International Perspectives

Abstract

Kosovo declared independence on February 17, 2008. The political and medical postconflict environment in Kosovo before independence was the setting for a United States Agency for International Development (USAID) program involving collaboration among public and private United States partners developed for leveraging resources to increase effectiveness. The formal 18-month effort focused on improved perinatal outcomes and was part of a longer and broader past and future effort that continues. The Alliance’s primary partner in Kosovo was the Ministry of Health (MoH), and there were two primary components. The antenatal care in family medicine component addressed Kosovo priorities in primary care and family medicine while implementing antenatal care at family medicine centers using the World Health Organization (WHO)-recommended guidelines. The perinatal care component included technical and material assistance at the University Clinical Center in Pristina to introduce, educate, and support evidence-based interventions, including prenatal steroids, the Neonatal Resuscitation Program (NRP), continuous positive airway pressure (CPAP), and exogenous surfactant. The strategy of the Alliance employed education and clinical interventions to address a primary goal of system development. Observation and comments included the conclusion that the Alliance was successful as an improvement and change agent that advanced perinatal or reproductive system- and nation-building. This pilot program can serve as a foundation for further effort.