Partnering for Progress: The PPP Driving Innovation in Albania’s Lab Services

For years, Maksim Byku regularly visited a local health laboratory in Elbasan, Albania to monitor his health through various tests. He had to deal with multiple challenges: prolonged wait times, steep fees, and the lab’s frequent requests for him to return to repeat tests due to inconclusive or inaccurate results.

Byku is not alone. For decades, Albania’s ’s health system struggled with inadequate lab facilities that failed to provide quality health care. Essential chemicals for tests were often in short supply, so many patients had to go to more expensive private labs. Yet even there, results were inconsistent, as only one private lab met international standards. These factors drove up health care costs in the country. Before 2019, out-of-pocket health expenditures in Albania were among the highest in the Balkan region, making up 55 percent of the nation’s health care spending.

Accessible Care Close to Home

Between 2020 and 2023, the first 4 years after the PPP went into effect, Albania’s health system performed more than 12 million tests, introducing new diagnostic tools for heart attacks, heart failure, blood clots, and acute infections. During this period, about 1.7 million Albanians received critical lab services free of charge through the public health system.

Patients like Byku now have access to public labs equipped with cutting-edge technology, regardless of where they are located. One central public lab in the capital, Tirana, handles referrals from other labs and provides emergency and specialized testing for tumor markers, hormones, and genetics, among others. Six regional labs, meanwhile, conduct a range of tests, and the remaining hospitals operate satellite laboratories to conduct laboratory analysis quickly.

 This new system has eliminated the need for some patients to travel to Tirana, the capital city, for specialized tests. Routine testing and samples collected within local communities are safely transported to the nearest regional or central lab, depending on the type of test, and results are returned in a seamless and efficient manner.

Prescribed tests are free of charge to referred patients, including those who are uninsured, allowing everyone to access free laboratory services throughout the country.  At the same time, the PPP contract is performance-based so the consortium has to meet clearly defined performance indicators for timely and quality services, such as maximum turn-around time, daily quality controls, and accreditation of a list of critical tests. As a result, Albanians have access to improved lab services through the public system within the government-set budget.

Community Impact

For Sabri Gurakuqi, a fellow patient in Elbasan, the success of this PPP serves as a shining example of the transformative power of PPPs in healthcare: “I fully respect the staff working for the Laboratory Network, they are heroes. I am a long-time patient and know things from before, so I can confirm that the equipment of the laboratory network is very modern—the latest technology— and the number of the analyses is multiplied compared to the number of the analyses that we used to do before.”

As Albania continues its journey towards a healthier and more prosperous future, the impact of this PPP will be felt for generations to come. And as countries around the world grapple with similar challenges in delivering healthcare services, the Albanian model offers valuable insights into how collaboration between the public and private sectors can drive positive health outcomes.

Published August 2024.