1. Occupational Health
Kosovo
RilindZenelaj&Xhevat Shkodraˡ ’²
ˡ Professor at Faculty of Medicine²Manager at Red Cross of Kosovo

2. Flag of Republic of Kosova
The Republicof Kosovo is located in Balkan Peninsula in south-eastern Europe
The Republic of Kosovo declared independence on 17 February 2008
Surface of Kosovo is 10,908 square kilometers.
Population (2011 census) 1,733,872
Density 159/
Male50.4% 873,598
Female 49.6% 860,274
Life expectancy female,years 71
Life expectancy male,years 67
Population below of age 14 years 28%
15-64 years 65%
>65 years 7%
Employment Over 250,000
GDP per capita(2010),Euro 2,383

3. Labor force
Employment
During the period 1999- onward the Kosovar labor market wentthrough important changes and one of
the main factor is the privatization process of the state-owned enterprises.
The average number of employed persons in private sector has a tendency toward increasing.
In 2010 the level of employment of the central age group(25-54) was 34%.
The main branch of economy in 2009 has been tradingwith participation of employment 17.4% followed
by education (13.4%),production(9.9%),administration (9.8%) and construction(7.9%).
Figure 1.Level of employment
Unemployment
The male unemployment rate in 2009 was 37.4% of central age group (age 25-54)
Female unemployment was 52.0%
Analyzing the unemployment by demographic group,there is an increasing trend in the registered
unemployment persons belonging to the age of 15-24

4. Figure 2.Level of unemployment
Occupational Health and Occupational Health Legislation
Occupational Medicine of Kosovo based on its activity is relatively new. This was organized through
Occupational Medicine in local level of Health Houses (now Main Family Medicine Centre) or through services
and units of occupational medicine at the other forms of institutional health organization in Kosovo.
Being faced of occupation circumstances of last decade, this segment of health passed through important
changes to its dysfunction.
An important role had the Unit of Occupational Medicine at the National Institute of Public Health which also
was stopped of working.Formally had also the Association of physicians of the Occupational Medicine.
Before war (1999) Kosovo has had 65 specialist of Occupational Medicine.
Nowadays of Occupational Medicine
Today’s in Kosovo are 31 active specialists of OM.
This generation belongs to the age of 40-68 years, so it is old and not regenerated.
Today’s a few of them are working out of their field of specialization as a result of bad organization of OM.
Currently, is considered that in Kosovo are employed over 250,000 workers, while quadruple is able and
waiting to work. So the ratio of employees with a doctor is 1:8000, far away fromEuropean norms.

5. Regional specialists of OM in Kosovo
0%
3%
7%
Prishtina (17)
16% Mitrivica (6)
Prizren (5)
Peja (2)
55%
Gjilan (1)
19% Gjakove
Figure 3. District distributed specialists
Responsible body on OH
1. The Ministry of Health
2. The Ministry of Labor and Social welfare
Main laws in force for OH
The OH is part of public-public health system. The administrator of Health system is the Ministry of Health.
The health system is organized on three levels, primary, secondary and tertiary. The Occupational health is part
of tertiary level and is managed by two occupational health institutes, one located in Obiliq (10 km away from
Capital city) and the second one in Gjakova (western part of Kosovo),and 7 local OM services.
Presently all health system is ruled based on provisional health law which was adopted by United Nations
Mission in Kosovo and Provisional Kosovo Self Governmental Institutions (Health law no.2004/4) which is
under revision and very soon there will be a new law foreseen to be adopted by assembly by the end of this
year. In the other hand there is not special legislation which regulates the aspect of occupational health as a
specific entity.
Fortunately, we have a new labor law (labor law No.03/L-212) which was approved in year 2010 and came into
force in beginning of year 2011. This law talks about the safety in work and the rights of workers. Due to this
law the employer is obliged to ensure the worker with proper protection in work and provide proper protective
devices as well as it is obliged to undertake all measures to secure healthy and safe working environment.
Novelties in this law are also the extension of sick leaves from 15 calendar days into 30 working days and
extension of maternity leave from 3 months into 6 months.
As I mentioned our health system is public-public we do not have health insurances fund and the government
pays all health services. As both occupational institutes are part of health system workers-patients do not pay for
services that they receive but due to lack of fund in some cases some of health services are limited.

6. The health insurances fund law is under preparation. Major part of it have been concluded but due to financial
cost it has been postponed for approval in next year based on advises of World Bank and International
Monetary Fund.
The rights and obligations concerning labor relations are regulated in order of priority by the following sources:
a) The constitution of Republic of Kosovo
b) The collective contract of employment?
c) The individual contract of employment
d) Code of labor
Occupational accidents and occupational disease
The deficiencies on the accurate evaluation of the occupational accidents are conditioned by the following
factors:
1. Lack of accident declaration
2. Lack of mild injuries
3. Lack of registration of the self employed persons or part time employers
4. The information about injured persons is deficient etc
Reporting occupational diseases
It is very difficult to report Occupational disease because of:
1. The partial coverage with health service of the enterprises
2. Deficient specialization of doctors engaged full time on health service in enterprises
3. The deficient of cabinets for Occupational disease
For this reasons the numbers of Occupational injuries is far away from what is present in the field
The most occupational diseases in Kosovo are Pneumoconiosis leads by Anthracosis.
Occupational health education
Faculty of Medicine
There is a subject of Occupational Medicine at least 45 hours for Medical students,and specialization on
Occupational Medicine that last 3.5 years.
Moreover, there is no training for occupational health nurses.
Occupational Health services

7. Both institutes provide professional services through diagnostic testing of patients. The services are
/divided into following departments:
• Otorhinolaryngology
• Gynecology
• Medical laboratory
• Ophthalmology
• Internal Medicine
• Cardiology
• Neurology
• Psychiatry
• Dermatology
• Pulmology
• X-Ray Department
• Occupational Medicine
Discussion
1. Low number of OM specialists
2. Urgent needs to increase the scientific and professional staff as: sanitary inspector, hygienists,
psychologist etc.
3. Half of the municipalities does not have OM staff
4. More than half of OM specialists are concentrated in Prishtina
The future of Occupational Medicine
This should be based on:
1. The maximum utilization of existing human resources
2. Continual increasing of professional staff
3. Development of information system within health information system
4. Orientation from curative form to preventative one
5. The recovery of Association of physicians of the OM
6. Establishment of Central Institute of Occupational Medicine

8. Operating scheme of Occupational medicine
DEPARTMENT OF SCIENTIFIC
RESEARCH
-scientific projects
-scientific meeting
-edition of scientific magazine
MEDICINE FACULTY
INSTITUTE OF
OCCUPATIONAL HEALTH
DEPARTMENT OF PROFESSIONAL PRISHTINE
DEPARTMENT OF TRAINING AND
DISEASES EDUCATION OF NEW GENERATION
-hospital treatment -permanent education
-examination -training
-evaluation of working ability -specialization
Figure 4. Operating scheme of Occupational medicine, done and presented to Government by
Prof.Dr. XhevatShkodra

9. Main Problems?
The main problems are:
Health system and health financing. There is inadequate financing of health services and health needs,
with other words lack of finances offered by government for health sector and there is not clear policy to
develop health sector and produce proper legislation for regulate health financing.
References
1. Shkodra ,Xhevat Prof.Dr.2002 Resurset e tanishmenjerëzore,aktivitetet e
tyrenëkuadërtëMjekësisësëPunësdhenevojatpërtrajnim
2. Arënliu-Qosaj, Fatime and Koçinaj-Berisha,Merita 2010. Transition in Health and Health Care in
Kosovo
3. Kosovo Agency ofStatistics,2009.SocialStatistics.Health Statistics.
4. ____.2011.Kosovo Census
5. ____.2009.Population Statistics
6. ____.2009. Economic Statistics.
7. ____.2009.Labour Market Statistics
8. UNDP.2012. Kosovo Human Development report 2012-Private sector and employment
9. Law No. 2003 / 19 On Occupational Safety, Health Andthe Working Environment
10. Law No. 2004/4 Kosovo Health
11. Law No.03/L-212 On Labor