• The provision of uninterrupted emergency medical service at primary care but also at municipal hospitals is under-funded, inadequately staffed and under equipped. 
• Inadequate and insufficient training for doctors and nurses for the management of emergencies. Medical emergency guidelines / protocols and/or algorithms do not exist. 
• Community engagement initiatives regarding health emergencies preparedness and response, are almost completely absent. 
• The earthquake in 2019 and the COVID-19 pandemic have sparked increased awareness and sensitivity on disasters and health emergencies. 
• Both the National Strategy for Development and Integration 2021 – 2030 and the National health strategy 2021 – 2030 set for the first time as a priority the strengthening of the system response to emergencies at local and central level. 

• Population in 5 selected territorial areas (“TACA regions”, 530’000)
• PHC doctors and nurses (779)
• MoHSP, Institute of Public Health, National Medical Emergency Center, Health service erator, Agency of quality assurance, National Center for Civil Protection and local CSOs 

Outcome 1: Public health actors engage in effective and efficient health emergency preparedness and response.

Outcome 2: Emergency medical services of high quality are available to people in the entire country, in particular at primary healthcare level.

Outcome 3: Citizens and CSOs take an active role and contribute to a constructive dialogue with the Government of Albania to improve the country’s resilience to public health emergencies.

Expected Results:  

• The regulatory framework, standards, and guidelines for health emergencies are updated/revised
• Roles and responsibilities of primary health care services in the health emergency system are defined
• The national training system for management of public health emergencies is strengthened
• The epidemiological surveillance system is strengthened 
• The network of 24/7 health centers, municipality hospitals is strengthened in delivering emergency services
• Clinical guidelines and protocols for health emergencies at primary health care level are implemented 
• Institutional development and capacities of “Together for Life” and other CSOs are strengthened to advocate for a community participatory approach in emergency preparedness and evidence-based health policy development

Results from previous phase:  

• Communities and institutions rely on central government for support when emergencies occur
• Need of an after-action review that focuses on bringing together key stakeholders for collective learning, documenting lessons learned and institutionalizing best practices seen during the COVID 19 response 
• Emergency services at the level of primary health care and municipality hospitals is disregarded by the health insurance and is not properly reported and financed
• Communities need better education on health emergencies