Health and nutrition indicators are still far from neighbouring countries and in particular the EU average. Primary health care needs additional fiscal and human resources, and the institutional and legal arrangements stand in the way for a more economical solution. The current allocation of budgetary resources is focused on programs like curatitive care and drug administration programs, while there is too little spent on preventative and primary health care.
One of the major challenges in Kosovo is the improvement of mother and child health status to improve the parenting skills of parents and caregivers on mother and child health care, nutrition and development. There is a lack of knowledge and awareness among communities and families about adequate home care management, child physical and cognitive development and general reproductive health.
Kosovo has a very high fertility rate and amongst the poorest maternal and child vital indicators in Europe. Between 35,000 children are born each year, in a population of nearly two million people. The infant mortality rate is estimated at between 35 to 49 per 1,000 live births, while under 5 mortality rate is estimated at 69 per 1000. Both rates are at least twice as high as those of neighbouring countries. The main causes of mortality include perinatal conditions, respiratory diseases and diarrhea. More than 95% of mothers give birth in a health facility, nevertheless maternal mortality is high.
Immunization coverage rates have increased to over 90%, however due to low awareness, parents tend to delay some of the vaccines scheduled by the Ministry of Health. The immunization remains low among Roma, Ashkali and Egyptian communities. Inappropriate breastfeeding and infant feeding pattern raise major concerns as a determinant of the observed nutrition problems. The vast majority of sampled children under 2 years of age are breastfed, at least partially (90%). The prevalence of exclusive breastfeeding is only 12% for children under 6 months.
Despite the fact that 84% of households consume iodized salt, nearly 50% of women and the school-age children have an inadequate urinary iodine concentration, due to either low quantity of consumption or inappropriate usage during the cooking process. Inadequate iodine levels can lead to poor physical and mental development of children.
Only 64% of the population has access to clean water. On average less than 50% of households are connected to public sewage and in rural communities this figure falls to around seven%.
The main environmental problems are air pollution, waste management and heavy metal pollution particular with lead in Mitrovica municipality with highest blood lead levels in the world.
The 2007 MDG report on Kosovo calls attention to an alarmingly low rate of pre-school enrolment. Unlike many other countries in the region, Kosovo doesn’t have a strong tradition of early childhood development programmes or pre-school education. There is not enough attention within the family directed to interaction with very young children and low awareness on the need to stimulate a child’s physical and cognitive development from an early age.
Preschool in Kosovo includes childcare and kindergarten institutions for children from the age of 9 months to 5 years and also pre-primary services within primary schools themselves for children aged 5 to 6.
Currently less than 10% of children aged 3 to 6 in Kosovo have access to early childhood education and development programmes. The majority of existing pre-schools and kindergartens or pre-primary classes are located in urban centres. Since state-provided rural early childhood education services, such as pre-schools or kindergartens, did not exist during the previous administration, there is little knowledge base regarding the meaning or processes of early learning. The Ministry of Education, Science and Technology aims to increase children’s access to early learning programmes up to 25% by 2005.