Maternity Underutilization in Kosovo

Maternities in Kosovo are not being effectively utilized for deliveries or many other aspects of maternal care. Because finite resources are being invested in these facilities without proportional service delivery, the Ministry of Health (MOH) has identified this issue as a priority. In partnership with Action for Mothers and Children (AMC), the Dartmouth Global Health Policy Lab team conducted a mixed methods study to investigate the underutilization of maternities and develop policy approaches to strengthen the maternal health care system. Specifically, the team sought to understand the:

• most commonly utilized care pathways for maternal health care
• main drivers of maternity underutilization
• gaps in services offered in the maternal health care system
• perceptions of care from patients and providers
• implications of different options for restructuring maternities

These findings informed policy options for restructuring maternities. These options are intended to improve the quality of maternal health care and increase overall access to services by restructuring maternities. The Ministry of Health (MOH) may consider:

• • Option 1: Close maternities
  • Option 2: Repurpose maternities into Women’s Wellness Centers
  • Option 3: Functionalize maternities for delivery

From June 15 to August 20, 2019, the team conducted more than 30 interviews with health workers, MOH officials, administrators, patients, and other health care experts. The team visited facilities across all levels of the public health sector to understand the current conditions of maternal health care access and the potential implications of options for restructuring maternities.