Spasovski, Mome

Preferred name

Spasovski, Mome

Official Name

Spasovski, Mome

Main Affiliation

mome_spasovski@medf.ukim.edu.mk

Now showing 1 - 10 of 13

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Rising prevalence of diabetes: evidence from the national registry in North Macedonia
(Oxford University Press (OUP), 2019-11-01)
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Stevanovski, G
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Disease reporting and data collection are key tools for the health care systems in order to identify opportunities to address burden of diseases. The country’s diabetes patients register was the first registry to be integrated with the e-health system in North Macedonia in 2017. We aimed to estimate type 2 diabetes mellitus prevalence and effectiveness of diabetes control as one of the proposed national priorities in tackling the non-communicable diseases. </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Cross-sectional descriptive study was conducted on patients entered in the National Diabetes Register in 2017/2018. Patients’ socio-demographic and anthropometric characteristics in association with diabetes’ complications and outcomes were determined by Pearson correlation coefficient (P < 0.0001, 95% CI).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>This study identified a total of 35541 patients with a diagnosis of diabetes, out of which 32888 with type 2. This corresponds to a prevalence rate of 1583.9 per 100,000 population. The prevalence increased with age (65+) and was higher among females than males (56.8% vs. 43.2%). Over 80% of type 2 patients were overweight out of which 34.5% obese (BMI>30kg/m2). Diabetic retinopathy is reported as first diagnosed complication in diabetic patients, followed by neuropathies and vascular complications. Patient’s low level of education and higher BMI were associated with increased number of early and late-onset complications.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Evidence accumulating suggests high burden of complications in type 2 diabetic patients, indicating that the patients understanding of diabetes care, treatment adherence and healthy lifestyle are important topics to be address by health professionals in order to avoid complications and premature deaths in people with diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>Key messages</jats:title> <jats:p>Integrated reporting of non-communicable diseases and risk factors is needed to complete current information gaps, from completeness of data to quality and comparability. The action plan for chronic diseases should specifically address diabetes control, as most of the patients with diabetes have high prevalence of comorbidities, complications and unfortunate outcomes.</jats:p> </jats:sec>
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Understanding the health context for implementation of a new digital psychosocial intervention for improvement of the mental health in North Macedonia
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2022-06-23)
Novotni, Ljubisha
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Markovska-Simoska, Silvana
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Milutinovikj, Milosh
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<jats:p>The aim of this study was to identify the contextual attributes in North Macedonia and their characteristics relevant to the implementation of a new digital intervention to improve mental health, called DIALOG+. This research is the first of its kind in North Macedonia due to the analysis of contextual attributes that may affect the effectiveness of the intervention and its acceptability in various settings of mental health care. Some of the data processed in this paper were provided and analyzed by the National Mental Health Strategy 2018-2025 and other relevant accompanying documents from the World Health Organization and action plans, as well as through interviews with stakeholders (patients, carers, clinicians and policy makers) for their opinion before introducing the DIALOG + intervention and the report on the assessment of the situation in the centers where the implementation of the intervention should have started. The collected data were then mapped to a framework developed by the Ottawa Implementation Group, which included 14 contextual attributes. The results are summarized in 2 subgroups, and are presented as facilitators and barriers to implementation, specific to the mental health system in North Macedonia. The characteristics of DIALOG + (widely applicable psychosocial intervention) are in accordance with modern assumptions for psychosocial rehabilitation of patients with psychosis. Hence, we can conclude that it is a useful tool for professionals in monitoring and achieving the true vision and mission of these institutions. It will help patients reintegrate into society, become more independent and use their full potential in the pursuit of healthy and functional living.</jats:p>
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Smoking Prevalence and Attitudes Toward Smoking Among Medical Doctors in the Republic of Macedonia
(European Network for Smoking and Tobacco Prevention, 2018-06-13)
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The legal and institutional response to gender-based violence in Macedonia
(Institute of Public Health of Republic of Macedonia, 2018-12)
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Spasovska, Elena
Background: The role of the women and gender equality are important issues in Macedonia, both the Constitution and the national laws guarantee equality between men and women. Additionally, Macedonia has ratified both the Convention on the elimination of all form of discrimination against women (CEDAW) and the Istanbul Convention. However, widespread violence against women and girls persists. Objective This study examines the legal and institutional state response to gender-based violence, the potential and shortcomings of legislative and policy action. Methods An extensive desk research was conducted of policy documents, national strategies, reports and specific legislation, enriched with public policy framework analysis and system approach. Results Legal protection in Republic of Macedonia, in case of gender-based violence is realized through a positive legal framework, addressing domestic violence, rape, sexual violence as well as sexual harassment at the workplace and trafficking in women. Over the past decade, one national strategy was implemented for protection against domestic violence, and one action plan for the fight against human trafficking and illegal migration. Institutional response and support services include: six women’s shelters for survivors of domestic violence, one for victims of trafficking, complemented with free legal aid, three counseling centers and three women’s help lines. Discussion Despite this progress in the adoption of national violence laws, major challenges persist related to the application of legislation, procedural challenges in providing evidence and access to legal, healthcare and other services for survivors. Furthermore, laws are not enforced due to the culture of patriarchy and social norms. In addition, there is not specific provision that criminalizes rape or sexual assault within marriage, nor a shelter for survivors of sexual violence. Conclusion This study concludes that a comprehensive approach and overarching strategy is needed, to include: violence prevention, strengthening legal and policy frameworks and co-operation between all involved actors.
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Lifestyle risk factors and control of chronic non-communicable diseases
(Institute of Public Health of Republic of Macedonia, 2018-06-15)
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Chingoska, Daniela
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Pecev, Petar
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Non-communicable diseases, also known as modern-life diseases, are the leading cause of morbidity and mortality in the world and in the Republic of Macedonia. The complexity of their occurrence, often associated with multifactorial etiology and lifestyle risk factors, has a significant impact on preventive interventions, requiring broad intersectoral cooperation. The aim of the paper is to present thecurrent situation and burden of malignant neoplasms, cardiovascular diseases and diabetes in the Republic of Macedonia, associated with unhealthy lifestyle. Comparison between the mortality data for cardiovascular and malignant neoplasms and the prevalence of diabetes with data for Croatia, Slovenia and France was made. Data on morbidity and mortality for malignant neoplasms, cardiovascular diseases and diabetes was obtained from the reports on the health status of the population in the Republic of Macedonia, from the Register of chronic non-communicable diseases, as well as from the annual health reports for the population in R. Macedonia 2014 and 2015 and HFA database of the World Health Organization. The results are statistically analyzed, tabulated and graphically presented using an analytical-descriptive method. The data shows that in R. Macedonia the mortality rate from cardiovascular diseases is 545 per 100,000 inhabitants in 2014, and 180.4 per 100,000 inhabitants of malignant neoplasms. The prevalence of type 2 diabetes for 2013 expressed at the rate of 100.000 inhabitants is 2386.3. In R. Macedonia the data shows a continuous decline in hospital morbidity, both of cardiovascular diseases and malignant neoplasms, while ambulatory - polyclinic morbidity is on a steady increase. France shows the lowest rate of CVD mortality and malignant neoplasms. By analyzing the risk factors of chronic non-communicable diseases, we have noticed that a high percentage of the population in R. Macedonia has unhealthy lifestyle, especially the young population.
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Challenges in the organization of the emergency care units in Skopje
(2019)
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Pangovski, Ivan
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Mehmedoviкј, Zlate
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Hasani, Shpresa
Background: Emergency ambulance care is regulated at national level, where services are provided manly at the public health centers with free access to all, as integrated care consists of ambulance services, home visits and night shifts services. Aim: This study provides an evaluation of emergency medicine preparedness, national response plan to manage health threads and outlines the current demands on the health care system. Methods: Retrospective analysis on patient's medical records was conducted to review emergency care, including ambulance services provided on the territory of the capital city, Skopje. Operational, human resources capacity, availability and time response were the assessed outcome measures, compared with community needs and national operational minimum standards for care, equipment and qualifications. Results: In our study we have analyzed 181785 medical records of provided integrated ambulance services per 700,000 inhabitants in 2018, recorded by the Health Center. The average rate of emergency calls per day was 88, out of which 22 were level 1 emergency, with response time of 36 minutes. The delay in time response is the result of lack of operational and human resources. According to the population there should be minimum of 100 teams, but the public emergency units have only 28 teams with total of 57 medical doctors and 11 emergency vehicles, out of which, two type A for patient transport and nine emergency ambulances type B. Conclusion: Enhancing the capacity of emergency and ambulance care is an important demand on the health care system in order to meet community and local needs. Introducing a paramedic workforce in the ambulance services and collaboration with social and mental health teams to improve access and quality of services are proposed interventions.
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Health System Preparedness And Response For COVID-19 Pandemic In North Macedonia
(Македонско лекарско друштво = Macedonian medical association, 2020-11)
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Chingoska, Daniela
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Pangovski, Ivan
Objectives: Health systems are the first defense line against epidemics and pandemics. However, in the past two decades, several epidemics including the SARS-CoV-2 virus pandemic have shown unprecedented challenges for the health system’s response and the need to strengthen national capacities and preparedness plan in terms of sustainability and financing. The main objective of this study was to explore the preparedness of the health system and to evaluate the national health -care response to COVID-19. Material and Methods: World Health Organization’s (WHO) toolkit was used for assessing health-system capacity for crisis management and emergency preparedness. Assessment of essential attributes and key components for health system function: a) leadership and governance; b) health workforce; c) medical products vaccines and technology; d) health information; e) health financing; f) service delivery. Data was retrieved from legislation and policy documents, reports, and publications published at the official websites of the Ministry of Health, Institute of Public Health, and Government of the Republic of North Macedonia. Results: The national risk management was led by the Government and the Ministry of Health based on the national plan for preparedness and response of the healthcare system in emergencies, crises and disasters as well as an adapted version of the WHO’s strategic preparedness and response plan, according to which the country was classified as level 3 preparedness. Shortage in laboratory testing capacity, personal protective equipment and healthcare capacity as ICU ventilators and health workforce capacity were the main challenges for the national health system. Informing the public community was an important component of the national response which included risk communication, key prevention and preparedness measures to ensure individuals adopt protective behaviors and daily infographic statistics. Conclusion: COVID-19 is a public health emergency that tested the resilience of the national healthcare system as well as other sectors of government and the whole society. We identified a great need to increase capacity to identify suspected cases of COVID-19 in the general population, to introduce participatory community interventions, and to ensure sustainable financing in the health sector for crises and epidemics. An absolute priority in the pandemic is hospital preparedness and health workforce training and coordination.
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Parental education as a determinant of obesity in children
(2023)
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Mihajlova, Katerina
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This cross-sectional study aims to investigate the influence of parental education on children’s health-related behaviours and obesity risk status using the data on children aged 7 years and their families living in Macedonia and participating in the 5th round of the WHO European Childhood Obesity Surveillance Initiative. Overall 31.6 % of the children were overweight and 15.3 % living with obesity, with little difference between genders. The results showed that the prevalence of overweight and obesity was higher among children whose parents had a medium level of education (36.1 %) with a small difference between low (34.3 %) and high level (32.4 %) of parental education. A high level of parental education was associated with “healthy” behaviours in children, who were more likely to eat daily breakfast, fresh fruit and vegetables, had less frequent consummation of soft drinks (less than three times a week), and were more likely to practice sport at least two hours a week compared to children whose parents had a low level of education. However, sedentary behaviour in children measured as at least two hours of screen time daily was more prevalent in children of parents with a high level of education. These findings indicate that parental education should be considered in population-based interventions design, although comprehensive research and approach are needed in evaluating the family environment to better address obesity drivers in children.
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Strategy for Developing a Smoking Cessation Program in Macedonia
(E-Cronicon, 2020)
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Arben Rexhepi
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Macedonia has one of the highest smoking rates in Europe and ranks among the top ten globally. Although there is a moderately strict anti-smoking legislation, tobacco free policies are not financially supported and smoking cessation activities are not included in the regular educational process of health workers in the country. Smoking cessation is not considered a medical intervention, there is no consistent access to nicotine replacement therapy or other cessation medications, nor are they covered by health insurance. The goal of the partners from Henry Ford Health System and the University St Cyril and Method in Skopje was to develop and adapt a Certified Tobacco Treatment Specialists program (aCTTS). A team of physician champions was created to facilitate implementing the program and to educate respiratory and internal medicine specialists, as well as general practitioners who proceeded treating patients for tobacco dependence. During the first four months of the intervention 64,668 patients visits were registered, 25,710 (40%) of them for tobacco-related diseases. Of the latter, 18,558 (72%) included smoking cessation counseling, which by itself is a great progress to reaching a striving population of smokers.
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Knowledge about human papillomavirus and associated factors among population in the Republic of Kosova
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2022)
Kosumi, Ernad
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Above 70% of sexually active women and men will be infected with human papilloma irus at some point in their lives, and several may yet be infected in more than one circumstance. Around 80% of sexually active women acquire HPV infection, while for the most part, they are asymptomatic with the immune system-mediated clearance of contagion within 6–12 months. High-risk papillomavirus is accountable for causing cancer associated with the cervix, vulva, vagina, anus, penis, and oropharynx. This survey aims to investigate the level of knowledge among residents in the Republic of Kosova regarding human papillomavirus (HPV) infections and HPV-associated diseases and to discover the relationship between these factors. Material and methods: A cross-sectional survey was performed by investigating the knowledge concerning HPV infection in the population aged 18 to 35+ years. The study was conducted in the interval from June 2021 - August 2021. The sample included 500 participants. The questionnaire was anonymous, and participants were free to end the participation at any time, without finishing the questionnaire. Results: More than half of the respondents knew about HPV - 70.0%, and 29.6% did not know. Respondents with secondary and higher education showed 18 times more knowledge for HPV (OR = 18.1311 95% CI: 8.7465-37.5852) than respondents with primary education. To the question Can HPV cause cancer of the cervix, 37.2% (n=186) of the respondents gave a correct answer. The results presented that most participants knew what HPV was (70%), but they also revealed that most participants had low or moderate knowledge about HPV, which was a comparable result with earlier studies. A small number of participants in this survey knew that HPV could heal by itself (12.8%), which was similar to results presented in other surveys. Conclusions: It is important to improve the inadequate knowledge about HPV among the population in the Republic of Kosova. In order to do that, it could be significant to assess which factors affect the knowledge so that young women and all adolescents will get pushed to use protective measures against cervical cancer and have protected sexual behaviour

Spasovski, Mome

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