South Eastern European Journal of Public Health (SEEJPH) <p>The South Eastern European Journal of Public Health (SEEJPH) is an open-access international peer-reviewed journal involving all areas of health sciences and public health. Devoted to the global health SEEJPH welcomes submissions of scientists, researchers, and practitioners from all over the world, but particularly pertinent to southern and eastern countries in transition.</p> en-US (Prof. Genc Burazeri PhD) (Prof. Genc Burazeri PhD) Wed, 23 Mar 2022 00:00:00 +0000 OJS 60 The InterAction Council Joanna Nurse Copyright (c) 2021 Joanna Nurse Sat, 21 May 2022 00:00:00 +0000 Self-assessment of essential public health operations in Kosovo <p><strong>Aim:</strong> The National Institute of Public Health of Kosovo (NIPHK) considered the challenge of assessing the availability and performance of critical public health services in Kosovo. To this end, support was requested from the World Health Organization (WHO) European Regional Office, through the WHO office in Pristina, for an action-oriented process. The systematic process of the self-assessment of public health operations aimed to generate sufficient empirical evidence to identify the strengths and weaknesses of the country’s health services and functions to provide recommendations for future public health actions in Kosovo.</p> <p><br /><strong>Methods:</strong> The NIPHK team followed the systematic self-assessment methodology of the Essential Public Health Operations (EPHO) model that the WHO’s regional office for Europe developed. The appraisal was conducted throughout 2018 and the first quarter of 2019 and involved a broad spectrum of public health actors. It also followed a participatory, interdisciplinary, and inter-sectoral approach. It was developed in three phases: preparation and collection of information, analysis and interpretation of the data, and critical recommendations for the Kosovo health authorities’ consideration.</p> <p><strong>Results</strong>: The assessment resulted in an overall score of 48% sufficiency for the set of public health operations (core and enablers). The most in need of development were EPHO 6, which is related to governance (only 20% of what is needed in this dimension as a whole), followed by EPHO 3, which considers vital aspects of health protection (35%), and EPHO 10, which is related to research capacities (40%). Based on the EPHO assessment results, the specialized teams developed a set of priority recommendations to strengthen the implementation of the EPHOs in Kosovo.</p> <p><br /><strong>Conclusion:</strong> The self-assessment revealed that, despite ongoing initiatives and measures to strengthen public health, the application of EPHOs has much room for improvement. We believe that decision-makers can use this method and the findings that it reveals to implement the most effective interventions to protect and promote the population’s health. In addition, the methodology and experience can be used for educational and training purposes.</p> <p><br /><strong>Acknowledgments:</strong> We acknowledge the work of the national working group, participating experts, and institutions in the EPHO assessment process, without which the self-assessment exercise would not have been possible. We thank the members of the WHO’s regional office for Europe and the WHO’s office in Pristina for assisting in the work of the national working group by providing expertise and logistical support. We also thank Professor Laura E. Cruz for her contribution to the English editing of this paper.</p> <p><br /><strong>Sources of funding:</strong> Work regarding the self-assessment was funded by the WHO’s regional office for Europe, the WHO’s office in Pristina, the National Institute of Public Health, and the Ministry of Health of Kosovo.<br /><br /><strong>Conflicts of interest:</strong> The authors of this article were part of the national working group for the self-assessment process. The first author (MB) received a consultancy fee from the WHO for coordinating, collecting, and analyzing the data required for the assessment reported in this article. The co-author (MM) received a consultancy fee through a professional assignment from WHO. The last author (JMM) also played a consulting role through a professional assignment from WHO.</p> <p><br /><strong>Disclaimer</strong>: The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the decisions or policies of the WHO.</p> Merita Berisha, Naser Ramadani, Florie Miftari Basholli, Naim Jerliu, Isme Humolli, Ardita Tahirukaj, Maria Maraokuli, Jose M. Martin-Moreno Copyright (c) 2022 Merita Berisha, Naser Ramadani, Florie Miftari Basholli, Naim Jerliu, Isme Humolli, Ardita Tahirukaj, Maria Maraokuli, Jose M. Martin-Moreno Wed, 11 May 2022 00:00:00 +0000 Health behavior, stress and obesity among working age women in Myanmar <p><strong>&nbsp;</strong></p> <p><strong>Aim</strong>: &nbsp;This study aimed to determine the prevalence of overweight and obesity and to investigate the association between socioeconomic factors, health behaviors, health literacy, knowledge, attitude, physical and mental health status, and overweight and obesity among working age women in Myanmar.</p> <p><strong>Methods</strong>: A cross-sectional study was conducted among 1,094 women aged 18 to 59 years old who were recruited by using multistage random sampling from 12 townships out of 6 districts among three states/regions. A structured questionnaire was developed and applied to assess the prevalence of overweight and obesity. Generalized Linear Mixed Model (GLMM) was performed to determine the association between dependent and independent variables after controlling the effects of covariates presenting adjusted OR and 95% confidence interval.</p> <p>&nbsp;</p> <p><strong>Results: </strong>More than half of the respondents were with overweight and obesity (51.28%; 95%CI: 48.31-54.23). The multivariable analysis indicated that factors significantly associated with overweight and obesity included; aged 31-59 years (Adjusted Odds Ratio (AOR) = 1.72, 95%CI:1.22-2.40), living without family (AOR= 2.07, 95%CI:1.20-3.57), average monthly income ≥200,000MMK (AOR= 1.38, 95%CI:1.05-1.82), parity≥1 (AOR= 1.61, 95%CI: 1.17- 2.23), high fat &amp; protein consumption ≥5-days per week (AOR= 2.90, 95%CI:1.91-4.39), alcohol consumption (AOR= 2.53, 95%CI:1.91-3.36) and moderate-severe stress (AOR= 1.47, 95%CI:1.11-1.94).</p> <p>&nbsp;</p> <p><strong>Conclusion: </strong>More than half of working age women were with overweight and obesity. Socioeconomic status, health behavior and stress are the factors behind over nutrition. The findings provide relevant evidence to develop the appropriate policies and public health interventions in order to minimize the burden of overweight and obesity. Likewise, it is anticipated that this outcome would support the prevention of cardiovascular and other chronic diseases.</p> <p><strong>&nbsp;</strong></p> <p><strong>Conflicts of interest: </strong>None declared.</p> <p>&nbsp;</p> <p><strong>Ethical Consideration: </strong>Ethical Consideration was taken from Khon Kaen University Ethics Committee in Human Research (the approval number, HE632117) and Department of Medical Research, Yangon, Myanmar (Approval number Ethics/DMR/2020/109). A coding scheme was used and every document was destroyed on completion of research. Written consent was obtained from all participants prior to participation.</p> <p><strong>&nbsp;</strong></p> <p><strong>Acknowledgement: </strong>The authors would like to express our sincere appreciation to all working age women in study areas for the data collection. Special thanks to the Faculty of Public Health, Khon Kaen University, Thailand for the financial and technical support.</p> Win Mya Mya Htut, Kittipong Sornlom, Wongsa Loahasiriwong Copyright (c) 2022 Win Mya Mya Htut, Kittipong Sornlom, Wongsa Loahasiriwong Fri, 27 May 2022 00:00:00 +0000 Market and welfare valuation of the economic burden of diseases attributable to air pollution exposure in the Western Balkans <p><strong>Aim</strong>: The population in the Western Balkans is exposed to high air pollution concentrations, among the highest in Europe, causing death and disability. Research, however, on the resulting economic cost in the region is still limited. We estimate the economic cost of the adverse health effects from air pollution exposure, including fine particulate matter (ambient and household) and ambient ozone air pollution in the region.</p> <p>&nbsp;</p> <p><strong>Methods: </strong>We employ both market and welfare-oriented methods. According to the Cost-of-Illness (COI) approach, we estimate both the direct (healthcare expenditure) and indirect cost (mortality and morbidity cost). Against the shortcomings of a market-based valuation, the Willingness to Pay (WTP) approach is also used. The most recent data from the Global Burden of Disease Study 2019 are used.</p> <p>&nbsp;</p> <p><strong>Results: </strong>Under the COI approach, total economic cost is estimated at PPP$ 6.3 billion. Equivalently, it ranges from 0.8% of GDP in Croatia to 2.39% of GDP in Bosnia and Herzegovina. The WTP methodology yields a significantly higher estimate, equal to PPP$ 76.7 billion. The monetary amount associated with the disease burden of air pollution is significant.</p> <p>&nbsp;</p> <p><strong>Conclusion: </strong>Public health policies should include monitoring of the adverse health effects of air pollution. Abatement policies should aim at reducing ambient air pollution as well as the dependence on polluting household energy usage. The reduced economic cost can be accompanied by benefits associated with climate change mitigation and an overall improvement in population’s health status, an important aspect given the current COVID-19 pandemic.</p> <p><strong><em>&nbsp;</em></strong></p> <p><strong>Authors’ contribution: </strong>Maria Panteli: Conceptualization; Data curation; Formal analysis; Methodology; Software; Writing - original draft; Writing - review and editing. Sofia Delipalla: Conceptualization; Methodology; Supervision; Writing - review and editing.</p> <p><strong>&nbsp;</strong></p> <p><strong>Source of funding: </strong>No funds, grants or financial support were received for conducting this study.</p> <p>&nbsp;</p> <p><strong>Conflicts of interest:</strong> None declared.</p> Maria Panteli, Sofia Delipalla Copyright (c) 2022 Maria Panteli, Sofia Delipalla Sat, 21 May 2022 00:00:00 +0000 Respiratory symptoms among urban traffic policemen in Bangladesh: A cross-sectional study <p><strong>Aim:</strong> There is accumulating evidence that roadside pollution is detrimental to health. This study aims to compare the risk of adverse respiratory symptoms in different categories of traffic police including traffic constables, sergeants, and inspectors working in the polluted environment.</p> <p>&nbsp;</p> <p><strong>Methods:</strong> The study population consisted of 369 randomly selected traffic police personnel from the city of Chittagong in Bangladesh. Information on their occupation and respiratory health symptoms were collected. The health outcomes were coughing, coughing sputum, coughing up blood, shortness of breathing, wheezing, and chest pain with deep breathing.</p> <p>&nbsp;</p> <p><strong>Results:</strong> The risk of coughing [adjusted Odds Ratio (AOR) = 4.469, 95% CI=1.265-15.793], coughing sputum [AOR= 3.687, 95% CI= 1.004 -13.540], coughing up blood [AOR=1.040, 95% CI=0.227-6.162], shortness of breathing [AOR=3.937, 95% CI=1.069-14.500], wheezing [AOR= 2.464, 95% CI= 0.613-9.906] and chest pain with deep breathing [AOR=2.163,95% CI= 0.560-8.349] was higher in traffic constables on comparison to inspectors. In sergeants odds increased for coughing up blood [AOR=1.102, 95% CI= 0.283-4.286] and wheezing [AOR=1.260, 95% CI= 0.304-5.229].</p> <p>&nbsp;</p> <p><strong>Conclusion:</strong> There was a substantial difference in the risk of studied respiratory symptoms between different categories of traffic police jobs.</p> <p><strong>&nbsp;</strong></p> <p><strong>Conflicts of interest:</strong> None declared.</p> Parvez Ahmed, Mahim Eaty, Nazmul Alam, Leela Anthony, Nawzia Yasmin Copyright (c) 2022 Parvez Ahmed, Mahim Eaty, Nazmul Alam, Leela Anthony, Nawzia Yasmin Sun, 19 Jun 2022 00:00:00 +0000 Correlates of level of satisfaction among primary health care workers in Albania <p><strong>Aim: </strong>The aim of this study was to explore the level of satisfaction of primary health care staff in Albania and the factors associated with it.</p> <p><strong>Methods: </strong>A cross-sectional study was conducted in Tirana city, the Albanian capital, from 11 November 2020 until 25 November 2020. Among all health centers (HCs) and health centers of specialties (HCSs) of Tirana Municipality, there were selected randomly a HC in rural areas, a HC in urban areas and one HCS. All the staff (doctors and nurses) being present at the time of data collection was interviewed, using an international standardized tool (the Dartmouth-Hitchcock Medical Center instrument) assessing the satisfaction with various elements of the work in PHC, validated in Albanian. A total of 102 PHC staff were included in the study. Binary logistic regression was used to assess the association of staff satisfaction with independent factors.</p> <p><strong>Results: </strong>The aspects of work most appreciated by PHC staff (% satisfied or very satisfied) were: respectful treatment by colleagues (78.2%), staff morale and their positive attitude towards work (73.2%). The most disliked aspects of work by PHC staff (% dissatisfied or very dissatisfied) were: current salary (60.8%), stress at work (38.3%), physical and medical infrastructure in the institution (27%). Staff in rural HCs, older staff, females and nurses and family doctors are more likely to be satisfied compared to their respective colleagues.</p> <p><strong>Conclusion: </strong>Our findings suggest various factors associated with the satisfaction of PHC staff in Albania. These findings could be guiding future efforts aiming to improve the work conditions of the professionals working in primary health care in Albania.</p> <p><strong>Conflicts of interest:</strong> None declared.</p> <p><strong>Acknowledgment:</strong> This study was funded by the “Health for All Project” in Albania (, which is a project of the Swiss Agency for Development and Cooperation (SDC).</p> Alvi Naum, Ervin Toçi, Dorina Toçi, Genc Burazeri, Robin van Kessel, Katarzyna Czabanowska Copyright (c) 2022 Alvi Naum, Ervin Toçi, Dorina Toçi, Genc Burazeri, Robin van Kessel, Katarzyna Czabanowska Wed, 23 Mar 2022 00:00:00 +0000 An examination of the diversity of beer and cider products sold in Irish supermarkets in the context of health promotion advice <p><strong>Aim: </strong>Current health promotion advice relating to the consumption of beer and cider in</p> <p>Ireland is very firmly based on nominal pints and half pints of beer. This study sought to determine if the assumed alcohol strength of beer and cider available in a sample of mainstream supermarkets was appropriate. This study also sought to examine if the assumed size of containers of beer and cider was accurate.</p> <p><strong>&nbsp;</strong></p> <p><strong>Methods: </strong>All beer and cider products in a purposive sample of Irish mainstream supermarkets was examined. Data was input into SPSS and examined.</p> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>Results: </strong>There is a substantial level of variation in the container size and alcohol content of beer available in mainstream supermarkets in Ireland.</p> <p><strong>&nbsp;</strong></p> <p><strong>Discussion:</strong> Current health promotion advice in Ireland is out of date and does not enable people to easily monitor their drinking and follow healthy drinking guidelines.&nbsp;The obvious answer is the enactment of the Public Health (Alcohol) Act, 2018, that has already been passed requiring alcohol containers to display the number of grams of alcohol contained. However, this element of the legislation, despite being passed into law, has yet to be either enacted, or even given a date for enactment.</p> <p><strong>&nbsp;</strong></p> <p><strong>Authors’ contributions</strong>: All authors contributed equally.</p> <p>&nbsp;</p> <p><strong>Conflict of interest</strong>: None declared.</p> <p>&nbsp;</p> <p><strong>Source of funding</strong>: No funding was received for this project.</p> <p>&nbsp;</p> <p><strong>Compliance with Ethical Standards: </strong>&nbsp;Ethical approval was not required for this study.</p> Frank Houghton , Cáitlín O’Mahony Copyright (c) 2022 Frank Houghton , Cáitlín O’Mahony Mon, 11 Jul 2022 00:00:00 +0000 Condemning the War in Ukraine & the Need for Peace Frank Houghton, Lisa Scott O’Rourke Copyright (c) 2022 Frank Houghton, Lisa Scott O’Rourke Wed, 23 Mar 2022 00:00:00 +0000 The willingness of COVID-19 vaccination and associated factors: A systematic review <p><strong>Aim:</strong> Vaccination is an effective approach to avoid infection and reduce morbidity and mortality of infectious diseases. However, in previous infectious disease vaccination programs, some people were hesitant to get vaccinated. To develop an effective vaccination program or policy, the government or public health officials need to understand the factors that influence the willingness of COVID-19 vaccination from the various studies.</p> <p><strong>Methods: </strong>Between 1-18 December 2020, articles were searched from PubMed and ScienceDirect with the following key terms: Willingness, Acceptance, Acceptability, COVID-19 vaccine, and COVID-19 vaccination. &nbsp;Eligibility for article inclusion criteria was determined by PRISMA.</p> <p><strong>Results:</strong> 20 studies were included in this review. All studies were conducted in the early days of the COVID-19 pandemic. The willingness of COVID-19 vaccination ranged from 60-97% among the general population, 28-63% among healthcare workers, 56-65% among parents or caregivers, and 73% among factory workers. The common factors that affected the willingness of COVID-19 vaccination:&nbsp; gender, age, education, individual perception about diseases and the vaccine, trust in the government, statements of public health officials and health providers.</p> <p><strong>Conclusion: </strong>Concerns about disease risk, effectiveness, and side effects are important factors associated with vaccination willingness. To avoid vaccination hesitancy in the community, public health officials need to disseminate detailed information about the vaccines like efficacy level and side effects, and continue to provide information about the risks of COVID-19 for personal health and others through various online media to avoid vaccination hesitancy.</p> <p><strong>Conflict</strong>: None declared.</p> Tiara Fani, Kriswiharsi Kun Saptorini, Aprilia Diah Anggreani Copyright (c) 2022 Tiara Fani, Kriswiharsi Kun Saptorini, Aprilia Diah Anggreani Mon, 09 May 2022 00:00:00 +0000