Influence of social factors on the dynamics of suicide." Social Medicine Journal 4: 14.
Countries, territories and regions: Bulgaria
The problem of suicide is a serious one. Major questions such as the meaning of life, the freedom of choice and the freedom of personality depend on its solution. According to the data from the National Center for Medical Sciences about five people commit suicide every day in Bulgaria. Respectively, one of these five is a teenager. There are different ways of committing suicide. There are various factors and reasons that cause the suicidal attempt too. Mostly, it is a mixture of psychological, social, economic, cultural, political and religious reasons. Some of the most significant are the psychological reasons, formed under the influence of various social factors.

Kazizc, S. (2001). "Health system in Yugoslavia." Lancet 357(9265): 1369.
Countries, territories and regions: Serbia and Montenegro

Keil, T. J. and V. Andreescu (1999). "Fertility policy in Ceausescu's Romania." J Fam Hist 24(4): 478-92.
Countries, territories and regions: Romania
This study tests a model for the impact that Ceausescu's pro-natalist policies had on the Romanian fertility rate between 1967 and 1989. Using time-series analysis the authors' findings show that the Ceausescu regime continually struggled with the Romanian population to increase the national birthrate. As a result the regime's policies, there was a significant increase in overall fertility between 1967 and 1989, when the Ceausescu regime was overthrown. Reasons are offered as to why Romania pursued such policies and was able to make them work, while other Eastern and Central European regimes proved to be less able to sustain drives to increase national fertility. This article also presents a model of what has happened to the Romanian fertility rate since 1989, showing that there has been a significant decline in fertility in the post-Communist period.

Kerekovska, A. (2001). Project on Transferring Global and European health policy Targeting to Bulgaria: Issues of Cross-Cultural Interpretation. Bulgaria, Department of Social Medicine, Biostatistics and MI, Medical University of Varna. Countries, territories and regions: Bulgaria

Kerger, M. L. (2000). "A mission unlike any other. Life in a Kosovar refugee camp." J Christ Nurs 17(3): 24-7.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Kianicka, S. and C. Rutschmann (2001). The 'Yamabol-Roma Project'. Development, results and possible future strategies of a Project of the Bulgarian Red Cross, supported by the Swiss Red Cross (May 2000-March 2002). With a Review of the General Situation of Roma in Bulgaria. Bern, Switzerland, SWISS RED CROSS International Cooperation. Countries, territories and regions: Bulgaria

Kinra, S. and M. E. Black (2003). "Landmine related injuries in children of Bosnia-Herzegovina 1991-2000: comparisons with adults." Journal of Epidemiology and Community Health 57: 0-1.
Countries, territories and regions: Bosnia and Herzegovina

Kinra, S., M. E. Black, et al. (2002). "Impact of the Bosnian conflict on the health of women and children." Bull World Health Organ 80(1): 75-6.
Countries, territories and regions: Bosnia and Herzegovina

Kirkup, B. (2000). "Hands-on public health in Kosovo." J Public Health Med 22(3): 447-9.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Klugman, J., J. Micklewright, et al. (2002). Poverty in the Transition: Social Expenditures and the Working-Age Poor. Florence, World Bank
UNICEF Innocenti Research Centre Florence
UNICEF Innocenti Research Centre and University of New South Wales. Countries, territories and regions: Eastern Europe

Kocova, M. (2002). Introduction of thyroid screening program in the Republic of Macedonia. Skopje, Pediatric Clinic. Countries, territories and regions: Macedonia
The Report presents the goals and achieved activities in the thyroid screening program. Goals: to detect all newborns at risk for congenital hypothyroidism (elevated TSH; to diagnose the hypothyroidism with additional tests, to start treatment early, during the first month of life; to avoid mental and physical handicap of children with congenital hypo-thyroidism. Previous activities for introduction of thyroid screening in Macedonia: In 1998 Department of endocrinology in Pediatric Clinic conducted pilot study (grant of 25000 DM from the Soros Foundation) and 1000 newborns from the O&G Clinic were screened and 1 child was detected. Later this programme was incorporated in the strategy for the Project for perinatal and neonatal health funded by the World Bank. Kinderspital-Zurich donated additional equipment and training for the team from genetic laboratory. On April 16th, 2002, the screening started for all newborns from Gynecology&Ovstetric Clinic, nursery Cair, nurs ery in Bitola and later Sistina, Prilep, Kumanovo and Strumica nurseries joined the program. During 8.5 months 7482 analyses were performed i.e. with screening covered 90% of births. During this period 4 children with hypothyroidism were detected. On Narional level it is expected annually to detect at least 20 newborn suspec-tive for congenital hypothyroidism, half of them will be confirmed and treated and will avoid mental and physical handicap only by this procedure. The Report presents the costs of treatment and rehabilitation for handicapped late detected child with hypothy-roidism (27952 E) compared to the costs of 5614 E for the early detection, i.e. 5.5 times more expensive. Next step is institutionalization of this programme whithin the legisla-tion of the Ministry of Health.

Kohler, I. (2001). Adult and old-age mortality dynamics in Bulgaria and Russia (dissertation). Faculty of Social Sciences,. Odense, University of Southern Denmark. Countries, territories and regions: Bulgaria

Kojuharova, I. (2002). Harm Reduction development program. Program Evaluation. Sofia, Bulgaria, Creda Consulting Ltd,
Open Society Foundation. Countries, territories and regions: Bulgaria

Kondaj, R. (2002). "Management of refugee crisis in albania during the 1999 Kosovo conflict." Croat Med J 43(2): 190-4.
Countries, territories and regions: Albania
The report presents key data on Kosovo refugees in Albania during the 1999 crisis in Kosovo. In a three-month period, from March through May 1999, Albania received, accommodated, and cared for 479,223 officially registered refugees from Kosovo (FR Yugoslavia). Many foreign governmental and non-governmental organizations helped the Albanian government during the crisis. The Government cooperated with the organizations through Government Commission, which appointed a Special Coordinator to the Emergency Management Group that coordinated factors and actions in the field. A Health Desk was established by the Emergency Management Group to provide an overview of the health impact of the crisis upon refugees and domestic Albanian population. There were no serious outbreaks of infectious diseases, but the Health Desk registered 2,165 cases of diarrhea without and 14 cases of diarrhea with blood in the stool. Scabies and lice affected around 4% of the refugees. After the refugees retu rned to Kosovo, Emergency Management Group continued to coordinate the work on the rehabilitation of the refugee-affected areas. In this phase, humanitarian emergency work served as a bridge between emergency activities and normal development.

Kosovar AIDS Committee (2001). Action Plan for the establishment of a comprehensive HIV/AIDS prevention programme for Kosovo, Kosovar AIDS Committee. Countries, territories and regions: Kosovo, Serbia and Montenegro

Kostadinova, T. and E. Mutafova (2002). "Integrated care - a new Health Care Paradigm." Health Economics and Management Journal 1(3).
Countries, territories and regions: Bulgaria
The article presents actual issues concerning the problems of organization, financing, and management of integrated care. The basic principles of this new field in health care are discussed. Theoretical and practical aspects of the problems are an international overview of the development of integrated care together with proposals for adapting the experience to the conditions of the Bulgarian health care. The process-oriented approach is preferred as appropriated in the process of adaptation

Koulaksazov, S., S. Todorova, et al. (2002). Health Care Systems in Transition: Bulgaria - Draft. Copenhagen, European Observatory on Health Care Systems.
Countries, territories and regions: Bulgaria

Kovacevic, L. and U. Laaser (2001). "Public health training and research collaboration in South Eastern Europe." Med Arh 55(1): 13-5.
Countries, territories and regions: South Eastern Europe
The health care systems in South Eastern Europe are characterized by a predominantly curative orientation. During the last decade public health became insufficient due to war as well as economic and political changes. Today there is a lack of competence in public health above all in health management and strategy development, but also in the fields of health surveillance and prevention. The great need for a sustainable collaboration and support in advanced training and continuous education of qualified professionals to reach required conditions was recognized. Therefore, the project for the development of training modules and research capabilities in public health in South Eastern European countries (SEE) was proposed to the Stability Pact (PH-SEE Project). The project is to support the reconstruction of postgraduate public health training through development of teaching materials in English for the Internet. A regional network of lecturers in the health sciences will be esta blished. The up to date texts should be of international standard but also be of regional specificity.

Kovacic, L. and Z. Sosic (1998). "Organization of health care in Croatia: needs and priorities." Croatian Medical Journal 39(3): 249-55.
Countries, territories and regions: Croatia
AIM: Description and analysis of the present situation of health care system in Croatia, and its characteristics in the transitional process of restructuring. METHODS: A descriptive method was used. The data from the regular statistical publications were used for the analysis. RESULTS: Croatia is faced with problems similar to those in other countries of the Central and Eastern Europe (CEE), such as control of health expenditure, balancing the development of different segments of health care services, stabilization of effectiveness and quality of care, transition from one-party system to pluralistic democracy, introduction of a free market economy, war devastations, etc. On the other hand, the Croatian experience in the development of a decentralized and integrated primary health care, decentralized health insurance system, education of general/family practitioners, and a tradition in the implementation and development of public health measures, have facilitated and contribut ed positively to the whole process of transition. CONCLUSION: In contrast to the economic difficulties, war devastations, and changing the social system, the Croatian health care system proved its stability and sustainability. The highest priority and needs are now related to coping with unhealthy behavior of the population, such as smoking, accidents, physical inactivity, and nutritional problems, which should be solved and controlled by the implementation of preventive programs, organization and management of public health services, and further focusing onto the integrated type of primary health care in the organization of services. Hospital services need more intensive and skilled management, as well as support measures for better quality of work.

Kovacs, L. (1997). "Abortion and contraceptive practices in Eastern Europe." International Journal of Gynecology and Obstetrics 58: 69-75.
Countries, territories and regions: Eastern Europe

Kozaric-Kovacic, D., D. Kocijan-Hercigonja, et al. (2002). "Psychiatric Help to Psychotraumatized Persons during and after War in Croatia." Croat Med J 43(2): 221-228.
Countries, territories and regions: Croatia

Krstev, S., B. Perunicic, et al. (2002). "Occupational health in Yugoslavia." Int J Occup Environ Health 8(2): 137-43.
Countries, territories and regions: Serbia and Montenegro
Occupational health in Yugoslavia was once well organized in accordance with WHO declarations and ILO conventions and recommendations. Since the 1990s, the system has been disrupted by destruction of the former Yugoslavia, wars, refugees, changes in the economy, and NATO bombardment. Economic trends, main industries, and employment and unemployment conditions in Yugoslavia are presented. The organization of occupational health services, their tasks, and prevailing problems are discussed. Occupational diseases and relevant research and educational opportunities are described. The authors conclude by suggesting approaches to improving worker's health in the future.

Krvgic, S., O. Niciforovic-Surkovic, et al. (2001). "Quality of life assessment in school-age children and adolescents in Yugoslavia from the viewpoint of the children adn their parents (Article in Serbo-Croatia - Roman)." Med Pregl 54(7-8): 323-6.
Countries, territories and regions: Serbia and Montenegro
INTRODUCTION: Quality of life assessment among children is relatively new and a poorly investigated concept. Previous results of investigations indicated that parents and children have different perceptions. The main aim of this study was to review health and quality of life components among schoolchildren and youth, from the aspect of pupils and their parents, and to determine differences in assessment of the investigated concept between children and their parents. MATERIAL AND METHODS: The study was performed on a random sample of children and youth (No 600) and their parents. The assessment model was a Yugoslav adaptation of CHQ-CF87 and CHQ-PF50. DISCUSSION AND RESULTS: There is still no adequate answer to the question "who is the most appropriate person to be examined". Over 50% of studies are based on parental assessment. Apart from CHQ-CF87 we have used "parent version" of the questionnaire (CHF-PF50). Comparison of mean values of each scale of both versions of questionnaires significant correlation was established (between 0.31-0.50). However, by investigation of differences between mean values, a significant variation regarding components of health and quality of life between children and their parents was established in 8 out of 10 scales analyzed. CONCLUSION: In our study children valued components of health and quality of life as worse in regard to their parents. Significant differences were established in 8 out of 10 scales analyzed. Significant correlation between children's and parental answers was reached by comparative analysis. The correlation coefficient was 0.31-0.50.

Laaser, U., D. Donev, et al. (2002). "Public health and peace." Croat Med J 43(2): 107-13.
Countries, territories and regions: South Eastern Europe
The modern concept of public health, the New Public Health, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New Public Health essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks fo r health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of pub lic intolerance is important. The vital interplay between the informed public and efficient administration, however, can only exist in an open society. The link between democracy and health of the people, and between public health and economic welfare is real. The Public Health Collaboration in South Eastern Europe (PH-SEE) evolved just in time to reconnect and strengthen disrupted professional networks in the region as a prerequisite of effective public health action.

Lang, S. (2001). "Croatian health in European transition." Croatian Medical Journal 42(1): 95-6.
Countries, territories and regions: Croatia

Langenbrunner, J. C. (2002). "Supplemental health insurance: did Croatia miss an opportunity?" Croatian Medical Journal 43(4): 403-7.
Countries, territories and regions: Croatia
Croatia continues to face a health-funding crisis. A recent supplemental health insurance law increases revenues through first increasing co-payments, then raising the payroll tax to cover those co-payments. This public finance "slight-of-hand" will not solve the system's structural issues and may worsen system performance both in terms of efficiency and equity. Should Croatia have considered private supplemental insurance as an alternative? There is a new single private supplemental health insurance market now evolving over the EU countries and into Eastern Europe. Croatians could take advantage of lowered costs due to larger risk pooling and the lower administrative overhead of mature insurance organizations. Private supplemental insurance, when designed well, can address several objectives, including a) increased revenues into the health sector; b) removal of the public burden of coverage of selected services for certain population groups; and c) encourage new ma nagement and organizational innovations into the sector. Private and multiple company insurance markets are thought to be superior in terms of consumer responsiveness; choice of benefits; adoption of new, more expensive technology; and use of private sector providers. Private sector insurers may also encourage "spillover" effects encouraging reforms with public sector insurance performance. There is already an emerging private insurance market in Croatia, but can it be expanded and properly regulated? The private insurance companies might capture as much as 30-70% of the market for certain services, such as high cost procedures, preferred providers, and hotel amenities. But the Government will need to strengthen the regulatory framework for private insurance and assure that there is adequate regulatory capacity.

Lawlor, E. F. (1998). "The demand for policy analysis in health reform: the view from the Romanian partnership." J Health Adm Educ 16(2): 207-21.
Countries, territories and regions: Romania
Health reform initiatives in Central and Eastern Europe (CEE) assume the existence of two kinds of infrastructure: 1) health care resources that can be mobilized to provide services in a market context and 2) intellectual resources that can be mobilized to plan, design, analyze, implement and evaluate new policy. Considerable attention has been devoted to the requirements for management in health sector reform in the CEE (JHAE, Fall 1994). Relatively little attention has been paid to the intellectual and workforce requirements for policy analysis and leadership in the health sector as well as related policy areas (Berman 1995). This paper begins with an overview of the broad contours and expectations for health reform in the CEE region. It then asks what analytic and public management capital is necessary to guide these policy changes within countries. A specific example of the need for analytic and management capacity is drawn out of the recent Romanian proposal to create he alth insurance houses (plans) in the 40 judets (districts) across the country. Finally, the paper examines the obstacles and issues involved in expanding the role and number of policy analysts in the CEE.

Legins, K. and O. Saraci (1999). "Albania, STDs and youth culture." Entre Nous Cph Den 42: 9.
Countries, territories and regions: Albania

Leonardi, G. S., D. Houthuijs, et al. (2002). "Respiratory symptoms, bronchitis and asthma in children of Central and Eastern Europe." Eur Respir J 20(4): 890-8.
Countries, territories and regions: Eastern Europe
The multicentre Central European Study of Air Pollution and Respiratory Health (CESAR) aimed to measure the respiratory health of schoolchildren using a standardised questionnaire in six countries of Central and Eastern Europe (CEE), allowing comparisons within this region and with other European countries. A cross-sectional study was conducted in 25 urban areas of Bulgaria, Czech Republic, Hungary, Poland, Romania, and Slovakia in 1996. Parents of 21,743 schoolchildren of age 7-11 yrs completed a questionnaire based on items from the World Health Organization and International Study of Asthma and Allergies in Childhood questions on cough and wheeze symptoms, as well as on diagnoses by doctors. Life-time prevalence of bronchitis was 55.9%, asthma 3.9%, and asthmatic, spastic or obstructive bronchitis 12.3%. In CEE countries the prevalence of bronchitis is higher and prevalence of asthma appears lower than in Western Europe. However, if asthma is defined as a diagnosis of eith er asthma or asthmatic, spastic or obstructive bronchitis, then its prevalence is comparable to Western Europe, or higher. In this region, within-country variation for most respiratory parameters is less than between-country variation. Between-country comparisons in doctors' diagnoses appear dependent on the choice of definition of asthma. Europe-wide comparisons in prevalence of respiratory symptoms and diagnosis are reported in this study. Some of the East-West difference in asthma prevalence may be attributable to differences in diagnostic practice.

Levenstein, C. (1997). "Environmental and occupational health during social transition in central and eastern Europe. Selected fragments of the eighth annual symposium. May 26-31, 1997, Blgoevgrad, Bulgaria." Int J Occup Med Environ Health 10(4): 461-6.
Countries, territories and regions: Eastern Europe

Levett, J. (2002). "Contributing to Balkan public health: a school for Skopje." Croatian Medical Journal 43(2): 117-25.
Countries, territories and regions: Macedonia
The absence of social well-being and growing vulnerability are alarming for a large portion of people living in the Balkan countries. The Stability Pact is currently targeting the issue of social cohesion, which holds out promise for as yet unrealized development. Both the World Health Organization and the Council of Europe have called attention to the population vulnerability and growing disparity in health status between that region and Europe. Reversal of present trends demands the support of the international community and the strengthening of all public health institutions, human resource training, and population health research. Given the severity of the problem space of population vulnerability, these actions are more than ever indispensable to the health sector of the region. The paper describes an encouraging dialogue for Balkan health conducted by the National School of Public Health in Athens, Greece over the past decade and emphasizes the work of the newly created Public Health in South Eastern Europe (PH-SEE) Network (www.snz.hr/ph-see), which provides new opportunities for engagement in regional public health through Public Health Schools and Institutes. There is a need for public health curricula development and a closer linkage of all Schools with the Association of Schools of Public Health in the European Region. A curriculum for peace and public health is already under development in institutions in Athens, Greece; Mostar, Bosnia and Herzegovina; and Zagreb, Croatia. Soon to be added to the group of regional institutions is the School of Public Health in Skopje. It is a policy response to considerable need in a country showing pre-conflict conditions in the heart of the South Eastern Europe. Within the general framework of public health development, a School of Public Health in Skopje can be of great national benefit. Suggestions are made for its function under an umbrella of interdisciplinarity and autonomy, and the need to st eer a path clear of medical dominance. According to a related mission statement, the School is to be implemented as an academic center of excellence and innovation, with the worthy purpose of improving the health of the population, with particular attention to the disadvantaged, underserved, and vulnerable. It can aid policy enactment, capacity building, and vulnerability research, promote the development of new training curricula for human rights and public health, and contribute to regional public health. The implementation of the School has a symbolism attached to it as a Balkan response for the elimination of the causes for political violence.

Levy-Bruhl, D. (2002). Support to the Albanian EPI. Summary of findings and recommendations, Departement des Maladies infectieuses Institute de Veille Sanitaire. Countries, territories and regions: Albania

Levy-Bruhl, D. (2002). "Health and peace." Croat Med J 43(2): 114-6.
Countries, territories and regions: South Eastern Europe
Health and peace are closely linked. One cannot have one without the other. Although health and peace are desirable conditions, we human beings often thwart our best intentions to achieve and maintain them. War has profound impacts on human health. In addition to direct consequences, including the fact that 90% of all deaths related to recent wars were among civilians, war has several indirect consequences, including long-term physical and psychological adverse health effects, damage to the social fabric and infrastructure of society, displacement of people, damage to the environment, drainage of human, financial, and other resources away from public health and other socially productive activities, and fostering of a culture of violence. Many public health issues can be both a consequence and a cause of war, including infectious diseases, mental health disorders, vulnerability of population groups, disparities in health status within and among countries, and weakening of huma n rights. We, health professionals, can promote peace in many ways and facilitate this work by demonstrating our values, vision, and leadership.

Liegois, J.-P. and N. Gheorghe (1995). Roma/Gypsies: A European Minority. London, Minority Rights Group.
Countries, territories and regions: Europe

Lindmark, G., M. Horga, et al. (1999). Towards better reproductive health in Eastern Europe: Concern, Commitment and Change, WHO Scientific Working Group on Reproductive Health Research, Central European University Press,
WHO. Countries, territories and regions: Eastern Europe

Lis, J., M. J. Eliades, et al. (2001). "Post-war Kosovo: Part 3. Development and rehabilitation of emergency sservices." Prehospital Disaster Med 16(4): 275-80.
Countries, territories and regions: Kosovo, Serbia and Montenegro
The recent crisis in Kosovo led to nearly complete destruction of a healthcare system serving the needs of approximately 2 million people. Even prior to the crisis, the pre-existing healthcare system had inadequate provisions for the delivery of Emergency Medical Services. More than 440 diverse governmental and non-governmental organizations (NGOs) arrived to assist (and often compete) in the rehabilitation of Kosovo's healthcare needs. Each brought with them individual biases and strategies for how this rehabilitation should occur, and each faced numerous unforeseen barriers to the implementation of its programs. The authors used a four-step, multi-modal, needs assessment to gather information on the needs and potential barriers to the implementation of a program to rehabilitate emergency services as discussed in Part II. This paper chronicles the phases of the Emergency Medicine program development and the process of responding to barriers and changing needs. The program's successes and failures are noted, and the actual barriers encountered are reviewed. Overall, the needs assessment tool employed in this program was useful in the implementation of a program to restore and rehabilitate Emergency Services in Kosovo. The authors recommend the use of combined quantitative and qualitative methods for developing priorities for interventions in post-conflict settings following complex emergencies.

Lisaev, P., S. Kostadinov, et al. (2000). "Epidemiology and prevention of sexual crimes. Role of the physician." Social Medicine Journal 2: 21-24.
Countries, territories and regions: Bulgaria
The epidemiological studies show that sexual abuses are the type of crimes increasing the fastest in the world. There is no much information about this crime against the personality in the specialized literature in Bulgaria. In a study of ours for a 14-years the percentage rate of the examinations made due to such cases compared to all other examinations is 2.96%. The main affected group is within 8-18 years (83.2%). The frequency rate in women and girls age 14-18 is the highest - 217/100 thousand people, average for the period. The sexual crime prevention is the responsibility of the whole society

Ljubic, B. (1997). "Health care reform in Bosnia-Herzegovina and reorganization of emergency medical services. (Article in Serbo-Croatian (Roman)." Med Arh 51(1-2 Suppl 1): 55-7.
Countries, territories and regions: Bosnia and Herzegovina
The reform of the constitution of Bosnia and Hercegovina would be incomplete if it did not have the reform of the emergency conditions. The Ministry of health of Bosnia and Hercegovina is determined to complete reorganization of the emergency health services. The principles and models of this reorganization are based upon the experiences before and during the war, but they are also based upon the experiences we shared with another countries in Europe and in the world. Reorganization is to be done with the degree of responsibility considering the importance of the matter. In this work there principles and factors which are determinators for the quality and efficiency of these services. The definition of standards and instruments of evaluation are suggested so that the higher institutions could watch over the efficiency of these services.

Ljubic, B. and B. Hrabac (1998). "Priority setting and scarce resources: case of the Federation of Bosnia and Herzegovina." Croat Med J 39(3): 726-80.
Countries, territories and regions: Bosnia and Herzegovnia
The priority setting within the context of scarce resources in the Federation of Bosnia and Herzegovina (BH) can be divided into priorities within the health care services provision and priorities within the reconstruction process. Facing the resource scarcity, the Federation of BH has chosen to increase health insurance contribution rate to establish cost-sharing arrangements (co-payments) and priority setting to ration access to certain services funded by the compulsory health insurance ("basic package" of the health care services). Reconstruction process of the health care facilities is conducted on the federal level through the effective managerial infrastructure ("project implementation units"). This study reports on the consequences of the war in BH as a peculiar context of the overall reform objectives and priority setting.

Ljubic, B., B. Hrabac, et al. (1999). "Reform of Health Insurance in the Federation of Bosnia and Herzegovina." Croat Med J 40(2): 160-5.
Countries, territories and regions: Bosnia and Herzegovina
The aim of this report is to provide an overview of the reform of health insurance in the Federation of Bosnia and Herzegovina (FBH). Health financing and resource allocation policies in the FBH are also summarized. Health financing should be ensured through three types of health insurance: compulsory, supplementary, and voluntary. The revenues for the compulsory health insurance will be ear-marked through payroll taxation. Facing the scarcity of resources, the Federation authorities have decided to raise the proportion of the payroll contribution as compared to the pre-war level and engage in various arrangements of cost-sharing and priority setting in health care. The resource allocation policy underlines two key parts of the health care reform: contracting mechanisms and payment systems. We also discuss the optimal correlation between solidarity and competition in the course of the ongoing reform of the health insurance in the Federation. The social function of a competent health system, where the well-being of the population is viewed as a sociological category of the overall society's concern, requires considerable subsidization. Incentive-based market mechanisms may be introduced into some of the segments of health care system but only under government-led control of the effects of such measures.

Lock, K., E. M. Andreev, et al. (2002). "What targets for international development policies are appropriate for improving health in Russia." Health Policy and Planning 17(3): 257-263.
Countries, territories and regions: Eastern Europe

Lopes Cardozo, B., A. Vergara, et al. (2000). "Mental health, social functioning, and attitudes of Kosovar Albanians following the war in Kosovo." JAMA 284(5): 569-77.
Countries, territories and regions: Kosovo, Serbia and Montenegro
The 1998-1999 war in Kosovo had a direct impact on large numbers of civilians. The mental health consequences of the conflict are not known. OBJECTIVES: To establish the prevalence of psychiatric morbidity associated with the war in Kosovo, to assess social functioning, and to identify vulnerable populations among ethnic Albanians in Kosovo. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional cluster sample survey conducted from August to October 1999 among 1358 Kosovar Albanians aged 15 years or older in 558 randomly selected households across Kosovo. MAIN OUTCOME MEASURES: Nonspecific psychiatric morbidity, posttraumatic stress disorder (PTSD) symptoms, and social functioning using the General Health Questionnaire 28 (GHQ-28), Harvard Trauma Questionnaire, and the Medical Outcomes Study Short-Form 20 (MOS-20), respectively; feelings of hatred and a desire for revenge among persons surveyed as addressed by additional questions. RESULTS: Of the respondents, 17.1% (95% confiden ce interval [CI], 13.2%-21.0%) reported symptoms that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PTSD; total mean score on the GHQ-28 was 11.1 (95% CI, 9.9-12.4). Respondents reported a high prevalence of traumatic events. There was a significant linear decrease in mental health status and social functioning with increasing amount of traumatic events (P</=.02 for all 3 survey tools). Populations at increased risk for psychiatric morbidity as measured by GHQ-28 scores were those aged 65 years or older (P =.006), those with previous psychiatric illnesses or chronic health conditions (P<.001 for both), and those who had been internally displaced (P =.009). Populations at risk for poorer social functioning were living in rural areas (P =.001), were unemployed (P =.046) or had a chronic illness (P =.01). Respondents scored highest on the physical functioning and role functioning subscales of the MOS-20 and lowest on the mental hea lth and social functioning subscales. Eighty-nine percent of men and 90% of women reported having strong feelings of hatred toward Serbs. Fifty-one percent of men and 43% of women reported strong feelings of revenge; 44% of men and 33% of women stated that they would act on these feelings. CONCLUSIONS: Mental health problems and impaired social functioning related to the recent war are important issues that need to be addressed to return the Kosovo region to a stable and productive environment. JAMA. 2000;284:569-577

Ludicke, F. and M. Horga, A (2001). "Reproductive health in eastern Europe: a collaborative training project in Romania." Reproductive Health 91(11): 1761-3.
Countries, territories and regions: Romania
Since the fall of the Berlin Wall, fundamental political changes in eastern Europe have affected the Soviet-style health care systems that formerly provided basic care for everyone. Many of these systems have collapsed, and the new systems of social insurance that have replaced them often are inadequate. Advanced Training in Reproductive Health in Romania aimed to create an authority in family planning and reproductive health in selected Romanian university centers and to improve training and research capabilities. Initially, the project had 2 main goals: to provide advanced training in reproductive health and family planning to Romanian obstetrics-gynecology specialists from the main university centers-which would allow them to train other physicians (obstetricians, gynecologists, and general practitioners) and medical students-and to develop, test, and finalize specific training materials in Romanian to be used by the new trainers.

Lunn, R. J. (2002). Harm Reduction, the EU Accession Process and EU Drug Policy. Draft, Columbia University Budapest Law Centre. Countries, territories and regions: Europe

Macedonian Interethnic Association (MIA) (2002). KAPB Survey among women of reproductive age in R. Macedonia, Macedonian Interethnic Association (MIA),. Countries, territories and regions: Macedonia
The aim of this survey was to generate data on how women of reproductive age from dif-ferent national groups perceived reproductive health issues, including HIV/AIDS/STI knowledge, attitudes as well as beliefs about first sexual intercourse, open conversation about sex, contraception, induced abortion, family planning and unintended pregnancies. Special questionnaire has been developed as instrument for this baseline survey which has been conducted with 1.208 women of reproductive age from different national groups (the representative sample has been taken out of 120.863 in reproductive age who are living in Skopje-capital of Macedonia. The age of sexual debut of women in Macedonia is higher than for many other European countries. There is a tendency for women to begin their sexual careers earlier and the level of education makes slight difference Only 49.4% interviewees had mother-child open conversation about "SEX" and contraception: Macedonian (57.6%), Turkish (59.5%), Albanian (17.1%) and Roma women(14.8%). Most of the women (41.9%) used condoms to avoid the pregnancy, 28.4% used the safe period, only 11.5% used contraception pills, 7.8% used IUDs, 1% used injection and 9% do abstinence. 97.6% of interviewees knew about "AIDS", 31.8% of women got the information trough the radio and 32% from handouts. 54% of the interviewed women believe there is some risk involved in friendship with HIV/AIDS person, 71.8% find risks dental clinic used by HIV/AIDS people, Almost 85.3% responded there was risk in having sex with an HIV infected person even when using a condom, 76.6% having mutual masturbation while 84.3% said there was a risk asociated with oral sex. Over 75.8% of respondents believe that the act of giving blood can place them at some level of risk infection by the HIV virus. It is equally important to note that 64.9% of all interviewed women felt they have some chances of ever being exposed to the disease. 75.3% of the women worried about getting AIDS. Over 65.8% had not changed any of their behaviors to avoid being infected with HIV. 17.8% responded that AIDS patients should be treated in hospitals and 67.8% felt that there should be special hospitals for AIDS patients and specially trained medical staff (71.9%), should be responsible for taking care.. 59.0% of all interviewed women will never let their child play with a friend who has HIV/AIDS.

Macedonian Ministry of Health (2002). Program for Preventive Health Care in Republic of Macedonia. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Ministry of Health. Countries, territories and regions: Macedonia
The measures, tasks and activities that have to be realized every year by 10 Institutes for Health Protection and Republic Institute for Health Protection-Skopje, in accordance with the Article 110 of the Health Care Law, are specified in the Program for preventive health care in R. of Macedonia. The Program includes the type of the tasks and activities, contents, scope and time periods for their accomplishment as well as financial means for realization of the Program. With measures, tasks and activities confirmed in this Program, all the citizens of the Republic of Ma-cedonia will be guaranteed and provided their rights, needs and interests specified in the Health Care Law with the character of health promotion and measures and activities related to preven-tion against the diseases. With this Program the provisions of large number of laws that regulate the issues for appearance and spreading of contagious and other diseases that have social- medi-cal importance are realized, as well as the impact of the environmental factors to the health status, taking measures for protection and health promotion of the people. Measures, tasks and activities are accomplished by the sanitary-hygienic, epidemiological, laboratory (microbiology) and social medicine sections of the regional Institutes for Health Protection located in the mu-nicipalities: Bitola, Kochani, Kumanovo, Ohrid, Prilep, Strumica, Skopje, Tetovo, Veles and Shtip. They in turn supervise 21 Hygiene Epidemiological Surveillance Services located in health centres spread across the country. The activities of the Institutes for Health Protection in-clude: collecting, processing and analysis of the data related with diseases, health condition of the population, hygiene and epidemiology, infectious and other diseases of social-medical rele-vance, as well as other conditions affecting the health of the population; collecting, processing and analysis of data related with health activity; health care design and planning; research and observing of the hygienic and other condition related with air protection, food products and products for general consumption, drinking water, waste water and materials, participation in preventive sanitary supervision during construction of buildings and other structures; observing and implementation of measures for active protection of the population from infectious and other diseases of social-medical relevance; investigations related with food consumption, as well the diseases resulting from inadequate food consumption and proposes preventive measures; profes-sional and methodology activities related with epidemiology, microbiology, hygiene, social medicine including organization of health care, health statistics, as well as epidemiology related with particular branches of health care; proposals and implementation of unique health education programs for the given area, including cooperation with other health organizations; and Microbi-o logy, parasitology, hygiene, toxicology-biochemistry and other laboratory analyses within the scope of the activity.

Maclehose, L. (2002). "Health Care Reform in the Republic of Moldova." Euro Observer 4(4): a5-6.
Countries, territories and regions: Moldova

Maclehose, L. (2002). Health Care Systems in Transition: Moldova (Draft). Copenhagen, European Observatory on Health Care Systems.
Countries, territories and regions: Moldova

Maclehose, L. (2002). "Health trends in the EU and the candidate countries. Common Challenges?" Eurohealth 8(Special issue): 5-8.
Countries, territories and regions: Eastern Europe, Europe

Macovei, M. and A. Coman (1999). "Implications for HIV/AIDS of laws affecting men who have sex with men in Romania ACCEPT (The Bucharest Acceptance Group)." Med Law 18(2-3): 335-49.
Countries, territories and regions: Romania
In this article, the authors discuss the predicament, in Romanian society, of one group that is especially vulnerable to HIV infection and AIDS: men who have sex with men. Such men are driven to secrecy, and discouraged from disclosing themselves even to obtain the help and information they need, because Romanian law prohibits homosexual overtures, denies legal recognition to gay and lesbian organisations, often imposes strong disincentives in the way of those seeking diagnostic tests for HIV or for venereal disease, and still penalizes same sex relations themselves in many circumstances. Social and administrative circumstances in Romania have also aggravated such men's vulnerability. Drawing especially on the United Nations' International Guidelines on HIV/AIDS and Human Rights, the authors offer several recommendations for reform.

Macpherson, D. W., J. E. Weekers, et al. (2002). "Health of displaced Albanian Kosovars in the former Yugoslav Republic of Macedonia; fitness to travel and health outcomes assessment." Prehospital Disaster Med 17(2): 53-8.
Countries, territories and regions: Macedonia
INTRODUCTION: During the 1999 conflict in Kosovo, an estimated 850,000 people were displaced from Kosovo. Many thousands of these people arrived in the Former Yugoslav Republic of Macedonia (FYROM), for whom a humanitarian evacuation programme (HEP) was conducted by the United Nations High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM). More than 91,000 people were moved to third countries under this programme. METHODS: A health assessment tool was designed, validated, and implemented to document the health status of the refugees prior to departure. The IOM evaluated 41,652 pre-travel "fitness to travel" medical assessments for refugees transported by the Organization. A colour coding system for fitness-to-travel was used to clearly identify refugees to the receiving health authorities according to their health condition at the time of departure. RESULTS: A total of 41,652 fitness-to-travel assessments were performed between 05 April and 25 June 1999, and were entered into a database. There were 21,923 females and 19,566 males. The average age was 25.3 years (women, 26 years; men, 24.3 years). Of these assessments, 4,647 (11.2%) individuals who were deemed fit-to-travel required medical assessment at the host destination, and of those 1,204 required urgent care. The majority of health complaints were acute respiratory tract infections and hypertension. CONCLUSIONS: A rapid and efficient system for fitness-to-travel was created to assist in the management of health issues related to the urgent and mass movement of refugees. The collected health information was of use to health-care planners during the crisis and for those responsible for the health-care of newly arrived refugees. The lessons learned have implications for future similar operations and for the development of research and education programs for both the refugees and the host recipient nations.

Marinkovic, J., N. Kocev, et al. (2002). "Trends in mortality in Serbia, excluding the provinces 1973-1994 (article in Serbo-Croatian (Cyrillic)." Srp Arh Celok Lek 128(9-10-309-15).
Countries, territories and regions: Serbia and Montenegro
The war and break up of former Yugoslavia began in 1991. In May 1992 the United Nations imposed economic sanctions on Serbia and Montenegro which were suspended only in November 1995. The purpose of this study was to assess the effects of the war and UN sanctions on health of the population of Serbia without the provinces of Vojvodina and Kosovo. The period 1973-1994 was studied. Mortality data were derived from unpublished and published materials of the Federal Institute of Statistics [1]. Refugees, who, because of civil war, came to Serbia and Montenegro from other parts of former Yugoslavia, were not counted as a part of the population when mortality rates were calculated. Mortality rates were standardized directly using the "European population" as the standard [2]. The least square method was used to fit mortality rates to different trend curves. Linear trend was used whenever it significantly (p < 0.05) demonstrated the existing mortality rates. To measure the possible effect of the war and sanctions (WAS) on mortality between 1991 and 1994, dummy variable (variable WAS) consisting of 0's and 1's was made to signify the passage from the period before and the period after the beginning of the war and sanctions [3]. Over the period 1991-1994, characterized by the war and UN sanctions, in women aged 25-34, 35-44 and 75-84, total mortality was significantly higher than expected on the basis of the trend for the preceding period (p = 0.006, p = 0.000 and p = 0.015 respectively). The opposite effect was found in the age group 85+ (p = 0.012)/Table 2. Of major causes of death, in age group 25-34, mortality from endocrine diseases increased more rapidly in both sexes (p = 0.000) and mortality from urogenital diseases in women decreased more slowly than expected (p = 0.006). On the other hand, in age group 85+ mortality was significantly lower for cardiovascular diseases in both sexes (p = 0.035 and p = 0.006), for respiratory diseases in men (p = 0.011) and for neoplasms in women (p = 0.006)/Table 4. In addition, in the years 1991 and 1992 the increase in mortality from injuries and poisoning was evident in men aged 15-24, 25-34 and 85+ years (Graph 5). Our results show that over the period 1991-1994 changes in mortality were present in some age groups and were caused by certain groups of diseases. In men, besides mortality of infectious disease which decreased more slowly during 1991-1993 than expected, [4], the main departures were found in the mortality from injuries and poisoning and in mortality from endocrine diseases. The excess of death due to injuries and poisoning in the age group 15-34 can be explained as a direct consequence of the war. There were no military operations on the territory of Serbia, but young men from Serbia were nevertheless engaged in the war in other republics of former Yugoslavia. The outstanding increase in mortality caused by injuries and poisoning in men aged 85+ has two explanations. The first is the fact that suicide rate which was on an average of 86 per 100,000 over the period 1984-1990 rose to 140 per 100,000 during the period 1991-1993. In the year 1994 it fell to 92 per 100,000. Since there were no great differences in percent distribution of suicides among all deaths caused by injuries and poisoning in the two periods (27% in 1984-1990 and 20% in 1991-1993), it is clear that the rise of suicidal rate cannot be the only explanation for increased mortality from injuries and poisoning. In a situation when medical services were badly overextended (lack of medical equipment and proper maintenance of the existing equipment, lack of drugs and other medical inputs, a large number of wounded coming from Bosnia as well as numerous refugees) [5, 6], priority had to be given to younger age groups. Higher mortality due to endocrine diseases in men and women aged 25-34 years and higher mortality due to urogenital diseases in women of the same age s can be most probably attributed to poor medical supplies. Although formally excluded from the international economic blockade medical supplies were in practice badly affected by the fact that the dinar was rendered almost worthless and the Ministry of Health could no longer pay the medical inputs. In addition, bureaucratic hurdles of getting clearance from the UN added months of delay and made foreign companies unwilling to trade [5, 7]. The supply and distribution of drugs within the country was also irregular because communication lines were cut and local companies were not prepared to risk distributing drugs that nobody could pay for [7]. Higher than expected mortality in women aged 25-44 over the period 1991-1994 could be probably explained by their higher vulnerability (period of fertility) and the fact that the main burden of family survival was on them, so they had no time to think and to take care of their health. (ABSTRACT TRUNCATED)

Marinova, J. (2001.). "'The Epidemy' of abortion in Bulgaria - recent status at the end of the century." Social Medicine Journal 2: 20-21.
Countries, territories and regions: Bulgaria
Abortion rate dynamic and structure has been presented on the base of officially published information. The rate of abortions per 1000 women aged 15-49 has been decreased at the end of the period by 58.48% since 1990. Abortion structure has been presented by their type and by women's age, marriage situation and number of children in the family. Groups at higher risk of unwanted pregnancy have been outlined. The complex of main factors related to abortion rate and structure has been discussed.

Marinova, J., S. Markova, et al. (2000). "Factors of the decision on abortion: results from an empirical study." Social Medicine Journal 2: 10-13.
Countries, territories and regions: Bulgaria
Abortion has often been subjected to ethical analysis in particular among theologians and moral philosophers. Many of these analyses focus on the moral dilemma imposed by the intentional destruction of life and therefore eliminate the social context around the abortion. The aim of this report is to present how women who faced to the real situation to decide to abortion consider determinants of their decision. 398 women who had already decided to terminate their pregnancies were inquired by self-administered questionnaire. Their voluntary consent for participation in this study was taken. They represent 95% of all women undergone an induced abortion in Clinics of Obstetrics and Gynecology in Stara Zagora for the period of three months. Determinants in abortion decision were considered by women's basic demographic, social characteristics, their relationships with the partner and the responsibility in this respect as well. More than one third (34.4%) of the women considered care and responsibility for the children as their main cause to decide to terminate the present pregnancy. The second position in the range of the abortion determinants (21.3%) was connected with the "expenses" needed for the child if the pregnancy were to be carried to full term. The continuing education was pointed as a main cause for the decision by 8.3% of the women (third position in the range). Analysis of the determinants of the decision to abortion affirm the understanding that faced to the real situation to decide to abortion women applied ethics of care.

Marinova, J., K. Peeva, et al. (2001). "Family planning and health insurance system." Social Medicine Journal 4: 24-26.
Countries, territories and regions: Bulgaria
The aim of this article is to underline the importance of the obligatory health insurance system and general practitioners for meeting needs in family planning in Bulgaria on the base of the best experience in the world. The authors focus on the experience of the Netherlands as a country leader in family planning. Results from self-administered empirical study among 109 general practitioners were discussed. Almost a half of the physicians inquired (46.8%) do not manage to perform all the activities included in the maternal health general program by their self assessment. General practitioners do not accept yet the activities in family planning as their obligation and responsibility (79.8%). On the base of the analysis presented authors underline as important need the following: implementation of the effective way to motivate General practitioners to accept family planning activities as important and responsible part of their work and contraceptive counseling and service inclu sion in the obligatory health insurance system.

Marmot, M. and M. Bobak (2000). "International comparators and poverty and health in Europe." BMJ 321: 1124-8.
Countries, territories and regions: Eastern Europe, Europe

Marusic, A. (2001). "Croatian Health Minister resigns after dialysis deaths." Lancet 358(9291): 1431.
Countries, territories and regions: Croatia

Marusic, A. (2001). "Health ministers of South East Europe agree to cooperate to improve health." Lancet 358(9285): 902.
Countries, territories and regions: South Eastern Europe

Marusic, A. (2002). "Croatia opens a national centre for the prevention of smoking." The Lancet 359(9310): 954.
Countries, territories and regions: Croatia

Marusic, A. (2002). "Peace through public health in southeast Europe?" Lancet 5(359): 54.
Countries, territories and regions: South Eastern Europe

Marusic, A. (2003). "Religious leaders and celebrities back Croatia's first national no-smoking day." The Lancet 361: 842.
Countries, territories and regions: Croatia

Masic, I. (2001). "Public health in Bosnia and Herzegovina." Med Arh 55(1): 5-8.
Countries, territories and regions: Bosnia and Herzegovina
It has been presented flow of socio-medical development and implementation on former Yougoslavia and Bosnia and Herzegovina territory in last thirty years. The names of those who are deserved for socio-medical development and its insufficiency on the organization on health system and some specific parts of it. Doubtlessly, the social medicine, as science and profession, and specially that one in Bosnia and Herzegovina, had high level among other disciplines, but also as profession per se, specially at the International level. There is huge evidence of numerous projects, congress papers, recognized by indigenous and international audience.

Mastilica, M. (1999). "Out of pocket payments for health care in Croatia: implications for equity." Croatian Medical Journal 40(2): 152-9.
Countries, territories and regions: Croatia
AIM: To assess the distribution of out-of-pocket payments for health care in Croatia by income groups. METHODS: The study is based on data from 1994 out-of-pocket health expenditure survey carried out through interviews of randomly selected adults in two major cities of Croatia, Zagreb and Split. We analyzed co-payments for public health care services and other payments related to private practice, non-prescription medicaments, or informal payments to health care providers. Spending of each income group was analyzed as a share of its income and as proportion of total payments. RESULTS: We found an inequitable pattern of out-of-pocket health care payments. Burden of out-of-pocket expenditure was not equally distributed among income groups, with persons from the low income group paying about six times larger share of their income than the high income group. When we compared the proportions of income received by different groups with the proportions of their payments, the result s indicated (again) that the low income persons payed proportionally more than those with high income. CONCLUSION: Distribution of out-of-pocket payments in Croatia is regressive, with a greater burden falling on lower income persons. Possible introduction of the mix of health care financing would need reconsideration of the policy measures to balance equity and efficiency.

Mastilica, M. and S. Babic-Bosanac (2002). "Citizens' views on health insurance in Croatia." Croatian Medical Journal 43(4): 417-24.
Countries, territories and regions: Croatia
To examine the citizens' attitudes toward health insurance and its reform in Croatia, and their views on private payments for health care services. METHOD: In 1999 and 2000, we surveyed 500 randomly selected adults from all regions of Croatia, aged 40 years and over. The questionnaire included questions on social health insurance, private payments for health care, and background information. The net response was 393 (79%). The analysis of the data collected included univariate and multivariate analyses to test the differences in the attitudes among sociodemographic and socioeconomic groups. RESULTS: Most interviewed Croatian citizens (83.2%) expressed the opinion that everybody should have access to health care services, irrespective of the health insurance contributions. However, 32.1% agreed that the utilization of services should depend on the payment of contribution; 39.1% believed that the money they contributed to health insurance corresponded to health care services th ey received; 60.1% agreed that insurance rate should increase proportionally to income. When asked about reforms, more than half (53.4%) thought that the current health insurance covered less benefits than 10 years earlier, whereas more than a third believed that changes offered more choice (36.9%) but less equity (37.7%), and 46% disagreed with the introduction of the basic package of health care benefits and supplementary insurance. About the same percentage of respondents thought that they had already been paying too much for health care out of their own pockets. CONCLUSION: Citizens in Croatia do not hold a positive opinion on health insurance reform. They fear the changes would bring about limitations in their social rights and increase their financial burden.

Mastilica, M. and M. Chen (1998). "Health Care reform in Croatia: the consumers' perspective." Croatian Medical Journal 39(3): 256-66.
Countries, territories and regions: Croatia
AIM: Assessment of the Croatian health care system (under the reform) from the perspective of the users of health care services. We analyzed the consumers' satisfaction with health care system, health care expenses and access, and described the consumers' attitudes toward health reform, examining the differences among sociodemographic groups. METHODS: The study is based on a data set collected in 1994 through the interviews with randomly selected adults in two major cities of Croatia: Zagreb and Split. RESULTS: A great proportion of respondents were dissatisfied with the current health care services, quality of health care facilities and equipment, and encountered difficulties in access. The elderly, women, and those with lower socioeconomic status were more likely to be dissatisfied and to consider out-of-pocket payments for health services as a problem. A great number of the respondents believed that the reform would either fail or would not achieve significant results. Com pared to the younger and higher socio-economic group, the older and lower socioeconomic groups were more likely to evaluate the health care reform negatively. CONCLUSION: Croatian government decided to rationalize the health care system without taking much account of the impact of health reform on the consumers. Revealed dissatisfaction with the health care services might be linked with the expressed doubts in health care reform and concern that changes could worsen the consumers' position as patients.

McKee, M. (2002). "Substance use and social and economic transition the: need for evidence." International Journal of Drug Policy 13(6): 453-459.
Countries, territories and regions: Eastern Europe

McKee, M. and S. Oreskovic (2002). "Childhood injury: call for action." Croatian Medical Journal 43(4): 375-8.
Countries, territories and regions: Croatia
We aim to raise awareness of the burden of avoidable death and disability attributable to childhood injury in Europe in general and Croatia in particular. As formerly common causes of childhood death have declined, injuries have become the most important single cause of death in childhood in European countries. Yet, there are large differences between countries, and especially between the eastern and western parts of Europe. The existence of these differences, reflecting rapid declines in some countries, indicate the scope for prevention. But injuries are low on the policy agenda for various reasons, including their lack of visibility. We advocated the development of integrated intersectoral policies underpinned by an effective public health structure.

McKee, M. and V. Schkolnikov (2001). "Understanding the toll of premature death among men in eastern Europe." BMJ 323: 1051-5.
Countries, territories and regions: Eastern Europe

Mehic-Basara, N., I. Ceric, et al. (1999). "Refugees, returnees and rehabilitation." Med Arh 531(39-41).
Countries, territories and regions: Bosnia and Herzegovina
Health and social security services are the basic elements which people have the right to ask for from their community. Strong efforts are made to reform the function of this support system all over Bosnia-Hercegovina. With a mutual effort made by Ministry of Health and mental health professionals the Community Mental Health Centres might be an excellent support for people with mental health problems in the society. This is true even for the heavy influx of returnees. The Community Mental Health Centres are expected to handle about 80% of people with mental health problems in the society where people live, or in the new establishments for returnees. However there is a great need for Ministry of Health to design the policy and edict precise rules. The same is true for Ministry of Social Affairs which in co-operation with social workers and other professionals have to reform the Centres for Social Work. However, even if resources are slowly growing, there still seems to lack in communication of the two basic elements, health and social security. Respective ministries in The Federation of Bosnia-Hercegovina need to co-operate and the Ministry of Health and Social Affairs in Republika Srpska needs to strong in developing a co-operation between the centres in the field.

MIA-Macedonian Interethnic Association (2002). Annual Report (in Macedonian and English). Skopje, MIA. Countries, territories and regions: Macedonia
The Macedonian Interethnic Association (MIA) has created a strong network within the country for the provision of AIDS awareness, human rights and support for PLWHA. Every day from 10.00-16.00, MIA runs an AIDS library as well as an AIDS INFO tele-phone line that responds to questions with strict confidentiality, provides information and offers psychological support. MIA has developed promotional material on HIV/AIDS, translated into the local languages. MIA in conjunction with a Bulgarian NGO has worked with young Roma girls who were at risk of becoming sex workers. The organiza-tion has also provided education activities for high school children, students and women of all nationalities. MIA was the first NGO to do hold an AIDS awareness campaign on St. Valentine's Day. MIA successfully campaigned with the media and well-known me-dia personalities in support of AIDS prevention and condom use. MIA has conducted KAP survey on representative sample of women of reproductive age (14-49 years) in ur-ban and rural parts of Skopje.

MIA-Macedonian Interethnic Association (2002). Condom Market in Macedonia. (in Macedonian and English). Skopje,, MIA. Countries, territories,and regions: Macedonia
MIA-Macedonian Interethnic Association has done a survey about the condom market in Macedonia in November 2002. The results had shown that there are 55 different brands of condoms each with about 10 subtypes, sold single or in packet of three. The places where they can be found defer from the pharmacies, supermarkets, food stores, clothes stores, video rental stores, market etc. Most of them do not have the information about expire data, some of them are out of order since year 2000, most of them do not take in-formation about the producing standards and among some of them the brand written the packet do not respond with the type of condoms inside. Most of the condoms are with suspicious quality or with confirmed bad quality and are sold in the central part of the towns. The cost of the condoms defer from 0.2 - 0.4 EUR, with variation in prices de-pending of the place of sale. Results have shown that 35.9% of the participants buy con-doms "wherever". 43.6% answered that there is no differences between the partners who is buying a condom. 46.3% are not using condoms permanently. For 34.6% of the par-ticipants the only criteria for buying condoms is their price (preferably the chipper).

Michnea, A. and I. Gherhes (2001). "Impact of metals on the environment due to technical accident at Aurul Baia Mare, Romania." Int J Occup Med Environ Health 14(3): 255-9.
Countries, territories and regions: Romania
The S.C. Aurul S.A. is a joint venture company owned by the Esmeralda from Australia and the "Remin" National Company of Precious and Non-ferrous Metals in Romania, established in 1992. The design concept was to transport the mining waste away from the city, while the gold and silver in the tailings could be recovered, using efficient and modern technology that was not available at the time the dam was established. On 30 January, 2000, at 22.00, the dam burst and released 100,000 cubic meters of tailing pulp, heavily contaminated with cyanide and cyanide complexes, especially with copper, into the Lapus and Somes tributaries of the river Tisa. The paper deals with the impact of metals on the environment associated with their presence in surface waters, river sediments and soils.

Miller, W. L., A. B. Grodeland, et al. (2000). "If you pay, we'll operate immediately." J med Ethics 26(5): 305-11.
Countries, territories and regions: Bulgaria, Eastern Europe
OBJECTIVES: To study the attitudes of health care staff in four postcommunist countries towards taking gifts from their clients--and their confessed experience of actually taking such gifts. DESIGN: Survey questionnaire administered to officials including health care staff, supplemented by focus-group discussions with the general public. SETTING: Ukraine, Bulgaria, Slovakia and the Czech Republic. PARTICIPANTS: A quota sample of 1,307 officials including 292 health care staff, supplemented by stratified national random samples of 4,778 ordinary members of the public and in-depth interviews or focus-group discussions involving another 323. MAIN MEASUREMENTS: Explicit justifications and willingness to accept offers, reported frequency of offers, and personal confessions to accepting "money and expensive presents" as well as smaller gifts. RESULTS: Health care staff were far more inclined than the average official or public servant to accept "money or an expensive present" if offered, far more inclined to justify asking clients for "extra payments", and far more inclined to confess that they had actually taken gifts from clients recently. Judged by their own confessions, hospital doctors were only rivalled by traffic police and customs officials for taking money or expensive gifts from their clients. CONCLUSIONS: Poor pay does not explain why doctors so often took large gifts from their clients. Moral self justification, opportunity, and bargaining power are much more effective explanations.

Ministry of Foreign Affairs of the Republic of Moldova, Institute for Public Policy, et al. (2001). Participation in the Stability Pact as an accelerator of the social and economic reforms in the region, (International Conference, Chisinau, Moldova, 7-8 December 2001)
http://www.ipp.md/publications/sesiunea_plenara/en.html.
Countries, territories and regions: Moldova
This reference contains full text papers presented at the international conference "Participation in the Stability Pact as an accelerator of the social and economic reforms in the region" held in Chisinau, Moldova on December 7-8, 2001. This event was organized by the Ministry of Foreign Affairs of the Republic of Moldova, the Institute for Public Policy (IPP), the Institute for Political Studies and International Relations (IPSIR) with the financial support of the Friedrich Ebert Foundation from Germany. Moldova's admission in June 2001 as a full member in the Stability Pact was a very important achievement for the country, which declared the European integration as its strategic long-term goal. The conference goal was to hold discussions and to come with suggestions that could be considered while elaborating the action plan for an efficient involvement of the Republic of Moldova in the Stability Pact activities. From the other side, the conference was aimed to inf orm more largely the society about the Stability Pact's ideas. Pannell sessions held within the frameworks of the conference have focused on democratization and human rights, economic reconstruction, co-operation and development, and on security issues, justice and internal affairs. 174 registered participants and 20 representatives of mass media (18 local and 2 Ukrainians) took part in the conference. 44 reports were presented (10 of them by foreign experts) during the conference.

Ministry of Health (2000). Health Care Reform. Strategy and Plan for the Reform of the Health Care System and Health Insurance of the Republic of Croatia, Ministry of Health. Countries, territories and regions: Croatia

Ministry of Health (2000). National Program on Prevention, Early Diagnostics and Treatment of Tuberculosis, Bulgaria, www.mh.government.bg/ programs_and_progects/nac_program_profilactic.php/. Countries, territories and regions: Bulgaria
During the last 10 years tuberculosis attained great socio-medical significance which is due to two factors:

1. Progressive increase in incidence and prevalence on a global and regional scale. Nowadays tuberculosis is the most wide-spread infectious disease in the world.
2. Increase in frequency of bacteria, resistant to tuberculostatics.
On account of these 2 reasons, Tuberculosis will attract the attention and efforts of health institutions more and more /both on the short-term and the long-term run/.
After 1990 deterioration of all epidemiologic indicators of tuberculosis endemy is apparent in Republic of Bulgaria:

1. Incidence in 1990 has been 25,1 to 100 thousand population and in 1998 - 50,0.
2. Prevalence in 1990 has been 125,3 to 100 thousand population and in 1998 - 182,2;
3. Number of smear-positive patients has grown /1325 in 1998 compared to 903 in 1996/

Increase of incidence is mostly at the expense of increase of pulmonary tuberculosis.
Data analysis has revealed that fight against tuberculosis has to include mainly actions to control precisely tuberculosis of the lungs.
In 1991 44th World Health Assembly stressed the significance of tuberculosis epidemy in the world and appealed to the governments and health structures in order to start concrete actions. Main accent of resolution accepted at the 51st session of the general meeting of WHO, carried out in May, 1998 in Geneve, was the political will and financial support of governments given to the national programs on control of tuberculosis. A Bulgarian delegation participated as well.

Program Objectives

1. Assure optimal application of prophylactic measures against infection with tuberculosis.
2. Decrease risk of infection and disease.
3. Ensure early /in due time/ diagnosis of tuberculosis.
4. Ensure adequate treatment for all people suffering from active form of tuberculosis.
5. Improve functioning of the specialized health establishments, connected to prevention, diagnostics and treatment of patients suffering from tuberculosis.
6. Creating monitoring system for newly detected cases and the outcome of their treatment
7. Public popularization of the problem 'Tuberculosis'.
8. Improve qualification of medical personnel on the problem 'Tuberculosis'.

Strategy

Public, non-governmental and other institutions, having an opinion and concerned with tuberculosis, take part in the process of program implementation - Ministry of Health, Ministry of Finance, Ministry of Labor and Social Policy, Ministry of Justice, Ministry of Defense, Medical Universities, Institutes and Colleges, authorities of local self-government /municipal authorities/, producers and importers of anti-tuberculosis drugs and apparatuses / appliances.
Council on Tuberculosis to the Minister of Health is in charge of program management. Head / General Directorate "Preventive and Curative Care" and the Regional Centers for Healthcare (RCHC) are in charge of coordination and control of the accomplishment / fulfillment of the objectives.

Activities

?. For Objective 1:
1.1. Carry out immunization and re-immunization with BCG - vaccine to all who are subjects / liable contingents.
1.2. Carry out unified chemoprophylaxis with Rimicid to all contingents, having indications for its application.
1.3. Explore the possibilities to reduce re-immunizations with BCG-vaccine.

??. For Objective 2:
2.1. Guarantee seasonable and overall coverage of all contact persons.

???. For Objective 3:
3.1. Make fluorographic examinations among people belonging to high risk groups, in: regions of incidence higher than the average for the country, imprisonment places, psychiatric and public institutions, young men who have not done their military service yet, etc.
3.2. Purchasing 1 mobile digital fluorographic installation / outfit to cover risk groups for early diagnostics of tuberculosis, tumors in the lungs and other pneumopathies.
3.3.Substitution of outdated X-ray apparatuses in specialized medical institutions for tuberculosis treatment
3.4.Implementing methods for direct bacteriological examination of the expectoration for ?ycobacterium tuberculosis of every patient susceptible to tuberculosis.

?V. For Objective 4:
4.1. Unified treatment for all patients suffering from active form of tuberculosis in conformity with WHO recommendations and concerted with the new methodical instructions, accepted in Republic of Bulgaria.
4.2. Provision of necessary amount of tuberculostatics to cure all patients having active form of tuberculosis.
4.3. Application of the DOTS strategy of newly detected cases by stages in particular regions.
4.4.Clarification of the frequency of smear-positive patients of resistant to tuberculostatics TB bacteria.
4.5.Provision of drugs to cure TB bacteria resistant to first-line antituberculosis drugs.

V. For Objective 5:
5.1. Define a set of criteria to assure quality of work at the medical institutions

V?. For Objective 6:
6.1. Update documentary basis and implement computerized system in order to register newly detected cases and the outcomes of their treatment.
6.2. Supply of computers to regional TB dispensaries to be included in the system.

V??. For Objective 7:
7.1. Set up a team of experts for PR, which will provide information on tuberculosis-related problems on behalf of Ministry of Health.
7.2. Increase of knowledge and sanitary culture of people who are healthy, of tuberculosis patients and their families: organization of a month on fight against tuberculosis, TV and radio broadcast, press conferences, publications in the media, information materials /booklets, newssheets/.

V???. For Objective 8:
8.1. For personnel working in pneumo-phtisiatric medical institutions - specialized training in pneumology and phtisiatry in conformity with the contemporary requirements for the specialty, which will be carried out in the clinics in Pneumology and Phtisiatry to the Medical Universities in Sofia, Plovdiv, Varna and Pleven.
8.2. For personnel working in medical institutions for outpatient care - organization and implementation of seminars by regions for university and college /secondary school/ graduates on the problem 'Tuberculosis'.
8.3. Coordination with medical faculties to increase the horarium to six classes in TB in the courses of Postgraduate Qualification - General Medicine, internal diseases, pediatrics and infectious diseases /AIDS/.

Ministry of Health (2000). Public Health in Moldova 1999. Chisinau, Scientific and Practic Center of Health and Health Management, UNICEF. Countries, territories and regions: Moldova
This publication consists of both analytical reports and tables of basic statistical data describing the health care system and population's health in the Republic of Moldova in year 1999 comparing to previous years. This is an annual survey carried out by the National Scientific and Practical Center of Public Health and Health Management of Moldova that has collected data from the Health Districts Administrations of 12 judets/districts of Moldova, hospitals and clinics from Chisinau city. A brief analytical material and complex data on statistics describe the general figures of health care in Moldova for 2000 including the epidemiologic conditions, basic analysis of health care resources, the overall figures of health care budget distribution for 1999, demographic situation, population's morbidity, primary care system, in-patients services providing, data on maternal and children's health and evidence of activities provided by the auxiliary medical services, etc.

Ministry of Health (2000). Health Status in Moldova 2000. Chisinau, Scientific and Practical Center for Public Health and Management. Countries, territories and regions: Moldova
This publication is an annual survey carried out by the National Scientific and Practical Center of Public Health and Health Management of Moldova that has collected data from the Health Districts Administrations of 12 judets/districts of Moldova, hospitals and clinics from Chisinau city. The material consists of a general assessment of health care in the Republic of Moldova and basic statistics describing the health care system and the health status of the population of Moldova in year 2000. You may find data comparison to other countries, basically NIS, and to data of health status in Moldova for previous years. The general assessment part and statistics present the overall figures of health status in Moldova for 2000 including the epidemiologic conditions, basic analysis of health care resources, the overall figures of health care budget distribution, demographic situation, population's morbidity, primary care system, in-patients services providing, data on maternal and ch ildren's health and evidence of activities provided by the auxiliary medical services, etc.

Ministry of Health (2001). The Albanian National Drug Demand Reduction Strategy for the Period 2001 - 2004. Tirana, Ministry of Health. Countries, territories and regions: Albania

Ministry of Health (2001). National Programme for the Mental Health of the citizens of Republic of Republic Bulgaria, 2001-2005. Bulgaria, Ministry of Health. Countries, territories and regions: Bulgaria
Introduction
Mental health is deemed in need of particularly profound changes. Psychiatric services are called to abandon their seclusion and build coalitions with the social, housing, employment and education sectors and work in collaboration with general and emergency health care at local level. The priority task is the rapid improvement of the quality of life of the severely mentally sick who are doomed to social exclusion under the current institutional system.

Major flaws in the current mental health system
1. Disadvantages of the institutional model of service provision.
Institutional psychiatry is grounded on the public attitude of discrimination of the victims of psychiatric illness and is argued with dangerousness as evidenced by challenging illness behavior. Institutional psychiatry ends up being preoccupied with control in spite of its aspirations to incite compliance with medical treatment. In addition, hospital care, if designed to standard, is too expensive to be afforded by the country given its staggering economy.

2. Disadvantageous public attitudes.
Rejection is the prevailing public attitude to mental illness, and it has economic and legal implications for patients and families.

3. Flaws in the current services.
" Current systems of care do not cater for individual needs.
" The utilization of services depends on the capacity of patients to manage their own care, which they mostly lack.
" Institutional care encourages dependency.
" Agencies do not provide descriptions of their services to enable patients to make choices.
" Regional needs are not taken into account in service development.
" There is no system to evaluate the cost effectiveness of services put in place.
" The prevailing medical model fails to handle problem of living.

III. Objectives of the National programme
" To reduce the incidence and prevalence of psychiatric disorders
" To reduce the mortality related to psychiatric disorders
" To reduce the negative consequences of psychiatric disorders
" To improve the quality of psychiatric services and interventions and develop mechanisms for control and monitoring of treatment
" To combat psychiatric stigma and improve the quality of life of patients
" To integrate psychiatric care and general health care
" To study the causes and outcome of psychiatric disorders
" To reduce readmission rates by 30 % in 5 years
" To raise specific needs-related interventions by 50%.

Progress report: March 2002
" An epidemiological survey of psychiatric morbidity has been launched in association with World Mental Health 2000 project.
" A demonstration project has been initiated in the city of Sofia to establish new services for severely mentally sick in the community.

Ministry of Health (2001). National Programme on Mental Health 2001-2010. Bulgaria, Ministry of Health. Countries, territories and regions: Bulgaria

Ministry of Health (2001). National Health Strategy, Bulgaria. Sofia, Bulgaria, Ministry of Health. Countries, territories and regions: Bulgaria
Alarming tendencies have emerged in Bulgaria during the last few decades, necessitating prompt actions.
There is a decrease in the number of the overall population /decrease is even higher for the rural population/, increase in mortality /which is also higher among the rural population/ and a decrease in the average life expectancy.
Birth rate in Bulgaria has shown strong, lasting tendency of decrease during the past four decades due to negative influence of some socio-economic and demographic factors. Since 1970 the frequency of abortions has increased and has exceeded /since 1980/ the number of childbirths. The number of stillbirths has also grown since 1990, the tendency being stronger among rural population.
Increase in overall mortality is characterized by alarming growth of the number of deaths among the rural population, increase of mortality of active population in the age group from 29 to 59 years of age and increase in infant mortality.
In the course of one decade, causes for death have kept their relatively steady structure. In 1998, about 2/3 of deaths are due to diseases of blood vessels and circulatory system /66,2%/, neoplasms are in the second place /13,3 %/ as a cause for death, followed by diseases of respiratory system /4,1 %/ and trauma and poisoning /4,2 %/, i.e. approximately 88 % out of all deaths in Bulgaria are due to the four groups of diseases mentioned above.
The morbidity data has shown a significant predominance of diseases of respiratory system /39,0 %/ In the second place are diseases of nervous system and sense-organs /12,1 %/, diseases of skin and hypodermic tissue, diseases of circulatory system, trauma and poisoning, diseases of genito-urinary tract and disorders of digestive system. These classes of diseases form 86,5 % of overall morbidity.
There was re-emergence of Tuberculosis, Infectious diseases, Sexually-transmitted diseases, Mental disorders. Deteriorated physical development and decay in health are apparent especially among the younger age groups. A serious problem of growing importance is overweight, measured by BMI (Body-mass index), i.e. the weight in kilograms divided by the height in square meters /?2/. Surveys in some country districts have revealed that 31,5 % of males and 40,1 % of females have BMI- 20-35; 47,1 % of males and 30,0 % of females have BMI from 26 to 30, and BMI over 30 has been measured for 19,8 % of males and 21,4 % of females. BMI in Bulgaria is growing with age more rapidly among females than among males.

Risk factors and groups
Among Socio-economic risk factors are:
" Chronic unemployment: The number of registered unemployed in 1997 was 534 100, i.e., about 13,7% of the overall population /15,0 % in the towns and 17,3% in the villages/.
" Decrease in incomes of the major part of population: At the end of 1997 the incomes of 65,6 % of the population are below the living wage and about half of the population is at the poverty line.
" Aggravated structure of expenditures: Population is categorized as 'poor' when more than 40 % of household income are spent on food. The percentage of total revenues of the households, spent on food, has increased from 31,6 % in 1990 to 59,7 % in 1997. At the end of 1997 the pensioners have expended more than 64,2 % of their total revenues on food.
" Aggravated structure of consumption: Average intake of milk, fresh fruits and potatoes, for example, is below the advisable / recommended physiological requirements. During the recent decade monthly consumption of fresh fruits has been reduced in half - from 1,7 to 0,8 kg per capita. The registered decrease in meat consumption is from 1,3 to 0,7 kg per capita per month, while milk consumption has been diminished from 2,2 to 1,2 ?g.

Another risk factors are the ones connected to behavior and the way of life / lifestyle/.
" Tobacco-smoking: Consumption of tobacco products in Bulgaria is increasing annually. The percentage of male smokers / 49,0 % in 1996 / remains unchanged for the last several years, but at the same time it is the highest in Europe. The percentage of female smokers has increased from 10,7 % in 1980 to 23,8 % in 1996
" Excessive Consumption of Alcohol / Alcohol Abuse: Percentage of alcohol consumers at the age over 15 years who consistently / habitually drink alcohol, has grown for the ten-year period (from 1986 to 1996): for males it has changed from 76,4 % to 81,5 %, and for females - from 33,6 % to 49,9 %. According to expert assessment, the number of people who abuse alcohol in Bulgaria is 280 000 - 300 000 individuals.
" Drug abuse: In 1990 there were about 2 000 heroin-addicted and addicted to other narcotic substances persons and about 40 000 addicted to psychotropic medicines.
" Risky sexual behavior: Increased sexual activity is observed at an early age, high percentage (41%) of sexual contacts with more than one partners, frequent change of partners, etc. The number of young people who always use condoms, has grown but percentage of those who never use condoms, remains unchanged (22-23%, the comparison has been made between 1995 and 2000).
" Unbalanced diet: Bulgaria is one of the ten European nations, whose population consumes high-calorie food. The greatest part in Bulgarian structure of food consumption is taken by bread and animal fats. Intake of nutrients, containing protective elements such as vitamins /especially during winter and spring seasons/ is very low. Consumption of culinary salt is traditionally high. One of the probabilities is that there is a causal relationship between salt intake and high mortality of cardio-vascular diseases in Bulgaria.
" Low level of physical activity: About 2/3 of the population is characterized by very low physical activity
" Psychosocial stress: it was found that every 13th Bulgarian man /7,5 % / and every 10th Bulgarian woman has suffered from a mental disorder /10,6 %/.

There is also slight increase in the environmental risk factors and almost no change in genetic risk factors. However, some of the secondary risk factors have become issues of growing importance. For example, High blood pressure: during the last years arterial hypertension has been spread among 12 to 16 % of the population, with a growing share among the young age groups. Diabetes: Prevalence of diabetes among males is 1,74 %, and among females - 2,08 %. This is a 10 times repeated increase in comparison to data for the period 1946 - 1980, during which the prevalence has been relatively stable. At the present time the number of diabetes cases is about 150 000 individuals. Obesitas and overweight: the number of overweight people is significantly higher in Bulgaria / compared to the other European countries /57,5 % of males and 54,0 % of females or a total number of 3 650 000 persons. Obese are 10,9 % of males and 16,2 % of females from the country population.
Risk groups in Bulgaria are: people with low incomes, ethnic communities, disabled people. They present that part of population towards which priorities should be oriented. They need specific measures to look after their health and restore it, but without injuring the interests of the other groups of Bulgarian population. Health self-assessment of individuals is as follows: 13,8 % describe their health as 'very good'; 41,0 % - good; 30,1 % - satisfactory; 11,9 % - bad; 3,2 % - very bad. In comparison with the Netherlands /1990/, 81,5 % of the Dutch assess their health as 'very good' and 'good', and only 2,0 %- as 'bad'.
National health indicators specify that during the past two decades /for some indicators-even earlier/ there was a gradual development of negative processes. The continuous period of their development forms a steady tendency towards deterioration. Currently this trend is endangering biological substratum of the nation in a historical perspective.
National Health Strategy is meant to build up strategic approach to solve health problems of the nation. The steps to overcome lack of balance in Bulgarian health care are outlined in this document, as well as the way to put an end to negative trends in nation's health. Gradual achievement of European standards for health care is aimed.
National Health Strategy contains the basic long-term outlines for development in health care. It is the basis to form the health policy in our country. By this reason, strategic health priorities and goals are included in it. Concrete objectives and the way to realize them are worked out in the National plan for operation to implement the strategy.
Priorities in Bulgarian health care are:

" Discontinue negative tendencies and create conditions to improve nation's health;
" Develop structural and institutional changes in health care system, with a view to increase its effectiveness;
" Stabilize and develop structures and functions of Public Health;
" Develop the newly-created economic relations in health care system and the incentives for high quality;
" Achieve decentralization and improvement of the management and development of intersectoral cooperation, public communications and eurointegration;
" Adapt human resources in health care system to the new economic conditions and professional requirements.


Bulgarian Professional Association of medical doctors and Dentists' Union in Bulgaria, together with NHIF, are the main partners of Ministry of Health in the process of formation and implementation of the national health policy. There also exists an effective intersectoral cooperation with other governmental and non-governmental structures: Ministry of Finance, Ministry of Environment and Water, Ministry of Education and Science, Ministry of Agriculture, Ministry of Transport and Communications, Ministry of Labor and Social Policy. Collaboration with other organizations and structures is important to implement National Health Strategy:

Among the international partners are: WHO, World Bank (WB), Council of Europe Development Bank, International Development Fund, United Nations Population Fund (UNFPA), United Nations Agency for International Development (USAID), the program of German government TRANSFORM, etc.

Expected results of the application of National Health Strategy include positive changes in five directions (which are at the same time strategy priorities):

" Restrict negative trends in health status of Bulgarian population;
" Increase effectiveness of health care system and approximate it to the standards of developed countries;
" Increase the quality of health care activities in the field of promotion, prophylaxis and rehabilitation,
" Stabilize the system of health care funding;
" Adapt human resources and citizens to the new economic relations, structural and institutional changes in health care.

Ministry of Health (2001). National Programme for Prevention, Treatment and Rehabilitation of Drug Abuse in the Republic of Bulgaria 2001- 2005. Bulgaria, National Centre for Drug Abuse. Countries, territories and regions: Bulgaria
National Program on Prevention, Treatment and Rehabilitation of addictions in Republic of Bulgaria is based on the experience of developed countries in Europe and North America and completely conforms to the strategy and program on narcotic substances accepted by the EU (2000 - 2004).
During the past 10 years the problems related to drug abuse have become issues of growing importance. There is a broad spectrum of narcotic substances used mainly by the young generation in Bulgaria.
Starting as a small group of several dozens of people during the 60s, since the late 80s drug abuse has gathered speed. At the beginning of the 90s the estimates have revealed that about 1500 individuals use regularly heroin, while at the end of the 90s their number has increased to a population of 25-30 000 people.
At the present moment almost the whole spectrum of illegal drugs is offered for sale in Bulgaria. It results in a serious increase in the number of drug-addicts among the general population of young people and in particular among pupils. Marijuana is the most wide-spread narcotic - 24.0 % of the pupils in Sofia secondary schools have tried cannabis at least once. This is about 3 times increase compared to the year 1995 (9.2 %).
Heroin is the narcotic substance which can be classified as the greatest threat to public health. More than 95% of the cases searching for help and in need of treatment in the National Center of Drug Addictions in 1999 were actually heroin - addicted individuals. Usually it is taken intra venous (by more than 75% of drug addicts). The mean age of the young people dependent on heroin has fallen from 24.7 to 21.5 years for the period 1995 - 99.
Particularly perilous is the tendency to start to use heroin at a very early age. The average age of first heroin injection has decreased from 21.4 to 18.4 years of age for the last 5 years. Getting used to drugs when the personality is still unformed, may lead to fast development of a heavy opiate-addiction and an early social desadaptation, as well as risky injection and sexual practices. As a result, more than 50% of patients addicted to heroin have not completed their secondary education and approximately 86% have not had a regular job / steady work for the recent year.
Percentage of heroin - addicted IDUs infected with hepatitis C, who are under treatment, exceeded 70% in 1999. The increased percentage of virus-carriers of hepatitis C means that there is a higher public health risk of development of an AIDS epidemy, as well as a progressive somatic damage and a necessity of integrated complex medical care for these people.
The requirements to health care system in the country are constantly growing. The number of hospitalized individuals with drug addiction has doubled for the past 5 years. From 1990 to 1998 it has increased more than 5 times.
The population of heroin-addicted as a whole is marginalizing very fast which is expressed by an early drop of school and a growing criminalization. The group of young people depending on opiates is expanding. They will need more and more medical, social, juridical, educational, labor and other services. These, combined with the growing criminalization, will lead to a fast rise in the financial burden of Bulgarian society, caused by drug abuse and drug dependence.
The purpose of the program is to restrict the spread of drug abuse and its inauspicious / adverse health and social effects / consequences for the young Bulgarian generation.
The strategy of the program includes the consideration of drug abuse as a complicated phenomenon with a multifactoral genesis in the context of the bio-psycho-social model.
Participants in the process of program implementation include state, non-governmental and other institutions related to the problem "Drug Addictions" - Ministry of Health, Ministry of Education and Science, Ministry of Labor and Social Policy, Ministry of Defense, State Agency for Youth and Sports, National Center for Addictions, medical universities, institutes and colleges, the authorities of municipal / local administration, non-governmental organizations.
Management of the program is carried out by the Secretariat of the National Drugs Council.

The main areas of intervention and goals of the program are:

Area 1 - Prevention of drug abuse among young Bulgarian people
Area 2 - Consumer - oriented, ensuring equal access, effective treatment of drug addictions and diseases stemming from them
Area 3 - Rehabilitation and programs supporting young IDUs in their efforts to recover and return to society to which they belong
Area 4 - Activities and programs to diminish health and social damages, caused to the society and the particular individual as a result of drug abuse
Area 5 - Information and infrastructure assurance

Target groups of the project are:
" Young people as a whole
" Parents and adolescents
" Individuals dependent on narcotics and their relatives.
" In the medical network:
o GPs
o Specialized Psychiatric Network
o Institutions and organizations, occupied in prevention of drug abuse
o Municipal and regional authorities
o NGOs

The whole period for program implementation is 5 years. The stages for program implementation include an initial (preparatory) stage of 1 year to construct and approbate the organizational scheme for implementing the National program, and a 4-year stage of realization, divided into 1-year programs.

Funding of Republican budget - Financing of program activities will be accomplished by Republican budget according to Annual Budget Act on the basis of a yearly plan, worked out by Ministry of Health and approved by National Council on Drugs. The means will be allocated, laid out and accounted for within the framework of annual budgets of the relevant Ministries responsible for accomplishment of the activities and the grants will be regulated by Secretariat of National Council on Drugs. For the period from 2001 to 2005 (including 2005) the program for prevention, treatment and rehabilitation of drug addicts will utilize / assimilate 9,958,830 levs, the annual expenditures being 198,600 levs for the first year and approximately 2,500,000 levs for each one of the following 4 years.

Ministry of Health (2001). Croatian Health Reform, Ministry of Health Croatia. Countries, territories and regions: Croatia

Ministry of Health (2001). Stability pact questionnaire (Macedonia), Ministry of Health. Countries, territories and regions: Macedonia

Ministry of Health (2001). Strategy for improvement of Health Protection of the Population in the Republic of Macedonia. Skopje, Macedonian Academy of Sciences and Arts, Ministry of Health.
Countries, territories and regions: Macedonia
This Strategy has been prepared by a team of experts (Public Health, Clinicians, Economists, Layers, as well as, members of the Academy) engaged by the Ministry of Health and Macedo-nian Academy of Science and Art. The main goals and targets that should be achieved by the Year 2010 are presented in the Strategy. Beside the short description and analysis of the current system the main emphases is being addressed to the general strategy development process in the next 10 years as well as specific topics in the area of health insurance, different levels of the health care services, health education, Public Health and improvements in selected areas of the WHO HFA goals as children health, ageing, cardiovascular and malignant diseases, mental health, diabetes, drug abuse, kidney diseases, accidents and injuries, and Environmental Health Action Plan. The document is in a process of a public debate.

Ministry of Health (2002). WHO European Framework Convention for Tobacco control - Challenges for Macedonia, Ministry of Health. Countries, territories and regions: Macedonia
The information in this document is based on the WHO documents as well the Macedonian regu-lation in the relevant areas. Document is structured in seven chapters: summary review, introduc-tion, development of the internatinal regulation for smoking control, development of the National regulation for tobacco control, comparison analysis of the WHO European Frame Convention on tobacco control and Macedonian legislation, conclusions, recommendations for further activities. On February 19 2002 Macedonia as many other EU countires has signed the Warshav Declara-tion for "Europe without smoking" which opened the door for developmet of the ECST-European Strategy for Tobacco Control, defining the Fourth action plan, final FCTC, as well strenghtening the Regional solidarity and partnership against smoking.

Ministry of Health (2002). Report on the implementation of the UN Convention for Elimination of all Forms of Discrimination against Women. Countries, territories and regions:

Content: This Report gives and overview of the progres and achieved activities in the implemen-tation of the UN Convention for elimination of all forms of woman discrimination in the health sector. Section 1: review of the health strategy and policy in Macedonia, the organisation of health delivery system, as well additional measures needed to improve the health status. In sec-tion 2 rhe helth care and health status of women is presented through demographic and vital indi-cators, mortality causes of death, and specific morbidity indicators for women. Sections 1 and 2 elaborate the implementation of the article 12 of the Convention and appropriate recommenda-tions. Section 3 is review of measures of women health care and mean elaboration of other Con-vention recommendations. The fourth section is general conclusion of the Convention implemen-tation and directions for future activities.

Ministry of Health (2002). Health Sector Transition Project in Macedonia (1996-2002), Ministry of Health, World Bank. Countries, territories and regions: Macedonia
The main problems in the health sector were defined as :Overemployement of the staff in the PHC (doctors) and the number of available doctors heavily affects incorrect re-distribution - the actual current average list size:Low motivation, low quality of the PHC services, high referrals rates for higher level, big expenses for drugs and hospital care, unsatisfied users, bad non-satisfactory health status, limited solvency: Main Objectives: Improve the health of the population by improving the quality of basic health services Increase efficiency i.e. less expenditures to achieve appropriate health care services Sup-port an initial phase of policy reforms to enhance cost-effectiveness, fiscal sustainibility and patient choice within the health system. The mainProject Components were :Health Finance and Management: (base cost US$ 3.8 million) to support the Govern-ment's efforts to prepare and implement health financing reforms; Basic Health Services (base cost US$ 7.0): The main objective was to strengthen primary health care and health promotion, particularly in rural areas; Pharmaceutical Policy and Supply (base cost US$ 5.7 million): to promote more rational use of drugs through strengthening local ca-pacity for competitive drug procurement. In parallel with that a special PR campaign has been conducted.

Ministry of Health (2002). Program for treatment and drugs for malignant diseases, dialysis, transplantation, diabetes, hemophilia, growth hormone. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Anually), Ministry of health. Countries, territories and regions: Macedonia
The estimations are that during 2002 there will be 1.150 patients for dialysis, around 15 new kid-ney transplantations and around 6000 new patients of malignant diseases. In the same time the expectations are for 45.000 diabetes patients, 7.500 of them insulin dependent. Around 50 chil-dren in average annually have a need of growth hormone. It is estimated as well that for 220patients from hemophilia A and B there will be a need of 6.000.000 IE of factor VIII and 2.000.000 IE of Factor IX. The Government takes the commitment to cover the financial costs of the program in collaboration with the Health Insurance Fund - HIF(for the insures).

Ministry of Health (2002). Program for tuberculosis control. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Ministry of Health. Countries, territories and regions: Macedonia
It is estimated that during 2001 in Republic of Macedonia 1194 cases of active TB had been reg-istered (61.6/100.000 population) among them 961 hade the respiratory form. The incidence was 34.5new cases/100.000. 161 of the new cases were children. The activities are being imple-mented through the Institute for lung disease and TB, who is doing the measures for early detec-tion, surveillance of the work of the regional institutes, BCG vaccination and specific health sta-tistics and documentation, health promotion and education of the health workers. The costs should be covered through the state budget and the HIF.

Ministry of Health (2002). Program for brucelosis. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Ministry of Health. Countries, territories and regions: Macedonia
The aim of the program is eradication pf the brucelosis among the people through continuous monitoring and epidemiological analysis, implementation of the plan and preventive measures, early detection and laboratory confirmation (BAB tests and Wright reaction), health promotion. The responsible institutions are the public health institutes in the country in collaboration with the Institute for Epidemiology on the Medical Faculty. The Government and the HIF will finance the planned number of investigations and activities.

Ministry of Health (2002). Program for AIDS. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annu-aly), Ministry of Health. Countries, territories and regions: Macedonia
This is a joint program between the Government and WHO, UNICEF, UNDP. and it is imple-mented through the health institutions, education, Red Cross and the media. In the content there is a set of epidemiological investigations and surveillance, laboratory testing, education of the health workers and health promotion activity among the whole population and especially the risk groups. Among the institutions the most exposed are the public health institutes, Institute for Epidemiology, Clinic for Infective diseases; Psychiatric Clinic and the National Committee for AIDS prevention and management. The whole program is planned to be financed by the State Budget

Ministry of Health (2002). Program for blood donation. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Minstry of Health. Countries, territories and regions: Macedonia
The program is a part of the obligation of the goverenmt to organize the process of fulfilling the basic needs for blood and blood products in the country. The minimum annual needs of the coun-try are based upon the criteria of 3% of the population what means around 55.000 blood dona-tions planned for 2002. The scope of the program activities is: planning of the actions in different environments; regular contact with different subjects on the field; distribution of educative mate-rials; interviews, promotion, evidence and documentation, informations and public campaigns. The responsible institutions in the program are the Institute for Transfusiology and the National Red Cross.

Ministry of Health (2002). Program for general check-ups of children and student. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Ministry of Health. Countries, territories and regions: Macedonia
The aim of the program is to implement the need for specific screening of the health stsus of the vulnerable groups such are the school age children and youth especially in the phase of intensive physical and psychological growth and development. The checking's are being applied by the Dispensers for school medicine and the content of the work is: surveillance on the growth and development, early detection of the different type of hereditary malformations, prevention of cer-tain diseases, treatment. The checking's are obligatory for the school population in I, III, V and VII grade of elementary school. The total number of children planned to be checked in 2002 is 125.344 in elementary school and 43,819 in secondary school and 8917 students. The costs should be covered by the state budget and the HIF.,

Ministry of Health (2002). Program for mother and children. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Ministry of Health. Countries, territories and regions: Macedonia
Target population: women in reproductive age (22.7% of total population or 450 000) and chil-dren at age 0-6 years (11.2% or 218 000). The objectives of this Program are to: to reduce peri-natal and infant mortality; improve education of mothers about the care of newborns and infants; early detection, evidence and diagnosis of development problems; parent education for children with development problems; education women in reproductive and for whole family; improve health woman's status during pregnancy, delivery and lactation; decrease morbidity for acute respiratory diseases and diarrhea; multisectoral cooperation. Planned activities: 1. Strategy for health promotion of women in reproductive period: promotion of family planning as precondi-tion of safe motherhood and optimalisation of conditions for proper children growth and devel-opment. contraception counseling health promotion, health care for planned and wanted preg-nancy; 2. Strategy for health promotion in preschool children: preventive activities: check-ups, active immunization, patronage services; Activities for Institute for Mother and child: technical assistance in the Program implementation, surveillance of mothers and children; education for health personnel in primary health care; preparation and publishing of risk factors for newborns. Health promotion activities.

Ministry of Health (2002). Program for immunization. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Ministry of Health. Countries, territories and regions: Macedonia
In this Program according to the by-law for Compulsory Immunization the list of immunizations is given with target population and calendar for each immunization. Continuous immunization is conducted for: Tuberculosis, Diphtheria, Pertussis, Tetanus, Poliomyelitis acute, Morbilli, Pa-rothitis, Rubeola. Immunization per epidemiological indication is conducted for: Morbilli, Tu-berculosis, Lyssa, Yellow Fever, Cholera, Tetanus, Typhus Abdominalis, Tetanus, Hepatitis B, Poliomyelitis acute.

Ministry of Health (2002). Program for special population groups and specific diseases of uninsured. (in Macedonian) - "Official Gazette" of RM. No 41/2002 (Annualy), Ministry of Health. Countries, territories and regions: Macedonia
This Program is for special target groups: uninsured children from 1 to 18 years (9000) and eld-erly over 65 (25 000) and uninsured persons with special diseases (10 000). The aim of this Pro-gram is to provide funding from to Central budget for basic health care: doctor examination, ba-sic diagnostic investigations. emergency services, out-patient and in-patient treatment (except drugs on receipt in PHC, emergency dental services).

Ministry of Health (2002). Program for patients with mental diseases and drug abuse. (in Macedonian) - "Offi-cial Gazette" of RM. No 41/2002 (Annualy). Countries, territories and regions: Macedonia
Target population: patients with mental diseases and drug abusers treated in three specialised hospitals in Skopje, Demir Hisar and Negorci, in total 2 150. Out of them around 500 are with-out health insurance. 1000 patients are with mental diseases, out of which 400 are in acute stage of disease under medical treatment in the above mentioned hospitals covered by the Health in-surance Fund. The breakdown of costs for the treatment of these patients, that should be pro-vided from the Central budget is given in the last section of this Program.

Ministry of Health (2003). Project for Act on Blood, Blood Products and Their Application (www.mh.government.bg. Bulgaria, Ministry of Health. Countries, territories and regions: Bulgaria

Ministry of Health (?). National Programme on Oncological diseases prevention and treatment-screening programme for cervix, breast and prostate cancer. Bulgaria, Ministry of Health. Countries, territories and regions: Bulgaria

Ministry of Health and IBF (2000). Perception of Albanian public on the health care system , July 2000. Korrik, Ministry of Health, IBF. Countries, territories and regions: Albania

Ministry of Health and National Committe for Diabetes (2002). National programme for prevention of Diabetes Mellitus, Macedonia, Ministry of Health, National Committe for Diabetes. Countries, territories and regions: Macedonia
One of the reasons for the increasing concern of diabetes is the growing number of diabetics and the fact that the disease will lead to acute and late complications and eventually death if not treated properly. The reason is that diabetes constitutes an extensive economical burden on the health system. It was estimated that in Macedonia currently there are 70-80,000 people with dia-betes (3,5-4%). 1,200 out of the total number is diagnosed with diabetes type 1, the rest have type2. In the introduction part of the document, the need for National register on diabetes melli-tus, as well the necessity for education of the patients and health professionals and public aware-ness are as well underlined. The objectives have been divided in three groups: short term (updat-ing the program, and register, continuation of the education and efficient use of the guidelines); medium term (develop more effective programs for behavioral changes related to the lifestyle; develop national target s for reducing rates of acute hospital admissions; ensure screening of all pregnant women for diabetes to reduce health risks to the mother and fetus) and long term objec-tives (improvement of the general and specific preventive measures toward complications, im-provement of the health status of population in general, efficient control and rationalization of the costs for diabetes).

Ministry of Health and Phare Programe (1997). Strategy for the implementation of the primary health care policy (MoH, Phare program), May 1997. Tirana, Ministry of Health,
Phare Program. Countries, territories and regions: Albania

Ministry of Health, USAID, et al. (2001). Report on the Conference: Reproductive Health at the beginning of the new Millennium (MoH, USAID, Albanian Parliament), March 12-13. Tirana, JSI-TASC
USAID. Countries, territories and regions: Albania

Ministry of Health and World Bank (2001). HSTP -Public opinion about reforms in health services in Macedonia, Ministry of Health
World Bank. Countries, territories and regions: Macedonia
There is no doubt that the public transparency is one of the most important conditions for the success of the process of changes in the health sector. In regard to this and in parallel with the process of designing and implementing of a series of essential changes in the health sector especially in the PHC, there was a need of launching a major public educa-tion program. The Project Unit requested a proposal from external and local PR consult-ant as well as from PR firms to assist with the design and implementation of a multi-media public information campaign. In a separate activity the IPU conducted a public opinion research regarding the HC system and ongoing reforms. The results from this re-search could be of highest value for early use in the design and development of the cam-paign.Main Objectives were: Improve the Public Relation capacity of the Ministry of Health; inform the public about the planned and performed reforms and how the reforms will affect the individuals and to build public confidence in the reforms. Strengthening the internal PR capacity of the MoH; Developing training seminars for journalists who specialize in health care issue, and develop and implement a Public Information Cam-paign on behalf of the MOH and HIF(jointly) after a proper process of public opinion re-search. In the research process of public opinion, special emphasizes beside the general population, have been put on the target groups with a special concern or interest in health reforms.The data and analysis from the national survey has been presented to the MoH and HIF. The results were not nearly as negative as the expectations were. Very gener-ally, the public is satisfied with their PHC but are frustrated by the administrative proce-dures,lack of knowledge about the HC reforms, lack of access to specialists, quality of the pharmaceuticals available and conditions of health clinics, hospitals and equipment. They are also not very happy with the commitmen t to participate in the costs of the HC services.

Ministry of Health and World Bank (2001). National Drug Policy (Macedonia), Ministry of Health
World Bank. Countries, territories and regions: Macedonia
There was a lack of coherent strategy paper and policy in the field of drugs on the na-tional level. In the pharmacoeconomical area the situation is unstable and uncertain as well. Namely, it is estimated that the total annual turnover of the Macedonian pharmaceu-tical market vary from US$ 40 to 300 million (US$ 2 to 150 per capita). The main objec-tive was to produce a paper what will describe an unique and systematic approach in the drug policy field, aiming to satisfy the optimal needs for efficient, safe and economically available drugs of the citizens and the patients. The main project components: Legislative and Regulatory framework; Selection of drugs and rational use, drug information system and information's for drugs; Supply and economic strategies for drugs; Human Resources development, monitoring and evaluation, the strategy paper was publicly adopted on a workshop in May 2001. Immediately after that the Ministry of Health and the Govern-ment also adopted the do cument as a National policy document.

Ministry of Health and World Bank (2002). Perinatal Project - Health Sector Transition Project, Macedonia,, Ministry of Health
World Bank. Countries, territories and regions: Macedonia
This is one of the best stories in the last ten years on World Bank Projects. It can be seen on this web site http://www.worldbank.org/

Perinatal Project (1999-2001) was part of Health Sector Transition Project (HSTP) im-plemented by International Project Unit (coordination, management and procurement of equipment), Ministry of Health (civil works), World Bank (Credit IDA No.2889-MK), UNICEF (civil works) and technical assistance by Royal Prince Alfred Hospital, Sydney. The Primary objective of this Project was to decrease the perinatal mortality rate, while the overall objective was to focus on a neonatal intensive care network on the national level. The aim of the Project was to recommend a National strategy for perinatal care. Challenges faced: Frequent change of the Ministers of Health and directors of hospitals, Kosovo crisis, war in 2001 and primary opposition of neonatologists. The Project incor-porated key strategic elements: regionalisation of neonatal care, transfer of high risk mothers to Skopje and a national transport service for sick neonates, evidence-based edu-cation and practice, organisati onal framework for perinatal services. Major Achievements CME Center established and training for level II and III neonatal providers including both doctors (50%) and nurses (25%); Structural development of the planned level III unit in O&G, the relocation of the level III unit in the Paediatric clinic and the develop-ment of space for a neonatal transport service; Introduction of equipment to level II and III units and the transport service; Introduction of neonatal rotations in paediatric training and basic neonatal teaching in undergraduate medical training; Introduction of neonatal post basic training for nurses/midwives; Establishment of Perinatal Committee; Devel-opment of evidence based management protocols (Cochrane, Welsh database etc); Estab-lishment of a Maternal, Perinatal and Infant Mortality Committee; Development and im-plementation of standardised psychometric and neurodevelopment testing for all high-risk neonates. Quantitative indicators: Overall a de crease of 21% in the Perinatal Mor-tality Rate, after careful data collection from 16 hospitals (>93% births), compared 3years before intervention 1997-99 with 2 years after starting intervention 2000-01 (27.4 to 21.5 per 1000 births) and decrease of 36% in early neonatal deaths in babies >1000g (12.0 to 7.7 per 1000 live births), reflecting the postnatal thrust of the program. Conclusion: The goal now is to decrease PMR to < 10 per 1000 by 2005. This requires attention to the ob-stetric/midwifery component of perinatal health.

Ministry of Health and World Bank (2002). Tuberculosis Control Project in Macedonia, Ministry of Health,
World Bank,. Countries, territories and regions: Macedonia
Main objective of this Project was to decrease the tuberculosis (TB) incidence and preva-lence and to improve the TB control in the country by organizational changes, education and procurement of equipment. Implementation: The TB Project was part of the overall Health Sector Transition Project (HSTP) and was implemented as a joint project sup-ported by International Project Unit (IPU) - Ministry of Health (Project coordination, management and procurement of equipment), World Bank (Credit IDA No.2889-MK) and WHO (technical assistance for Strategy development, developing guidelines for TB treatment and financial support for the civil works). The implementation of this Project started in July 1999 and has been completed in 2002. Political changes of the Minister and directors, Kosovo crisis, and political situation in the country were serious obstacles for this Project as for the others. Coordination with WHO's work on improving TB pre-vention and treatment helped to improve the development impact of the equipment pro-cured through HSTP.. Major Achievements of this Project are: 1) the Strategy - National Program for Control of Tuberculosis in Republic of Macedonia as a 5-year plan for 2000-2005, based on the DOTS Strategy and with systematic approach to the control of TB in the country; 2) new equipment for Institute for Lung Diseases and TB and 6 TB out-patient dispensaries; 3) rehabilitation of TB dispensaries; TB guidelines and education for PHC doctors. The outcome of all these activities is decreased TB incidence rate from 40 in 1995 to 31.6 per 100000 in 2000. Conclusion: The Project was successfully completed and good outcomes achieved, but still TB rates are much higher compared to countries in Central and Western Europe.

Ministry of Health and Social Affairs of the Republika Srpska and WHO (1997). Strategic Plan for Health System Reform and Reconstruction 1997-2000. Republika Srpska. Countries, territories and regions: Bosnia and Herzegovina

Ministry of Health and Social Welfare (1998). Health Financing Reform. Banja Luka, Ministry of Health and Social Welfare,. Countries, territories and regions: Bosnia and Herzegovina

Ministry of Health and Social Welfare (1999). Health Policy Targets and Measures in Republic of Srpska by the year 2020. Banja Luka, Ministry of Health and Social Welfare. Countries, territories and regions: Bosnia and Herzegovina

Ministry of Health and Social Welfare (1999). Strategy of the health Promotion in the Republic of Srpska. Banja Luka, Ministry of Health and Social Welfare. Countries, territories and regions: Bosnia and Herzegovina

Ministry of Health Macedonia Tobacco prevention programme: Survey of smoking prevalence among physicians in Europe - on the sample of 1203 physicians. Ministry of Health - Survey, Minstry of Health. Countries, territories and regions: Macedonia
Health Education and Prevention of tobacco smoking in RM - small grant from the WB. A suit-able placard was prepared and distributed to the primary and secondary schools, accompanied with health education (presentation) among the children in the biggest part of the country; Quit and win 2002 Project: with participation of 60 health workers from the country in cooperation with the Finish Institute for Health; WHO European Partnership Project to reduce Tobacco De-pendence; The level of the smoking habit among the secondary school age youth (in cooperation with WHO and CDC Atlanta) preparation and distribution of suitable placards and health promo-tion materials. The integral forms of the reports present in the WHO Liaison Office- Skopje.

Ministry of Health Macedonia National Action Plan for Prevention Alcohol-Related problems- Ministry of Health- Draft version, Ministry of Health. Countries, territories and regions: Macedonia
Main aims of the documents are : decreasing of the consumption among youth and decreasing of the number of the dependents; reduction of the alcohol harm effects and mortality ratio, im-provement in the special service organization including the improvement in the legislation and involvements of the NGOs.The plan for primary prevention includes the education and promo-tion activities in parallel with a proper reorganization of the services. In the secondary and terti-ary level the emphasize should be put on the improvement in the technical capabilities of the ser-vices and rehabilitation and resocialization of the dependents. The documents is also proposing the possibilities for financing of the activities through the state taxes.

Ministry of Health Macedonia (2000). Project for rehabilitation of the patronage system in Republic of Macedonia-Policy Document, Minstry of Health. Countries, territories and regions: Macedonia
The Document has been supported by WHO and UNICEF and has been developed with a net-work of 14 pilot communities. The basic criteria for selection was the ratio of live births, infant mortality and size of the area. One of the aim was to train a team of educators who will continue the further traings and education on the field. A significant link had been established with the WHO Collaborative Center for Health Care in Maribor (Slovenia). A group of 13 selected nurses from allover the country have been initially trained in Maribor. The main topics were : general health care, improvement of the health care of mothers and children, communication skills espe-cially important in the process of creating of improved profile of local community. The attention have been addressed to the family, local health , social and psychological needs, multisectoral collection of data, development of efficient individual solutions, criteria for intersectoral collabo-ration in the monitoring of th e conditions. The total number of 206 nurses have been trained in the local centers. Among others, the basic methods applied were : health-education, team method, method of dispenser work, epidemiological method, basic statistical method. In the scope of the project the 14 education centers received a field vehicle.

Ministry of Health Macedonia and Institute for Lung diseases (2002). The National Tuberculosis Program 2000-2004, Jaap Ween, KNCV, Netherlands and S.Talevski. Skopje, Institute for Lung diseases
Ministry of Health Macedonia. Countries, territories and regions: Macedonia
The program is a 5 year plan for 2000-2005, based on the DOTS strategy and provides a system-atic approach to the control of tuberculosis in the country, outlining a new policy, a comprehen-sive strategy regarding structure and organization, detailed plans for implementation and training and a budget for investment and recurrent costs. The Tb incidence in the country varies between 35-40 per 100.000 ( high compared to the countries in Central Europe). There is an introduction of the current status of Tb in Macedonia, Institutional and human capacities infrastructure, 5 year implementation plan with the structure of the activities, prevention, rehabilitation, technical ad-vice and budget. The list of annexes presented: reported cases and distribution, activities of the institutions and laboratories, tasks of the National Policy Committee, Quality assurance, defini-tion of the patients.

Ministry of Health National Committee Macedonia Improvement of Diabetes Care and Chronic Complications with Strict Glycaemic Control According to the National Programme for Prevention of Diabetes Mellitus in RM, Ministry of Health National Committee Macedonia. Countries, territories and regions: Macedonia
The Document have been adressed to the professionals but also to the patients, general popula-tion and stakeholders with significant role in the prevention and monitoring of this extremely important diseases. The important news and especially the possible complications from diabetes have been presented as well as the different type of costs ( direct, indirect and other). The current status in the country is also presented. On the end the part of the Action Plan presents the short-term targets ( implementation of the Program, introduction of National Diabetes register, contin-ual professional education);medium-term target ( a proper Lifestyle programs for the population; proper treatment of the chronic complications and proper control of the pregnant women status) and long-term tasks ( improvement in the prevention measures and prevention from the chronic complications from diabetes; Management of the material costs for diabetes).

Ministry of Health Romania (1997). "Measles outbreak - Romania 1997." MMWR Morb Mortal Wkly Rep. 1997 Dec 12;46(49):1159-63.
Countries, territories and regions: Romania
During December 1, 1996-September 30, 1997, a total of 20,034 cases of measles (incidence: 88.7 per 100,000 population) were reported to the Ministry of Health (MOH) in Romania (Figure 1); 13 cases were fatal. The outbreak began in December 1996, peaked in May 1997, then declined. Cases occurred in the capital (Bucharest) and all 40 other districts (1996 total population: 22.6 million). District-specific attack rates were highest in the northwest and lower in the south, ranging from 10 to 258 cases per 100,000 population. This report describes the investigation of this epidemic by MOH and estimates the efficacy of measles vaccine using the screening method; the findings of the investigation suggest that high routine vaccination coverage with a single dose of measles vaccine with an estimated efficacy of 77%-90% was not sufficient to prevent periodic outbreaks of measles.

Ministry of Health Romania and WHO/Europe -Liaison office in Moldova (2001). Direct Support to the Moldavian Ministry of health in the field of Healthcare reform 1998 - 2001, Ministry of Health Romania,
WHO/Europe -Liaison office in Moldova. Countries, territories and regions: Moldova
This support had 2 components: A. Romanian Governmental Technical and Financial Support offered to the Republic of Moldova in the field of Healthcare Reform, through the NIRDH (1998); B. Study tour to Romania of leading Moldova managers involved in Health Insurance implementation (2001)
A. In 1998, NIRDH was asked by the Romanian MoH to be the leading institution responsible to design and implement a project aiming to support the Moldavian MoH in the healthcare reform process. During the need assessment stage, the Moldavian MoH expressed the need for technical assistance mainly related to the implementation of a health insurance scheme in Moldova and asked for the Romanian experience in this field. The activities carried out by the consultants from the Institute for health Services Management consisted of a 3 days workshop in Moldova on health insurance and resource allocation, management training at NIRDH for the Moldavian specialists and acquisition of documents, books, journals in the Moldavian language.
B. In 2001, WHO/EURO - Liaison Office in Moldova asked NIRDH to organize a study tour to Romania of leading MDA managers involved in Health Insurance implementation in the Republic of Moldova. Romania has been implementing a new system of social health insurance from 1998. Its experience in developing and implementing the health insurance system was considered useful to Moldova, as there are many similarities regarding health care system as well as the common language, heritage and traditions. Technical assistance was provided on the mechanisms and tools necessary for the starting phase of introduction of insurance (organization of national company), as well as on important specific aspects (formulation of benefit package, management at sub-national/judet level, the allocation of resources in the health care field, the establishment of the level of the contribution and the mechanisms used for premium collection etc.).

Misigoj-Durakoviae, M., S. Heimer, et al. (2000). "Physical Activity of Urban Adult Population: Questionnaire Study." Croat Med J 41(4): 428-432.
Countries, territories and regions: Croatia

Moldova, R. o. (2001). Republic of Moldova 2001: National Environmental Health Action Plan. Countries, territories and regions: Moldova

Moldova, R. o. (2002). PRSP Preparation Status Report - Republic of Moldova. Chisinau. Countries, territories and regions: Moldova

Mollica, R. F., N. Sarajlic, et al. (2001). "Longitudinal study of psychiatric symptoms, disability, mortality, and emigration among Bosnian refugees." JAMA 286(5): 584-8.
Countries, territories and regions: Bosnia and Herzegovina, Croatia
CONTEXT: Evidence is emerging that psychiatric disorders are common in populations affected by mass violence. Previously, we found associations among depression, posttraumatic stress disorder (PTSD), and disability in a Bosnian refugee cohort. OBJECTIVE: To investigate whether previously observed associations continue over time and are associated with mortality emigration to another region. DESIGN, SETTING, AND PARTICIPANTS: Three-year follow-up study conducted in 1999 among 534 adult Bosnian refugees originally living in a refugee camp in Croatia. At follow-up, 376 (70.4%) remained living in the region, 39 (7.3%) were deceased, 114 (21.3%) had emigrated, and 5 (1%) were lost to follow-up. Those still living in the region and the families of the deceased were reinterviewed (77.7% of the original participants). MAIN OUTCOME MEASURES: Depression and PTSD diagnoses, based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and measured by t he Hopkins Symptom Checklist-25 and the Harvard Trauma Questionnaire, respectively; disability, measured by the Medical Outcomes Study Short-Form 20; and cause of death, determined by family interviews with review of death certificates, if available. RESULTS: In 1999, 45% of the original respondents who met the DSM-IV criteria for depression, PTSD, or both continued to have these disorders and 16% of respondents who were asymptomatic in 1996 developed 1 or both disorders. Forty-six percent of those who initially met disability criteria remained disabled. Log-linear analysis revealed that disability and psychiatric disorder were related at both times. Male sex, isolation from family, and older age were associated with increased mortality after adjusting for demographic characteristics, trauma history, and health status (for male sex, adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 1.17-5.92; living alone, OR, 2.40; 95% CI, 1.07-5.38; and each 10-year increase in age, OR, 1.91; 95% CI, 1.34-2.71). Depression was associated with higher mortality in unadjusted analysis but was not after statistical adjustment (unadjusted OR, 3.12; 95% CI, 1.55-6.26; adjusted OR, 1.85; 95% CI, 0.82-4.16). Posttraumatic stress disorder was not associated with mortality or emigration. Spending less than 12 months in the refugee camp (OR, 11.30; 95% CI, 6.55-19.50), experiencing 6 or more trauma events (OR, 3.34; 95% CI, 1.89-5.91), having higher education (OR, 1.90; 95% CI, 1.10-3.29), and not having an observed handicap (OR, 0.11; 95% CI, 0.02-0.52) were associated with higher likelihood of emigration. Depression was not associated with emigration status. CONCLUSIONS: Former Bosnian refugees who remained living in the region continued to exhibit psychiatric disorder and disability 3 years after initial assessment. Social isolation, male sex, and older age were associated with mortality. Healthier, better educated refugees were more likely to emigrate. F urther research is necessary to understand the associations among depression, emigration status, and mortality over time.

Mooren, T. T., K. De Jo9ng, et al. (2003). "The efficacy of a mental health program in Bosnia-Herzegovina: Impact on coping and general health." J Clin Psychol 59(1): 57-69.
Countries, territories and regions: Bosnia and Herzegovina
The efficacy of a community-based psychosocial program in Bosnia-Herzegovina during the war and immediate postwar years (1994-1999) was described in this article. Ten centers provided various kinds of psychological help in the besieged city of Sarajevo and the towns of Zenica, Travnik, and Vitez. Since 1994, an intensive monitoring system has documented data on clients, interventions, and outcomes. This study focused on the systematic evaluation of counseling interventions aimed to alleviate the distress in wartime. The sample consisted of 3,283 and 1,785 inhabitants of Sarajevo, Zenica, Travnik, and Vitez who filled out the GHQ-28 and IES respectively. Pre- and post-assessments were compared throughout consecutive years (1994-1999) and across age groups and both sexes. Outcomes of these scales reflected very high scores, especially among people between 30 and 40 years of age. Furthermore, intake scores increased in time rather than decreased. Differences between pre- and pos tmeasurements are highly significant-throughout the years. Analyses revealed substantial proportions of clinically recovered or generally improved individual functioning, although some clients revealed no improvement. Copyright 2003 Wiley Periodicals, Inc. J Clin Psychol 59: 57-69, 2003.

Morb Mortal Wkly Rep (MMWR) (1997). Morb Mortal Wkly Rep (MMWR) 46(49): 1159-63.
Countries, territories and regions: Eastern Europe

Morris, K. (1999). "Agencies respond to deepening humanitarian crisis in Balkans." Lancet 1999 Apr 24;353(9162):1423.
Countries, territories and regions: South Eastern Europe

Mossialos, E. and M. McKee, Eds. (2000). eurohealth, Focus on Central and Eastern Europe and Central Asia. eurohealth.
Countries, territories and regions: Eastern Europe

Mujkic, A., G. Vuletic, et al. (2002). "Evaluation of community based intervention for the protection of children from small arms and explosive devices during the war: observational study." Croatian Medical Journal 43(4): 390-5.
Countries, territories and regions: Croatia
To evaluate the influence of a community-based intervention aimed at reducing the risk of unintentional injuries caused by small arms and explosive devices accessible to children during the 1991-1995 war in Croatia. METHOD: From May 5 to June 15 in 1994 and 1995, we performed a cross-sectional survey on exposure of the children in Croatia to different small arms and explosive devices, using specially prepared questionnaires. The survey was conducted in Dubrovnik-Neretva and Karlovac counties, where community-based intervention was carried out, and Lika-Senj and Sisak-Moslavina counties, where only national intervention was implemented. The sample included a total of 5,317 parents and 2,581 children. The response rate was 98%. All participants were asked to give answers according to current situation. RESULTS: Approximately a third of children in the counties without community-based intervention and a fifth in the counties with community-based intervention could access small a rms and explosive devices at home. Boys were more exposed than girls (p=0.001). In the communities with community-based intervention, children were less exposed to the devices, such as small-arms, hand grenades, and explosives, which were the main cause of injuries. In 1994, parents in counties without community-based intervention handled weapons in front of their children in 45% cases vs 31% of those in the counties with community-based intervention (p<0.001). In 1995, the percentages were 44 and 32, respectively (p<0.001). CONCLUSION: Although it is impossible to quantify the exact amount of risk reduction due to health intervention alone, community-based intervention reduced the exposure of children to weapons.

Muresan, C. (1999). "The decrease of life-expectancy at birth in Romania; some crisis contributing factors." Health Place 5(2): 187-92.
Countries, territories and regions: Romania

Mutafova, M., H. P. van de Water, et al. (1997). "Health expectancy calculations: a novel approach to studying population health in Bulgaria." Bull World Health Organ 75(2): 147-53.
Countries, territories and regions: Bulgaria
The measurement of life expectancy in terms of either good or poor health is a novel approach to studying the health of the population in Bulgaria. The pilot study reported here-carried out among people aged > or = 60 years in a middle-sized Bulgarian town-was designed to obtain information on the years of functional restrictions expected among the elderly. In accordance with the answers to a series of questions (recommended by WHO), subjects were categorized as disabled, handicapped, or having different states of perceived health. The indicators "disability-free life expectancy", "handicap-free life expectancy" and "healthy life expectancy" (based on self-perceived health) were calculated according to Sullivan's method. The results show, for example, that 8.0 of the 16.0 years that men aged 60 years may expect to live, on average, will be free of disability. For men aged 80 years the figures are 1.3 of 5.5 years. For women at 60 years and 80 years the results are 7.3 and 0.5 disability-free years of 19.2 and 7.3 expected life years, respectively. Similar results were found for handicap-free life expectancies and healthy life expectancies. At all ages, the proportion of life in a condition free of disability, free of handicap, or in perceived good health is substantially lower for women than for men. Women may expect to live longer, but a greater proportion of their life will be spent in poor health. The approach presented here for measuring the health status of the elderly may be helpful as an aid to planning medical and social care and for the development of public health policies.

National Assembly of Republic of Bulgaria (2003). National Assembly of Republic of Bulgaria. www.parliament.bg. Countries, territories and regions: Bulgaria

National Center of Health Informatics (2001). Public Health Statistics Annual. Bulgaria, 2000. Sofia, Bulgaria, Ministry of Health. Countries, territories and regions: Bulgaria

National Committee for Prevention of AIDS and Sexually Transmitted Diseases (2002). National Program on Prevention and Control of AIDS and Sexually Transmitted Diseases 2001-2007. Sofia, Bulgaria, Ministry of Health. Countries, territories and regions: Bulgaria
The present incidence of HIV/AIDS in Bulgaria is comparatively low. A total of 314 HIV-positive patients have been recorded since testing began. Data from recent years, however, indicate a trend of an increasing number of newly infected people. Whereas in 1990 only three new cases were registered, during 2000, this number has increased tenfold. The WHO record ranks Bulgaria seventh of the ten countries most at risk of infection over the next 10 years. If effective measures are taken now, based on the Situation Analysis, the HIV epidemic could be contained in Bulgaria. The rate of other sexually transmitted infections, which is an indicator of HIV infection has increased over the last ten years. Since 1990, there has been an alarming trend in the number of syphilis cases. Whereas in 1990 the number of newly recorded syphilis cases was 378 (4.5 out of 100,000), in 1999, there were 2509 new cases (30 out of 100,000). According to WHO criteria, some regions of the country are on the verge of an epidemic outbreak.
The Situation Analysis revealed the main determinants of the rapid growth of HIV/AIDS infection in Bulgaria. The following factors directly affect the infection rate: risky sexual behavior (unprotected sex); high incidence of sexually transmitted infections; and risky injecting drug use practices (shared needles and syringes). Some of the indirect factors are: poverty (economic insolvency); prostitution; drug and alcohol abuse; low health awareness; low general education of some vulnerable groups; and high (labor) mobility. The lack of an overall policy addressing high risk behavior and HIV/AIDS prevention, as well as the ineffectiveness of the relative institutions, agencies and services, and the transition are other indirect factors.
In the medical practice, blood products and invasive procedures pose the highest risk. The following are indirect factors: lack of standards and good practices; insufficient skills for diagnosis, consultation and treatment of HIV/AIDS.
Several groups have been identified as the most vulnerable to HIV/AIDS and STIs:

A. Adolescents and Young People.
B. Injecting Drug Users.
C. CSW - Commercial Sex Workers / Prostituting Women and Men.
D. MSM - Men who have Sex with Men.
E. Roma Community.
F. Isolated Groups and Imprisoned Individuals.

The purpose of the National Action Plan for Prevention and Control of AIDS and STIs is to assist the Government to meet its policy objective to maintain the current low incidence of HIV/AIDS and mitigate the factors which contribute to the spread of the virus. The Action Plan offers specific actions, responsible actors, and partnerships to implement the National Strategy on HIV/AIDS and other STIs. A National AIDS and STIs Committee has been established.

National Committee to fight AIDS and tuberculosis (2002). Application form for proposal to the global fund. Proposed title "Prevention and Control of HIV/AIDS/TB among the Groups most at risk in Bulgaria 2003-2007. Bulgaria. Countries, territories and regions: Bulgaria

National Economic Research Associates (NERA) (1999). Health Care System in Romania, National Economic Research Associates NERA. Countries, territories and regions: Romania
This report examines the current health care system sector by sector. It identifies existing problem areas and evaluates current reform efforts. On the basis of this analysis we then propose our own recommendation to improve further the health care system of Romania.
NERA's short term reform recommendations focus on the two key reforms which are currently priority areas in Romanian health care: smoothing the transition to the new health insurance system and developing the primary care sector. As the health care system is an integrated network functioning at the level of its weakest link, there are also a number of other complementary short term's recommendations. For the purpose of implementation NERA believe that the following four recommendations should be treated with priority: definition of the Guaranteed Health Care Package (GHCP); effective collection of insurance fund premium contributions; enforcement of primary care gatekeeping; reform of the pharmaceutical reimbursement system.

National framework Contract (2001). National Health Insurance Fund (www.nhif.bg). Countries, territories and regions: Bulgaria

National framework Contract (2002). National Health Insurance Fund (www.nhif.bg). Countries, territories and regions: Bulgaria

National Institute for Research and Development in Health, Colentina Hospital, et al. (2002). Romania Health Information Digest No 1/2002, National Institute for Research and Development in Health,
Colentina Hospital,
Romanian Nursing Association,. Countries, territories and regions: Romania
The first publication contains specialized articles presented at the various conferences and congresses by medical staff from the instituti0ons that work together for the release of relevant publications, namely: National Institute for Research and Development in Health, Colentina Hospital and Romanian Nursing Association.

National Institute for Research and Development in Health, UNICEF, et al. (1999). Private expenditure for health - Romania 1996-1999, National Institute for Research and Development in Health,
UNICEF
CHSP
NIS. Countries, territories and regions: Romania
The National Institute for Research and Development in Health realizes the study. The study is a result of a partnership with the National Institute for Statistics and Economic Studies that provided the primary data collected in the Household Survey. It had the financial support of UNICEF and Center for Health Services and Policies. The aim of the study is to offer the Ministry of Health and Family, National Insurance House, College of Physicians and other potential users more information (otherwise inexistent) needed to decision making for the health care services reform. For the moment the health system decision-makers have few data available regarding medical consumption of the population and regarding the factors that influence it and very few data regarding health expenditures of the population.
The study wants to answer the following questions, trend included for years 1996-1999: Which are the population health care expenditures? What are their territorial variations? Which are some of the influencing factors over the population health care expenditures? Which is the health care consumption and which are it's influencing factors? How frequent are the health problems perceived and declareted by the population? How frequent is the handicap?
In interpretation of the data regarding morbidity token into account the way the survey was conducted: the interview has one month recall period; the interviewer is writing only what the respondent is declaring, without asking for any medical records to justify their affirmations; frequently the interviewers do not have medical education; the results are for years 1996-1999, foe which, with small exceptions, the data were collected using the same methodology; all the amounts of money expressed in lei-prices of month January, current year.

National institute of Statistics (2000). The use of Household Budget Data for Estimating Household Final Consumption 1996-2000 (Romania)(www.insse.ro), National institute of Statistics. Countries, territories and regions: Romania
This is a project aiming the adjustment of the Family Budget Survey in order to assure a better representation of the households with high income and expenditure and the updating of the analytical tables relative to the estimations of the Household Final Consumption in the year 2000.
See web page: www.insse.ro

National Institute of Statistics (2001). Health Indicators for years 1994 - 1998. June. Countries, territories and regions:

National Institute of Statistics, European Community Statistical Office (EUROSTAT), et al. (2000). Health Survey 2000 (www.insse.ro), National Institute of Statistics,
European Community Statistical Office (EUROSTAT),
National Institute of Statistics of Italy (ISTAT),
Romanian Institute of Economic and Social Surveys and Samplings,
Romanian MInistry of Health,. Countries, territories and regions: Romania
General objective of the subproject is represented by the preparation and implementation of a statistical sampling survey in population households providing statistical data about population health in Romania.
Among these objectives was point out the following: collection of statistical individual data about main aspects of population health: temporary physical and psychic inability, medical devices, chronic diseases, medical services using, consumption of medicines, long-term physical inability etc.; possibility to point out the connection between health and: living style (weight and height, nutrition, food regime, consumption of alcoholic drinks, tobacco, physical activity), environmental factors (living conditions), demographic, social and economic characteristics (sex, age, civil status, professional status etc.); identification and commensuration of population categories found under unflavored situations, using some nonmonetary indicators: precarious health, employment under inadequate working conditions, dwelling low standard etc; and getting subjective data referring to the way of health perception by each person.
See web page: www.insse.ro

National Statistical Institute, National Centre for Health Information, et al. (1999). Health Protection. Bulgaria, National Statistical Institute,
National Centre for Health Information,
Ministry of Health. Countries, territories and regions: Bulgaria

Niksic, D., I. Masic, et al. (1999). "Health education as a factor in decreasing traffic accidents (article in Serbo-Croatian (Roman))." Med Arh 53(2): 109-12.
Countries, territories and regions: Bosnia and Herzegovina
Traffic security in post-war Bosnia and Herzegovina is getting worse. Use of motor vehicles and frequency of roads are in constant increase. Import of cars of different types, models, ages and quality caused that we are among the countries with insufficiently developed traffic security. Critical group of the traffic participants consists of young people and children. Their behaviour in traffic depends on their knowledge and attitude gained at home and school. Goal of this paper is to point out the importance of health-education activities in traffic security development. Evaluation was performed among the school children in a transit area in Bosnia and Herzegovina. Results show that school children have no enough knowledge about traffic rules; 13.4% of them don't know a single traffic sign. Even 19.9% of them got injured in traffic accidents, out of which 41.4% got injured while riding a bicycle and 22.4% as pedestrians. These initial results show that level of children's tra ffic culture can be raised only through systematic and permanent education within regular curriculum. Topics on traffic security should be an integral part of education programme, and presented through various subjects.

No authors listed (1996). "Wild poliomyelitis outbreak in Albania." Indian Pediatr 33(12): 1072-3.
Countries, territories and regions: Albania

No authors listed (1999). "Reproductive health kits provided by UNFPA to Kosovar refugees." Guttmacher Rep Public Policy 2(3): 12-13.
Countries, territories and regions: Kosovo, Serbia and Montenegro

No authors listed (2001). "First Congress of Social Medicine - Public Health of Bosnia and Herzegovina. Health care systems in countries member-states of the stability pact. Abstracts." Med Arh 55(1): 41-67.
Countries, territories and regions: Bosnia and Herzegovina

No authors listed (2003). Current Public Health Initiatives in Serbia. Countries, territories and regions: Serbia and Montenegro
This paper presents several ongoing activities in Serbia related to the development of new public health: organization of the series of the public health conference, introducing a working group for public health within the MoH, assessment of the network of IPHs, working on the public health strategy, initiatives for the establishment of Serbian Public Health Association, and initiative for the establishment of the School of Public Health. The general topics of public health conferences are listed together with participants coming from different stakeholders important for public health development.

Noema (2000). Public Opinion and Attitudes towards the Health Reform in Bulgaria. Qualitative and Quantitative Study. Sofia, Bulgaria, Open Society Fondation. Countries, territories and regions: Bulgaria

Noema (2001). Public Opinion and Attitudes towards the Health Reform in Bulgaria. Qualitative and Quantitative Study. Sofia, Bulgaria, Open Society Foundation. Countries, territories and regions: Bulgaria

Nordyke, R., J and J. W. Peabody (2002). "Market reforms and public incentives: finding a balance in the Republic of Macedonia." Social Science & Medicine 54: 939-953.
Countries, territories and regions: Macedonia
The Republic of Macedonia is undertaking sweeping reforms of its health sector. Funded by a World Bank credit, the reforms seek to improve the efficiency and quality of primary health care (PHC) by significantly strengthening the role of the market in health care provision. On the supply-side, one of the key reform proposals is to implement a capitation payment system for PHC physicians. By placing individual physicians on productivity-based contracts, these reforms will effectively marketize all PHC provision. In addition, the Ministry of Health is considering the sale or concessions of public PHC clinics to private groups, indicating the government's commitment to marketization of health care provision. Macedonia is in a unique position to develop a new role for the private sector in PHC provision. The private provision of outpatient care was legalized soon after independence in 1991; private physicians now account for nearly 10% of all physicians and 22% of PHC physicians. If the reforms are fully realized, all PHC physicians-over 40% of all physicians-will be financially responsible for their clinical practices. This study draws on Macedonia's experience with limited development of private outpatient care starting in 1991 and the reform proposals for PHC, finding a network of policies and procedures throughout the health sector that negatively impact private and public sector provision. An assessment of the effects that this greater policy environment has on private sector provision identifies opportunities to strategically enhance the reforms. With respect to established market economies, the study finds justification for a greater role for government intervention in private health markets in transition economies. In addition to micro-level payment incentives and administrative controls, marketization in Central and Eastern Europe requires an examination of insurance contracting procedures, quality assurance practices, public clinic ownersh ip, referral practices, hospital privileges, and capital investment policies.

Nordyke, R. J. (2002). "Determinants of PHC productivity and resource utilization: a comparison of public and private physicians in Macedonia." Health Policy 60(1): 67-96.
Countries, territories and regions: Macedonia
The dominant reform paradigm for developing countries introduces market forces into health care provision to improve quality and efficiency. Yet, there is very little empirical evidence as to how individual physicians respond to such incentives. Using a survey of primary health care providers in the Republic of Macedonia, the effect of privatization on physician workload and resource utilization is examined. The survey of physicians in public and private clinics provides extensive data on physician demographics, practice patterns and capital inputs, with an innovation being a measure of physician skill based on responses to several clinical vignettes. Physician production of patient visits is modeled as a jointly determined process of workload and input utilization. Such a formulation acknowledges the endogeneity of input and output and, more importantly, allows the straightforward estimation of the demand equations for labor and capital inputs. Controlling for physician and practice characteristics, private physicians do exhibit higher productivity and greater capital resource use per patient. Major factors influencing workload and resource use are skill and referral rates, both of which have important implications for designing comprehensive and effective physician incentive systems.

Novotny, T. (2002). World Bank Southeastern Europe HIV/AIDS Assessment., World Bank. Countries, territories and regions: South Eastern Europe

Nuri, B. and J. Healy (1999). Health Care Systems in Transition: Albania. Copenhagen, European Observatory on Health Care Systems.
Countries, territories and regions: Albania

Nussbaum, A. (2002). "Democratic health care for a democratic Kosovo." The Lancet 360(Suppl): s51-2.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Okolyski, A. (1997). Bedingungen der AIDS -prevention in Bulgarien. Institut fur Rehabilitationswissenschaften. Berlin, Humboldt-Universitat zu Berlin. Countries, territories and regions: Bulgaria

Omanic, A., A. Cemrerlic, et al. (2001). "Health condition of the inhabitants of the Federation of Bosnia and Herzegovina in 1999." Med Arh 55(1): 19-22.
Countries, territories and regions: Bosnia and Herzegovina
In this paper is being presented the health condition of the inhabitants in F Bosnia and Herzegovina on the basis of the available negative indicators of health as follows: morbidity and mortality. The morbidity is being presented the review of the leading diseases of the adult inhabitants old 19 and more years, of preschool and school age children. The mortality, as better indicator of health condition of the inhabitants, is presented by leading causes of death, according the sex and age. These data we compared with those from 1991 and noticed that are not recorded great deviations.

Omeragic, F. (1996). "Reproductive health and family planning in Bosnia and Herzegovina. Results from the first year of a post-war programme." Entre Nous Cph Den Dec(34-45): 17.
Countries, territories and regions: Bosnia and Herzegovina

Omeragic, F. (1998). "Bosnia-Herzegovina; a case study in service collapse. Safe motherhood." Entr Nous Cph Den Spring(38): 12.
Countries, territories and regions: Bosnia and Herzegovina

Onceva, S., D. Donev, et al. (2001). "Tobacco smoking, alcohol and drug consumption among youngsters in the Republic of Macedonia." Med Arh 55(1): 27-8.
Countries, territories and regions: Macedonia
OBJECTIVE: To evaluate students attitude and behaviour (16 years old) towards their lifestyle in consumption of tobacco, alcohol and illegal drugs; drugs' availability and the problems related; as well as some social and financial aspects; social relations of students etc. MATERIAL AND METHODS: A survey was conveyed with students from different ethnic groups--16 years old from every school in the country. ESPAD 99 unified questionnaire was used. RESULTS: TOBACCO: 42% persons responded that they have never taken tobacco in their life. 17% has taken a cigarette 1-2 times and 20% have used tobacco over 40 times/occasions (Macedonians 22%, Albanians 11% (12 = 24.92 for p < 0.05). During the last month, 37% youngsters in Macedonia have taken tobacco (in Ireland-41%, Finland 37%, Italy 36%, Croatia 32% and Slovenia 19%). ALCOHOL: 31% persons responded that they have never tried alcohol in their life (Macedonians 20%, Albanians 77% and Turks 76%). Ti is the similar situation for not-taking alcohol during the last year (Macedonians 30%, Albanians 83%, Turks 76%) and in the last month (54% Macedonians, 88% Albanians and 85% Turks). 33% responded they have been drunk at least once in their life 51% Macedonians, 11% Albanians and 14% Turks), and during the last month 20%. Most frequent used alcohol drink is wine (4.4% have used it over 40 times during the last month). Asked if they think they will take alcohol when they will have 25 years, 33% Macedonians, 73% Albanians and 77% Turks responded negative. ILLEGAL DRUGS: Around 1/4 stated that their friends are taking marijuana. 2.5% stated that most of their friends take marijuana. 8% stated that their friend take ecstasy, 3.6% stated that some of their friends take heroin. 5% responded they have taken tranquilizers-sedatives in the period less than 3 weeks. In average, 2.8% respondents wanted to try illegal drug--Serbs- (20.6%), Roma (21%) and Macedonians (14.3%), Albanians (6.5) and Turks (6.9%). 1.28% stated they have smoked heroin 1-2 times. Intravenous heroin used over 40 times 0.4% respondents. Ecstasy tried 1-2 times 0.64%, alcohol + tablets took 2.9% respondents. Alcohol and marijuana in the same time tried 1-2 times in life time 2.37% or in total 4.13%. Asked if they feel themselves lonely, positively responded 28% or 26% Macedonians, 37% Albanians, 35% Turks and 30% Serbs. Asked if they are satisfied with the finance situation in their home 32.4% responded very satisfied. There is significant difference among different ethnic groups (Macedonians 23%, Albanians 71%, Turks 54%, Serbs 27% and Roma 47%). Not satisfactory situation is at 8.36% Macedonians, 0.7% Albanians, 2.3% Turks, 5.9% Serbs and 5.2% Roma. CONCLUSION: 58% persons responded taken tobacco in their life. There are significant differences in alcohol consumption among different ethnic groups--Albanians and Turks take alcohol more rarely than Macedonians, due to the cultural/religious circumstances. Experi menting with drugs is Ok for males-more than females. However, youngsters are pretty lonely (1/3 have stated that they are lonely most of the time). There is a need for realization of health promotional curricula in schools, that will include life skills education and strengthening of personality, self esteem development and care for their own health to prevent drug addiction.

Onchev, G. (2001). "Quality of life and schizophrenia." Social Medicine Journal 4: 8-10.
Countries, territories and regions: Bulgaria
Paradigm change about schizophrenia over the last century is received briefly with account for data from clinical research, achievements of the neuro-sciences, and processes in the social practice. Determination of the modern concept about quality of life (QoL) in the chronic mentally ill by these developments is assessed. Different aspects of defining QoL, its components, as well as methodological problems in QoL's measurement with emphasis on the subjective awareness, are examined. The conceptual framework of the interface treatment / QoL, its correlation with clinical and social factors, as well as the role of the neuronal plasticity for the delayed response in changing QoL, are discussed. Some aspects of QoL in the mental health staff and perspectives ahead of implementation of the concept of QoL in the mental health care are reviewed.

Onchev, G. (2002). "Quality of life and schizophrenia (part two)." Social Medicine Journal 1: 10-12.
Countries, territories and regions: Bulgaria
The conceptual framework of the interface treatment / QoL, its correlation with clinical and social factors, as well as the role of the neuronal plasticity for the delayed response in changing QoL, are discussed. Some aspects of QoL in the mental health staff, and perspectives ahead of implementation of the concept of QoL in the mental health care are reviewed.

Open Society Foundation (2002). Assessment of specialized medical care of drug users and alcoholics in prison, Open Society Foundation. Countries, territories and regions: Bulgaria
During the last decade there is an alarming tendency, caused by the sharp increase of the people using drugs and alcohol. The gradual decrease in the age of first drug / alcohol use is even more troublesome.
Drug abuse is a risk factor with very heavy consequences for the individual, the family and the whole society. It may result in: decrease in quality of life, untimely death, infections, AIDS, overdose, problems in families, criminality, reduction in the intellectual potential, damages in the genetic code and fund of the nation. According to the estimates about 200 000 individuals in the year 2000 have tried any type of narcotic substance. More than 70 000 use drugs regularly and 30 000 out of them are heroin-addicted. It is well-known that heroin is the most dangerous drug for health of the individual and public health.
Age limit of the people who have used heroin for the first time, has decreased from 25 years of age ( in the year 1995 ) to 18 ( in the year 2000 ). Hardly 7 % of the individuals, addicted to drugs, have searched for medical help.
Alcohol abuse also is and has always been a phenomenon of negative social effects. According to data of the experts, the number of persons who abuse alcohol reaches about 40 % of the overall population and approximately 5 % of the individuals are addicted to alcohol. Commencement of drug and alcohol use at an early age leads to a rapid development of heavy dependence / addiction and social degradation.
The early discovery, specialized medical care and overall behavior and attitudes towards drug and alcohol addicts in the prisons is an issue of constantly growing importance.

The purpose of the present document is to make an assessment of the level of specialized medical care delivered to the drug addicts and alcoholics in the prisons and to give recommendations for its improvement. The duration of the study was from November 2001 to May 2002.

Open Society Foundation Sofia, Bulgarian Center for Not-for-Profit Law, et al. (?). NGOs As Health Services Providers in Bulgaria. Campaign for Legislative Change, Open Society Foundation Sofia,
Bulgarian Center for Not-for-Profit Law,
Parliamentary Center for European Law Foundation,. Countries, territories and regions: Bulgaria

Open Society Institute and IHRD International Harm Reduction Development (2001). Sex Worker Harm Reduction Initiative Mid-Year Report. A Guide to Contacts and Services in Central and Eastern Europe and the Former Soviet Union. New York, IHRD International Harm Reduction Development,
Open Society Institute,. Countries, territories and regions: Eastern Europe

Open Society Institute and Network Women's Program (2002). Bending the Bow. Targeting Women's Human Rights and Opportunities. New York, Network Women's Program
Open society Institute. Countries, territories and regions: Eastern Europe

Oreskovic, S. (1998). "New priorities for health sector reform in Central and Eastern Europe." Croat Med J 39(3).
Countries, territories and regions: Eastern Europe

OSI (2001). Roma Health Issues in Central and Eastern Europe. Background materials. draft August 2001. New York, Open Society Institute. Countries, territories and regions: Eastern Europe

OSI/CHSP, Romanian Ministry of Health, et al. (1997-2000). National TB Control Program 1997-2000,, OSI/CHSP,
Romanian Ministry of Health,
World Bank,. Countries, territories and regions: Romania
The National TB program had started in 1997 in partnership with the Romanian Ministry of Health and the World Bank. The need of the program was expressed by the high level of TB incidence and prevalence in Romania (the highest in Europe).
The objectives of the program were: introducing the DOTS (Direct Observed Treatment Short-course therapy) concept among the specialists doctors, according to the WHO regulations; improving the diagnose and the treatment of the TB; increasing the public awareness about the danger of the TB as a contagious disease; Creating of a computerized network of TB Centers, one in each district, with the role of storing, processing and reporting of the epidemiological data regarding TB; improving the diagnostic system and the treatment of TB patients in prisons through professional training to medical personnel and through a minimal endowment of TB labs within prison's hospitals; improving the follow-up of the patients discharged from the hospital and surveillance of the long-term treatment of TB with the help of a network of volunteers - pilot project in an area with high incidence and prevalence.

Palacio, R. (1999). "Bulgaria: sexually transmitted diseases." Entr Nous Cph Den(42): 8.
Countries, territories and regions: Bulgaria

Paleru, G. (2000). Injecting drug use in Romania: a field-report based on an initial assessment. Bucharest, Institute of Health Services Management. Countries, territories and regions: Romania
There are indications of increased injecting drug use in Romania associated with the increased cross-border traffic of heroin. At the same time, there are indications of HIV transmission associated with drug injecting in countries close-by or neighbouring Romania. In the absence of data on patterns of injecting drug use, we undertook a preliminary assessment in four major Romanian cities (Bucharest, Iasi, Constanta and Timisoara) to describe the extent and nature of drug injecting and its associated adverse health consequences. The assessment is the first of its kind on injecting drug use in Romania. We found that little information exists on injecting drug use. In addition, we found recruiting IDUs into the assessment difficult. We note that future assessments need to find ways of recruiting IDUs directly in the community. We also note the need for future assessments to concentrate in greater detail on the potential for intervention developments in prevention, health promoti on, treatment and policy.

Parliamentary Center for European Law Foundation (2002). Comparative legal analysis of EU and Bulgaria in the area of patient rights. Countries, territories and regions: Bulgaria

Paunic, Z., N. Vavic, et al. (1998). "Serbian doctors and ethnic Albanian." Lancet 3551(9105): 830-1.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Pavlova, M., W. Groot, et al. (2000). "Appraising the financial reform in Bulgarian public health care sector: the Health Insurance Act of 1998." Health Policy 53(3): 185-99.
Countries, territories and regions: Bulgaria
The public health care services in Bulgaria were deteriorating, especially during the decade of transitional process. The method of health care finance was a major reason for the poor performance of the Bulgarian public health care sector. Bulgarian policy-makers decided that an insurance-based financial mechanism could help to rescue the failing public health care services. This paper explores the social benefits and the feasibility of the insurance-based finance in the Bulgarian public health care sector. The discussion in the paper implies that, in the current conditions of economic recession, the insurance-based health care finance can not be socially beneficial for Bulgaria. Moreover, the insurance implementation seams to be unfeasible due to a lack of sufficient financial resources.

Pavlova, M., W. Groot, et al. (2002). "Public attitudes towards patient payments in Bulgarian public health care sector: results of a household survey." Health Policy 59: 1-24.
Countries, territories and regions: Bulgaria
This paper analyses the attitudes towards patient payments in the Bulgarian public health care sector. The analysis is based on results of a household survey conducted in the region of Varna (the third largest city in Bulgaria) between May and June 2000. The data are collected through interviews based on a standardised questionnaire and are analysed by non-parametric statistical procedures. The results show that the majority of the respondents accept to pay for public health care services if these services are provided with good quality and quick access. On average, charges for primary and dental care receive higher approval than charges for hospital services. A large percentage of the sample disagrees with charges related to actual service cost or service quality and nearly all respondents consider a ceiling on payments appropriate. According to the majority of the interviewed, the charges should be retained at the place of service provision. The sample shows strong support for an extensive system of exemptions from payments.

Pavlovic, E. and A. Marusic (2001). "Suicide in Croatia and in Croatian immigrant groups in Australia and Slovenia." Croatian Medical Journal 42(6): 669-72.
Countries, territories and regions: Croatia
: To compare suicide rates in Australia, Slovenia, and Croatia with suicide rates in Croatian immigrant groups in Australia and Slovenia in a 10-year period. METHOD: We analyzed records for completed suicides of the residents of Australia in a decade between 1988 and 1997 and Croatia and Slovenia in a decade between 1985 and 1994. The Croatian Catholic Centers in Australia had 31 completed suicides reported in their Parish Registries in the decade between 1985 and 1994. In Slovenia, 141 completed suicides of Croats were reported in the same decade by the Institute of Public Health of Republic of Slovenia. RESULTS: The suicide rate and method of suicide in the Croatian immigrant group in Slovenia (26.01/100,000/year; 60% of hanging) converged towards those of the host country (31.43/100,000/year; 76% of hanging), perhaps as a function of the years since migration from Croatia (22.53/100,000/year; 42% of hanging). Somewhat higher male-female ratio in this immigration group (3.5 5) could be explained by their lower social status. Surprisingly low suicide rate was calculated for the immigration group in Australia (3.10/100,000/year). CONCLUSION: Croat immigrants to Australia have the lowest suicide rate, but the highest male-female suicide ratio, which could be a consequence of underreporting of suicides by Croatian Catholic Centers in Australia. Different suicide data sources can be a source of significant bias in cross-cultural comparison of suicide behavior.

Peabody, J. W., R. Nordyke, et al. (1999). Capitation Evaluation Program (CEP), Early Analysis of Round One Data. (in English) - RAND, DRU 2049-WB,. Countries, territories and regions: Macedonia
This report presents descriptive analysis from Round One of the Ministry of Health's and RAND's Capitation Evaluation Program (CEP). The main aim of this report is to guide the Ministry of Health in the planning phase of its Continuing Medical Education (CME) program and Capitation Pilot Program. The focus is on findings from the CEP's Facility survey to elucidate the characteristics of practicing primary care physician. The report begins with a brief introduction to the Health Sector Transition Program and the design of the CEP. The overall design of the CEP is a prospective case control study. It is con-ducted in the two intervention municipalities and two other similar municipalities se-lected as control sites both before implementation of the Pilot Program (Round One) and one year afterward (Round Two). The intervention sites receive all elements of the re-forms: Capitation payment system, new basic benefits package, and continuing medical education (CME.) The control sites receive only the basic benefits package and CME. The CEP uses a variety of instruments and methods to evaluate the impact of the reforms: 1) the Household Survey, 2) the Exit Survey, 3) the Facility Survey, and 4) the Clinical Vignettes, which are done as part of the Facility Survey. The results are presented in se-ries of tables with discussion on 1) utilization characteristics by provider, defined as ei-ther the physician or the health care facilities, 2) physician characteristics, and 3) struc-tural quality measurements. Conclusions highlighting the policy implications derived from these early CEP findings. Overall, primary care physicians are underutilized, having panels of fewer than 1,000 patients and spending an average of 28-35 minutes per patient, including follow-up visits. Referral patterns between different specialties and sites are fairly stable. Utilization of health care services is very closely linked to insurance status. Private practitioners have n ot segmented the health care market. Rural clinics care for two vulnerable populations, elderly and children. Almost half of the rural clinics are rated as being in poor condition and have inadequate supplies and basic equipment. By con-trast, it is surprising that almost one third of the private facilities have laboratory facili-ties. The policy consequences are twofold: First, services can be expanded through the private sector; however, if these laboratory services are covered by insurance, there will be a costly moral hazard to overuse these services. In the long run this suggests that fi-nancial regulations and clinical licensing of outpatient laboratories will be required from the government.
Capitation has been introduced in Macedonia in July 2001 with private physicians.

Pension Assurance Company Doverie (2003). Insurance Company Doverie (www.poc-doverie.bg/en). Countries, territories and regions: Bulgaria

Petrova, G. I. (2001). "Monitoring of national drug policies - regional comparison between Bulgaria, Romania, Macedonia, Bosnia Herzegovina." Cent Eur J Public Health 9(4): 205-13.
Countries, territories and regions: Bulgaria, Romania, Bosnia and Herzegovina, Macedonia
After the profound economic and political changes most of the East European countries started market-oriented reforms. During the last 10 years rapid development of the private pharmaceutical sector and a slow privatisation process was observed. The balance between the private and public sector became very important for achieving NDP goals. The goal of this study is to evaluate the availability and development of the NDP structures in East European countries--Bulgaria (BG). Romania (Rom), Macedonia (Mac), Bosnia Herzegovina (BiH). For the assessment of the availability of NDP structures a questionnaire focused on seven main NDP components was used. These components are: legislation and regulations; essential drug selection and drug registration; drug allocation in the health budget/public sector financing policy; public sector procurement procedures; public sector distribution and logistics; price policy; information and continuing education on drug use. According to the surv ey the most developed NDP structures are drug legislation and regulations (incl. quality control), drug registration and drug distribution. We can assume that the people have access to different drugs of appropriate quality and in time. The systems for public drug financing, procurement and price policy are under developing or not efficient enough. The financial availability of drugs is difficult. There is a lack of objective drug information and postgraduate education is not oriented on the ED. It means that there is no guarantee for rational drug prescription and usage of drugs on the markets.

Petrova, M., L. Koeva, et al. (2000). "Goiter in pregnancy - identification of risk factors for its progression." Social Medicine Journal 2: 18-20.
Countries, territories and regions: Bulgaria
A prospective cohort study was undertaken among pregnant women in the region of Varna to evaluate risk factors for progression of goiter in pregnancy. The sample included a total of 167 pregnant women with goitrogenesis at 1st trimester pregnancy. The cohort was followed up for a period of 1 year and 9 months (a year after delivery) to assess a progression in goiter development. The relative risk was measured separately for each potential risk factor. The results of the study show that smoking, diabetes type 1, insufficient iodine prophylactics, presence of antithyroid antibodies and family history are strongly associated with higher risk for development and unfavorable progression of goiter in pregnancy

PHNIP (2002). Country Health Statistical Report Bulgaria. Washington DC, PHNIP. Countries, territories and regions: Bulgaria

PHO - Republic Institute for Health Protection (2000). Program for Health education in Republic of Macedonia: Republic Institute for health protection - Skopje (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia

Pilav, A. and S. Dracic-Purivatra (1999). "Problems in health statistics reporting in Bosnia-Herzegovina (Article in Serbo-Croatian (Roman)." Med Arh 53(3 Suppl 3): 43-5.
Countries, territories and regions: Bosnia and Herzegovina
Health-statistic information system in Bosnia and Herzegovina is presented, its content, problems and reform objectives in accordance with new European trends. Adequate and prompt health information plays a key role in the policy of planning and decision-making at all health levels. Therefore, data collecting must be conducted in accordance with the country's needs aimed to the health promotion and health of the population improvement. Scope and structure of health information system varies from country to country depending on health status of population, health policy and, of course, economic capacity. Public Health Institute of Federation BH is authorized by the Law to conduct statistical research in the health sector, and, therefore, the Proposal of statistical research in health sector is made, according to these regulations. This Proposal offered 17 statistical researches for 1998. Unfortunately, only 7 researches have been carried out. The shortcomings of the existing h ealth-statistic information system have been found out on the local, cantonal, entity and state level.

Podmore, W. (1999). "Effects of NATO's bombing in the Balkans." Lancet 1999 Jun 26;353(9171):2249.
Countries, territories and regions: Serbia and Montenegro

Popov, M. (2001). "Assessment of quality and quality of assessment of the hospital care in Bulgaria." Health Economics and ManagementJournal 1.
Countries, territories and regions: Bulgaria

Popova, S. and G. Kolev (2000). "Problems and needs of physically disabled women." Social Medicine Journal 2: 7-9.
Countries, territories and regions: Bulgaria
An individual inquiry by mail, aiming to investigate the problems and needs of physically disabled women, has been carried out among 56 women, registered at the Center for disabled people - Varna. The methods applied are in compliance with ICIDH. The results of the survey made possible the elaboration of proposals that are to help the social adaptation of physically disabled women, as well as their professional and personal realization.

Popovic-Grle, S. (2002). Project Proposal: "Improvement of Tuberculosis Control in Croatia - Education Programme for Chest Physicians, General Practicioners and Community Service Providers, University Hospital for Lung Diseases "Jordanovac", Zagreb. Countries, territories and regions: Croatia

Porter, M. and N. Haslam (2001). "Forced displacement in Yugoslavia: a meta-analysis of psychological consequences and their moderators." J Trauma Stress 14(4): 817-34.
Countries, territories and regions: Croatia, Bosnia and Herzegovina, Serbia and Montenegro, Macedonia, Kosovo
A meta-analysis was conducted to synthesize what is known about differences in mental health between refugees and nonrefugees from the former Yugoslavia. The analysis focused on moderating effects of a variety of enduring, contextual stressors. Results indicated that refugees suffer significantly more mental health impairment than nonrefugees. The psychological consequences of forced displacement were found to vary significantly as a function of chronic stressors (e.g., locus of displacement and type of accommodation in exile) and were also associated with otherfactors (e.g., degree of war exposure in the nondisplaced groups, participant age, and time of data collection as reflected in year of publication). Implications for the study of refugee mental health are discussed.

Priftanji, A. V., E. Qirko, et al. (1999). "Asthma and allergy in Albania." Allergy 54(10): 1042-7.
Countries, territories and regions: Albania
BACKGROUND: The risk of allergic disease may be influenced by the degree of "westernization". A survey was conducted to ascertain whether the prevalence of allergy was lower in Albania than elsewhere in Europe, as it has been the most isolated European country. METHODS: The subjects were residents of Tirana aged 20-44 years. A screening questionnaire was completed by 2653 subjects. A more detailed questionnaire was administered to a random sample of 564 respondents, together with skin prick tests and serum IgE assay. RESULTS: The prevalence of wheeze in the last year, and of wheeze without a cold, was lower in Albania than in any country that participated in the European Community Respiratory Health Survey. Nasal allergy and atopy (as indicated by serum specific IgE) were also uncommon in Albania, although serum total IgE concentrations were high. CONCLUSIONS: The findings confirmed the hypothesis of a low prevalence of allergy in Albania. Possible reasons include t he recent economic isolation of Albania, the infrequency of smoking by women, the lack of domestic pets, and the high incidence of childhood infection and parasitic infestation. The prevalence of allergy and its potential determinants should be monitored in Albania as that country acquires the characteristics of other parts of Europe.

Programs for Training and Research in Public Health (2001). Report of the Second Conference "Public Health training and Research Col-laboration in South Eastern Europe". (in English) - Stability Pact for South Eastern Europe : Public Health Collaboration in South Eastern Europe (PH-SEE) : Programs for Training and Research in Public Health. Ohrid. Countries, territories and regions: South Eastern Europe
The Second PH-SEE Conference entitled "Public Health training and Research Collabo-ration in South Eastern Europe (PH-SEE)" was held in Ohrid, Macedonia from 14 to 16 September 2001. The Conference was organized by the Department for Social Medicine, Medical Faculty-Skopje, as part of the development project on the reconstruction of pro-grammes for training and research in public health in South Eastern Europe, the Stability Pact. The Conference for representatives from different training and research public health institutions in SEE countires was organized with the following objectives: to broaden and strength of public health professionals among SEE countries; to review the state of the PH-SEE program development especially the review process; to recommend and initiate further development of mutual public health curriculum and training modules to discuss feasibility in development of a common Internet-Platform; to identify priorities of national public health re search projects and stimulate further collaboration and joint research within SEE network. This Conference Report includes the summary of presenta-tions, conclusions of discussion and agreement on the following main topics: Report on the School of Public Health in Skopje; forthcoming Conference on Public Health and Peace in Macedonia; Consortial agreement of PH-SEE; status of the PH-SEE curriculum; SEE-Minimum Indicator Set; Research on Migration and Health in SEE; Status of Web-site Development; Report on the4th Dubrovnik Conference of SEE Governments; Agenda for 2001-2002.

Project Coordinator Unit, World Bank, et al. (2001). Executive Summary. Institutional Assessment, TB and HIV/AIDS, Project Coordinator Unit,
World Bank,
Health Investment Fund,. Countries, territories and regions:

Puvavic, S., B. Hrabac, et al. (1997). "Vaccination coverage in Bosnia and Herzegovina during the 1992-1995 War." Croat Med J 38(2).
Countries, territories and regions: Bosnia and Herzegovina

Pyle, G. F., C. R. Thompson, et al. (1998). "Rebuilding the Healthcare System in Mostar: Challenge and Opportunity." Croat Med J 39(3).
Countries, territories and regions: Bosnia and Herzegovina
A basic premise of this article is that the political and ethnic division of the city of Mostar imperils community health planning efforts beyond those normally encountered in the aftermath of war. Bosnia and Herzegovina is divided among ethnic groups, and the city of Mostar is further subdivided between the Croatian and Muslim interest groups. In that respect, Mostar presents a very special challenge to those planning the reconstruction of the health care delivery infrastructure. A new healthcare delivery plan was organized by the Federation of Bosnia and Herzegovina in 1996. This paper examines obstacles involved in implementing that plan in light of some epidemiological indicators of current health conditions.

Radita, N. (2002). Roma in Moldova: On the Edge of Existence. Roma Rights, Nr. 1, Extreme Poverty, European Roma Rights Centre. Countries, territories and regions: Moldova

Rahman, A. and L. Katzive (1999). "Central and Eastern Europe: recent trends in abortion law." Med Law 18(2-3): 373-87.
Countries, territories and regions: Eastern Europe
The authors analyze recent developments in the abortion laws in seven countries in central and eastern Europe, Albania, Bulgaria, the Czech and Slovak Republics, Hungary, Poland and Romania, first country by country, then thematically, comparing the ways these countries' laws deal with gestational age limitations, specifications about the practitioners who may perform abortions and the facilities in which they may be performed, third-party authorization and notification requirements, mandatory counseling requirements, restrictions on the availability of abortion information, fees for abortion services and the question of fetal rights. At the conclusion of their discussion of each of these thematic issues, they recommend ways in which these laws might be made better and fairer, in form and in practice, for the women in these countries who find it necessary to consider having abortions.

Rankova, S. (1999). "Reproductive health in Bulgaria - development and problems." Med Law 18(203): 203-11.
Countries, territories and regions: Bulgaria
Dr. Rankova documents the current demographic crisis in Bulgaria, relates it to issues of reproductive health in that country, and describes briefly and comments on the current efforts to improve the health care system there.

Reamy, J. and S. Oreskovic (1999). "Life Expectancy in Central and Eastern European Countries and newly Independent States of the former Soviet Union: Changes by Gender." Croat Med J 40(2): 237-243.
Countries, territories and regions: Eastern Europe

Republic Institute for health protection (2002). Program for Health education in Republic of Macedonia. (in Macedonian) - (Annually). Skopje, Republic Institute for health protection. Countries, territories and regions: Macedonia
The main goals that should be achieved in the current year with Program implementation are presented in the introductory part. The Program is based on the recommendations from the Regional institutes for health protection according to their defined priorities. The priorities and content of the health education and promotion are presented as well the type, measures, activities, tasks and scope of methods and means for Program implemen-tation. Expert bodies are recommended as precondition for successful implementation.

Republic Institute for Health Protection (1998). Cancer register; Republic Institute for health protection - Skopje, 1998-2000 (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
This register is based on the following data sources: registration forms for malignant neoplasms, death certificate, histological and cytological findings, additional informa-tion for the patient. Incidence crude and standardized rate is presented by primary lo-calization, age and sex, place of living, urban-rural, occupation. Mortality is presented by primary localization, age and sex, place of living. Ten most frequent primary lo-calization are presented in males and females.

Republic Institute for Health Protection (1999). Project proposal for investments in the scope of NEHAP implementation process in the republic of Macedonia. Skopje, Republic Institute for Health Protection,. Countries, territories and regions: Macedonia

Republic Institute for Health Protection (1999). Environmental Health Characteristics of Refugees Reception Camps in the Republic of Macedonia. Skopje, Republic Institute for Health Protection. Countries, territories and regions: Macedonia
In the period April-June 1999 during the Kosovo Crises in the Republic of Macedonia were accommodated about 350.000 Kosovo refugees, which is 18 % from total popula-tion lives in the state and 111.400 of them were in the camps. The health-environmental impact to all mediums: land, air and water wasn't quantificated, but it was linked with the Kosovo refugees number: accommodation, new water supply systems, more than 1.300 000 m2 occupied land for camps, food supply, latrines, solid and liquid waste deposal, burned woods and some medical and other solid waste, etc. The sanitary and epidemiol-ogy situation in the Kosovo refugees camps in the territory of the Republic of Macedonia was marked as unsafe, first of all because of luck of infrastructure in the camps and also low density (11.55 m2 per person versus 30 m2 per person recommendation from WHO). A proper set of preventive and control measures has been proposed.

Republic Institute for Health Protection (2000). Report for the Implementation of the Program for Preventitive Health Care in Republic of Macedonia: Republic Institute for Health protection (Annually). Skopje, Republic Institute for Health Protection,. Countries, territories and regions: Macedonia
Republic Institute for Health Protection prepares annual reports for the implementation of the general Preventive Health Care Program while the Regional Institutes for Health Pro-tection prepare annual reports for the implemented programs in their region. Accom-plished activities in the department for: a) Social medicine: Statistical research of special National interest according to the Program for statistical research collection, control, processing and analysis of the morbidity, workload and health personnel and individual forms for delivery, abortion, injuries at work and 10 non-communicable diseases of spe-cial interest; health for all indicators; health map in Macedonia, ambulatory and dispan-sery morbidity, cancer register, diabetes register, report for the health status and health care of the population in Macedonia, analysis of in-patient morbidity, program and report for health promotion; b) Sanitary-hygienic department: monitoring of; water supply and quality of dr inking water; surface water from health aspect; air quality in urban settle-ments and it's impact regarding to people's health; noise; nutrition and diet; food health safety; daily intake from chemical contaminants; environmental radioactive contamina-tion; health safety of subjects for common use; c) Epidemiological department: report for prevention and control of communicable diseases: respiratory and intestinal acute conta-gious diseases, zoonoses, other, sub-department for tropical, quarantine diseases and AIDS; monitoring of influenza and similar respiratory diseases; Report for AIDS preven-tion program; Report for the realization of the program for research, spread and control of brucelosis.

Republic Institute for Health Protection (2000). Report for implementation of the Program for Health education in Republic of Macedonia; Republic Institute for Health Protection - Skopje, 1998-2001 (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
This Report is prepared using the same type of reports from the Regional Institutes for health protection presenting the scope and content of the accomplished activities as planned with the Program for Health education for that year. Special emphasis is put on the patronage services as well other health institutions involved in the health education of the population.

Republic Institute for Health Protection (2001). Report for Contagious Diseases in the Republic of Macedonia for 2001. Skopje, Republic Institute for Health Protection,. Countries, territories and regions: Macedonia

Republic Institute for Health Protection (2001). Health for All in Republic of Macedonian Health Indicators for 2000 - system for data presentaiton: Republic Institute for health protection (www.rzzz.org.mk). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
WHO standards for data collection and reporting, HFA Indicators, national and database; selected indicators presented by regions

Republic Institute for Health Protection (2001). The level of radioactivity and possible health effects, Republic Institute for Health Protection,. Countries, territories and regions: Macedonia
The report presents the results of the annual monitoring of the level of the radioactivity in the different media of the environment, conducted by the Republic Institute for Health Protection in 2001. The level of the radioactivity as well the concentrations of radioactive Uranium, Sr 9o and Cs 137 have been followed in the air, atmospheric fall out, soil, sur-face waters (selected rivers and lakes), drinking waters, human (milk and other selected foods) and animal food on 7 different locations in the country. Around 2000 samples were being measured during the year. The concentrations registered during the year are significantly lower than the maximum allowed concentrations. Despite the fact that the morbidity and mortality ration from the malignant diseases is in process of increasing, there are no sufficient evidence for the significant correlation with the level of radioactiv-ity.

Republic Institute for Health Protection (2001). Food quality status in republic of Macedonia, Republic Institute for Health Protection. Countries, territories and regions: Macedonia
There is no efficient monitoring system in the Country to monitor soil contamination as a basic resource of primary production, as well as of irrigational waters. Secondary production is characterized by high num-ber of new, small enterprises, facing insufficient equipment with the required apparatus, premises and staff; the tendentious towards rapid profit gaining leads to a situation in which many of them apply technological procedures that are professionally insufficient, thus causing direct impact on the food safety. With domestic products, the improper samples of tested products are detected in 2-4% from total number among the indus-trial origin; 10-15% between small and medium food enterprises, due to the non-professional treatment. The contamination in domestic products in tested samples were found in 4-6 % cases of industrial origin, about 10 % from small enterprises, and 8-10% in distribution. Risk posing foods, according to the number of false findings, are: ice-cre am, milk and diary products, meat and meat poultry products. In the period 1980-2000 in the Republic of Macedonia has existed a general trend of registered cases of Alimentary toxic infections (ATI) ) and relatively high morbidity rate (in the rank 80-85/100.000); enterocolitis is still a sig-nificant epidemiological problem in the Republic of Macedonia. Disagreeing in criteria, methodology in practices and diagnostical procedures make some difficulties in proper definition of health condition for the diagnostics of entrocolitis.

Republic Institute for Health Protection (2001). Information about status and problems in the patronage health service in Macedonia.(in Macedonian). Skopje, Republic Institute for Health Protection. Countries, territories and regions: Macedonia
Current organization, personnel, education, equipment and services in the pa-tronage service in Macedonia, on national and regional level. The emphasis is put on the problems and recommendations for further activities for improvement of these services.

Republic Institute for Health Protection (2002). Report for the Realization of the Program for Research, Spread and Control among the people of Brucelosis in the Republic of Macedonia for 2001. Skopje, Republic Institute for health Protection. Countries, territories and regions: Macedonia

Republic Institute for Health Protection (2002). Health Map in Republic of Macedonia; Republic Institute for health protection Skopje (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
Three volumes: Volume 1 – general with data for whole Macedonia: basic demographic data, vital indicators, net, staff and workload of health organizations at all levels, registered morbidity with special emphasis on communicable diseases, non-communicable diseases of special social-medical interest and mortality – the most frequent causes of death. Volume 2 and 3 – special with the same type of data for each municipality.

Republic Institute for Health Protection (2002). 16 Statistical tables for the Statistical Year book: Republic Institute for health protection Skopje (Annually), Social Medicine Department. Countries, territories and regions: Macedonia

Republic Institute for Health Protection (2002). Ambulatory and Dispensary Morbidity; Republic Institute for health protection-Skopje (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
Out-patient morbidity is presented by department: general practice, preschool and school
children, women, occupational medicine, oral health, skin diseases, TB) on National level
and by municipality; urban-rural, by age and sex, structure of diseases

Republic Institute for Health Protection (2002). Diabetes Mellitus Register Republic Institute for health protection - (Annually)1999. Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
This register is based on the data provided by collection of the registration forms for diabetes (according to the Law for evidence in health). Data are presented on national and municipality level: urban-rural, place of living, by age and sex, occupation, type of diabetes, complications, type of treatment, health organization.

Republic Institute for Health Protection (2002). Report for the health status and health care of the population in republic of Macedonia: Republic Institute for health protection - Skopje (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
Content: demographic characteristics of the population in Macedonia; specific indica-tors for the health status of the population; organization and staff of the health care organizations in Macedonia; health care and health status of: adults, preschool chil-dren, school children and youth, women; department of TB and lung diseases, skin diseases, medical rehabilitation, oral health, blood transfusion, laboratories, pharma-cies, health education and health promotion.

Republic Institute for Health Protection (2002). Information about hospital utilization in Macedonia; Republic Institute for health protection- Skopje (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
The workload and utilization of hospitals in Macedonia is presented by type of hospi-tals on national level and per municipality using the following parameters: number of in-patient treated, hospital days, average length of stay, utilization of beds, bed func-tion(turnover).

Republic Institute for Health Protection (2002). Program for general check-ups of school children and students in Republic of Macedonia; Republic Institute for health protection - Skopje, 1998-2001 (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
The need, importance and goals of the general check-ups as classical screening method for this population are presented in the introduction of the Program. The content of the check-ups is presented for different grades: first, third, fifth, seventh in primary school, first and fourth in secondary school and at university: general check-up, oral health check-up and laboratory biochemical and blood examination. The number of examinees, needed staff and funds are presented on national level and by municipality.

Republic Institute for Health Protection (2002). Report for the implementation of the Program for general check-ups of school children and students in Republic of Macedonia: Republic Institute for health protection - Skopje (Annually). Skopje, Social Medicine Department. Countries, territories and regions: Macedonia
analysis of the conducted general check-ups: coverage of children and students, content and conditions as well as quality of the medical documentation and evidence. In the second part of the Report pathological findings are presented and analysed by age groups, compared with the conditions from the previous year.

Republic Institute for Health Protection (2002). Analysis of In-patient morbidity in Republic of Macedonia in 1999 and 2000. Republic Institute for health protection - Skopje,, Social Medicine Department. Countries, territories and regions: Macedonia
General part: basic characteristics of in-patient morbidity in Macedonia in 1999 and 2000. number of patients, hospitals days and average length of stay by group of disease, age and sex, the 10 most frequent diseases, morbidity by regions and type of hospitals. Special part consists the morbidity parameters presented for each disease group with the 10 most frequent diseases.

Republic Institute for Health Protection (2002). Information about health personnel and organisations in Macedonia in 2001.Republic Institute for Health Protection, Skopje,, Social Medicine Department. Countries, territories and regions: Macedonia
Structure of health personnel and health organization on national and regional level.

Republic Institute for Health Protection (2002). Global research on smoking among youth in Macedonia (in Macedonian). Skopje, Republic Institute for health Protection
WHO
CDC
Canadian Association for Public Health. Countries, territories and regions: Macedonia
This survey is part of the global Project conducted in many European countries as joint Project of WHO, Centers for Disease control and Canadian Association of Public Health. The aim of this survey was to generate data about smoking among youngsters at age 13-15 i.e. in 7th and 8th grade of primary and 1st grade of secondary school. Sample has been done with special methodology in Centers for Disease Control in Atlanta from the list of Schools and students prepared by Ministry of Education. Around 2000 students from 75 schools, divided in 6 regions, urban and rural were interviewed during the first phase of this Project. Team: Social medicine specialists have conducted the survey in Skopje, Bi-tola, Veles, Ohrid, Shtip and Tetovo, during December 2002. The questionnaires have been sent to CDC for data netry and processing. The second phase of this Project is edu-cation on computer processing and statistical analysis of the data. The third phase is preparation of National Act ion Plan and National Final Report.

Republic Institute for Health Protection (2002). Health Promotion in the Republic of Macedonia,. Skopje, Republic Institute for Health Protection. Countries, territories and regions: Macedonia
The five selected priorities for the Health Promotion development in the country are : review of the health status and health care of the population; establishment of the National Committee for Health Promotion (NCHP); defining the priorities and needs for investments in the health; devel-oping the National Strategy for Health Promotion and changes in the health policy. In 2001 the priorities and needs for Health Promotion were defined as : Decreasing the mortality from dis-eases of circulatory system, mortality of malignant diseases, injuries and decreasing of road traf-fic accidents; providing a healthier nutrition and preparations of nutritional norms and standards for different population groups by age, sex and occupation, promotion of physical; exercises with improvement of recreation and sport conditions, specially in schools; decreasing the diseases of addiction ( drugs, alcohol, tobacco);establishing monitoring of the living environment smoke free zones, traffic mode rnization etc.);promotion of the mental, oral and sexual health ; prepara-tion of the national curriculum on health promotion; monitoring of the health indicators; health promotion in rural areas. Different health projects titles with health promotion spirit have been listed.

Republic Institute for Health Protection, Ministry of Health of the Republic of Macedonia, et al. (2002). International Conference Promoting health through physical activity and nutrition. Health Promotion in the Republic of Macedonia. Radenci, Slovenia. Countries, territories and regions: Macedonia

Republic of Bulgaria Council of Ministers (2002). National Environmental Health Action Plan. Sofia, Republic of Bulgaria Council of Ministers,. Countries, territories and regions: Bulgaria
The Second European Conference on Environment and Health, held in Helsinki, Finland, in June 1994, prioritized the development of national environmental health action plans. The Conference endorsed the basic guiding document for attainment of this objective: the Environmental Health Action Plan for Europe (EHAPE). It was decided to start with a pilot project involving six Countries, territories and regions: Bulgaria, Hungary, Italy, Lithuania, the United Kingdom and Uzbekistan, as a priority international action in support of the European countries' efforts to develop their national plans.

The development of the NEHAP in Bulgaria was initiated by Council of Ministers Decision No. 298 dated July 13, 1995, which designated as leading institutions Ministry of Health and Ministry of Environment. This Decision also assigned tasks and responsibilities with regard to activities for environmental health protection to the Ministry of Industry, Ministry of Finance, the then Committee on Energy, Committee on Tourism, Committee on Forestry, Ministry of Regional Development and Construction, Ministry of Agriculture and Food Industry, Ministry of Transport, Ministry of Economic Development, Ministry of Defense, Ministry of Interior and Ministry of Labor and Social Affairs.
The implementation of the National Action Plan was launched by Decision No. 314 dated June 29, 1998. A total of 205 tasks were fulfilled in the period between 1998 and 2000. Great efforts were made to contain environmental pollution and negative impacts on human health. The NEHAP is a well motivated and realistic plan and an effective instrument by which the Republic of Bulgaria can approximate its policy and actions to those of the European Union. The ultimate goal of the NEHAP is to formulate and implement a long-term policy of protecting this nation's health and ensuring country's sustainable development.
The policies to protect public health from environmentally determined hazards are implemented, basically by Ministry of Health (MoH) and Ministry of Environment and Water (MoEW). Ministry of Labor and Social Policy (MoLSP) implements the occupational health policy. The structures tasked with implementing these ministries' policies at regional and municipal level are Hygiene and Epidemiology Inspectorates with the MoH, the Regional Environment and Water Inspectorates with the MoEW, and the Regional Labor Inspectorates with the MoLSP, respectively. The central subordination of these regional structures is a prerequisite for consistency of environmental health policies throughout the country. The policy to protect public health in connection with the quality of the environment is directed by Deputy Minister of Health and Chief State Health Officer of the Republic of Bulgaria and by Disease Prevention and State Sanitary Control Directorate of the Ministry of Health. The nationa l centers and the entire network of Hygiene and Epidemiology Service implement this policy.
Policies of prevention and monitoring environmental quality are formulated and coordinated by the Ministry of Environment and Water.
The varied spheres of action on environmental health issues require multisectoral partnerships to ensure coordination and consistency in setting priorities and planning necessary actions. The Supreme Environmental Expert Council with the Ministry of Environment and Water, as well as all other interagency expert councils, make decisions taking account of all possible environmental impacts and targeting public health protection. Environmental expert councils, involving the same key partners and embodying the same principle, operate at regional and municipal level, making decisions on construction projects, plans and projects of local importance.

ACTIONS

1.1. Improve the system of control and prevention of environmentally induced diseases. Draft and pass through Parliament a Public Health Act to supersede the effective National Health Act.
Deadline: 2002
Responsible: MoH

1.2. Sign an Agreement between the Ministry of Environment and Water and the Ministry of Health on regular exchange of information.
Deadline: 2002
Responsible: MoH, MoEW

1.3. Elaborate municipal environmental health action plans based on the main priorities of the National Environmental Health Action Plan, focusing on preventive action and specifying the amount of funds needed and the sources of funding.
Deadline: 2003-2004
Responsible: MoRDPW, municipalities, MoH, MoEW

1.4. Draft and adopt an Ordinance regulating public access to information on environmental and public health issues.
Deadline: 2003
Responsible: MoH, MoEW

Republic of Bulgaria Ministry of Health (2001). National Health Strategy. Better Health for a better future of Bulgaria. Sofia, Republic of Bulgaria Ministry of Health. Countries, territories and regions: Bulgaria

Republic of Macedonia (2000). Pre-school organisations and infant schools at primary schools for children care and upbringing in the Republic of Macedonia, State Statistical Office. Countries, territories and regions: Macedonia
The publication contains data on children in pre-school organisations such as: public nurseries, kindergartens, half-day stay at primary schools.

Republic of Macedonia (2001). Population evaluation in the Republic of Macedonia according to sex, age and municipalities, State Statistical Office. Countries, territories and regions: Macedonia
Publication contains data based on an estimated population according to sex and age in the Republic of Macedonia and by municipalities.

Republic of Macedonia (2002). Census of Population, Dwellings and Households. Countries, territories and regions: Macedonia
Censuses are the biggest source of statistical data referring to the population, households and dwellings in the Republic of Macedonia. This data are essential during macroeco-nomic studies and balance preparing, and especially for marketing and business research guiding.
The State Statistical Office conducted the Census 2002. First results will be published two months after the Census completion (late January).

Republic of Macedonia (2002). National Programme for Prevention of Diabetes Mellitus. Forms for specialists - Improvement of Diabetes care and chronic complications with strict glycaemic control according to the national programme for prevention of diabetes mellitus, National programme for prevention of diabetes mellitus. Countries, territories and regions: Macedonia

Republic of Macedonia (2002). National Programme for prevention of Diabetes Mellitus. Forms for General Practitioners - Improvement of Diabetes care and chronic complications with strict glycaemic control according to the national programme for prevention of diabetes mellitus. Countries, territories and regions: Macedonia

Republic of Macedonia (2002). Workshop on "emission regulations of road vehicles in CEEC". Country report of the Republic of Macedonia. Skopje, Republic Institute for Health Protection. Countries, territories and regions: Macedonia
Beside the presentation of the general level of air pollution and emissions in the country a special attention has been put on the needs for improvement of the gasolines. The main characteristics of the country relevant to the lead phase out process are: High per capita vehicular lead emissions (vehicular lead emissions in 1995, more than 25 g/capita of lead). Low market share of unleaded gasoline (9.3% of gasoline consumption in 1995, 15.3% in 1999). High limit value for lead content (0.6 g/l up to 31/12/2004, 0.3 g/l in the transitional period 01/01/2005-31/12/2005, 0.15 g/l after).
Deficit in domestic needs for "white products" due to low rate of crude processing.
High average age of the fleet of vehicles (in 1999, 57% of all registered private cars are above 15 years old). Suitability in the use of unleaded gasoline of the greatest part of car fleet (according to estimates more than 70% of the registered cars in 1999 can run on un-leaded). Possibility for dual distribution of leaded and unleaded gasoline at the 75% of gasoline stations. Delay in the lead phase-out process compared to other CEE countries (SILAQ countries). Only sparse initiatives and measures for acceleration of the lead phase-out process.
Low public awareness about the adverse environmental and health effects.
Environmental Health Impact assessment of the influence of lead and sulfur.

Republic of Macedonia State Statistical Office (2001). (Natural) Population Change in the Republic of Macedonia, 2001. Statistical Review. Skopje, Republic of Macedonia State Statistical Office. Countries, territories and regions: Macedonia
The latest demographic data for births, deaths, migrations and other, with breakdown for the Republic of Macedonia and by municipalities, are presented in this publication.

Republic of Macedonia State Statistical Office (2001). Reported, Accused and convicted Perpetrators of Criminal Offence in 2000 - adults and juveniles. Skopje, Republic of Macedonia State Statistical Office. Countries, territories and regions: Macedonia
Publication contains statistical data, which are result of regular annual statistical re-searches and ensures data on conductors of crime actions, at all phases of it, from appli-cation submission through to subject judgement.

Republic of Macedonia State Statistical Office (2001). Pre-school institutions and infant school at Primary schools for Children Care and Education in the Republic of Macedonia in 2000. Skopje, Republic of Macedonia State Statistical Office. Countries, territories and regions: Macedonia

Republic of Macedonia State Statistical Office (2002). Labour Force Survey October 2001. Basic Definition, Methods and final results. Skopje, Republic of macedonia State Statistical Office. Countries, territories and regions: Macedonia
This publication presents basic results of the Labour Force Survey. The Survey, com-pletely harmonized with ILO standards, is the most comprehensive data source for status and movement of the labour market in the Republic of Macedonia.
The publication contains data for the structure of labour force, unemployment by gender, qualifications, reasons and duration of unemployment, active population by gender and qualification structure, part-time engagement etc.

Republic of Macedonia State Statistical Office (2002). Emigrated and Immigrated Persons in the Republic of Macedonia, 2001. By municipalities. Skopje, Republic of Macedonia State Statistical Office. Countries, territories and regions: Macedonia
Basic data for migration movements in the Republic of Macedonia, given by municipali-ties are also, clearly and concise presented in this publication

Republic of Moldova (2002). Interim Poverty Reduction Strategy Paper. http://poverty.worldbank.org/files/Moldova_IPRSP.pdf
Countries, territories and regions: Moldova

Republic of Moldova Ministry of Health (2001). Multi-year strategic plan for immunization 2002 - 2006. Draft. Countries, territories and regions: Moldova
This document presents a complex analysis of the background, the current situation and the prospective of implementing a sustainable and long duration strategic plan of immunization in the Republic of Moldova. A multi year strategic plan is described for the period of 2002-2006 and has been developed by the Ministry of Health. The National Immunization program (NIP) is presented with detailed highlights of its main components. Brief comprehensive information is given on legislation issues related to immunization in Moldova, national immunization schedule and general statistics of vaccination coverage, diseases morbidity and mortality. The document contains reliable references to resources and donor support to NIP. The main goal of this the multi year strategic plan for immunization is to reduce morbidity and mortality from vaccine preventable diseases of Moldovan children through universal accessibility to NIP and ensuring of quality and safe immunization. The document offers a detailed description of the strategic plan with specific activities under each objective and according to main strategies. Organizational charts and national surveys' data are presented in the annexes to this document.

Republika Srpska (1999). Law on Health Protection - No 01 875/01(http://www.pcuhealth.org/dokumenti/zzdravstena_zastitaEn.htm). Banja Luka. Countries, territories and regions: Bosnia and Herzegovina

Republika Srpska (1999). Law on Health Insurance 01-802/01(http://www.pcuhealth.org/dokumenti/zzdravsteno_osiguranjeEn.htm). Countries, territories and regions: Bosnia and Herzegovina

Republika Srpska Ministry of Health and Social Welfare and Public Health Institute (1999). Cindi Programme. National Protocol. Banja Luka, Republic of Srpska Ministry of Health and Social Welfare,
Public Health Institute,. Countries, territories and regions: Bosnia and Herzegovina

Richards, T. (1999). "Restoring medical services in Kosovo will be a massive task." BMJ 318(7199): 1646.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Ritsatakis, A., J. Levett, et al. (1999). Neighbours in the Balkans: Initiating a Dialogue for Health. Athens, WHO Europe
National School of Public Health.
Countries, territories and regions: South Eastern Europe

Romanian Ministry of Health (2000). Reform of Health Sector Financing - November 1998 - June 2000, GVG - Germany and Maxwell Stamp - UK, (Report available in English). Countries, territories and regions: Romania
The main goals of the project (PHARE project RO 97/12/L002) was to assist an efficient implementation of the Social Health Insurance Law and an efficient health care service provision, taking into account EU best practice. The specific objectives were to assist: establish a qualified and well organized health insurance network including review of the contractual relation; establish a functioning health insurance scheme; establish an appropriate information system for the health insurance house (HIH); improve the health management; elaboration of a strategy for heavy medical investment.
The Project has elaborated recommendation that served as a reference frame for the next phase of the reform and in this respect ensured sustainability. The Project has participated in or produced many important recommendations in the following fields: Health Insurance Network and Scheme; Information System; Registration, Contribution, Reimbursement and Redistribution; Health Care Financial and Accounting Management; Heavy Medical Investment. It is therefore strongly recommended the European Commission to identify resources for continuous support of the final phase of the Romanian health sector reform.

Romanian Ministry of Health and CHEMA -Belgium and European Institute - Denmark (2000). Organizational Health Reform - December 1998 - June 2000 (Report available in English). Countries, territories and regions: Romania
Wider objective of the this project (PHARE project RO 97/12/L001) was to assist the MoH in developing and implementing a new general concept regarding an efficient health care services provision system, taking into account best EU practices. Specific objectives were: to develop a general concept for a decentralized health care system, including a clear definition of each level of care, their function within the system, the relationships prevailing among them, the necessary regulation to enforce the system and the ways of access of care seekers to each level; to achieve a workable organization structure, improved management and co-ordination capacity between the different levels of health care provision; to achieve an efficient structure of the MoH at central and decentralized level, and to aim at the existence in the system of independent providers of services; to achieve an appropriate use of hospital services through the definition and evaluation of the role and framework o f activity for hospitals and for alternatives to hospital inpatient care; to achieve a new design for ambulatory care, defining the roles of each type of ambulatory care, relationships among them; to strengthen the Program Implementation Unit of the MoH through establishment of co-ordination and communication means.

Romanian Ministry of Health and NICARE - UK (2000). "Drug policy - December 1998 - June 2000, (Report available in English)."
Countries, territories and regions: Romania
The report of "The National Drug Policy" covered the major problems of the following areas: 1) Improving and enforcing the legislation of the pharmaceutical sector; harmonization with EU requirements (pharmaceutical inspection and status of the inspector; good practice rules, including regulation of drug donations; support of the local industry; marketing authorization for the medicinal products); 2) Increasing the availability and accessibility of drugs (ensuring the data base concerning the statistical information of drug use; elaboration of the essential drug list; elaboration of reimbursed drug list; drug supply in remote areas); 3) Encouraging the rational use of drugs (continuing training of pharmacists, physicians; public information - self-medication; elaboration of the therapeutic guidelines; improving prescribing habits; relation physician - pharmacist - patient); 4) Defining, improving and enforcing the regulations concerning (pricing policy; drug financi ng; reimbursement within the national health insurance system);

Romanian MoH, Romanian NHIH, et al. (2002). Consensus Project: "Building the institutional capacity of national health insurance house and of district health insurance houses" - January 2000 - December 2002
(Report available in English). Countries, territories and regions: Romania
The general objective of the project RO-IB-99-CO-02 is to increase the effectiveness and the stability of the health insurance system to support Romania for adhering to European Union.
To attain the general objective of the association project, consideration should be given to the following strategic goals: building the efficient and appropriate managerial capacity of the National Health Insurance House and of the District Health Insurance Houses, as well as a constant capacity of training; expanding the operational efficiency of NHIH and DHIH by showing clearly the roles they play; and by the harmonosation of the institutional relationship; and, establish the Unit of the Continuous Education Coordination to develop, put in practice, and support training activities.

Roshi, E. (2001). Prevalence of risk factors in a group of patients with coronary heart diseases hospitalized at Tirana University Hospital Center, ( Lecturer at the Public Health department, Faculty of Medicine. Faculty of Medicine. Tirana, University of Tirana. Countries, territories and regions: Albania

Roshi, E. and G. Burazeri (2002). "Public health training in Albania; long way toward a school of public health." Croat Med J 43(4): 503-7.
Countries, territories and regions: Albania
AIM: To assess the needs for a school of public health in Albania, where health system has been going through difficult periods of transition after the collapse of the communist regime and its "Soviet" health system in 1991. METHOD: Review of the past and current state of public health training, as well as the evolution of the main institutions involved in public health training in Albania, in view of the recent attempts undertaken to establish a school of public health. RESULTS: Up to early 1990s, public health training in Albania involved mostly physicians and was based to a great extent on sanitary engineering approach. In the mid 1990s, the activities of the Department of Public Health of the Faculty of Medicine in Tirana focused on development of comprehensive public health training program. The aim of the current 2-year training program is to train public health specialists in a new fashion, in line with current international trends in the "new" publ ic health. However, the size and the background of the faculty of the Department of Public Health (8 members, 7 physicians) is too limited and medically oriented. Since 1969, the Institute of Hygiene and Epidemiology (later National Institute of Public Health) has been providing short-term (1-3 months) courses for hygienists, chemists, and microbiologists working at the district level. CONCLUSION: Only the establishment of a school of public health capable to train specialists according to international standards can meet the health needs of Albania.

Rrumbullaki, L., P. M. Theodorakis, et al. (2002). "Medical education in Albania; current situation and perspective, with reference to primary care." Croat Med J 43(1): 50-3.
Countries, territories and regions: Albania
A radical primary health care-oriented reform of the medical services in Albania is now under way, calling for adequate revision in medical education. The reform has started in 1994. In January 1997, the Department of Family Medicine at the Faculty of Medicine, University of Tirana, was established for the development of general practice and family medicine, and with it a new era in medical education in Albania has begun. Mutual agreements for international collaborations are being realized, modern medical textbooks are being published, and the importance of continuous medical education is gaining a deserved appreciation. Here we describe medical education in Albania, including undergraduate education, vocational training, and continuing professional development. The emphasis is given on primary care, with some suggestions for concrete actions that would improve the current situation. A brief descriptive account is given of the ongoing Albanian medical education reform, prima rily in the field of primary health care, which assumes its most interesting global aspects and at the same time reflects the unique demands of the country.

Rubin, M., J. H. Heuvelmans, et al. (2000). "Health-related relief in the former Yugoslavia; needs, demands and supplies." Prehospital Disaster Med 15(1): 1-11.
Countries, territories and regions: Croatia, Bosnia and Herzegovina, Serbia and Montenegro, Macedonia, Kosovo
INTRODUCTION: Many organizations rally to areas to provide assistance to a population during a disaster. Little is known about the ability of the materials and services provided to meet the actual needs and demands of the affected population. This study sought to identify the perceptions of representatives of the international organizations providing this aid, the international workers involved with the delivery of this aid, the workers who were employed locally by the international organizations, the recipients, and the local authorities. This study sought to identify the perceptions of these personnel relative to the adequacies of the supplies in meeting the needs and demands of the population during and following the war in Bosnia-Herzegovina. METHODS: Structured interviews were conducted with representatives of international organizations and workers providing aid and with locally employed workers, recipients of the assistance, and the authorities of the areas involved. D escriptive and inferential statistics were used to assist in the analysis of the data. RESULTS: Eighty-eight interviews were conducted. A total of 246 organizations were identified as providing assistance within the area, and 54% were involved with health-related activities including: 1) the provision of medications; 2) public health measures; and 3) medical equipment or parts for the same. Internationals believed that a higher proportion of the needs were being met by the assistance (73.4 +/- 16.4%) than did the nationals (52.1 +/- 23.3%; p < 0.001). All groups believed that approximately 50% of the demands of the affected population were being addressed. However, 87% of the international interviewees believed that the affected population was requesting more than it actually needed. While 27% of the international participants believed that > or = 25% of what was provided was unusable, 80% of the recipients felt that > or = 25% of the provisions were not usable. Whe reas two-thirds of the international participants believed that > or = 25% of the demands for assistance by the affected community could not be justified, only 20% of the recipients and authorities believed > or = 25% of the demands were unjustified. CONCLUSIONS: Many organizations are involved in the provision of medical assistance during a disaster. However, international organizations and workers believe their efforts are more effective than do the recipients.

Ruiz, E., X. Puges, et al. (2001). "Health intervention in an Albanian-Kosovar refugees camp." Gac Sanit 15(4): 456-358.
Countries, territories and regions: Albania
This paper focuses on the health intervention developed in a camp of Albanian-Kosovar refugees, displaced as a consequence of the Balcans war in Kosova. Between May and June 1999, the camp of Kavaje in Albania, received 1,700 refugees, with an average age of 24 years old. During this period, 1904 cases were registered at the primary health care centre settled in the camp. The most frequent causes of consultation were respiratory infections (22%), external causes (21%), skin infections and intestinal diseases (12%). A part of the psychological damage, the population attended didn't present with relevant health problems. Most of the visits to the doctor, related to the difficulties suffered on their way to the camp and to the conditions they were living on.

Sahatci, E. (1995). "The fight for reproductive rights in Central and Eastern Europe. Albania: discovering the human right to family planning." Plan Parent Chall 2: 25-6.
Countries, territories and regions: Albania

Sakoman, S. (2000). "Substance Abuse in the Republic of Croatia and National Program for Drug Control." Croat Med J 41(3): 270-86.
Countries, territories and regions: Croatia

Salama, P., B. Laurence, et al. (1999). "Health and human rights in contemporary humanitarian crises: is Kosovo more important than Sierra Leone?" BMJ 319(7224): 1569-71.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Salama, P., P. B. Spiegel, et al. (2000). "Mental health and nutritional status among the adult Serbian minority in Kosovo." JAMA 284(5): 615-6.
Countries, territories and regions: Kosovo, Serbia and Montenegro
: Since the beginning of the North Atlantic Treaty Organization intervention in Kosovo in June 1999, few objective data have been available on relevant health indicators for the Serbian ethnic minority in Kosovo. OBJECTIVE: To determine the prevalence of undernutrition among Serbian adults aged 60 years or older and psychiatric morbidity among the adult Serbian population in Kosovo. DESIGN, SETTING, AND PARTICIPANTS: A systematic random sample survey of 212 households was conducted between September 27 and October 2, 1999, in Pristina, the capital city, and in 10 towns in the rural municipality of Gnjilane in Kosovo. Of the 212 households surveyed, 204 adults aged 15 years or older completed the General Health Questionnaire-28 (GHQ-28) and anthropometric measurements were taken for 98 adults aged 60 years or older and for a comparison group of 51 adults aged 18 to 59 years. MAIN OUTCOME MEASURES: Body mass index of less than 18.5 kg/m(2) in older adults; nonspecific psychiatr ic morbidity among adults; and self-reported use of health care services, access to food rations, and primary sources of prewar and postwar income. RESULTS: Undernutrition was found in 11.2% (95% confidence interval [CI], 5.7%-19.2%) of Serbian adults aged 60 years or older compared with 2.0% (95% CI, 0.1%-11.8%) of Serbian adults aged 18 to 59 years. The mean (SE) total score for the GHQ-28 was 13.0 (0.52). In a comparison of the GHQ-28 scores of the Serbian adults with the Kosovar Albanian adults (data from a recent survey), the mean (SE) score adjusted for age and sex was 12.8 (0.52) vs 11.1 (0.58); P =.03, respectively. The GHQ-28 scores were also higher for the Serbians in the subcategories of social dysfunction (2.8 [0.17] vs 2.2 [0.13]; P =.008) and severe depression (1.9 [0.15] vs 0.9 [0. 09]; P<.001), respectively. Serbian women and persons living alone or in small family units were more prone to psychiatric morbidity. Of the 141 respondents reporting the need fo r health care services, 83 (57.6%) reported not obtaining such services; 204 of 212 (96.2%) households were on a food distribution list. The majority of prewar income came from government jobs compared with farming and humanitarian aid for postwar income. CONCLUSIONS: The undernutrition of older Serbian adults in Kosovo should be monitored. The high prevalence of symptoms of social dysfunction and severe depression suggest the need for implementation of mental health programs in the Serbian community. JAMA. 2000;284:578-584

Salchev, P. (2002). "The level of satisfaction of work performed by the physicians in the Primary Health Care (PHC)." Social Medicine Journal 4: 18-19.
Countries, territories and regions: Bulgaria
Two-stage sociological survey investigated, the satisfaction of professional realization among PHC physicians. First stage has been carried out in 1995 and second stage - in 2000. The study population in 1995 included the district therapist, district pediatrician and district gynecologist and in 2000 - the GPs, who made a contract with the NHIF. Likkert scale has been used . The mean age of the respondents in 1995 has been 39.4+8.47, and in 2000 - 43.26+6.97. Most of the physicians interviewed in 1995 agreed (2.22+1.21) with the statement that some of the daily activities in their work were senseless, and the result was even more drastic in 2000 (1.96+1.02). Both groups agreed with the opinion that their work interested them in the same way - respectively 1.55+ 0.78 (1995) and 1.79+0.94 (2000). The greatest part of the GPs shared the opinion that they faced too many unnecessary administrative duties - the ones in 1995 'agreed' (2.17+1.27) and those in 2000 'strongly agreed' (1.28+0.45). The physicians disagreed that they would gladly accept work in a sphere different from health care system even if the conditions and the payment were the same - 3.9+1.31 (1995) and 3.72+1.17 (2000) which meant that GPs appreciated the importance of their medical profession and had still kept their motivation for work. However, both groups rejected the statement that their payment was adequate and appropriate compared to the amount of their work - respondents in 1995 'disagreed' (4.49+0.98) and those in 2000 'strongly disagreed' (4.6+0.63). The conclusion drawn is that PHC physicians have low motivation due to comparatively low payment and great amount of administrative duties but they still estimate highly their work and show unwillingness to quit medical profession.

Salihovic, H., F. Kulenovic, et al. (2001). "Health care time of crisis, crises in health care - current reality in B & H Health Care System." Med Arh 55(1): 17-8.
Countries, territories and regions: Bosnia and Herzegovina
In the period from 1945 till 1992 the health protection had constant growth of coverage, availability and quality of protection in the promotion of health care of the inhabitants, and the health care activity noticed spreading of the network of health care institutions, evidently staff improving of all profiles of health care workers, and supplying of equipment so said in the accordance with the movements in for developed countries. The detaching for health care in 1990 amounted 6.9 per cent of that time BDP. The period from 1991 till 1955 is difficulty to analyze, because of the disturbances which appear in all sphere of life and work, and the period from 1996 till 1999 can be analyzed, from the already known reasons, only for the area of the Federation. The correct amount of the means of payment spent for health care in the postwar period is impossible incorrectly to confirm, except detaching from BDP (1999 3.7 per cent) arrived the donations in equipment, drugs, sanitary m aterial, training of staff, free of charge experts, means for the reconstruction of objects, to this in the future cannot be considered. Besides that the rate of detaching for the health care from BDP is less than before the war, BDP by it self is far lesser what means that the means of payment detached are far lesser. It is necessary the URGENT reform of health care financing system, evaluation strategy of the reform of health care which up-to-now did not show shifts, the bringing of instruments of planning in the health care, instruments of quality control, the legislator must define clearly the relations between the private practice, patients and state funds.

Sauer, D. J. (1999). "The "nameless children of Romania?" Ministry-sponsored fund helped disabled orphans in former iron curtain country." Health Prog 80(4): 60-1.
Countries, territories and regions: Romania

Schrope, M. (2001). "Plans to eradicate polio hit by virus outbreak in Bulgaria." Nature 411(6836): 405.
Countries, territories and regions: Bulgaria

Scientific and Practical Center for Public Health and Management (Moldova) and Ministry of Health Moldova (2000). Moldovan Health Statistics for 1999, http://stats.mednet.md. Countries, territories and regions: Moldova
The indicated web link makes reference to the national data basis of statistical indicators of health services and health status of the population of the Republic of Moldova for different years and for all country districts. The most recent data reported in this document are for 1999 and 2000. The same link can be used later in order to find updated information.

Senturia, K. D. (1996). "Maternal and child health in Albania." Social Science & Medicine 43(7): 1097-1107.
Countries, territories and regions: Albania
Women in Albania today live in a world very different from that of their parents and grandparents. In an increasingly "westernized" nation, women initially appear to have more autonomy within their families and greater power within society than their traditional ancestors had. From the reports of aid agencies and the former government, it appears that Albanian women's health has also greatly improved in the last half century. However, these reports are based largely on questionable statistics. At the same time, initial impressions based on women's public images can be deceptive. According to Albanian physicians, most of the data produced during the socialist era was falsified to improve the government's image. Furthermore, no comprehensive research projects have examined the multi-faceted nature of pregnancy including both social and physical factors. Albanian clinicians and international aid organizations need accurate indicators of maternal and child health to eit her corroborate or disprove the reports under discrepancy. The study reported here documents current health conditions for pregnant women and their offspring in Albania. Data for the study were collected in 1993 and 1994 from field sites throughout Albania. A total of 3250 medical charts from 1993 were abstracted from five maternity houses. Interviews were conducted during 1993-1994 with 1199 pregnant women who were followed through their pregnancies. Of these women, 938 were located at delivery. Their infants were weighed and assessed. The data show that infant birth weights, gestational ages and mortality rates are now comparable to the rest of Europe. Maternal disease rates and spontaneous and therapeutic abortion rates are also surprisingly low considering the previous reports. However, fertility rates remain relatively high compared to Western Europe. The results show that despite the degeneration of health services, maternal and child health in Albania is much better t han expected and vastly improved over the pre-communist era.

Senturia, K. D. (1997). "A woman's work is never done: women's work and pregnancy outcome in Albania." Med Anthropol Q 11(3): 375-95.
Countries, territories and regions: Albania
Albania has undergone extreme social and political changes during the past five years. Conditions regarding women's work and its effect on reproductive health have been unknown. During the 1993 and 1994, a cohort of 1199 pregnant women were followed to identify how work factors related to spontaneous abortion, infant low birth weight, gestation length, and perinatal mortality. A small subgroup was interviewed to examine qualitative issues including motivation, attitudes, and personal experiences regarding working and raising a family. Results reveal that certain work factors directly correlated with low birth weight, miscarriage, and/or perinatal death. The significant factors included: fewer household helpers, standing, working in hot environment, commuting, walking and carrying, and lifting heavy weights on the job. Most women were unemployed, and virtually all were deeply concerned about employment and poverty. Their challenge is to maintain an equilibrium between satisfac tion of economic needs and physical needs during pregnancy. International aid programs in Albanian maternal and child health must consider the physical repercussions from increased work on the job and little or no decrease in work at home.

Serbia, R. o. (2002). Health Policy of Serbia, as adopted in February 2002. Countries, territories and regions: Serbia and Montenegro

Shapo, L., R. Coker, et al. (2002). "Tracking diabetes in Albania: a natural experiment on the impact of modernization on health." Diabetic Medicine 19: 87-88.
Countries, territories and regions: Albania

Shiffman, J., M. Skrabalo, et al. (2002). "Reproductive rights and the state in Serbia and Croatia." Social Science & Medicine 54(4): 625-42.
Countries, territories and regions: Serbia and Montenegro, Croatia
The global reproductive rights movement arose in the late 1980s and early 1990s as a challenge to the population control paradigm that has dominated family planning policy for almost half a century. The essence of the challenge is to place women into the center of population discussions as subjects, not objects of policy, and to reorient family planning and health programs toward meeting the broad reproductive health needs of individuals, rather than the narrow population control objectives of states. Reproductive rights advocates argue that the use of family planning programs for developmentalist-oriented population control objectives is illegimate, and inevitably relegates women to the status of depersonalized policy "targets". The cases of Croatia and Serbia, the two dominant partners in the former Federal Republic of Yugoslavia, offer interesting twists on these reproductive rights issues. In Croatia and Serbia, unlike in many nations, the governments are delibe rately seeking to increase rather than decrease fertility levels. Moreover, the objective concerns identity politics, more so than development: the governments have encouraged increased fertility to safeguard the survival of their nations and to strengthen national power amidst threatening internal and external environments of ethnic conflict. In this paper, we examine the dynamics of pro-natalist fertility policy in Croatia and Serbia. We do so with a view to explaining why, despite similarities, the two have followed divergent paths. While reproductive rights violations have occurred in both nations, they have been markedly higher in Serbia than Croatia. To explain this divergence we look at a series of sociopolitical factors, including the space available for groups to mobilize in each political system; the degree of nationalistic extremism present in the discourse of central political leaders; and perceptions of threats and opportunities in external geopolitical environm ents. In conducting this analysis we seek to drive home the point that a nation's reproductive rights situation and prospects cannot be understood divorced from its sociopolitical context. We also raise an additional impetus for promoting the reproductive rights agenda--one largely unexplored in the family planning literature-that emerges from low fertility nations facing identity issues. Women's bodies must be protected not only against those states seeking to use their reproductive capacities for developmentalist-oriented fertility control, but also against those wanting their bodies for nationalistic-oriented fertility promotion.

Shuey, D. A., F. A. Qosaj, et al. (2003). "Planning for health sector reform in post-conflice situations: Kosovo 1999-2000." Health Policy 63(3): 299-310.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Simo-Algado, S., N. Mehta, et al. (2002). "Occupational therapy intervention with children suvivors of war." Can J Occup Ther 69(4): 205-17.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Situm, M., Z. Dogas, et al. (2001). "Increased Incidence of Colorectal Cancer in the Spit-Dalmatia County: Epidemiological Study." Croat Med J 42(2): 181-87.
Countries, territories and regions: Croatia

Skoufias, E. (1998). "Determinants of child health during the economic transition in Romania." World Development 26(11): 2045-2056.
Countries, territories and regions: Romania

Smith, P., S, W. Yule, et al. (2001). "War exposure and maternal reactions in the psychological adjustment of children from Bosnia-Herzegovina." J Child Psychol Psychiatry 42(3): 395-404.
Countries, territories and regions: Bosnia and Herzegovina
As part of a UNICEF-sponsored Psychosocial Programme in Bosnia, data were collected from a representative sample of 339 children aged 9-14 years, their mothers, and their teachers in order to investigate risk and moderating factors in children's psychological reactions to war. Self-report data from children revealed high levels of post-traumatic stress symptoms and grief reactions, but normal levels of depression and anxiety. Mothers' self-reports also indicated high levels of post-traumatic stress reactions, but normal levels of depression and anxiety. Child distress was related to both their level of exposure and to maternal reactions. Structural equation modeling was used to quantify the relationships between these risk factors and child distress, and to examine putative pathways to account for the association between child and maternal health. Children's adjustment was associated significantly with both exposure (phi = .37) and maternal mental health (phi = .37). Modeling also revealed a significant distorting effect of mother's own mental health on behavioural ratings of her child (psi = .59). Although evidence exists for an association between maternal mental health and mother rating errors, there is also a substantive association between maternal mental health and children's adjustment following war.

Social Development Department at the UN Mission in Bulgaria (?). Communication in Roma Community, Social Development Department at the UN Mission in Bulgaria,. Countries, territories and regions: Bulgaria

Spiegel, P. B. and P. Salama (2000). "War and mortality in Kosovo, 1998-99: an epidemiological testimony." The Lancet 355(9222): 2204-9.
Countries, territories and regions: Kosovo, Serbia and Montenegro
The total number, rates, and causes of mortality in Kosovo during the last war remain unclear despite intense international attention. Understanding mortality that results from modern warfare, in which 90% of casualties are civilian, and identifying vulnerable civilian groups, are of critical public-health importance. METHODS: In September 1999 we conducted a two-stage cluster survey among the Kosovar Albanian population in Kosovo. We collected retrospective mortality data, including cause of death, for the period of the conflict. FINDINGS: The survey included 1197 households comprising 8605 people. From February, 1998, through June, 1999, 67 (64%) of 105 deaths in the sample population were attributed to war-related trauma, corresponding to 12,000 (95% CI 5500-18,300) deaths in the total population. The crude mortality rate increased 2.3 times from the pre-conflict level to 0.72 per 1000 a month. Mortality rates peaked in April 1999 at 3.25 per 1000 a month, coinciding with an intensification of the Serbian campaign of "ethnic cleansing". Men of military age (15-49 years) and men 50 years and older had the highest age-specific mortality rates from war-related trauma. However, the latter group were more than three times as likely to die of war-related trauma than were men of military age (relative risk 3.2). INTERPRETATION: Raising awareness among the international humanitarian community of the increased risk of mortality from war-related trauma among men of 50 years and older in some settings is an urgent priority. Establishing evacuation programmes to assist older people to find refuge may prevent loss of life. Such mortality data could be used as evidence that governments and military groups have violated international standards of conduct during warfare.

Stamenkova, R., D. Dikova, et al. (2000). "News from Europe Bulgaria, a country undergoing total change." Soins 650: 27-9.
Countries, territories and regions: Bulgaria

State Statistical Office, M. (2002). Labour Force Survey 2001. Countries, territories and regions: Macedonia

State Statistical Office Macedonia (2000). Woman and Man in the Republic of Macedonia, State Statistical Office macedonia. Countries, territories and regions: Macedonia
With this publication the State Statistical Office offers the complete data referring to woman and man in the Republic of Macedonia from different points of view. The analy-sis for gender status in the Republic of Macedonia, would be additionally completed with data referring to education, vital aspects, living standards, legal aparatus and similar.

State Statistical Office Macedonia (2000/2001). Social Welfare of children, youth and adult persons in the Republic of Macedonia, State Statistical Office Macedonia,. Countries, territories and regions: Macedonia
The publication contains precise data about dorms for pupils-students, users of social welfare; dorms for accommodation of children without parents and parental care; organi-sations for accommodation of children and youths with psycho-physical development disorder; organisations dealing with educational neglected children and youths; organisa-tions for professional rehabilitation and organisations for accommodation and care of adult persons. Data regarding the Institutions for social care and welfare of children and child supplement are also presented in this publication.

State Statistical Office Macedonia (2002). Statistical Yearbook of the Republic of Macedonia. CD Rom, State Statistical Office Macedonia,. Countries, territories and regions: Macedonia

STIP (2000). Mortality reduction from malignant disease, STIP. Countries, territories and regions: Macedonia
Mission: To decrease the mortality from malignant diseases and rehabilitation with psy-chosocial support of the people with cancer in Macedonia. Main objectives of this NGO are: education and information about the most frequent malignant diseases, risk factors, screening and early detection and treatment of these diseases; psychosocial rehabilitation and support of patients with cancer and their families. This NGO has 4 sections: Health, Women, Environment protection and Volunteers. In 2001 financially supported by Open Society Institute this NGO opened The Center for women with breast cancer. This Center provides health promotion, counseling, psychosocial support and education to women with breast cancer and their families. During 2001-2002 more than 6300 beneficiaries have been served by this Center. 26 leaflets and brochures have been published, plastic guides for self-control, CD, poster and other educational materials were published and distributed. A seminar and guide f or volunteers have been prepared, many activities dur-ing the "week against cancer 1-8 March" have been accomplished, Breast simulator has been purchased (financially supported by FOSIM) and educational seminars for self-control have been organized twice monthly in small groups (5-10).

Stoicescu, I. and C. Didilescu (1998). "The evolution of the tuberculosis endemic in 1997 in Romania." Pneumoftiziologia 47(1): 11-3.
Countries, territories and regions: Romania

Sucholotiuc, M., L. Stefan, et al. (2000). "Extended applications with smart cards for integration of health care and health insurance services." Stud Health Technol Inorm 77: 1010-4.
Countries, territories and regions: Romania
In 1999 in Romania has initiated the reformation of the national health care system based on health insurance. In 1998 we analyzed this system from the point of view of its IT support and we studied methods of optimisation with relational, distributed databases and new technologies such as Our objectives were to make a model of the information and services flow in a modern health insurance system, to study the smart card technology and to demonstrate how smart card can improve health care services. The paper presents only the smart cards implementations.

Szilard, I., A. Cserti, et al. (2002). "International Organization for Migration: Experence on the Need for Medical Evacuation of Refugees during the Kosovo Crisis in 1999." Croat Med J 43(2): 195-8.
Countries, territories and regions: Kosovo, Serbia and Montenegro

Taub, N. (1999). "Post-communist limitations on reproductive rights: the German and the Romanian case." Med Law 18(2-3): 277-83.
Countries, territories and regions: Romania
This article examines legislative changes affecting reproductive rights that have taken place in two Central European countries since the dissolution of the Soviet bloc. Although some of these changes have been progressive, not all of them have been. Both countries will have to make further changes to be in full compliance with their international human rights obligations to accord women and men reproductive choice.

Terzic, J., J. Mestrovic, et al. (2001). "Children War Casualties during the 1991-1995 Wars in Croatia and Bosnia and Herzegovina." Croat Med J 42(2): 156-60.
Countries, territories and regions: Bosnia and Herzegovina, Croatia

The Economist Intelligence Unit (2002). Country Profile Croatia 2002. Countries, territories and regions: Croatia

The International Health Care and Health Insurance Institute (IHCHII) (2003). The International Health Care and Health Insurance Institute (IHCHII) (www.zdrave.net). Countries, territories and regions: Bulgaria

The Macedonian Nurses and Midwives Association (2002). "The status and the development of Nursing and Midwifery in Republic of Macedonia (in Macedonian) . Skopje,." Nursing Magazine.
Countries, territories and regions: Macedonia
The Macedonian Nurses and Midwives Association started to make reforms since the very beginning, making continuing educational programs for the nurses and the midwives. As soon as it was established, the Association made contacts with the WHO Collaborative Center in Maribor and organized workshops lead by their experts. Projects accomplished so far: 1994 - HIV Protec-tion of Nurses and Midwives at their workplace, 40 trainers were trained to further educate nurses and midwives; 1995 - Seminar on Quality Nursing Care when the Association was in-volved in the LEMON project of WHO that gave right to the Association to translate nursing ma-terials and that enabled the nurses themselves to write different guides and practical books as a result from the work of the specialized sections of the Association; 1996 - Breastfeeding project in partnership with UNICEF. A brochure on breastfeeding is printed in 3 languages (Macedo-nian, Turkish and Albanian); 1999 - Workshop for Nursing Lea ders; 2000 - The translation of the LEMON material (in the WHO curriculum for family nursing) and as an outcome of the Mu-nich Declaration that was signed by the Ministry of Health in the year 2000 was developed the project "Rehabilitation of the patronage system in Macedonia"; 2002 - The Association works in a partnership with the Danish Nursing Organization, having a seminar "Strengthening Profes-sional Organization". The Nursing Magazine was issued for the first time in the year 2002. Cur-rently The Association is engaged in the preparation of the National Strategy for development of nursing and midwifery and in the preparation of National Strategy for the development of health-care. Future plans are to help to organize a workshop on Nursing Documentation and also to translate the ICNP (International Classification for Nursing Practice) material and the Glossary of Terms.

The Public Policy Institute (2002). Barometer of Public Opinion, 2002. Public Opinion Poll, http://www.ipp.md/ publications/Barometer_of_Public_Opinion_-_November,_2002/en.html. Countries, territories and regions: Moldova
With the purpose to promote correct and transparent tools of reflecting the social political and economic life for ensuring the civil society access to information, the Soros Foundation Moldova has launched in 1998 a public opinion survey program - Barometer of Public Opinion. Annually, public opinion polls are performed in the framework of this program. The indicated document presents a publication of the results of a public opinion survey for 2002. The results of the survey focuses on the following fields: political options, popularity and notoriety of main political parties and personalities, living standards and life quality, economic and social governmental policy, other issues of major concern. A board of experts of the Institute for Public Policy has supervised the Program Barometer of Public Opinion - 2002. The survey was performed within the period of November 15-29, 2002 and has been carried out by the Center for Analysis and Sociological, Policy and Psychological Investigations CIVIS from Chisinau. The survey sample consisted of 1103 of adult population from 72 localities of the Republic of Moldova (excepting its Eastern districts and the city of Bender). Diagrams, tables and bar charts are the main graphical presentations used in the document. The content of specially elaborated questionnaires that have been used in the survey is presented at the end of the document.

The Public Policy Institute Moldova (2000). Barometer of Public Opinion, Public Opinion Poll, 2000., http://www.ipp.md/publications/BOPraport(english).ppt. Countries, territories and regions: Moldova
With the purpose to promote correct and transparent tools of reflecting the social political and economic life for ensuring the civil society access to information, the Soros Foundation Moldova has launched in 1998 a public opinion survey program - Barometer of Public Opinion. Annually, public opinion polls are performed in the framework of this program. The indicated document presents a publication of the results of a public opinion survey for 2000. The results of the survey focuses on the following fields: political options, popularity and notoriety of main political parties and personalities, living standards and life quality, economic and social governmental policy, other issues of major concern. A board of experts of the Institute for Public Policy has supervised the Program Barometer of Public Opinion - 2000. The survey was performed in August 2000 and has been carried out by the Institute for Marketing and Polls - IMAS from Bucharest, Romania in cooperation with SOCIO -Moldova from Chisinau. The survey sample consisted of 1096 persons from all Moldova's districts, representing the adult population of the Republic of Moldova. Diagrams and tables are the main graphical presentations used in the document. Interviews and specially elaborated questionnaires were the main methods used in the survey.

The Public Policy Institute Moldova (2001). Barometer of Public Opinion,2001. Public Opinion Poll,, http://www.ipp.md/publications/prezentare/en.html. Countries, territories and regions: Moldova
With the purpose to promote correct and transparent tools of reflecting the social political and economic life for ensuring the civil society access to information, the Soros Foundation Moldova has launched in 1998 a public opinion survey program - Barometer of Public Opinion. Annually, public opinion polls are performed in the framework of this program. The indicated document presents a publication of the results of a public opinion survey for 2001. The results of the survey are grouped in three main categories: general aspects of country economy, living standards and social issues, politics. A board of experts of the Institute for Public Policy has supervised the Program Barometer of Public Opinion - 2001. The survey was performed within the period of November 1-10, 2001 and has been carried out by the Center for Analysis and Sociological, Policy and Psychological Investigations CIVIS from Chisinau. The survey sample consisted of 1104 persons from 68 localities, representi ng the adult population of the Republic of Moldova (excluding the Transnistrian region and the city of Tighina (Bender). Diagrams and tables are the main graphical presentations used in the document. The content of questionnaires used in the survey is available.

The Republika Srpska Institute of Statistics (2002). Demographic Statistics published yearly. Banja Luka, The Republika Srpska Institute of Statistics. Countries, territories and regions: Bosnia and Herzegovina

Todorova, M. (1997). "Imagining the Balkans."
Countries, territories and regions: South Eastern Europe

Toma, T. (1997). "Romania to change health system." 315 7102(209).
Countries, territories and regions: South Eastern Europe

Toma, T. (2000). "Romanian national insurance cannot cover GPs prescriptions." BMJ 320(7236): 670.
Countries, territories and regions: Romania

Tomov, T., M. Mladenova, et al. (2002). Country Mental Health Profile of Bulgaria. Countries, territories and regions: Bulgaria

Turek, S. (1999). "Reform of health insurance in Croatia." Croatian Medical Journal 40(2): 143-51.
Countries, territories and regions: Croatia
After democratic changes in 1990 and the declaration of independence in 1991, Croatia inherited an archaic system of economy, similar to all the other post-communist countries, which had especially negative effects on the health system. Health services were divided into 113 independent offices with their own local rules; they could not truly support the health care system, which gradually stagnated, both organizationally and technologically. Such an administrative system devoured 17.5% of the total funds, and primary care used only 10.3% of this. Despite the costly hospital medicine the entire system was financed with US$300 per citizen. The system was functioning only because of professionalism and enthusiasm of well-educated medical personnel. Such health policy had a negative effect on all levels of the system, with long-term consequences. The new health insurance system instituted a standard of 1,700 insureds per family medicine team, reducing hospital capacities to 3.8 b eds per 1,000 citizens for acute illnesses. Computerization of the system makes possible the transparency of accounting income and expenses. In a relatively short period, in spite of the war, and in a complex, socially and ethically delicate area, Croatian Health Insurance Institute has successfully carried out the rationalization and control of spending, without lowering the level of health care or negatively influencing the vital statistics data.

Turek, S., I. Rudan, et al. (2001). "A large cross-sectional study of health attitudes, knowledge, behaviour and risks in the post-war Croatian population (the First Croatian Health Project)." Coll Antropol 25(1): 77-96.
Countries, territories and regions: Croatia
As the liberation of occupied Croatian territories ended the war in the country in 1995, the Ministry of Health and Croatian Health Insurance Institute have agreed to create the new framework for developing a long-term strategy of public health planning, prevention and intervention. They provided financial resources to develop the First Croatian Health Project, the rest of the support coming from the World Bank loan and the National Institute of Public Health. A large cross-sectional study was designed aiming to assess health attitudes, knowledge, behaviour and risks in the post-war Croatian population. The large field study was carried out by the Institute for Anthropological Research with technical support from the National Institute of Public Health. The field study was completed between 1995-1997. It included about 10,000 adult volunteers from all 21 Croatian counties. The geographic distribution of the sample covered both coastal and continental areas of Croatia and incl uded rural and urban environments. The specific measurements included antropometry (body mass index and blood pressure). From each examinee a blood sample was collected from which the levels of total plasma cholesterol (TC), triglycerides (TG), HDL-cholesterol (High Density Lipoprotein), LDL-cholesterol (Low Density Lipoprotein), lipoprotein Lp(a), and haemostatic risk factor fibrinogen (F) were determined. The detailed data were collected on the general knowledge and attitudes on health issues, followed by specific investigation of smoking history, alcohol consumption, nutrition habits, physical activity, family history of chronic non-communicable diseases and occupational exposures. From the initial database a targeted sample of 5,840 persons of both sexes, aged 18-65, was created corresponding by age, sex and geographic distribution to the general Croatian population. This paper summarises and discusses the main findings of the project within this representative sample of Croatian population.

Turnev, I. (2001). Common Health Problems among Roma - nature, consequences and possible solutions. Sofia, Bulgaria, Open Society Foundation. Countries, territories and regions: Bulgaria

Uitenbroek, D. G., A. Kerekovska, et al. (1996). "Health lifestyle behaviour and socio-demographic characteristics. A study of Varna, Glasgow and Edinburgh." Soc Sci Med 43(3): 367-77.
Countries, territories and regions: Bulgaria, Europe

Ulashi, M., B. Mema, et al. (2000). "Albania, to get out of a perverted health care system (Article in French)." Soins 647: 23-5.
Countries, territories and regions: Albania

UNAIDS (2000). HIV/AIDS National Strategy Development Documents UNFPA (2001). Sexual and reproductive health education - situation assessment. Sofia, Bulgaria, Deita Agency Ltd. Countries, territories and regions: Bulgaria

UNAIDS (2002). UN Theme group on HIV/AIDS for FR Yugoslavia. Activity Report for the year 2002, UNAIDS. Countries, territories and regions: Serbia and Montenegro

UNAIDS (2002). Fact Sheet 2002. Eastern Europe and Central Asia. Countries, territories and regions: Eastern Europe

UNAIDS, Ministry of Health and Family Romanian Government, et al. (2002). Southeastern Europe Conference on HIV/AIDS, Implementing the Global Declaration of commitment on HIV/AIDS, Bucharest, Romania.
Countries, territories and regions: South Eastern Europe

UNDP The Importance of Habitat
English version available at: http://www.undp.ro/publications/nhd.htm, UNDP. Countries, territories and regions: Romania
The Report reflects current UNDP orientations. It emphasizes the habitat as a distinct theme and attempts to outline a comprehensive picture of human development in terms of the evolution of labour resources, education and health, and social protection. In regard to certain social issues, the Report also includes the points of view of certain nongovernmental organizations, and research institutes. At the same time, it briefly presents the goals and programmes adopted by Romania in various fields of economic and social life, and attempts to provide decision-makers and civil society in general with certain guidelines by which to improve the strategies of economic and social development that are to be implemented in order to ensure sustainable human development. In this context, the mutual linkages of economic and social progress are totally acknowledged. Romania is constantly directing its efforts towards these two essential goals.

UNDP (1995). General Human Development Report Romania
http://www.undp.org/rbec/nhdr/1996/summary/romania.htm, UNDP. Countries, territories and regions: Romania
English version available at: http://www.undp.org/rbec/nhdr/1996/summary/romania.htm
In concluding the Report, attention is given to trying to identify some principles and actions for the implementation of a sustainable human development policy in Romania. These would provide the basis for a comprehensive national action plan as well as sectorial and regional programmes. The main recommendations in this regard are as follows: 1. Promotion of an economic, political and social environment which provides all individuals with a right to life and equal opportunities for future generations. 2. The observance of principles of equity, universality, non-discrimination and solidarity between generations in the pursuit of human development objectives, and in particular in relation to economic growth, balanced regional development, satisfaction of social needs. 3. The establishment of a Social Contract to prevent the deterioration of human capital through the strengthening of support to vulnerable groups. 4. The establishment of a reproducible production and consumption model to meet the population's social and cultural requirements, through the adoption of appropriate macro-economic policies and instruments. 5. Balanced regional development in different areas of human development. 6. The provision of a social safety net to protect vulnerable groups from the adverse consequences of macro-economic stabilization and adjustment measures, e.g. through social insurance and pensions; social security for the elderly, training for youth, etc. 7. Improvement of living conditions in under-developed areas, particularly in northern and southern Moldova, through the strengthening of infrastructure for water, power, sanitation, transport, communications, etc. 8. Improvement and consolidation of dialogue between Government and populations.

UNDP (1999). Revision of the Achievements of the Country, UNDP Romania. www.undp.ro/publications/nhd.htm
Countries, territories and regions: Romania
English version available at: http://www.undp.ro/publications/nhd.htm
Developed from the concept of UNDP's Human Development Report, these national policy reports, are produced at a country level, and are written and produced in Romania. The NHDRs compare data from regions, provinces or localities on indicators such as education, life expectancy, gender disparities and income, pointing to achievements and disparities. They have transformed the global debate on poverty and development over the past decade.

UNDP (2000). Albania Human Development Report. Tirana, UNDP. Countries, territories and regions: Albania

UNDP (2000). National Human Development Report, Republic of Moldova, UNDP. Countries, territories and regions: Moldova

UNDP (2000). Vulnerability Trends and Perception, Suspended Transition (1990-2000), Report No 0 (Serbia) of the Early Warning System for FRY, August 2000, UNDP. Countries and Regions: Serbia and Montenegro

UNDP (2000). National Strategy on HIV/AIDS and Sexually Transmitted Infections Bulgaria 2001-2007. UNDP Project BUL/98 (ENGLISH AND BULGARIAN), UNDP. Countries, territories and regions: Bulgaria

UNDP (2000). Women and Men in Romania (www.undp.ro/publications/nhd.htm), UNDP. Countries, territories and regions: Romania
English version available at: http://www.undp.ro/publications/nhd.htm
This statistical booklet presents a comprehensive and accurate set of gender statistics; an essential tool to ensure that government policy is directed at promoting gender justice and equality. It will also be a great source of information for NGOs and academics interested in issues concerning gender equality and advancement of women - e.g. political participation, economic life, family and households, laws, health, crime and violence, and education. For example, the data presented reveals that there is increased participation of women in the economy and that there is now equal access to higher education for young women. However, on the negative side, maternal mortality remains very high and there has been an increase in criminality, particularly among women. The booklet was produced by a team of experts, under the coordination of he National Commission for Statistics and is intended to be the first step in the general improvement of the Romanian statistics system in terms of its gender responsiveness.

UNDP (2000). Key Publications and Documents: Common Country Assessment for the Republic of Moldova, 2000.
http://www.undp.md/keypubdocument/common.html. Countries, territories and regions: Moldova
This is a web link to the available publications of UNDP, specifically the Common Country Assessment (CCA) document prepared by the United Nations Country Team and on the basis of ideas and reports of different UN Agencies in Moldova (UNDP, UNICEF, UNHCR, UNESCO, WHO, FAO and ILO), as well as on the papers and statistical data of various governmental departments, NGOs, research institutes and other organizations. The key issues of human development in the country, CAA-Moldova's methodology and problems have been discussed during the UN inter-agency Heads' meetings on March 24 and June 2, 2000. The CAA-Moldova focuses on main problems and domains for particular international cooperation, addressing the areas of governance, human rights, health care, education, gender equality, poverty eradication, environmental sustainability, regional disparities, etc. The level of national development (for 2000) is described in a holistic and analytical summary. Trends in the improvement of deterioration of the relevant indicators are identified. Priority areas for joint assistance from United Nation system are proposed. Recommendations are given on improving the CCA process and its outputs and on creation of a common database of key-indicators. A list of figures and tables and a bibliography are given at the end of the report.

UNDP (2000). Key Publications and Documents: National Human Development Report - 2000. http://www.undp.md/keypubdocument/index.html
http://www.undp.md/keypubdocument/HUMAN_2000_PDF.pdf. Countries, territories and regions: Moldova
This is a web link to the available publications of UNDP, specifically the National Human Development Report - 2000. The NHDR focuses attention on "key-points" for the development of the culture of peace in Moldova and possible ways of moving towards the society with the observance of human rights, sustainable human development, cultural diversity, and a good degree of moral and psychological comfort. 9 chapters of the report describe the UN concept of the Culture of Peace and its relevance for the Republic of Moldova, the role of state and human rights, socio-economic problems and policies, education and nation's health and civil society issues, etc. The basic components of Human Development Index are placed in the annexes to the report. Conclusions on main problems identified, a list of abbreviations and the bibliography of information sources used in the report are presented at the end of the report.

UNDP (2001). "Regional Human Development Report on the Impact of HIV/AIDS. Interview guide."
Countries, territories and regions: Eastern Europe

UNDP (2001). Human Development Report Bosnia and Herzegovina 2002. Sarajevo, UNDP. Countries, territories and regions: Bosnia and Herzegovina

UNDP (2001). National Human Development Report Social Exclusion and Human insecurity in FYR Macedonia, UNDP. Countries, territories and regions: Macedonia
Chapter 7 of the document has been addressed to Health Consequences of the Transition in Macedonia. In the Introduction there is a presentation of the health status of the high risk and very vulnerable groups as well as empirical evidence of the adverse health con-sequences of economic insecurity and social exclusion. The second part is named Influ-ence of Social and Economic Factors on the Health of the population and includes: social origin of the diseases, linkages between economic well-being and health, unemployment and health, nourishment and health, poverty, social exclusion and health. The third part is Major Indicators of Health Conditions in Macedonia: demographic and vital indicators, mortality and causes of death including the maternal mortality, morbidity as an indicator of the health condition of the population, immunization. The last part is addressed to the organizational infrastructure of the services, stuffing, system of the health insurance and ongoing proce ss of Health Care Reforms. In the conclusion a special emphasis has been put on the negative health sector effects of the transition, directions and suggestions for suitable strategies, programs and measures, health policy and formulation of the National Health Plan. There are four tables in the attachment presenting the basic health and vital indicators.

UNDP (2002). Kosovo Human Development Report, UNDP. Countries and Regions: Kosovo, Serbia and Montenegro

UNDP (2002). A decade later: Understanding the Transition Process in Romania. National Human Development Report Romania 2001-2002, UNDP. Countries, territories and regions: Romania
English version available at: http://www.undp.ro/publications/NHDR.pdf
Romania's transition experience during the last decade was frenzied and fragmented, fraught with multiple objectives and external pressures. The report examines this unique process of transition and examines the possibility of using the knowledge gained from the process for the formulation of new policies. The most important trends in the economic, political and social dimensions are highlighted, as well as the impact of the transition on human development. The message of the report is that, in a process as complex and entwined as the Romania transition experience, good governance and effective management of public resources can be a means to accomplishing people-focused development.

UNDP (2002). Bulgaria Human Development Index: Municipalities in the Context of Districts. Sofia, UNDP. Countries, territories and regions: Bulgaria

UNDP (2002). Human Development Report 2002. Deepening democract in a fragmented world, UNDP. Countries, territories and regions: Worldwide

UNDP (2002). National Human Development Report: Moldova 2002 (http://www.ipp.md/publications/studii/en.html), UNDP. Countries, territories and regions: Moldova
In 2002 the Institute for Public Policy in Moldova carried the project "UNDP National Human Development Report. Besides other studies on civil society, mass media as a governance factor, cultural values and education system, a particular study was performed to analyze the public health sector in the Republic of Moldova. The "Public health of the nation as a sum of individuals healths" publication presents comments on the main indexes that reflect the state of the public health in Moldova, based on the data of the Scientific and Practical Center of Public Health and Sanitary Management. This is an analytical study aimed to approach health not just like an individual problem but as a complex one that refers to the whole society. The conclusions given at the end of this document underline the main health related problems, such as continue increase of mortality indicators, actual medical-demographic tendencies and unfavorable modifications, insufficient financing, market of medical services. The basic factors and directions that would positively change the development of public health sector are briefly highlighted.

UNDP (2003). HIV/AIDS and the Roma in Central East Europe (draft), UNDP. Countries, territories and regions: Eastern Europe

UNDP (2003). Avoiding the Dependency Trap, UNDP. Countries, territories and regions: Eastern Europe, South Eastern Europe

UNDP, Ministry of Health, et al. (2000). National Action Plan for Prevention and Control of Acquired Immune Deficiency Syndrome and Sexually Transmitted Diseases 2001-2007 (BUL/98/005)(ENGLISH AND BULGARIAN). Sofia, Bulgaria, Ministry of Health,
UNDP,. Countries, territories and regions: Bulgaria

UNFCCC (2001). Vulnerability Assessment and adaptation options. Tirana, UNFCCC. Countries, territories and regions: Albania

UNFPA (2001). Sexual and reproductive health education - situation assessment. Sofia, Deita Agency Ltd, Bulgaria. Countries and Regions: Bulgaria

UNICEF (1999). Iodine Deficiency, Republic Srpska. Banja Luca, UNICEF. Countries, territories and regions: Bosnia and Herzegovina

UNICEF (1999). Women in Transition. Regional monitorin report No 6, UNICEF. Countries, territories and regions: Eastern Europe

UNICEF (1999). After the Fall - The Human Impact of ten years of transition. Florence, International Child development Centre. Countries, territories and regions: Eastern Europe

UNICEF (2000). The Situation of Children and Women in the Republic of Moldova 2000. Assessment and analysis., UNICEF. Countries, territories and regions: Moldova
The aim of this publication is to provide a complex assessment and analysis of the overall situation of children and women in the Republic of Moldova emphasizing the extremely difficult life circumstances and the jeopardizing of the basic human rights. Main trends and stipulations of the right to survival and development, education, special protection, participation, information and self-expression are described. Highlights of current legislative basis are presented within the chapters' content. Some general figures in numbers and percentages are given regarding the situation of women and children in Moldova. The conclusion addresses a number of key recurrent themes such as poor access, inadequate prevention, primary care and rehabilitation, lack of investment in quality, lack of information, insufficient alternatives to 'traditional' approaches, inadequate support and provision for early childhood care, the breakdown of care, education and protection systems, inadequate focu s of children and young people themselves. A list of references is provided at the end of the publication.

UNICEF (2000). Republika Srpska Multiple Indicator Cluster Survey 2000 (RS MICS 2000). Banja Luka, UNICEF. Countries and Regions: Bosnia and Herzegovina

UNICEF (2000). Recommendations for the Implementation of the UNICEF/WHO. Ministry of Health Project for the rehabilitation of the patronage System in the Republic of Macedonia (2000-2001). Skopje. Countries, territories and regions: Macedonia

UNICEF (2000). Baby Friendly Hospital Initiative Evaluation, Filomena Peitrantonio. Countries, territories and regions:

UNICEF (2000). Multiple Indicator Cluster Survey II, The Report for the Federal Republic of Yugoslavia. Belgrade, UNICEF. Countries, territories and regions: Serbia and Montenegro

UNICEF (2000). Multiple Indicator Cluster Survey. Republic of Moldova - 2000., UNICEF. Countries, territories and regions: Moldova
The 2000 Republic of Moldova Multiple Indicator Cluster Survey (MICS) is a nationally representative survey of households, women and children. The main objectives of the survey are to provide up-to-date information for assessing the situation of children and women in the Republic of Moldova at the end of the decade and to furnish data needed for monitoring progress toward goals established at the World Summit for Children and as a basis for future action. The results of the study are represented on topic sections such as education, water and sanitation, child malnutrition, child health, HIV/AIDS, reproductive health, and child rights. Special questionnaires were used for the survey. The sample for MICS was designed to provide various indicators at the national level and consists of two separate strata sampled data: Western and Eastern part of Moldova. An appendix with full technical details is enclosed to the report. The list of personnel involved in MICS in Moldova is availa ble.

UNICEF (2000). Young people in changing societies. The MONEE Project CEE/CIS/Baltics. Regional Monitoring Report No 7. Florence, UNICEF Innocenti Research Centre. Countries, territories and regions: Eastern Europe

UNICEF (2001). Economic Sanctions, Health and Welfare in the Federal Republic of Yugoslavia, 1999-2000. Countries, territories and regions: Serbia and Montenegro

UNICEF (2001). Poverty and Welfare Trends over the 1990s in FR Yugoslavia, Background paper prepared for the Regional Monitoring Report No 8: A Decade of Transition, UNICEF Innocenti Research Centre. Countries, territories and regions: Serbia and Montenegro

UNICEF (2001). Ten Years of Child Rights in Yugoslavia, 1990-2000. A Review. Belgrade, UNICEF. Countries, territories and regions: Serbia and Montenegro

UNICEF (2001). A Decade of Transition, Regional Monitoring Report No 8. Florence, UNICEF Innocenti Research Centre. Countries, territories and regions: Eastern Europe
This an end-of-decade report reviews the momentous changes in the 27 countries of Cen-tral and Eastern Europe and the Commonwealth of Independent States since 1989, focus-ing on the well-being of ordinary people and their children. As a record of the progress and setbacks of the 1990s and the lessons learned, this Report acts as a signpost for the way forward and will be useful tool for a decision-makers, economists, child rights cam-paigners and for children and young people wishing to make a difference. Based on a decade of authoritative research carried out by UNICEF's Innocenti Research Centre, the Report gives global picture of the transition process in the eight countries splintered into 27 experiencing a root and branch transformation of its social structure, its societies, in-frastructure and borders. Every one of them experienced some kind of economic crisis., while in many, tensions that had been simmering for years erupted into open conflict. The original goals of the transition were to raise the standard of living for everyone and to de-velop humane and democratic societies. In reality, the ultimate success of the transition will depend on improvements in social conditions and the promotion of human rights, as well as on economic strength. The human impact has been immense. Fundamental free-doms have been recognized in most countries. The Report is structured in five chapters, the statistical annex and glossary. 1. Changing Societies; Political Change and Develop-ment Perspectives, Social and economic Change during the Transition, Economic Re-forms and Individual Well-Being, Demographic Change and Family Formation; 2. In-come Inequalities and Child Poverty: Inequality in Household Incomes, Child Poverty, Public and Private Responses to Poverty; 3. Health: Outcomes and Policy: Disturbing Trends, Health over the Life Cycle, Growing Health Inequalities?, Challenges for Health Policy; 4. Education: Access and Opportunities: Changes in A ccess to Education, Equity in Access to Education, Costs, Financing and Governance, Outcomes; 5. Children de-prived of Family Upbringing: Child Vulnerability and State Intervention, Stability and Change in Institutional Care Patterns, Stability and Change in Foster Care, Guardianship and Adoption, Reasons for Public Care and Deprivation of Family Upbringing, Develop-ing a Strategy to Safeguard and Promote a Family Upbringing.
The Report have been produced with the participation of the central statistical offices in the countries of the region: Albania, Armenia, Azerbaijan, Belarus, Bosnia-Herzegovina, Bulgaria Croatia, Czech Republic, Estonia, Macedonia, Georgia, Hungary, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Poland, Romania, Russia, Slovakia, Slovenia, Tajikistan, Turkmenistan, Ukraine, Uzbekistan, Yugoslavia.

UNICEF (2001). Trends and indicators on child and family well-being in Bulgaria. Country paper. Background paper prepared for the regional monitoring report No. 8: A Decade of Transition. Florence, UNICEF Innocenti Research Centre. Countries, territories and regions: Bulgaria

UNICEF (2001). A Decade of Transition. Statistical Annex chapter. Florence, Innocenti Research Centre, Unicef. Countries, territories and regions: Eastern Europe

UNICEF (2001). TransMONEE 2001 database. Countries, territories and regions: Eastern Europe

UNICEF (2002). Household Survey of Women and Children Bosnia and Herzegovina 2000. Multiple Indicator Cluster Survey. Draft final report, UNICEF. Countries, territories and regions: Bosnia and Herzegovina

UNICEF (2002). A Brave New Generation, Youth in Federal Republic of Yugoslavia, Findings and Recommendations. Belgrade, UNICEF. Countries, territories and regions: Serbia and Montenegro

UNICEF (2002). Poverty and Welfare Trends in Moldova over the 1990s. Country paper. Background paper prepared for the Social Monitor (2002). Chisinau, UNICEF Innocenti Research Centre. Countries, territories and regions: Moldova

UNICEF (2002). CH Division Country Profile on Albania, UNICEF. Countries, territories and regions: Albania

UNICEF (2002). Consolidated Donor report for South Eastern Europe, UNICEF. Countries, territories and regions: South Eastern Europe

UNICEF (2002). Social Monitor 2002. Social Trends in Transition HIV/AIDS and Young People Quality of Learning in Schools. Florence, UNICEF Innocenti Research Centre. Countries, territories and regions: Eastern Europe

UNICEF (2003). MDG health indicators, FR Yugoslavia, UNICEF. Countries, territories and regions: Serbia and Montenegro

UNICEF (2003). MDG health indicators Romania, UNICEF. Countries, territories and regions: Romania

UNICEF (2003). MDG Health indicators Albania, UNICEF. Countries, territories and regions: Albania

UNICEF (2003). MDG health indicators Bulgaria, UNICEF. Countries, territories and regions: Bulgaria

UNICEF (2003). MDG health indicators Macedonia, UNICEF. Countries, territories and regions: Macedonia

UNICEF and Ministry of Health Macedonia (1999). Multiple Indicator cluster survey in FYR Macedonia with micronutrient component, National Institute of Nutrition. Countries, territories and regions: Macedonia
A survey to investigate the health and nutritional status of children and mothers in Mace-donia was carried out in September 1999.The survey was carried out on 1036 households and included 1765 children under 5 and 1749 women of fertile age (15-45). More than one third of the women were overweight, and mild and moderate anemia was observed in 12 % of the mothers. Low height-for -age was observed in 7% of the entire sample of the children with a higher proportion in the rural areas. Mild and moderate anemia was ob-served in 26% of the children (6-59 months). Half of the children studied had low values of ferritin with significant differences between urban and rural strata. In rural areas sever cases of iron deficiency were more common than in urban areas. There is however a widespread micronutrient problem, which although not severe, can be dealt with by die-tary modifications and improvements. Public health measures should be taken to ensure maintaince and surveillance of the immunization programme and to promote dietary rec-ommendations in adults: control body weight; promote fruit and vegetable consumption; promote the recommendation for complementary feeding: including meet, dairy products, fruit and vegetables from about sixth month.

UNICEF, UNOHCHT, et al. (2002). Trafficking in Human beings in Southeastern Europe. Current situation and responses to trafficking in human beings in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, The Federal Republic of Yugoslavia, The Former Yugoslav Republic of Macedonia,Moldova, Romania, UNICEF, UNOHCHT, OSCE-ODIHR. Countries, territories and regions: South Eastern Europe

UNICEF and World Bank (2001). Children in Bulgaria: growing impoverishment and unequal opportunities. Working paper No 84. Florence, UNICEF Innocenti Research Centre. Countries, territories and regions: Bulgaria

UNICEF Skopje Office, Republic of Macedonia, et al. (2000). Safe Motherhood Needs Assessment in the Republic of Macedonia, (in Eng-lish), Unit for Health Services Research and Interna-tional Cooperation, WHO Collaborating Center for Maternal and Child Health, Trieste, Italy. Countries, territories and regions: Macedonia
This document constitutes the report of the assessment of the current provision of mater-nal and neonatal health care that was carried out between September and November 2000 using the WHO Safe Motherhood Needs Assessment manual. The objectives of the as-sessment were to describe the availability, use and quality of antenatal, delivery and postpartum care provided to women and newborn babies at all levels within the health care system, and to identify gaps in the provision of this care. To achieve these objec-tives, seven forms from the WHO manual were filled in during visits carried out by nine surveyors to 10 hospitals, 14 health centers, and 11 health posts in 9 districts. The sur-veyed facilities assist a catchments population of about 1,740,000 people, about 85% of the total population in Macedonia. Findings: Services for pregnancy and childbirth are sufficient and cover most of the population. Economic accessibility does not seem to be a problem at the moment. Health pr ofessionals are present in adequate numbers and with sufficient qualification, while some responsibilities could be assigned to midwives. Also, the distribution of tasks between different levels of care could be improved through a process of progressive regionalizations. Health professionals address all aspects of obstet-ric and neonatal care. The quality of neonatal care is good and is improving. Poor care, however, has been observed in antenatal care and, even more, during labour and delivery. Unnecessary ultrasound scans are performed at almost each visit, with the consequent financial burden for health services. Care during labour and delivery should be recon-ducted to a human approach and should imply only evidence-based interventions. Post-partum care does not present particular problems, except for some lack of compliance with planned visits by the mothers. Guidelines and training on evidence-based antenatal care and care for labour and delivery seem to be the most im portant recommendations to be drawn from this assessment, and the priority for action.

UNICEF/WHO, Ministry of Health, et al. (?). Project on Prevention and Treatment of Drug Abuse in R Macedonia, UNICEF/WHO,
Ministry of Health,
Ministry of Labor and Social Affair. Countries, territories and regions: Macedonia

United Nations (2000). Republic of Moldova Common Country Assessment (draft), United Nations. Countries, territories and regions: Moldova
This is a draft of the Common Country Assessment (CCA) document prepared by the United Nations Country Team in accordance with the UN Secretary -General's reform program (aiming to prepare the United Nations for the challenges of the 21st century) and on the basis of ideas and reports of different UN Agencies in Moldova (UNDP, UNICEF, UNHCR, UNESCO, WHO, FAO and ILO), as well as on the papers and statistical data of various governmental departments, NGOs, research institutes and other organizations. The key issues of human development in the country, CAA-Moldova's methodology and problems have been discussed during the UN inter-agency Heads' meetings on March 24 and June 2, 2000. The CAA-Moldova focuses on main problems and domains for particular international cooperation, addressing the areas of governance, human rights, health care, education, gender equality, poverty eradication, environmental sustainability, regional disparities, etc. The level of national development (fo r 2000) is described in a holistic and analytical summary. Trends in the improvement of deterioration of the relevant indicators are identified. Priority areas for joint assistance from United Nation system are proposed. Recommendations are given on improving the CCA process and its outputs and on creation of a common database of key-indicators. A list of figures and tables and a bibliography are given at the end of the report. Note that this is a draft document and the final version may contain modifications in the content, being more accurate.

United Nations (2002). National Strategy for Poverty reduction in the Republic of Macedonia, - sup-portive materials ( Characteristics of the poverty, Poverty and access to ser-vices;Qualitative analysis of Poverty in RM, Rural and urban poverty) Web: www.forum.com.mk/forum/csid/csid.htm Conference for poverty reduction strategy in Rm, December 2002, United Nations. Countries, territories and regions: Macedonia
The main characteristics of the urban and rural poverty in RM have been presented by the local expert groups as well by the UN Country Team. In the cities the poor people have been caught in the "poverty circle" (slum poverty). They have been mostly recruited from the poorly paid workers, unemployed and pensioners, families with more children. They are mostly located in the suburb areas. The first group of indicators concerns housing and village conditions and second group the situation of the families, unemployment, health including the nutritional status and education. Poverty is broadly spread with about 40% of the population in RM who live in rural areas. The main elements of rural poverty are unresolved basic infrastructure needs of the rural areas-roads, bus lines, sufficient and top quality drinking water, poor sewage system and supply of goods, insufficient access to health care services and education institutions, low and insecure incomes from the agri-cul tural production, insufficient access for the private farmers to the market. In the third package of documents the Qualitative Approach of the analysis of the poverty in the country have been presented. The main criteria applied were : quality of the living condi-tions; ethnic origin; size of the households; beneficiary of social assistance.

USAID (2002). PHNIP Country Health Statistical Report. Bulgaria. Population, Health and Nutrition Information Project (www.health-bg.org). Washington , USA, USAID. Countries, territories and regions: Bulgaria

USAID (?). Bulgarian Health Reform Project, USAID. Countries, territories and regions: Bulgaria

USAID, UNFPA, et al. (1996). "Young Adult Reproductive Health survey- Romania."
Countries, territories and regions: Romania
To assess the impact of new programs and provide planning data for upcoming women's reproductive health projects and information, education, and communication campaigns, the United States Agency For International Development (USAID) and other international donors sponsored two additional national reproductive health surveys in Romania: a Young Adult Reproductive Health Survey conducted in 1996 (96YARHS) and the 1999 Romanian Reproductive Health Survey (99RRHS); both are similar to the 93RRHS in design and content, but they also include a sample of men.

USAID, UNFPA, et al. (1999). Reproductive Health Survey - Romania, USAID,
UNFPA, UNICEF, RPHHMA, NIRDH University of Medicine and Pharmacy,. Countries, territories and regions: Romania
All of these surveys (93, 96 and 99) were specifically designed to meet the following objectives: to assess the current situation in Romania concerning fertility, abortion, contraception and various other reproductive health issues; to enable policy makers, program managers, and researchers to evaluate and improve existing programs and to develop new strategies (a good example is use of 96YARHS data to provide data needed to develop sex education and health promotion programs); to measure changes in fertility and contraceptive prevalence rates and study factors that affect these changes, such as geographic and socio-demographic factors, breast-feeding patterns, use of induced abortion, and availability of family planning services; to measure the impact of public and private sector services over the past 6 years; to obtain data about knowledge, attitudes, and behavior of young adults 15-24 years of age; to provide data on the level of knowledge about transmission and preventio n of AIDS; and to identify high-risk groups and focus additional reproductive health studies toward them.
In addition, the 99RRHS provides judet (county) specific information for three USAID priority judets, Cluj, Constanta, and Iasi, which were oversampled to provide baseline data for project activities in these areas. In all three surveys, the questionnaire covered a broad array of reproductive health topics, including a pregnancy history, abortion, childbearing, contraceptive use, maternal and child health, health behaviors and attitudes. These surveys had a similar design and methodology; however, in 1996 and 1999, the surveys employed two separate probability samples to allow independent estimates for males and females. Trained interviewers conducted the interviews in a face-to-face manner at the homes of randomly selected respondents; households were selected by a multi-stage cluster design using Census enumeration districts as the sampling frame. In all three instances response rates among women were high: 92% in 1993, 93% in 1996, and 90% in 1999. The response rate was slightly lower for male respondents (87%).

Vakeflliu, Y., D. DArgjiri, et al. (2002). "Tobacco smoking habits, beliefs, and attitudes among medical students in Tirana, Albania." Preventive Medicine 34: 370-373.
Countries, territories and regions: Albania
BACKGROUND: Many surveys throughout the world have evaluated the smoking behaviors, beliefs, and attitudes of medical students, but no information is available from Albania. METHOD: A cross-sectional survey in classroom settings using a self-administered questionnaire was performed at the University of Tirana during October 2000. RESULTS: In the first and fifth years of medical school, 149 (68.5% women) and 185 (55% women) students, respectively, completed the questionnaire, with overall response rates of 82 and 92%. Tobacco smoking prevailed among males. The smoking rates among first-year medical students were 34% among men and 5% among women. Among fifth-year students, 55% of the men and 34% of the women smoked. The percentages of occasional smokers were 29 and 49%, respectively, among the first- and fifth-year students who smoked. Most medical students reported knowing the health hazards of tobacco. Most students in both groups believed that smoking should be restricted in hospitals. Slightly more than half of the students stated that they will regularly advise smokers against smoking in their future jobs. CONCLUSION: Tobacco smoking is common among medical students in Albania. Targeted antismoking training should be mandatory for medical students in Albania. (C)2002 American Health Foundation and Elsevier Science (USA).

Van der Stoel, M. (2000). Report on the situation of Roma and Sinti in the OSCE Area. The Hague, Organisation for Security and Co-operation in Europe, High Commissioner on National Minorities.
Countries, territories and regions: Europe

Vanier, V. K., M. J. VanRooyen, et al. (2001). "Post-war Kosovo: Part 1. Assessment of prehospital emergency services." Prehospital Disaster Med 16(4): 263-7.
Countries, territories and regions: Kosovo, Serbia and Montenegro
The United Nations Mission in Kosovo (UNMIK) designated that the World Health Organization (WHO) develop health policy to assist in the recovery and rehabilitation of the post-war health system of Kosovo. As a critical part of the pre-policy evaluation, an assessment of current prehospital medical services was performed. This assessment identified a basic healthcare infrastructure upon which additional prehospital capabilities can be built, especially in communications, staffing, equipment, and transport services. To serve Kosovo properly in the future, it is recommended that capacity building must include the parallel development of emergency departments and specialty-trained physicians.

Varga, C. (2000). "Comments on "The worst of both worlds: poverty and politics in the Balkans"." Environ Health Perspect 100(1): a14.
Countries, territories and regions: South Eastern Europe

Vasileva, Y. and Y. Borissova (2000). "Morbidity and mortality by malignant neoplasm of female genital organs in Bulgaria for the period 1989-1998." Social Medicine Journal 3: 15-17.
Countries, territories and regions: Bulgaria
The purpose of this work is to analyze the status and tendencies in morbidity and mortality by malignant neoplasm of female genital organs in recent 10 years in Bulgaria. There are estimated the temps of morbidity and mortality by diagnoses. It is made a comparative analysis about morbidity and mortality among separate Bulgarian regions in the last year of the observed period. As the basis information are used routine statistical data of registered cases of malignant neoplasm and mortality by causes, developed in NSI and NCHI.

Vassilev, M. (2000). "The use of psychoactive substances among young people in Sofia (results from a representative study)." Social Medicine Journal 1: 19-22.
Countries, territories and regions: Bulgaria
Some methodical details as well as main results from the first complex and representative study on psychoactive substances use among young people in Sofia are presented. Concerning results the attention is pointed on three basic topics: information about substances, risk factors, use (prevalence and characteristics).

Velik-Stefanovska, V. (2000). Former Yugoslav Republic of Macedonia An Overview of the HIV/AIDS Situation, UNICEF. Countries, territories and regions: Macedonia
The UNICEF RAR in Macedonia focused on young people in institutional care; inject drug users and male homosexuals. The first HIV positive case was registered in 1987, and the first AIDS case in 1989. As of 31 December 2001, the total number of officially registered cases of HIV/AIDS was 59, 41 AIDS and 18 HIV positive. 37 have already died. Currently, there are officially reported to be six people with AIDS in Macedonia and 16 people living with HIV. Three of these are cases of vertical transmission. Eight (13.5%) cases have been identified as inject drug users (IDUs) with average age of 19-29 years. The dominant mode of transmission is through heterosexual contact (59.3%) and homosexual 11.9%. The present male: female ratio of HIV/AIDS infection in the country is almost 2.1:1 compared with a ratio of 1.02:1 several years ago. Dominant age group is 30-39 and 20-29 years. Since the beginning of 2001, five new cases of HIV/AIDS have been registered (three AIDS cases and two HIV cases). HIV testing is available at four state virological laboratories in the country: the Clinic for Infectious Diseases (CID); the Institute of Clinical Biochemistry; the Republic Institute for Health Protection; the Insti-tute for Transfusion, and few private laboratories. Free testing is available with a doctor's referral or for people who have been in a high-risk situation. There is no mandatory HIV testing for pregnant women and there is little or no activity for prevention in this area. Prisoners are tested for HIV only when they are hospitalised for other health problems. The HIV test is not mandatory for Military School and Academy applicants. The testing of donated blood has been mandatory since 1987. Treatment for opportunistic infections is available through the AIDS Clinic at the Infectious Diseases (CID) in Skopje. There is no experience relating to the use of anti-retroviral therapy in Macedonia. The therapy (mono, double or triple) was available only for a very short period at the CID and only a few patients began treatment. Most patients receive only monotherapy. Government ser-vices offer no pre-test counselling. Several local NGOs operate telephone help-lines. Vul-nerable groups are: inject drug users (30% of IDUs who tested positive for Hepatitis C were HIV-positive); commercial sex workers/ trafficked persons, male homosexuals; peacekeepers/humanitarian personnel; mobile populations (refugees, internally displaced persons and international personnel) and young people aged 15 to 24 years are facing par-ticular risks during this period of political and social transition. HIV/AIDS prevention and treatment is mainly the responsibility of the MoH (in 1985 set up a National AIDS Commission). The Government signed "The Declaration of Commitment on HIV/AIDS" adopted in New York at the UN Special Session on HIV/AIDS in June 2001. The UN Theme Group (UNTG) on HIV/AIDS began its activities in Macedonia in November 1999. T he group is composed of UNDP, UNICEF, UNHCR, IOM, the World Bank and WHO and local NGOs HOPS, MIA, MMSA, HERA and TRUST.

Velkova, A. (2002). "The General Practitioner and the Geriatric assessment." Social Medicine Journal 4: 16-17.
Countries, territories and regions: Bulgaria
A survey has been conducted among 160 GPs in Pleven district. The purpose was to find out their level of knowledge about the meaning and importance of geriatric assessment and to identify their self-assessment of theoretical and practical training received in the field of geriatric medicine. The geriatric assessment includes the traditional anamnesis, physical status, functional status, mental and social functioning and Quality of life. The questionnaire consisted of 30 questions concerning socio-demographic and professional characteristics of the GP, the level of knowledge on the term 'geriatric assessment', self-assesment of their own theoretical and practical skills in the different fields of geriatric care, etc. The outcomes revealed that only 28.8% of the GPs were well-grounded in the meaning of geriatric assessment, 55% said they knew it partially and 16.2% did not know anything about it. The mean GPs' self-assessment in their theoretical knowledge in geriatry was 6.98 + 0.24 (scale based on 10 has been used). The results concerning the respondents' practical skills received higher self-assessment on the average - 7.37 + 0.20. The main conclusion was that more than half of the inquired GPs were not well-acquainted with the geriatric assessment most probably because of lack of a systematic course of education in geriatry.

Via vita (2002). HIV/AIDS prevention among drug users with sexual risk behaviour. Report on Macedonia. Bitola, FOSIM
HOPS. Countries, territories and regions: Macedonia
Target population: Drug users especially intravenous drug users in Bitola (the NGO works with 42 IDUs, while the estimation is that there are 200-300). Man activities: dis-tribution of needles, syringes, condoms, educational materials, health promotion, counsel-ing, health services, social services and social reintegration. In May 2002 Via-Vita in col-laboration with HOPS conducted a survey with employees of three state institutions: Cen-ter for Social care Bitola, Medical Center Bitola and Bitola Secretariat of the Ministry of Interior. The results show that a consensus has been achieved for the need of intersectoral cooperation and coordination on this very important public health problem. This NGO is established and financially supported by Open Society Institute.

Vitale, K., R. Marijanovic, et al. (2002). "Waters in Croatia between Practice and Needs: Public Health Challenge." Croat Med J 43(4): 485-92.
Countries, territories and regions: Croatia

Vladescu, C. (2003). Health in the Balkans. Romania report. Draft. Countries, territories and regions: Romania

Vladescu, C. and S. Radulescu (2001). Primary Health Services Output-Based Contracting to Lift Performance in Romania. Sept 2001.Network No 239, The Work Bank Group Private Sector and Infrastructure. Countries, territories and regions: Romania
In this articles the authors made a short presentation of the Romanian experience with the scheme of output-based contracts at the primary health care sector. In the paper are underline the importance of the pilot scheme of output-based contracts for developing the independent provision of primary health services, increasing the share of health spending going to preventive care, and improving access to health services, especially in rural areas. On the base of their analysis of pilot scheme the autos underline the following: by combining per capita payments with limited fee-for-service and other incentives, the output based contract developed in Romania seeks to encourage responsiveness to patients and key public health outcomes such as immunization and expanded access to health care-while still avoiding the problems of unconstrained fee-for service remuneration seen in some OECD countries; the purchasing authorities operating in Romania's weak regulatory environment, with in sufficient capacity and experience, have faced serious difficulties in monitoring both the number and the quality of services reported; the changes have not yet significantly reduced the use of hospital services or redistributed providers to improve access to health services in rural areas; the system may need to establish more credibility before it can persuade patients to change their behavior and doctors to move to undeserved areas.

Vladescu, C., S. Radulescu, et al. (2000). Health Care Systems in Transition: Romania. Copenhagen, European Observatory on Health Care Systems.
Countries, territories and regions: Romania

Vlahusic, A. (2002). Why Cardiovascular Diseases prevention and treatment are our Top-Priority?, Ministry of Health, Croatia. Countries, territories and regions: Croatia

Vulic, S. and J. Healy (1999). Health Care Systems in Transition: Croatia. Copenhagen, European Observatory on Health Care Systems.
Countries, territories and regions: Croatia

Westermeyer, J. (2000). "Health of Albanians and Serbians following the war in Kosovo: studying the survivors of both sides of armed conflict." JAMA 284(5): 569-84.
Countries, territories and regions: Kosovo, Serbia and Montenegro

WHO EUROHIS programme for chronic diseases- Report of testing in Republic of Macedonia- Institute of Epidemiology, Biostatistic with Medical Informatics, Medical Fac-ulty - University "St. Kiril and Metodij". Skopje-. Countries, territories and regions: Macedonia
The field-test Questionnaire consisted seven indicators : background variables, quality of life ( especially nutrition habits), alcohol consumption, physical activity, use of medicines( drug use habits) and health services, eventual chronic diseases (like asthma, cardio vascular diseases, can-cer etc. except mental health) and preventive measures ( control of blood presure,level of cho-lesterol in the serum, screening of breast and cervix cancer among women etc.). The survey cov-ered 600 persons from different age groups and different parts of the country. The method of face to face interview has been applied. The experience from this survey was that this kind of tests (HIS) has a significant capability for the information system and it provides a complete, various comprehensive and built in information about the health, health-related habits, medicine consumptions and personal and family characteristics, everything which appeared as a shortage in the current epidemiologica l investigations in the country.

WHO (1999). Hospital Restructuring in Moldova. Mission Report. Copenhagen, WHO. Countries, territories and regions: Moldova
On a special request form the Ministry of Health on Moldova, a WHO mission team of tree international experts has visited Moldova on March 20-27, 1999. The focus of the mission was on hospital restructuring in Chisinau, the capital city. The current document presents general information on current situation in Moldova acquired during the WHO mission visit through a variety of methods (interviews, direct observations, site visits, etc.).An extensive over-capacity in the hospital system with an increased number of physicians and the authorities' general awareness on the need to develop a strong primary care system are emphasized as most important problems of the health care services sector in Moldova. The document basically comprises the main issues for consideration identified by the mission team with specific recommendation related to each of these issues. Statistical data used in the report were retrieved from the country authorities, WHO country liaison office and WHO Regio nal Office for Europe. Line and bar charts are used as main graphical presentations for comparison. The report concludes with a general vision for future health care system in Moldova.

WHO (1999). Project title: Support Health Activities in Albania, the Former Yugoslav Republic of Macedonia and the Federal Republic of Yugoslavia (Montenegro), WHO. Countries, territories and regions: Albania, Macedonia, Serbia and Montenegro

WHO (1999). Final Technical report to the Government of Italy - Multi-sectoral emergency assistance to the victims of conflict in the Balkan region, WHO. Countries, territories and regions: South Eastern Europe

WHO (2000). Highlights on Health in Croatia. Copenhagen, WHO. Countries, territories and regions: Croatia

WHO (2000). World Health Report. Countries, territories and regions: Worldwide

WHO (2001). Highlights on Health in the Republic of Moldova. Copenhagen, WHO. Countries, territories and regions: Moldova
Highlights on Health in Moldova give an overview of population's health and health related situation in Moldova and compare its position in relation with other countries in WHO European Region. The Highlights do not constitute a formal statistical publication. As a rule, data have been taken from one common international source ("Health for All" - HFA, WHO Regional Office for Europe, issue June 2000); nevertheless, the comparability of data may be limited owing to differences in national definitions, registration systems, etc. Specific data from national sources are cited. Two main types of graphical presentation are used to illustrate comparisons between Countries and Regions: line charts and bar charts. The mortality data are used as main component of international comparisons; the charts are based on mortality rates standardized for the European standard population structure. The majority of indicators have been calculated at WHO Regional office for Europe, using a uniform m ethodology and software. For that reason, the values of some indicators in the HFA database may differ somewhat from national assessments based on other methods. A list of references and a glossary are given at the end of Highlights.

WHO (2001). "World Health Report 2001 (www.who.int/whr/2000/en/report.htm)."
Countries, territories and regions: Worldwide

WHO (2001). Workshop on enforcement of Environmental health legislation challenges for the public health sectors in Accession. Held in Prague 12-14 November. Republic of Macedonia Country Profile, WHO. Countries, territories and regions: Macedonia
One of the main priorities emphasized in the Temporary Agreement for Association between EU and Republic of Macedonia is the approximation of the legislation Those activities are part of the General Program for Approximation of the National Legislation with the EU Legislation, leaded by the Sector for EU Integration on the level of the Government and different sub-committees on the intersectorial basis.MoH experts are members of the join sub-committees in different fields ( mostly MoH and Public Health Institute's representatives). The paper presents the EU directives where Ministry of Health is the main responsiblesector (pharmaceuticals and food quality) and directives where MoH is participating ( drinking water, air quality, Environmental impact as-sessment, waste, occupational health). The paper as well presents the structure and scope of re-sponsibilities of the health inspectorates and public health institutes involved in the process of legislation enforcement.

WHO (2001). Mental Health in Europe. Country report from the WHO European Network on Mental Health, who. Countries, territories and regions: Europe

WHO (2002). Prefecture Public Health Laboratory Needs Assessment in Albania. TiranA, WHO. Countries, territories and regions: Albania

WHO (2002). Epidemiological Surveillance of Malaria in Countries of Central and Eastern Europe and Selected newly independent states. Sofia, WHO. Countries, territories and regions: Eastern Europe

WHO (2003). Croatian Healthy Cities Network, http://www.euro.who.int/ healthy-cities/CitiesAndNetworks/20011002_4. Countries, territories and regions: Croatia

WHO (2003). Environmental health policy, http://www.euro.who.int/eprise/main/WHO/pROGS/HEP/Home. Countries, territories and regions: Worldwide

WHO and European Commission (1999). Highlights on Health in Romania, WHO,
European Commission. Countries, territories and regions: Romania

WHO and European Commission (2001). Highlights on Health in Bulgaria, WHO
European Commission,. Countries, territories and regions: Bulgaria

WHO and HSBC (2002). Health Behavior in School Aged Children: Study in Macedonia (Conducted 1998 published 2002, new edition on new samples of school children is in process, WHO: HSBC. Countries, territories and regions: Macedonia
Aims to examine the attitudes of school-aged children regarding different aspects of health, and demonstrating health-related attitudes and behavior of young people. The special questionnaire, managed by trained interviewers was applied on a national sample of 1604 students divided into three age groups of 11,13 and 15 years old, with a proportionate number of ethnic Macedonians and ethnic Albanians. The research was carried out 1998(April-May) in the primary and secon-dary schools in Macedonia. The results of the study shows that the number of adolescents in Ma-cedonia who have tried tobacco/alcohol, who smoke or have got drunk, increases with their age. In addition, the higher the age, the lower the differences between sexes in this regard. The great-est differences have been noted between the ethnic groups-compared to young Macedonians, there are more young ethnic Albanians who experiment and smoke tobacco, and unlike them, young Macedonians experiment more with alcohol a nd get drunk.. In comparison with other countries, Macedonia has a lower percentage of young people who smoke and who have got drunk.

WHO and R. o. Macedonia (2002). National Program for prevention and control of chronic diseases in Republic of Macedonia: Draft Plan of actions (2002-2007), WHO,
Republic of Macedonia. Countries, territories and regions: Macedonia
The current organizational and human resources infrastructure especially in the Primary Health Care System in the country have been presented in the introduction part. Global aim: strategic document and action with intersectoral involvement. Main priorities: decrease of the Mb and Mt of cardio-vascular diseases and especially coronary disease, to decrease the cancer Mt especially wemen brest cancer , proper program for improvement monitoring and control of the lifestyle risk factors. A list of dietetic programs and physical activities have been presented. There is an imperative for establishemnt of a National Information Center for coordination of the intersecto-rial activities, as well as National Register of risk factors monitorng .

WHO and Ministry of Health (2001). Report on the National workshop on NEHAP and LEHAP implementation strategy in Republic of Macedonia. Skopje, WHO
Ministry of Health,. Countries, territories and regions: Macedonia
The Document presents the conclusion of a workshop held in Skopje with a participation of sev-eral government sectors representatives ( health, environment protection and urban planning, transport and communication, education and science), local governments and several research institutions and NGOs. The main topics of discussions were : redesign of the list of priority EH projects; the improvement of the relation between NEHAP and LEHAP; assessment of the EH risks with multisector approach and directions and dynamics of the future development of the Environmental Health Care services. It was emphasized that in the process of preparation of lo-cal environmental health plans (LEHAP) there should be an entire integration within the existing concept of drafting of LEAPs, activity leaded by the local governments and Ministry of Envi-ronment and urban planning.

WHO and Ministry of Health (2001). NEHAP Implementation in Republic of Macedonia: Environmental Health Risk Strategy paper, WHO
Ministry of Health. Countries, territories and regions: Macedonia
NEHAP Implementation in Republic of Macedonia : Environmental - Health Risk Strategy Ministry of Health Policy Document(2001)

The purpose of this document is to provide an overview of the basic principles and methods of environmental health risk management in the Republic of Macedonia. The Strategy discusses frameworks, approaches, and examples that illustrate the decision-makers, and public health practitioners (broadly defined) within the environmental health sector who are involved in an environmental health risk management issue, policy, or decision. It is intended to provide a broad overview of concepts at a level of detail appropriate to convey a basic understanding of the components of an environmental health decision. The main EH "hot spots" in the country have been presented. In the new risk assessment strategy the main emphasize will be put on :Strengthening of the cooperation between MH and MEnv with regard to issues related to the policy on environmental health management, including information exchange.Elaboration of municipal action plans regarding environmental health in acc ordance with the basic principles contained in the NEHAP, with an accent on preventive aspects and indication of required finan-cial resources and their sources. Monitoring, analysis and evaluation of the NEHAP implementa-tion by Intersectional Environmental Health Board. Provision of continuous contact and informa-tion exchange between the Inter-Sectional Council and the public.

WHO, Ministry of Health, et al. (2002). Action plan for food and nutrition in the Republic of Macedonia, WHO,
MINistry of Health,
Republic Institute for Health Protection,. Countries, territories and regions: Macedonia
The aims of the Plan have been defined as : Improvement of the quality of life; improvement of the level of the knowledge for the importance and possible consequences of bad nutrition; im-provements in the food production and improvements in the environmental protection. Six main sectors of the Plan are : Food production ( private , small and public bigger food producers linked with the professional institutions from the veterinarian, health and agricultural areas. Food Safety ( international food control standards and procedures) Nutrition ( at home, in the school, kindergarten and working place); Health Care System; Environmental Protection and Education including promotion. The current level of food quality as well as specific health and nutritional status of the different population groups in the country have been also presented. There is a proc-ess of establishing a new Food legislation as well as new institutional infrastructure with Food agencies and inspectorates as well new structure of laboratory control.

WHO, Ministry of Health, et al. (2002). Flood in Lezha, Shkodra, Berat, Skrapar, Gjirokastra - Rapid Health Assessment , October, WHO,
Ministry of Health,
UNICEF,. Countries, territories and regions: Albania

WHO and Ministry of Health macedonia (1999). NEHAP Implementation in Republic of Macedonia : Project proposal for investments in the scope of NEHAP implementation process in the Republic of Macedonia, Policy document, Ministry of Health. Countries, territories and regions: Macedonia
The list of project proposals have been classified in two groups : General projects addressed to the improvement in the institutionalization of the EH services including the occupational health care services, Human resources development, changes in the Legislation, Public Participation Campaign and establishing of a new EH Information system. The responsible institutions in this part are the two ministries : for Health and for Environment and urban planning. Second, larger group pf projects have been addressed to specific EH topics in the country such are : Local Envi-ronmental Health Action Plans (LEHAP) with emphasize on the problem of Veles city; projects linked to the problem of drinking water quality as well as waste water treatment; air quality, food quality. There is a concern for insignificant interest of donor agencies.

WHO and Republic of Macedonia (2002). Health, Environment and safety management in Enterprises (HESME) Strategic Framework, WHO,
Republic of Macedonia,. Countries, territories and regions: Macedonia
The document is prepared in the scope of the WHO HESME initiative. The main topics and pri-orities in this field in the country: Improvement of the health status of the working population and professional profile (trainings) of the workers, decrease of the costs for health protection of the workers and early retirements, proper and efficient organizational structure of Occupational health care services in the country , improvement of the legislation. The proposed future organi-zation of the Occupational Health care services on three different levels have been presented, with the main emphasize on the primary level with high prevention and promotion activity. There is also an imperative for improved information system in this field. The proposed source for financing are the Health Insurance Fund, specific preventive programs as well as the funds created in the Law fro local government.

WHO, Republic of Macedonia, et al. (1997). National Committee for Iodine deficiency: National Program of Improvement of the Iodine deficiency in Republic of Macedonia. Skopje, WHO
Republic of Macedonia,
UNICEF. Countries, territories and regions: Macedonia
The latest investigations in RM, shows the prevalence of around 18 % of endemic goitre among 11.500 investigated school age children. In some of the regions (Eastern part) the percentage is close to 30% of the examined children. In the last years, every year a new 1000 cases have been registered, what is a sign for inefficient program of iodization. The committee defined the main clinical criteria for early detection : the size of the gland, the level of iodine in the urine, TSH level among neonates and the level of tyreoglobulin in the sera. The main recommendations in the program are : the improvement of the regulations, monitoring and control of the process of iodization of the salt, the import and the trade including the storage and the market, education, information health promotion, regular evaluation of the progress made

WHO and UNICEF (2002). Review of National Immunization Coverage 1980-2001, WHO
UNICEF. Countries, territories and regions:
The review presents a description of immunization coverage levels (in %) estimated based on reported data to WHO and UNICEF. The survey was conducted in the population of 12-23 month olds, vaccinated any time before survey. Data of the survey were collected from cards of history, shifted 1 year to match with birth cohort and are presented in line charts for comparison by years from 1980 to 2001. The survey includes data of BCG, DTP3, Pol3, Measles, HepB3 immunization. The general figures of the multiple indicator cluster survey conducted in 2000 are also included. Data on immunization coverage for HepB3 are presented only from 1995 to 2001.

WHO European Office for Integrated Health Care Services (2003). Health Promoting Hospitals. Working for Health. (www.es.euro.who.int/). Barcelona, WHO. Countries, territories and regions: Europe

WHO Humanitarian Office (2001). Draft Action Plan for Mental Health. Skopje, in a process of acceptance in the MoH, WHO. Countries, territories and regions: Macedonia
As main aims of the National Policy in the Mental Health are : improvement of the mental health in the whole community, prevention of the mental harm effects; decreasing of the influ-ence of the mental harm effects on the individuals, families and the community; the guarantee of the human rights of the mental ill patients, improvement of the efficiency and accessibility of the special services. The final aim is to improve the value of the mental health on political and health level among the governmental and non-governmental institutions; improvement of the legisla-tion; transferring the treatment accent from the central and special institutions to community ori-ented services as a part of the global action for the improvement of the quality of the mental health care services. The Document presents the current situation in the field of the mental health in the country; the principles of the National Policy; the Aims; the Financing of the Program; the Strategy for improvement of the efficiency of the services; Education and training; Action Plan for the period 2001-2011.

WHO Regional Office for Europe (1999). Emergency Preparedness and Response: Multi-sectoral assistance to the victims of conflict in the Balkan region (1999), WHO. Countries, territories and regions: Macedonia, Serbia and Montenegro
The project objective was to ensure adequate WHO field presence in the mentioned coun-tries in order to strengthen the service delivery capacity of the primary health care sys-tems, referral hospitals and drug distribution top the victims of the conflict in Serbia proper, Montenegro and FYR Macedonia as well for coordination and management. The project was donated by the Italian government and contributed for fully operation of the WHO humanitarian offices in the countries. WHO's coordination of the still massive presence of humanitarian health agencies in the area had considerable positive impact in optimizing the use of the available resources and avoiding duplication of interventions? WHO provided continuous support for appropriate production and dissemination of in-formation on the health status, health problems and available resources for health? As a result of this involvement, WHO has been in a position to guide the transition from hu-manitarian health programmes to su stainable and cost-effective development activities? Among others, in FYR Macedonia a special attention was put on the process of de-institutionalization and social inclusion of children with learning disabilities and Preven-tion and treatment of drug abuse.

WHO Regional Office for Europe (2001). Emergency Preparedness and Response: Suport Health activities in Albania, FYROM and FR Yugoslavia (2000-2001), WHO. Countries, territories and regions: Albania, Macedonia, Serbia and Montenegro

WHO/Europe (2003). "HFA Database, January 2003."
Countries, territories and regions: Europe

WIIW Balkan Observatory (2003). Macroeconomic developments in the southeastern European countries, http://www.wiiw.ac.at/balkan/data.html. Countries, territories and regions: South Eastern Europe

Wong, E. (2002). Rapid Assessment and Response on HIV/AIDS among Especially Vulnerable Young People in South Eastern Europe, UNICEF. Countries, territories and regions: South Eastern Europe
RAR is a research methodology designed to rapidly assess a current vulnerable situation in a community. The goals of this RAR was to collect data for types of risk behavior of vulnerable young people (aged 10-24 years) as a basis for developing and implementing appropriate interventions for HIF prevention and to build capacity of local research teams for future RARs implementation. 26 cities from Macedonia; Albania; Bosnia and Herze-govina; Croatia and Yugoslavia participated in RAR from October 2001 to February 2002. 26 Field Teams received training in the RAR research methodology, and conducted fieldwork, data collection and data analysis. Various vulnerable groups were selected as target groups: youth in school, young drug users, and young inject drug users; sex work-ers, young male homosexulas. Additional target groups selected by some cities were: mobile population; sailors; juvenile delinquents; young people deprived of parental care; out-of-school youth or Roma youth. Instrument. 13 different questionnaires were used in this Project with a set of 18 core questions included in each of them. Sample. The tech-nique of snowball or network sampling was used to recruit participants in the survey. Over 5,100 questionnaires were completed and 2,200 young people participated in either interviews or focus groups. Methodology. Through questionnaires, interviews, focus groups, existing information, observations and mapping, data were collected and ana-lyzed. The findings and recommendations presented in this report were prepared at re-gional and country levels according to target groups. A separate country summary was prepared from each country's RAR report. Findings: Regional summary of key findings: easily accessible.drugs; alcohol, cannabis, ecstasy and pharmaceutical drugs were the most frequently used by the different target groups; over 90% of injecting drug users (IDU) had sex under influence of drugs yet only 14% used condoms regularly while over 60% shared needles and syringes; accessibility to and quality of the provided harm reduc-tion services needed to be addressed; 21% of the young groups who did not use drugs (n=2,594), stated that they had sex (n=546), while 55% of them always used condoms during sex; 10% of the young male homosexuals who had sex (n=233), had one sexual partner in the past year and 54% always used condoms; HIV testing was stated as free, anonymous and accessible; HIV/AIDS, drug and sex education in the school curricula was either non-existent on inadequate. Conclusion: The regional findings revealed that young people are engaging in risk behaviors that put them at risk of HIV. Based on the above findings and on the recommendations outlined in the various country RAR reports, recommendations at the regional level were prepared and grouped under the following subject headings: Policy and Legislation; Harm Reduction Services; HIV Testing; Con-doms; Young people; Sex Workers and Young MSM; S urveillance and Research.

Woodside, D., J. Santa Barbara, et al. (1999). "Psychological trauma and social healing in Croatia." Med Confl Surviv 15(4): 355-67.
Countries, territories and regions: Croatia

World Bank (1998). Building Relationships, Restoring resources: Presenting Romania's health Insurance Law to the Public
(Report of the World Bank Romania Health Care Team, June 1998, available in English), World Bank,. Countries, territories and regions: Romania
This report presents the findings of attitude research conducted to assist in planning a public information campaign for Romania's new health insurance law.
It has three parts: Part I The Background: How Romanians Think About Health Care; Part II the message : Presenting the health Insurance House; and, Part III: Target demographics and Media Choice: Whom to reach and How?
According with the study methodology the public opinion research presented here was done in two phases: Phase I: Qualitative -- 12 in-depth interviews (5 general public, 5 health professionals, 2 journalists). Conducted April 1-15, 1998; and, Phase II: Quantiative-- 600-interview national survey. Conducted April 27-May 13, 1998. The fieldwork was conducted by MIA Marketing, Bucharest.
Questionnaires and analysis by Craig Charney of Charney Research, New York.
The report present also the Key Findings - Attitudes towards Health Care and a Strategic Summary about Health Insurance Information Campaign.

World Bank (1999). Former Yugoslav Republic of Macedonia - Focusing On the Poor - volume 1 Main report; Volume II Statistica Annex; Report No 19411-MK. Countries, territories and regions: Macedonia

World Bank (1999). Moldova, Poverty Assessment. 19926. Washington, DC, World Bank. Countries, territories and regions: Moldova

World Bank (1999). Project Appraisal document on a proposed loan in the amount of US$29.0 million to the Republic of Croatia for a Health System Project.July 2, 1999. Report No 19155, World Bank. Countries, territories and regions: Croatia

World Bank (1999). Poverty Assessment, May 1999. (Moldova)
http://www.worldbank.org. md/__C2256BA4003F5E49.nsf/ DocumentsInEnglish/62E204212512410C2256BBE004AC8FA? OpenDocument. Countries, territories and regions: Moldova
This report is written at the request of the Government of Moldova and published by the World Bank in 1999. It provides a detailed analysis of the situation regarding living standards in the country, and presents a framework for policy for the Government's emerging social assistance program. The report is structured in 3 main sections that describe the poverty factors in transition period, give reliable data on poor, prices and incomes, and highlight the role of the state. The main components of Moldova's poverty alleviation strategy concerns key elements needed to increase the ability of individuals to lift themselves out of poverty, as well as options and constraints for the Government to provide a helping hand to those unable to get out of poverty. The report includes numerous figures, tables, comparator boxes, and policy and tool boxes with basic data for Moldova. It draws on data from two surveys: the Moldova Department of Statistics revised Household Budget Survey, for February (pilot), May and August 1997, and later updates until December 1998, and an ethnographic survey of poor households conducted in November 1996. The main report concentrates on analyzing the results for the Right Bank of Moldova. The technical papers, in Volume II of the report, also present evidence for Transnistria.

World Bank (1999). World Bank Report No.18410-RO: Romania - Health Sector Support Strategy, June 22, 1999
(Report available in English). Countries, territories and regions: Romania
This report was intended to serve three purposes. First, it presented policy options and recommendations that help the government prepare a health sector strategy. Second, it guided the policy dialogue between the WB and Romania. Third, it served as a useful reference for consultations among local, bilateral, and international organisations working in the health sector in Romania.

World Bank (2000). Moldova Health Investment Fund. Project Appraisal Document,, World Bank. Countries, territories and regions: Moldova
This document is a description of the "Health Investment Fund" (HIF) Project elaborated by the Ministry of Health of Moldova that aims to improve the health sector, by improving access to essential services for the poor. The project also includes support to strategic work aiming to controlling the TB and HIV/AIDS epidemics. This project appraisal document, as an official standard document of the World Bank, describes the project goals, objectives, strategic context, implementation strategies, activities, the involvement of stakeholders, NGOs, media, other organizations and partners, highlights of the international donor contributions, fiscal impact, expected results, sustainability and risks, loan conditions, allocations and disbursement proceedings of HIF project. In the annexes to this project appraisal document you may find information on project design, costs and costs benefit analysis, disbursement and procurement agreements, statement of loans and credits. Bas ic statistics for Moldova from 1977 to 1998 are presented in the "Country at a Glance" annex. Documents used in the project file are listed in one of the annexes to the document.

World Bank (2000). Kosovo. Living Standards Measurement Study Survey, Poverty and Human Resources,
Development Research Group,
World Bank,. Countries, territories and regions: Kosovo, Serbia and Montenegro

World Bank (2000). Health Reform Project Bulgaria 2000-2005, World Bank. Countries, territories and regions: Bulgaria

World Bank (2000). Making Transition work for everyone: poverty and inequality in Europe and Central Asia, World Bank. Countries, territories and regions: Eastern Europe

World Bank (2001). Romania Country Assistance Strategy. www.worldbank.org.ro
Countries, territories and regions: Romania

World Bank (2001). World Bank Activities in South East Europe. http://www.seerecon.org/DonorPrograms/WBSEE.htm
Countries, territories and regions: South Eastern Europe

World Bank (2001). Romania Country Brief. http://lnweb18.worldbank.org/ECA/ Romania.nsf/ECADocbyUnid/072FE01F3BD0BFF585256C3800749C02 ?Opendocument
Countries, territories and regions: Romania

World Bank (2002). Croatia Social Indicators, World Development Indicators CD-Rom. Countries, territories and regions: Croatia

World Bank (2002). Macedonia, FYR Social Indicators, World Development Indicators CD Rom. Countries, territories and regions: Macedonia

World Bank (2002). Albania Social Indicators, World Development Indicators CD-Rom. Countries, territories and regions: Albania

World Bank (2002). Moldova Social Indicators World Development Indicators CD-ROM, World Bank. Countries, territories and regions: Moldova

World Bank (2002). World Development Indicators CD Rom. Romania Social Indicators, World Bank. Countries, territories and regions: Romania

World Bank (2002). World Development Indicators. Bosnia and Herzegovina Social Indicators. CD-ROM, World Bank. Countries, territories and regions: Bosnia and Herzegovina

World Bank (2002). Interim Poverty Reduction Strategy Paper, Bosnia and Herzegovina, World Bank. Countries, territories and regions: Bosnia and Herzegovina

World Bank (2002). Implementation Completion Report on a loan in the amount of US$26.0 Million to the Republic of Bulgaria for a Health Sector restructuring Project. The World Bank Document, Report No 24282. Human Development Sector Unit Europe and Central Asia Region, World Bank. Countries, territories and regions: Bulgaria

World Bank (2002). Report No 23349 MK FYR of Macedonia - Public Expenditure and Institutional Review, April 2, World Bank. Countries, territories and regions: Macedonia
Besides the Executive Summary, the Document consists the parts for : Fiscal stability without reform, Policy formulation, Budget implementation, Monitoring and accountabil-ity, Human resources management and attached tables. The core institutional question out listed in the document is What changes in the structure, process, and capacity of govern-ment would better enable it to implement the sectoral policy reforms required to expedite Macedonia's transition to a market-oriented economy within the EU. In the health sector, the off-budget Health Insurance Fund (HIF) experienced rapid expenditure growth, large deficits and accumulated debt until 1999. Sharp improvement in the HIF's financial posi-tion was achieved in 1999 without accompanying structural change to tackle longstand-ing problems of inefficiency, ineffective care, and variable access to services, especially for the poor. Passage of a new Health Insurance Law in April 2000, and the conducted Health Sector Transition Project financed with WB IDA credit, provides the framework for introduction of some necessary reforms.

World Bank (2002). World Development Indicators, Yugoslavia, Fed. Rep. Social Indicators. Countries, territories and regions: Serbia and Montenegro

World Bank (2002). Poverty in Albania. A Qualitative Assessment. Technical paper No 520. Washington DC, World Bank. Countries, territories and regions: Albania

World Bank (2002). Bulgaria Social Indicators, World Bank. Countries, territories and regions: Bulgaria

World Bank (2002). Macedonia health Sector Transition project, draft implementation completion report, World Bank. Countries, territories and regions: Macedonia

World Bank (2002). Health Sector Transition Project - IDA Credit # 2889 - MK. Countries, territories and regions: Macedonia

World Bank (2002). Transition. The first Ten years. Analysis and lessons for Eastern Europe and the Former Soviet Union. Washington DC, World Bank. Countries, territories and regions: Eastern Europe

World Bank (2002). Moldova Country Brief. http://lnweb18.worldbank.org/ eca/eca.nsf/Countries/Moldova/ 6D77BD6402E0F21D85256C2500626BB0?OpenDocument
Countries, territories and regions: Moldova

World Bank (2002). Federal Republic of Yugoslavia Country Brief. http://www.worldbank.org.yu/ ECA/yugoslavia.nsf/ECADocByUnid/ 0249B85EC4446F0AC1256C450055DE59?Opendocument
Countries, territories and regions: Serbia and Montenegro

World Bank (2002). Building Institutions for Public Expenditure Management: Reforms, Efficiency and Equity - Romania; A Public Expenditure and Institutions Review - August 2002
(Document of the World Bank available in English), World Bank. Countries, territories and regions: Romania
This Public Expenditure and Institutions Review was undertaken at the request of the Romanian authorities at a critical juncture for public expenditure management in the country. After three years of economic decline, the Romanian economy began growing again in 2000, reaching a real GDP growth rate of 5.3 percent in 2001. While renewed growth engendered an overall improvement in the outlook for Romania's economy, the way in which it was being financed led to growing macroeconomic imbalances, including a rising current account deficit. To sustain the economic recovery and keep the country on a sustainable growth path, the Government defined a bold economic reform strategy. This strategy aimed at redefining the boundaries of the State by moving forward on banking and enterprise privatization; containing sources of quasi-fiscal deficit, especially in the energy sector; and reducing central government expenditures through better public expenditure management and further fisca l decentralization. These reforms were designed to allow the growth momentum to be sustained by renewed investment and export growth, minimizing the risks of a further build up in macroeconomic imbalances, and opening room to address the country's most pressing concern: rising poverty.
This review finds that the challenges for public expenditure management under the Government's economic reform strategy are two-fold: the need to ensure the sustainability of the current economic recovery by containing quasi-fiscal deficits, and keeping the government's consolidated budget deficit on target; and, a need to strengthen budget management to allow a fundamental shift in the manner in which a significant share of public resources is allocated in Romania.
Actions to strengthen budget management are the focus of this report. These actions include improving the Treasury accounting information to curb the practice of exceeding budget ceilings by accumulating payment arrears; accelerating the elimination of extra-budgetary funds; and subjecting foreign financed expenditures to greater budgetary scrutiny. These actions also include ensuring that the budgeting of local government activities and key public services is more transparent and that the funding of these activities is commensurate with actual needs. Measures to achieve these twin objectives range from defining more stable expenditure assignments for local government to improving the allocation criteria for funding of public services.

World Bank (2003). Health sector Reform Project/Romania Loan No. 4568 - RO, June 2000 - December 2003,, http://www4.worldbank.org/sprojects/Project.asp?pid=P008797. Countries, territories and regions: Romania
1.
The project are 5 components: Planning & Regulation of Health Delivery System; District Hospitals: Essential Upgrade &Integration; Primary Care Development; Emergency Medical Services; and, Public Health and Disease Control.
The project will strengthen the capacity for planning and policy development in the field of public health, and health service infrastructure and human resources. It will invest in physical assets and staff training for selected the primary health care, hospitals and emergency medical services based on identification of higher priorities.

World Bank (2003). Croatia country office. http://www.worldbank.hr/
Countries, territories and regions: Croatia

World Bank (2003). Albania country office. http://www.worldbank.org.al/
Countries, territories and regions: Albania

World Bank (2003). World Bank Investment Program in Bulgaria - Overview. http://www.worldbank.bg/operations/
Countries, territories and regions: Bulgaria

World Bank (2003). Romania country office. http://www.worldbank.org.ro/eca/romania.nsf
Countries, territories and regions: Romania

World Bank, Australian Health Insurance Commission, et al. (1998). Romanian Health Sector Financing Study - January - June 1998, (Report available in English). Countries, territories and regions: Romania
The main objectives of the project were to develop a Romanian Health Financing Model which aid decision making and act as a mechanism for the coordination of health policy analysis; and to provide policy advice and conduct analysis on issues relating the implementation of the Health Insurance Law, especially during 1998 and 1999. This paper outlines the preliminary Health Sector Projections obtained from the Romanian Health Financing Model. The software model allowed policy analysts to vary these assumptions to come up with different sets of projections.
The figures presented here refer to a "base case scenario" that was created for Romania as representative of the status-quo situation in 1997 and possible outcomes of 1998 and 1999. The parametric value of every assumption has to be treated carefully. Projections in this report are confined to population, health resources (workforce and hospital beds), service use (in-patient admissions and medical consultations) and public funded recurrent health expenditure. Workforce projections are used to cost labor related health expenditure. Population projections are used to estimate service use and service use projections are used to cost non-labor related health expenditure. Hospital beds are relevant for costing capital funding. Physical number of beds is projected but capital is not yet costed. Private funded health expenditure and revenue estimates, which are also based on population projections, are performed as a separate exercise. The projections have used trend valu es derived from 1994-1996. If it is considered that there is better data from special studies (e.g. projection of number of doctors), these can be incorporated into the projections.

World Bank and Government of Moldova (1999). Moldova Health Sector Reform Project. Restructuring Health Services in Central Judets, World Bank,
Government of Moldova,. Countries, territories and regions: Moldova
In February 1999, KPMG was commissioned by the World Bank and the government of the Republic of Moldova to develop proposals to help improving the provision of heath care to the population in Moldova. The agency was specifically asked to make recommendations relating to health services in the Central Judets, not including Chisinau, the capital. The population of Central Judets is approximately 350,000 based on 4 districts. The current document is a summary of KPMG review of health care in Moldova. The first part of the document describes the current organizational structure of health services in Moldova. The second part comprises a case for change analysis, followed by defining the future configurations of services, financial and staffing implication, proposals for reforming organizational structure, financing health services in the Central Judets of Moldova. The report underlines the needs and services in the Central Judets, but also describes a wider picture because, as a c entral area of the country, this region can not be seen isolated. A comprehensive current balance and propose modifications in the balance of the health care system resources, in terms of expenditures and staff, both in hospitals and primary care sector, is presented in the document. Recommendations are given focusing o improving the planning, efficiency and accountability of the health system.

World Bank, N. Institute, et al. Healthy Romania Project
(Report available in English and Romanian), World Bank,
Nuffield Institute
King's Fund College,. Countries, territories and regions: Romania
The report is the first comprehensive approach of the health and health care situation in Romania after 1990. It was produced as part of the first WB loan in Romania (150 millions USD) and assesses the status of the Romanian health care system at the beginning of the '90. Based on these data, it also made specific recommendations on measures to be taken in order to reform the health care system to be more efficient and responsive to patients' needs. The proposed measures are covering all areas of the health system, from human resource training and allocation to public health and management of the system. The report was one of the most influential policy documents produced after the regime change, and many of its recommendation has been incorporated in the structure of the new Romanian health care system (such as the institution of GPs paid on a per capita basis as the core of the primary health care system, or the development of Public Health and Management as a new career in the medical environment).

World Bank, Interhealth Institute, et al. (1998). Romania Health Sector Reform Study 1998, (Report available in English and Romanian), World Bank,
Interhealth Institute,
Romanian MoH,. Countries, territories and regions: Romania
This Report was the result of contract between WB and InterHealth Institute with the goal to provide technical assistance to the Romanian Government for implementation of the health sector reform. The conclusions, the recommendations and the costs are detailed in the report and the annexes. The report has three components: a short presentation of the proposal regarding the health reform strategy; recommendations for a health sector reform program accompanied by the development of institutional capacity and the management skills; and an investment program.
The health sector reform program is focused on five change strategic fields: burden of diseases; health financing system and provider's payment; organization, management and health services provision; physical assets; and human resources. The strategy of health sector reform was design according with policy decision regarding transition from a centralized and planed economy to a market economy.
The main recommendations were to support the transition from a centralized health system to a health insurance system financed by contribution of employers and employee and additionally through general taxation for covering the unpayers groups of population and for national public health programs.

World Bank, Project Coordinator Unit, et al. (2001). Institutional Assessment on Tb/HIV/AIDS. Chisinau, World Bank,
Project Coordinator Unit,
Moldova Health Investment Fund,. Countries, territories and regions: Moldova
This paper presents a social and institutional assessment on TB and HI/AIDS & STI performed in the frame of WB Health Reform Project in Moldova in the period of June-August 2001. This document provides reliable data and information on the institutional context within which the WB/MoH "Moldova Health Investment Fund" (Policy Development and Institutional Strengthening of the MoH, Strategies for TB/HIV/AIDS Component) Project activities are being prepared. The introduction presents a brief review of the economy situation in the Republic of Moldova. The first section of the document describes tuberculosis as a major public health problem in Moldova presenting highlights of the National Program in TB Control and gives a detailed evaluation of the internal capacities to implement the national strategies of TB control. The second section reveals drug abuse as a major factor of HIV/AIDS epidemics, the spilling out of HIV/AIDS into larger strata of the population and ev aluates the internal capacities to implement national strategies on HIV/AIDS and STI control in Moldova. Each section concludes with highlights of the main problems appraised as a result of this assessment and specific recommendations that focus on cost-effective distribution of scarce resources and prevention of spreading of TB/HIV/AIDS.
There is no bibliography or references available.

World Bank and Romanian MoH (1996). Pilot Health Decentralization Project - 1993-1996,
(Report available in English). Countries, territories and regions: Romania
The Health Decentralization Project was programmed in two stages: stage one was experimented with aspects of health services reform in four pilot districts and produced action plans; stage two these action plans implemented and evaluated prior to full scale health sector reform.

World Bank and Romanian MoH (2000). Health Care Planning Manual - (Manual available in English), World Bank,
Romanian MoH,. Countries, territories and regions: Romania
The purpose of this manual is to supply district authorities with practical tools for making a health care provision plan which is accepted by the major players in the field, and which is founded on accepted, transparent, and reproducible methods.
The manual will supply a number of practical statistical tools, which may be utilised in the planning process, as well as definitions of commonly used entities in health care planning. The manual describes the methodology of health care planning in terms of organisation, process, tools, and time-schedules.
The manual is based on a number of inputs, e.g. decentralised investment planning in Armenia (WB), District Planning of Health Care in Latvia (PHARE), Health Care Financing in Romania (PHARE), Registration of Health Care Network in Georgia (WB), Health Care Decentralisation in Rumania (WB), and Hospital Bed Assessment in Estonia (Danish Government).

Yule, W. (2000). "From pogroms to "ethnic cleansing": meeting the needs of war affected children." J Child Psychol Psychiatry 41(6): 695-702.
Countries, territories and regions: Bosnia and Herzegovina
Children are both the direct and indirect targets during wars. They are directly affected by violence aimed at them and their families; they are indirectly affected by the distress caused to their families; they may be internally displaced or find themselves crossing borders as asylum seekers. Their experiences during and immediately after war militate against their developing in a safe, secure, and predictable environment. Their human rights are compromised and their mental health put at risk. Whether in the country at and after war, or in the country that offers refuge, children's mental health needs have to be properly assessed and met. In many cases, children may only require a sense of safety and support via their family and school. In other cases, they require more complicated psychosocial interventions that address the various stress reactions they manifest. This paper addresses these issues against the context of a major community-based programme in Mostar in Bosnia d uring the recent civil war there. It argues that we have reasonably good screening measures to identify children at high risk of developing mental health problems. It presents an hierarchical model of support and intervention whereby psychosocial help is delivered primarily through schools with only a small proportion of more complex needs being met by specially trained mental health professionals. There is a strong need to evaluate various methods of delivering help and to develop new ways of reaching needy children in a nonstigmatising way.

Zamfir, C., D. Buzducea, et al. (1998). Towards a Child - Centered Society - A report of the Institute for research of Quality of the Life, Romanian Academy,
Department of Child Protection, UNICEF, European Commission, Council of Europe, USAID
World Bank. Countries, territories and regions: Romania
The report represents the points of view of the executing team, which bears the whole responsibility for its content. The report enjoys two sources of reference: the analysis done by the team during July-December 1996 and the analysis of Elena Zamfir, Catalin Zamfir and Marius Augustin Pop concerning the child support policy carried out in the first half of 1996.
The objectives of the project, as established by the initiating group composed of the UNICEF Representative Office in Romania, the delegation of European Commission, the Council of Europe, USAID, the World Bank and the Department of Child Protection of the Romanian Government might be formulated us follows: the identification of positive practices accumulated in Romania and the possibility of their replications and dissemination; the identification of critical points in the configuration of the present day situation of the child, the identification of the blocking sources in different areas and the design of the main lines for a coherent approach strategy for child-related issues; and the interest falls especially on what was considered by us to be, at present, the key variable of the process: the options at organizational, institutional, legislative and political levels.

Zhekova, N. and D. Kalaikov (2000). "The dynamics and structure of neonatal mortality in Bulgaria in the period of 1989-1998." Akush Ginekol 39(3): 12-5.
Countries, territories and regions: Bulgaria
AIM OF THE STUDY: To follow and analyse the state and the structure of neonatal mortality rate (NMR) in the last ten years in Bulgaria. MATERIAL AND METHODS: A retrospective study is fulfilled on the annual data of the National Health Statistic Institute concerning the NMR in a period of last ten years. Along to this the changes in the perinatal infant mortality rate (PIMR) including the stillbirth and the early NMR are studied. The results are analysed by a comparative method and presented graphically. RESULTS: The unfavorable trends in the social and economic development of Bulgaria in the last decade are associated with a constant increase of PIMR--from 10.8% in 1989 to 12.9% in 1998, and of its components respectively: the stillbirth--from 5.9% to 7.4% and of the early NMR--from 4.9% to 5.8%. The NMR has increased from 7.3% since 1989 to 8.3% in 1998, the highest level being in 1991--10.4%. Besides the level of prematurely has increased constantly for the recent ten years --from 6.5% to 9.6%. The leading causes of neonatal mortality in Bulgaria are: perinatal asphyxia, congenital malformations, neonatal respiratory distress syndrome (RDS) and perinatal infections. They have remained the same for the recent five years. From them only the mortality caused by perinatal asphyxia has decreased in 1998--to 41.3% in comparison with 1994--43.7% and by congenital malformations--from 29.4% to 23.4% in 1998, the highest reduction being of the malformations of the neural system (2 folds) and of the gastrointestinal system (5 folds). The NMR of the low-birth weight infants (birth weight < 2500 g) has been 58.1% in 1997 and of the very low birth weight infants (< 1500 g)--276.3%. The NMR of both groups premature infants has decreased in 1998, respectively--to 47.6% and 191.4%. The NMR of the term-born infants has been 13.2% in 1997 and 11.1% in 1998. CONCLUSIONS: The NMR in Bulgaria remains comparatively high, the larger part being on the account of the early NMR, and it has increased for the last ten years. The main causes of NMR have remained the same for the last five years in the leading place been the perinatal asphyxia, the congenital malformations and the neonatal RDS. There is a tendency to a decrease of the perinatal asphyxia and the congenital malformations as a course of NMR in the last five tears. The NMR of the premature infants has decreased in 1998 and is relatively low, but this may be due to the fact that a certain part of the deceased extremely low-birth weight infants (< 1000 g) has been still not registered.

Zoon, I. (2001). On the margins. Roma and Public Services in Romania, Bulgaria, and Macedonia. With a Supplement on Housing in the Czech Republic. New York, Open Society Institute.
Countries, territories and regions: Romania, Bulgaria, Macedonia