Self evaluation report

2.2. 1. Justification of study program for employment market in general

To create a new study program in allocation to the employment market, a research shows in general, that person with a tertiary education ranged at the minimum number of unemployment status. „An examination of the highest educational level reached by the employed is interesting as it shows that over a quarter of all the employed were educated up to tertiary level. “However, it illustrates that the requirements for getting a job are higher in government positions where almost half of all employees in these jobs are educated up to tertiary level“(cf. World Bank, Kosovo Agency of Statistics, 2012, p. 22). 10,5% of the employed population has a tertiary education. In relation to all employed persons 25,6% provide a tertiary education. This group is the second largest group of employed people. 5,3 % of unemployed person had a tertiary education. In allocation to other education level, the ranged next to unemployed person without a school level at the minimum unemployed persons.

Next to Universities Teacher in Health Care can be employed in secondary vocational schools or higher education schools as well.

	Municipalities	Vocational schools	Number of students
	Pristina	“ Dr. Ali Sokoli “ (Medicine)	788
	Gjilan	“ Asllan Elezi “	894
	Pejë	“ School of Medicine “	493
	Ferizaj	“ Elena Gjika “	788
	Mitrovicë	“ Xheladin Deda “	768
	Prizren	“ Luciano Motroni “	1511
	Gjakovë	“ Hysni Zajmi “	962
In total			61921

Figure 1, LIST OF VOCATIONAL HIGH SCHOOL (level III School of Medicine) IN KOSOVO

	Place	Institutions of higher education	Number of students
	Prishtinë	UP Faculty of Medicine, Department of Nursing and Midwifery	450
	Prishtinë	SHLP BPRAL “qeap-heimerer “	350
	Prishtinë	University “ Rezonanca “	N.N.
	Prishtinë	College “Univers “	N.N.
In total			At least 800

Figure 2, Institutions of higher education (public and private) in the respective study programme

c. Institutions of these profiles from the region Albania, Macedonia, and Montenegro

d. International institutions such profiles within INSTEAP project.

The graduates in “Education in Health Care” developed different competencies in the study programme. Regarding to these competencies they are able to work in different job sectors:

• 
  Teaching in health care institutions
  
• 
  Teaching at the Universities of Pristina
  
• 
  Teaching in vocational education schools
  
• 
  Teaching in competence centre
  
• 
  Research institutions
  
• 
  Consultant in health care
  

2.2.2. Justification of study program for employment market allocated to professions

The justification to establish a new educational programme derived from the immediate need for special qualifications in the field of health care.

The development of the Master programme “Education in Health Care “is integrated into the funded project Interdisciplinary structure reformation and higher education for new professions (INSTEAP) by the EU Commission, integrated into to the TEMPUS programme. The project team identified the demand and developed the project idea 2011/2012.

Based on our long experience in institutional work, besides the need for new qualifications, we were also able to identify the deficiencies in the existing qualifications in the Republic of Kosovo. The fact that there are certain fields that require urgent development, where the Kosovo nurses have the need for further development of specialized skills and knowledge in order to answer the current needs as well as enable an efficient functioning, was recognized by the national authorities such as the Ministry for Health of Kosovo.

Universities of Kosovo and universities of the region, which provide study programs in health system, do not have study programs for teaching educators in healthcare, or a clear approach for health managers. Therefore, the whole health system is lacking professional pedagogy as part of education. In addition, the majority of managers of healthcare institutions are doctors, without managerial knowledge and know-how does, which clearly result in a poor development and operation of healthcare settings, thus bringing a not well functionality of healthcare system in Kosovo. Hence, representatives of related professions give lectures; doctors are giving lectures to future nurses. It should be empathized that modules and didactic concepts find no use, which would have enabled a specific professional perspective. At this point international standard has changed and a specific qualification is more than necessary. Some Universities, which provide study programs in heath system, already declared officially regarding the creation of specific methods such as teaching towards problem solving, scientific orientation based on the data from healthcare research and teaching. Experiences in methods and expertise in these fields, as the ones shown in other countries, are not constructed yet sufficiently in all participatory universities of South East Europe, including Kosovo. The collapse of communist regimes has resulted not only in new professional challenges for the healthcare and healthcare staff but also in scientific grounds.

Workers of these countries are experiencing a rapid economy process of healthcare system. If compared with Western Europe countries, this development has been slower and has lead into new transformative processes and complex strategies. Tasks and challenges, which only partially have been renewed, require skills and abilities on healthcare from the responsible persons of Kosovo, which is something that is not part of education yet. Another factor that determines particularly the work of healthcare system and relevant study program is the right of the profession and necessary legal conditions to practice one’s profession. The transition of the system from the state, centralized and planned economy, into a modern, decentralized and transparent health system requires new definition of conditions. If solid steps in the legal macro-infrastructure so far have been made, there is still a need for legal medium and micro infrastructure.

Ministries and universities have not yet made a direct connection between them. No direct exchange has happened yet. This needs a specific expertise, which is lacking often in the country and it requires a close and coordinated collaboration between politics, professional society and university education. In a parallel-organized transfer, such views should be involved in the relevant programs curriculum, to become part of schooling. Direct communication between universities, ministries and the world of profession has envisaged to been built and established through the project.

This indicates that teaching skills and knowledge are missing in the health care system in Kosovo. The partner of Ministry of Education, Sciences and Technology and the Ministry of Health confirmed the need of teacher competencies. In a stakeholder workshop of the project, INSTEAP the opinion has been affirmed as well.

The teacher has to be an expert in his profession. However, expertise alone is not sufficient to teach. Learning success is highly dependent on the methodological and didactical treatment and correct integration in the learning context. Besides a subject-specific theoretical framework, it is necessary to deposit a pedagogical framework. “A common-political decision-making process has to be enabling at qualifications level. By suitable choice of elements in the curricula and the curriculum structure in lecture sequences, the learning process has to be developed, that the conditions and their efficiency could be proved in reviewed experiments. The core problem is caused in one of this different level of legitimacy suitable integration of competencies” (cf. Knab, 1971). That assumes, that teacher has competencies in pedagogical and didactical theories and experiences in practice these methods.

“The skills that participants in adult education programs do or do not develop have increasingly important implications in terms of workforce participation, long-term self-sufficiency, acculturation, and citizenship. A growing body of data shows that, in addition to obtaining and succeeding in a job, literacy and numeric skills are associated with the likelihood that individuals will participate in lifelong learning, keep abreast of social and political events, and vote in state and national elections“ (Benjamini and Hochberg 1995; OECD and Statistics Canada 2005; Sum, Kirsch, and Yamamoto 2004a).

The study programme will bee connected to the school system in Kosovo at the level of higher education.

School system from upper secondary education
Upper secondary education (age 15-18, grades X-XII; ISCED level 3)
High schools
Higher vocational education
Music and art schools
Post-secondary (VET) education (age 18+)
Higher education
Teacher programmes	Additional programme for professions
BA Teacher	BA Nursing
MA Teacher	MA Education in Health Care

Figure 3, Connection of the master programme Education in Health Care

Healthcare in Southeast Europe countries is a sector that needs reforms, as it is still within public institutions. The development of health care system in Kosovo was subject to political and economic influence. Supported by different nations and institutions, the Ministry of Health implemented institutions and developed several documents to optimize the health care system. Healthcare in Kosovo is one of the topics that need further development. Lack of structural reforms and low financing remains the main causes for the lack of healthcare, thus making a difficult path of transition and modernization (cf. Holst 2007, Bislimi 2006).

Raka (2009) stated, that „currently, the health care system in Kosovo consists of primary health care centres located in each municipality; secondary health care facilities at the regional level (hospitals); and tertiary health care centres – University Clinical Centre of Kosovo and other specialized institutions. Besides public sector, the private sector in health care has grown in the recent years and is predominantly focused on diagnosis and treatment“ (cf. Raka, wbc-inco net 2009, p. 10). Raka pointed out among other health research priorities: Research capacity strengthening- to upgrade scientific capabilities in health area (cf. Raka, 2009, p. 21).

The Ministry of Health developed a “Strategy of Health Care in Kosovo 2005-2015”, based on the Millennium Development Goals. In the main national policy goals in health care the Kosovo government in period 2005-2015 define one goal to “improve the health status of the population and the quality of the health care services” (cf. MoH, updated 2011, p. 11).

The determined results such as” quality of health care services improved and the level of professional medical knowledge and skills upgraded through improved education and training“ require also nurses, who has the knowledge about the relevance of economic point of view, evidence based nursing and methods.

However, the professional background of nursing is important for EDUCATION IN HEALTH CARE system, because he have among other areas to estimate the knowledge of education theories to support nursing students to estimate the potential demand of patient and to determine the effort of nursing. Without this professional and the educational knowledge, the education of nurses will not effective and efficient.

Percival and Sandorp, 2010 evaluated the objectives of the health reform in Kosovo as presented in the “Yellow Book”. They stated, that “family doctors have been trained, responsibility for primary care has been transferred to the municipal level, immunisation coverage has increased, and some maternal and child health indicators have improved. Yet many key reform initiatives, such as building the strength of primary care and establishing an effective health-financing system, were not fully implemented” (cf. Percival, Sandorp, 2010, p. 8).