The caddisfly fauna (Insecta: Trichoptera) of Shar Planina mountain (Republic of North Macedonia)

  • Abstract
  • Literature Map
  • Similar Papers
Abstract
Translate article icon Translate Article Star icon
Take notes icon Take Notes

Shar Planina mountain, spanning through North Macedonia and Kosovo, are a significant biodiversity hotspot in the Western Balkans. Despite their ecological importance, data on the region’s caddisfly (Trichoptera) diversity remain scarce and fragmented. This study compiles a comprehensive review of all published records alongside findings from a seven-year field investigation across various habitats in North Macedonia’s part of Shar Planina mountain. As a result, the first checklist of Trichoptera species for the region is presented. According to literature and our new faunistic data, a total of 63 species are currently known from Shar Planina mountain. Notably, ten species are newly reported for the mountain and one is newly recorded for North Macedonia. The study highlights the conservation significance of these species and identifies ecologically sensitive areas based on caddisfly distribution. These findings enhance our understanding of freshwater biodiversity in a region recognized for its rich natural heritage.

Similar Papers
  • Research Article
  • Cite Count Icon 3
  • 10.1111/jcms.13403
Battered by Geopolitical Winds, Bulgaria Struggles to Restart Much Needed Reforms
  • Aug 3, 2022
  • JCMS: Journal of Common Market Studies
  • Antoaneta L Dimitrova

Battered by Geopolitical Winds, Bulgaria Struggles to Restart Much Needed Reforms

  • PDF Download Icon
  • Research Article
  • Cite Count Icon 1
  • 10.4067/s0718-18762016000200001
Editorial: Enterprise Websites Usage in the European Union - Outlook to the Western Balkans Countries
  • Jan 1, 2016
  • Journal of theoretical and applied electronic commerce research
  • Ksenija Dumicic + 2 more

IntroductionThe Internet usage by individuals and enterprises has become unavoidable in the contemporary society [16], [20], [21], [25], [27], especially taking into account the European Commission's Digita l Agenda [6], [28]. Therefore, it is very important for enterprises to recognize usefulness and potential benefits of being present on the Internet [22], [27]. Although many enterprises use social media and Web 2.0 tools [2], [3], [23] there are still numerous enterprises that have not decided to open their own website yet [26].There are many factors which influence the decision whether to have or not to have a website [25]. However, in this paper only variables related to the information technology (ICT) usage for e-commerce purposes (online ordering and buying), and availability of ICT infrastructure (e.g. broadband availability) were taken into account as possible determinants of the decision on the establishment of a company's website. A similar approach was used by [1], [4], [15].In the analysis, the ICT development levels (in terms of enterprise websites, e-commerce and ICT infrastructure) in selected European countries were observed, with a special focus on the following selected Western Balkans (WB) countries: Bulgaria, Croatia, Greece, Romania, Serbia, Slovenia, and the Former Yugoslav Republic of Macedonia (FYROM). Since Bulgaria, Croatia, Greece, Romania, and Slovenia are the EU member states, whereas Serbia and the Former Yugoslav Republic of Macedonia (FYROM) are not, it is expected that these five EU member states have a higher ICT development level than the two named non-EU member states, which is in line with the previous research [5], [19].The paper is organized as follows. After a brief Introduction, Chapter 2 describes data and methods used in the research. In Chapter 3, results are discussed whereas in Chapter 4 conclusions are brought.in full.Data and MethodsThe data used in the analysis are extracted from the Eurostat database. The list of all selected ICT variables is given in Table 1. The percentage of enterprises having a website or homepage is determined as the dependent variable of the research, while there are also two groups of potential independent variables: e-commerce-related variables and ICT infrastructure-related variables. E-commerce-related variables measure the percentage of enterprises having purchased via computer-mediated networks and having received orders via computer-mediated networks. ICT infrastructure-related variables measure variables such as the percentage of enterprises with a broadband access (fixed or mobile). All the information is presented as the percentage of enterprises, having at least 10 employees, in a particular country in 2015. Financial sector enterprises were not included in the analysis.Data are collected for enterprises from 33 European countries, namely, for all the European Union member states (EU28), Iceland, Norway, Serbia, FYROM and Turkey. Even though the most recent data, from 2015, are collected for most of the countries, data from 2014 were used as an approximation for 2015 for Iceland, Serbia and FYROM. Similarly, because of the same reason data from 2014 were also used for the variable XPurch for Denmark and for the variable XMobBAcc for the United Kingdom. Unfortunately, the most recent data for the variable XPurch for Turkey are those for the year 2010, and this information was used as a proxy for the 2015 level, corrected by the increase in t he variable XOrder, which is available for the year 2015.First, an outlier detection and analysis is performed due to the fact that outliers could have a significant impact on the results of the analysis. The outliers were omitted from the analysis. Second, after omitting detected outliers, descriptive statistical results are provided for each variable separately. The position of the observed WB countries according to the values of the observed ICT variables is additionally examined using profile diagrams. …

  • Book Chapter
  • 10.1007/978-3-031-07191-1_14
A Proposal to Assess Civic Capacities in Higher Education: A Case from the Western Balkans – North Macedonia
  • Jan 1, 2022
  • Cassie L Barnhardt + 1 more

In working to achieve member status in the European Union, the Republic of North Macedonia seeks to institutionalize infrastructures of democracy. To date, few initiatives have considered how universities in North Macedonia prepare students for citizenship and social responsibility. Our research team of international collaborators has developed the ACE-HES survey to assess the relationship between higher education and democracy for the purpose of building national and regional civic capacities. Our survey represents one of the first of its kind because it addresses civic phenomenon at the postsecondary level of education. By highlighting the civic dimensions of higher education, our work constitutes a shift towards pursuing university reform through a cultural approach involving data and organizational sense-making. We describe the background foundations of the survey constructs and the framework. We also describe an assessment approach involving a whole-of-the-university approach (students, faculty, management) to foster collective commitments to democratic values and actions. While this project is situated in North Macedonia, it has been designed to be elaborated more broadly to other countries in the Western Balkans - a part of the world where democracy is relatively young and fragile, and university quality is inconsistent. Moreover, we present an approach that ties educational quality to democratic values through the mechanism of a nation’s enduring institutions – universities – with the ambition to strengthen the civil and higher education sectors simultaneously.

  • Research Article
  • 10.5325/hiperboreea.10.1.0128
Alexandre Kostov, ed. Contemporary Balkans. The Challenges of the 21st Century
  • Jun 1, 2023
  • Hiperboreea
  • Sorin Paliga

Alexandre Kostov, ed. <i>Contemporary Balkans. The Challenges of the 21st Century</i>

  • Book Chapter
  • Cite Count Icon 3
  • 10.1007/978-3-030-41272-2_26
North Macedonia: The Name in Exchange for European Union Membership?
  • Sep 9, 2020
  • Irena Rajchinovska Pandeva

North Macedonia is, in all probability, the poster country for the reluctant enlargement policy by the European Union (EU) towards the Western Balkan (WB). Due to a concoction of internal and external issues, over the past years the country was left standing still at the intersection of an alignment with the West or seclusion to the regional conundrum. North Macedonia became a candidate country for EU accession in 2005 as a frontrunner in the WB and pledged to follow the accession agenda, so the EU became highly involved into its daily politics equally by the process of integration and the membership conditionality. The first recommendation for the start of accession negotiations was announced in 2009, and even though it was followed by subsequent recommendations by the European Commission, the Council’s conclusion in October 2019 was a negative one. The decision not to open negotiations due to the objection of a few member states, most predominantly France, provoked a serious anti-EU sentiment in North Macedonia, and, beyond everything, a resentment since it was openly associated with the notion that the name was sacrificed in exchange for the EU accession. The reaction was widespread and intense and even led to the decision to have early parliamentary elections. In addition to the impact on national affairs, this outcome has disregarded the promise of EU enlargement policy in the WB, and North Macedonia in particular, and may challenge its stability and security, to such an extent that the impending North Atlantic Treaty Organization (NATO) membership, assurances of economic support and cooperation and EU regional and national presence cannot balance them out.

  • Research Article
  • Cite Count Icon 3
  • 10.21113/iir.v9i2.512
An Overview of Doing Business in Western Balkan: The Analysis of Advantages of Doing Business in Kosovo and North Macedonia
  • Dec 19, 2019
  • ILIRIA International Review
  • Dr.Sc Gëzim Jusufi + 1 more

Achieving sustainable market economies in the Western Balkan countries will depend on a number of barriers being overcome. For this reason, these countries lack competitiveness in the business environment. Many problems in the business environment are persistent but common problems across of the countries of this region are getting electricity and construction permits. These problems or barriers are set out in Doing Business Reports of World Bank. The paper reviews doing business in Western Balkan countries especially in Kosovo and North Macedonia. The main goal of this paper is to analyze of the advantages of doing business in Kosovo and North Macedonia, where does Kosovo stand in terms of doing business in relation to North Macedonia and what Kosovo needs to learn from North Macedonia in order to improve the business environment. To achieve the set goal, we have used the integrative review method. The results show that North Macedonia is a leader in the Western Balkans in doing business because the great campaign done by the Macedonian institutions for attracting Foreign Direct Investments (FDI). So, Kosovo should be based on North Macedonian practices. A new investment campaign in Kosovo would certainly have a positive impact on business environment.

  • PDF Download Icon
  • Research Article
  • Cite Count Icon 12
  • 10.1186/s13071-018-3051-x
An update of the Culicoides (Diptera: Ceratopogonidae) checklist for the Balkans
  • Aug 13, 2018
  • Parasites &amp; Vectors
  • Dubravka Pudar + 20 more

BackgroundThe prime significance of species belonging to the genus Culicoides Latreille, 1809 (Diptera: Ceratopogonidae) is their ability to transmit viruses such as bluetongue virus (BTV) to wild and domestic ruminants. Prior to 1998, BTV was considered exotic in Europe, but according to recent history of its outbreaks, it has become endemic in southern and eastern European countries circulating beyond its expected historical limits, into the Balkan region. The wind-borne long-distance dispersal of Culicoides spp. over water bodies and local spreading between farms emphasize the necessity of filling in the information gaps regarding vector species distribution. In most Balkan countries, data on Culicoides fauna and species distribution are lacking, or information is old and scarce.ResultsDuring this study, 8586 specimens belonging to 41 species were collected. We present the first faunistic data on Culicoides species in the former Yugoslav Republic of Macedonia (FYROM), Kosovo, Montenegro and Serbia. For other countries (Bosnia and Herzegovina, Bulgaria and Croatia), all historical records were compiled for the first time and then expanded with our findings to various extents. In all countries, confirmed or suspected BTV vector species belonging to the subgenera Avaritia and Culicoides were collected. The total number of species sampled during our field collections was 20 in Bosnia and Herzegovina (15 new records), 10 in Bulgaria (2 new records), 10 in Croatia (5 new records), 13 in FYROM, 9 in Kosovo, 15 in Montenegro, and 28 in Serbia. Of these, 14 species were registered for the first time in this part of the Balkans.ConclusionsThis paper provides the first data about Culicoides fauna in FYROM, Kosovo, Montenegro and Serbia, as well as new records and an update on the checklists for Bosnia and Herzegovina, Bulgaria and Croatia. These findings provide preliminary insights into the routes of BTV introduction and spreading within the Balkans, and present a valuable contribution to further research related to Culicoides-borne diseases in Europe.

  • Research Article
  • 10.35120/kij4701249d
US INFLUENCE IN THE REPUBLIC OF NORTH MACEDONIA AFTER THE PERIOD OF RENAMING
  • Aug 16, 2021
  • KNOWLEDGE - International Journal
  • Ilche Dimovski

The complex set of historical and political processes between the countries of the Western Balkans, as well as the absence of the EU from the region, complicates the process of building democratic and political capacities in these countries. The United States has a complex political approach to the Western Balkans, without having an exclusive ally in this part of the region. Although the region does not seem to be at the top of US policy priorities at the moment, the Western Balkans play an important role in its interests, especially when it comes to security issues, which have always been a top priority for the US administration. The public in the Republic of North Macedonia is still emotional about the process of changing the constitutional name, and the Prespa Agreement, although a closed topic for the US administration, at least judging by the last move of President Biden, is still not fully accepted, not only by the population, but also among some experts. Some critics comment on the distrust of the process "vis a vis" the constant blockades of the pre-accession negotiations with the EU, despite the name change, which by the way according to the amendments to the Constitution should be implemented in practice in parallel with the opening of EU negotiation chapters. This begs the questions: What is the US position on North Macedonia's strategic interests? Does and in what way does the United States influence North Macedonia through NATO? What are the benefits and prospects for North Macedonia from NATO membership? The purpose of this paper is to explain the US attitude towards North Macedonia from a geostrategic point of view by applying descriptive analysis. In 2008, after the Greek veto on Macedonia's membership in NATO, a Declaration on Strategic Partnership and Cooperation was signed between the United States and Macedonia, with which the United States guarantees the security of Macedonia, but without meaning a replacement for NATO membership. The Declaration is one of the most important agreements for North Macedonia, which emphasizes, among other things, the strategic commitment of both sides to Macedonia's integration into NATO and the EU, making the United States the only strategic partner and supporter (of the great powers) of Macedonia in its EU and NATO aspirations.Finally, in 2020, through the North Macedonian Embassy in Washington, the instrument for joining the North Atlantic Treaty was deposited, with which North Macedonia officially became a member of NATO.

  • Research Article
  • 10.5937/spm86-50170
Geopolitičke (ne)prilike vs. "zakasnelo" reagovanje spoljnopolitičke službe Severne Makedonije u procesu evropskih integracija
  • Jan 1, 2024
  • Srpska politička misao
  • Sanja Jelisavac-Trošić + 1 more

In the case study of the foreign policy of North Macedonia, we can clearly see how global events, viewed from the perspective of geopolitical circumstances, do not always and as a rule have a direct impact on national internal and regional events in the Western Balkans, nor on the foreign policy actions of the Western Balkan six. In the paper, four determinants were singled out, on the basis of which explanations were provided, in a scientific and research context, why the foreign policy mechanism of North Macedonia "failed" in the process of achieving defined foreign policy goals, above all the basic goal - the country's accession to the European Union. At the same time, the lack of effectiveness of foreign policy action was not in a cause-and-effect relationship with wider European and international geopolitical circumstances. The internal armed conflict in North Macedonia, which threatened to develop into a civil war between the dominant ethnic communities of Macedonians and Albanians, is the first indicator, i.e. the determinant of the explanation why the foreign policy mechanism of North Macedonia "failed" in the process of this country joining the European Union. Another significant moment that was missed in the European integration process of Skopje, covers the period from 2006 to 2017 with two stages: the period leading up to the NATO Summit in Bucharest in 2008 and the period after this summit, up to the change of power of former Prime Minister Nikola Gruevski, which has led to a multiple crisis within that country. The postponement of North Macedonia's accession to NATO in 2008, due to Greece's express refusal, with a focus on connecting the Macedonian nation with the heritage of the ancient Macedonians, with the simultaneous suspension of democratic capacities and principles that represent significant determinants in the process of joining the European Union, leads to missing out and moving away from the path accelerated European integration of North Macedonia. As a third determinant, pervasive corruption was singled out, which affected all levels of government, so that the internal circumstances in North Macedonia actually "worked to the advantage" of the European Union, which at that time as a whole, and also individual member states of the Union, were also moving further away from the policy of enlargement as a mechanism in the process of European integration of both North Macedonia and the remaining countries of the Western Balkans. The aforementioned challenges, which North Macedonia has been facing for almost thirty years, are not in a cause-and-effect relationship with external, whether regional, European or international, geopolitical circumstances and trends. We are talking about challenges that, regardless of the geopolitical dimension of the enlargement of the European Union from the point of view of Brussels and the member states of the European Union, significantly affect the dynamics of North Macedonia's accession to the European Union, that is, the effectiveness of the process of realizing this strategic foreign policy goal. However, it is important to mention the foreign policy action of North Macedonia from the point of view of international law and the provisions of the UN Charter, which represents a strong fourth determinant in the context of the realization of North Macedonia's foreign policy goals. Here, it was possible to see how the international positioning of North Macedonia is conditioned to the detriment of the provisions and norms of international law. In this way, the principles of equality, sovereignty and political independence were placed in a subordinate position in relation to the factual political powers in interstate relations, directly harming the principle of self-determination, in the context of the identity attributes of North Macedonia and the Macedonian people.In the period when geopolitical circumstances were favourable to North Macedonia, the opportunity for this country to become a member of the European Union was missed, thus achieving a strategic foreign policy goal, which in the context of the EU did not cause any consequences when it comes to the EU itself. However, the consequences for North Macedonia itself remained and only in the following period did the circumstances worsen and lead this country to a longer and more difficult path to accession. The future policy should be based on strong tactical tools, which are sufficiently flexible in relation to regional and international trends. First of all, North Macedonia needs a strong internal institutional infrastructure, which simultaneously ensures political, social and economic stability and predictability. In this way, it would be possible to realize the established goals of the foreign policy of North Macedonia.

  • Book Chapter
  • Cite Count Icon 3
  • 10.1007/978-3-319-91095-6_28
Emigrants from the Western Balkans: The Region’s Money Sacks?
  • Aug 13, 2018
  • Iris Koleša

Centuries of emigration from the Western Balkans have had an impact on political, demographic, social, and economic developments in the region. Research on mechanisms, determinants, and particularly the economic outcomes of emigration for both individual countries in the region and the Western Balkans as a whole has been scarce, though. This chapter thus aims to (1) provide an overview of the existing studies and official statistics on emigration from eight Western Balkan countries (Albania, Bosnia and Herzegovina, Croatia, Kosovo, the Former Yugoslav Republic of Macedonia, Montenegro, Serbia, and Slovenia), (2) outline the economic impact of emigration on the region, and (3) set an agenda for future research in the field. The analysis of emigrants’ economic engagement in the Western Balkans since transition in the 1990s to date demonstrates that, although the globally dispersed and numerous emigrants from the region seem to remain involved in their countries of origin’s economies through foreign direct investment, remittances, and migrant entrepreneurship, the overall impact of the Western Balkan’s emigrants on both national and regional economies is limited. Structural obstacles to development are identified as key barriers to emigrants’ more notable and impactful economic engagement in their countries of origin and the region as a whole. To substantiate policy that would enhance economic outcomes of emigrants’ involvement in the region, further studies of motivation for- and determinants of emigrants’ economic engagement in the Western Balkans at both the individual and migrant community levels are needed.

  • Abstract
  • Cite Count Icon 2
  • 10.1093/eurpub/ckac129.736
COVID-19 vaccine hesitancy in five Western Balkan countries
  • Oct 21, 2022
  • The European Journal of Public Health
  • S Matovic Miljanovic + 3 more

BackgroundThe vaccine hesitancy is a matter of global concern with inadequate global uptake postponing the moment of reaching herd immunity and bringing the COVID-19 pandemics under control. Countries in the Western Balkans struggle with vaccine hesitancy, trying to bring vaccine acceptance and ways to improve it into the focus.MethodsA cross-sectional study on vaccine hesitancy was conducted from July to September 2021 and included adult population from Albania, Bosnia and Herzegovina, North Macedonia, Montenegro and Serbia (1605 individuals). Convenience sampling was applied using anonymized online questionnaire (shared through social media) measuring, among others, trust in societal factors, social responsibility and, the credibility of information sources about COVID-19 vaccines.ResultsThe highest degree of trust in societal factors was found in North Macedonia (M = 3.65, SD = 1.06), followed by Montenegro (M = 3.50, SD = 1.19) and Serbia (M = 3.24, SD = 1.26). In Albania 44.7% respondents believed in reluctance of pharmaceutical companies to publish detailed research reports on the risks of adverse reactions to COVID-19 vaccines. The view that the health authorities when they encourage vaccination do so with the best intentions supported 66,3% respondents in North Macedonia and 49% in Albania and Serbia. The highest level of social responsibility (M = 4.12, SD = 1.09) was revealed in North Macedonia. Primary care physicians, health professionals in media, webpages of public health institutions, and scientific literature are the most trusted sources of information about COVID-19 in all countries.ConclusionsThe study demonstrated moderate trust in societal factors and moderately high level of social responsibility in all countries. The health professionals enjoy the greatest trust, which implies that medical doctors, especially physicians in primary health care should have a pivotal role in promoting vaccination and educating the general public in the Western Balkans.

  • Research Article
  • 10.37837/2707-7683-2020-40
Euroatlantic Integration in Western Balkans: Lessons for Ukraine
  • Jan 1, 2020
  • Diplomatic Ukraine
  • Vitalii Martyniuk

Ukraine’s constitutionally enshrined goal to become a NATO member encourages the state to more intensively explore and utilise the experience of the countries that have recently joined the Alliance, i.e. the countries of the Western Balkans. Their NATO integration comes amid relatively recent independence, resolution of post-war problems, and countering Russia’s influence in the region. This issue is similar for Ukraine, and therefore the article is devoted to studying the attitude and requirements of NATO to new candidate countries and a comparative analysis of the key features of Euro-Atlantic integration in the Western Balkans and mechanisms to counter them employed by Russia. The stability of the Western Balkans is seen by the Alliance as one of the key factors in Euro-Atlantic security, and NATO has made a political decision on the membership of the states of the region, some of which – Slovenia, Croatia, Albania, Montenegro, and North Macedonia – have already achieved this goal. NATO is not reducing its focus on the region, as Bosnia and Herzegovina is still a candidate country. The Alliance is also developing an in-depth partnership with Serbia to transform the region into an area of peace, security, and stability. Russia’s priority goal is to prevent Ukraine from joining NATO, as this will mean the final withdrawal of our country from the sphere of Russian influence. Meanwhile, Moscow will continue its anti-Alliance activities in the Western Balkans, pursuing a dual goal of diverting NATO’s attention from Ukraine’s Euro-Atlantic integration and maintaining and strengthening its influence in the region. The conclusions made in the article can be used to further develop Ukraine’s cooperation with NATO, prepare the country for membership in the Alliance and in the process of writing annual national programmes and planning activities for their implementation. Keywords: Euro-Atlantic integration of Ukraine, Western Balkans, NATO, Russian Federation.

  • Research Article
  • 10.52259/historijskipogledi.2025.8.13.288
Bosnia and Herzegovina between Russia and the West in the early 21st Century
  • Jun 30, 2025
  • Historijski pogledi
  • Izudin Šarić

The Balkans is an area where different groups of people live, who speak different languages, and whose culture and traditions are very rich. And as such, it has always been considered a place of possible conflicts of cultures and civilizations, of the West and the East. Throughout history, the Balkans have proven to be a powder keg, the place where many conflicts and problems arose. A place of dangerous living! The area of Southeast Europe is considered by the international community to be the Western Balkans. These include Serbia, Bosnia and Herzegovina, Montenegro, North Macedonia, Kosovo and Albania. Such a name, awarded by the European Union, speaks of the great importance of this area. The Western Balkans is a purely political term. The countries of the Western Balkans in the new geopolitical picture of the world found themselves in a split between the NATO alliance, America, the European Union and Russia. The presence of Russia in the Western Balkans represents a significant problem and does not contribute to regional stability. NATO's aspirations to expand into this region are aimed at admitting as many countries as possible to its membership, which is intended to further undermine Russia's role in this area. That is why Russia is trying in every possible way to prevent the expansion of NATO by creating further instability. Russian aggression against Ukraine has only fueled the efforts and efforts of the USA and the EU to speed up the process of accession of the countries of the Western Balkans to the European Union and the NATO alliance. The case of Bosnia and Herzegovina is probably a classic example of Russia's efforts to create instability in the region. Considering the internal organization of Bosnia and Herzegovina (two entities and Brčko District), as well as the current political situation, i.e. attitude of political actors from the Republika Srpska (RS) towards certain issues important for Bosnia and Herzegovina's progress towards EU integration, it is very important that the EU and NATO get involved as strongly as possible in solving this situation. Russia's influence on the current leadership of the RS is noticeable, primarily supporting Milorad Dodik's anti-Dayton and anti-constitutional activities, which in many ways slows Bosnia and Herzegovina 's progress towards the EU. Russia uses the weaknesses of the institutions in Bosnia and Herzegovina, as well as the shortcomings of the “West's” foreign policy engagement, in order to expand its spheres of influence and prevent NATO integration processes. Considering Russia's failure in Ukraine, the Western Balkans is becoming for Vladimir Putin an area where he wants to try to make certain “compensation”, especially in Bosnia and Herzegovina and North Macedonia where he has a lot of his supporters. In this regard, the heads of state and government of the member states of the European Union at the summit held on December 15, 2022, confirmed the recommendation of the European Commission and granted Bosnia and Herzegovina the status of a candidate on the way to the EU. Analysts claim that such a decision of the European Council is symbolic and that in practice it will not bring significant changes or benefits for citizens and the economy. Bosnia and Herzegovina still has a long way to go in implementing numerous reforms and harmonizing with the European acquis. But it shows the commitment of EU members to give Bosnia and Herzegovina incentives to join their membership.

  • Research Article
  • Cite Count Icon 5
  • 10.1111/hex.13562
(Dis)trust in doctors and public and private healthcare institutions in the Western Balkans
  • Jul 3, 2022
  • Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
  • Driton Maljichi + 10 more

IntroductionConsidering the geopolitical changes in the six Western Balkan countries—Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia—over the last three decades, particularly as it concerns the progress and changes in the healthcare systems, we argue that there is a need for a detailed analysis of people's trust in those healthcare systems and healthcare providers.MethodsIn this cross‐sectional, intercountry study, we examine the trust trends of Western Balkans citizens in medical doctors and public and private healthcare institutions from 25 July 2021 to 30 October 2021, with 3789 participants using a self‐reported questionnaire, and Google Forms. Snowball sampling is used to collect data from six Western Balkans countries: Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia.FindingsThe primary findings of our study show that citizens in the Western Balkans have a low level of trust in their healthcare system (X̄ = 4.3/10). Medical doctors working in private healthcare institutions, on the other hand, are afforded a higher level of trust (X̄ = 6.6/10) than those working in public healthcare institutions (X̄ = 5.7/10). In the event that they or their family members need to visit a health institution, half of the study participants would choose private healthcare institutions over public ones. We found a statistically significant difference between countries on the mean points from the questions concerning one's trust in the healthcare system, private healthcare institutions and medical doctors working in public and private sectors (p < .05).ConclusionDespite its limitations, this study is the first cross‐sectional research on the ‘trust interface’ among western Balkan citizens, revealing that they have low trust in their healthcare systems.Public ContributionThe information in this manuscript was gathered on the level of 3789 citizens from six Western Balkan countries. Before we began collecting data, we conducted a piloting procedure with 40 citizens who were clients of health institutions to validate the data collection questionnaire.

  • Supplementary Content
  • 10.1093/eurpub/ckaf161.1093
Health Spending and NCD Mortality in the Western Balkans: Trends, Outcomes, and Policy Lessons
  • Oct 1, 2025
  • The European Journal of Public Health
  • J Gabrani + 9 more

BackgroundNon-communicable diseases (NCDs) remain the primary causes of mortality worldwide. In the Western Balkans, cardiovascular diseases, cancers, and chronic respiratory diseases account for a substantial proportion of deaths, placing considerable strain on health systems and economies. While health expenditures increased between 2013 and 2021, the extent to which this translated into improved NCD outcomes remains uncertain.ObjectivesThis study analyzed trends in health expenditure and NCD mortality across five Western Balkan countries-Albania, Bosnia and Herzegovina, Montenegro, North Macedonia, and Serbia-applying the Economy of Well-being framework to evaluate whether increased health spending correlated with reduced mortality.MethodsA retrospective, descriptive, and correlational design was used. Health expenditure data (% of gross domestic product) were sourced from the WHO Global Health Expenditure Database and World Bank. Age-standardized mortality rates for cardiovascular diseases, cancers, and chronic respiratory diseases were extracted from the Global Burden of Disease Study 2021. Descriptive statistics and Pearson correlation analyses were performed for 2013-2021.ResultsAll countries reported moderate increases in health expenditure (e.g., Montenegro from 8.5% to 10.6% of GDP; North Macedonia from 6.7% to 8.5%). Despite this, cardiovascular mortality rose significantly in Albania (+120.05 per 100,000), Bosnia and Herzegovina (+70.05), and Serbia (+47.13). Cancer mortality also increased across most countries. Chronic respiratory disease mortality trends remained relatively stable.ConclusionsRising health expenditures did not consistently correspond with reductions in NCD mortality across the Western Balkans. To improve outcomes, future policies must emphasize efficient resource allocation, primary care strengthening, and preventive strategies aligned with systemic reforms.Key messages• Increased health expenditure across the Western Balkans has not consistently translated into reduced NCD mortality, highlighting the need for strategic, outcome-oriented investment.• Aligning health financing with well-being priorities requires stronger primary care systems, improved prevention strategies, and accountability mechanisms linking spending to health outcomes.

Save Icon
Up Arrow
Open/Close
  • Ask R Discovery Star icon
  • Chat PDF Star icon

AI summaries and top papers from 250M+ research sources.

Search IconWhat is the difference between bacteria and viruses?
Open In New Tab Icon
Search IconWhat is the function of the immune system?
Open In New Tab Icon
Search IconCan diabetes be passed down from one generation to the next?
Open In New Tab Icon