In Kosovo, particularly in rural areas, access to basic and reproductive health services remains limited. Chronic underfunding has resulted in shortages of medical equipment and specialists, poor-quality care and unreliable maternity and emergency services. Women from minority communities often face additional obstacles.
Recognising these challenges, the NGO Gruaja Fermere launched a local initiative aimed at improving women’s access to high-quality health care. A total of 291 participants, predominantly women and girls from 11 villages in the rural municipality of Rahovec, took part. Through a combination of awareness activities, education and advocacy, Gruaja Fermere empowered women to understand their rights and report violations, while also engaging with health institutions for meaningful systemic improvements.
Raising Awareness Through Education
Gruaja Fermere conducted 11 informal meetings to raise awareness about quality health care among women and girls, including from minority communities. These sessions focused on educating participants about their rights, with a special emphasis on reproductive and maternal health, and providing guidance on how to report violations. Women were also encouraged to actively advocate for their rights to local institutions. During the meetings, 20 cases of health rights violations were documented by Gruaja Fermere and later presented to the Family Medicine Centre in Rahovec. The participating women also highlighted their key priorities, including more, permanent doctors and nursing staff in rural areas, access to local specialist services, and expanded health education on topics such as family planning and non-communicable diseases.
Gruaja Fermere organised 11 lectures targeting Albanian, Roma and Serbian women. Led by a female doctor, the lectures covered topics such as breast and cervical cancer prevention, proper self-examination techniques and when to seek medical care, as well as the management of non-communicable diseases, in accordance with priorities expressed during the village meetings.
Strengthening Local Health Services
The initiative also included field visits to village clinics to assess the functionality of patient rights mechanisms. During the visits, Gruaja Fermere’s team checked for the presence of patient rights cards, complaint forms, complaint boxes and complaint reviewing committees. Several issues were identified: In some clinics, complaint boxes were missing entirely; where boxes were present, doctors informed that most patients were unaware of the reporting process; and in certain villages, doctors were rarely available, forcing residents to travel to Rahovec centre for care.
Discussions with local women revealed additional challenges, including lack of information from doctors, inadequate hygiene routines and missing follow-up appointments. While women expressed willingness to report issues towards improving the health care system, they often lacked confidence that institutions would handle complaints fairly.
Advocating for Institutional Change
Based on these findings, Gruaja Fermere prepared recommendations for improving complaint-handling mechanisms, which were shared with the Family Medicine Centre Directorate. A roundtable brought together eight municipal health officials, during which Gruaja Fermere advocated for the specific problems women had raised to be addressed. The discussions focused on improving access to health care and ensuring functional complaint mechanisms, as well as women’s most pressing health needs. Officials committed to implementing the recommendations wherever possible, setting the stage for tangible improvements.
Lasting Impact
Thanks to Gruaja Fermere’s advocacy efforts, Family Medicine Clinics were established in the villages of Brestovc, Zoqisht and Denjë, with doctors working from 07:00 to 15:00. Elderly people can now receive assistance at the clinics to open online accounts in E-Kosova, where they can choose a health care provider. The institutional system for managing patient complaints was strengthened. Patient rights cards are displayed, complaint boxes are functional, and a review committee ensures written responses within ten days. Women and men in Rahovec now have a clear, accountable path to raise concerns and receive responses guaranteed to them by law. Additionally, a doctor and nurse conduct home visits to provide care to those unable to reach the clinic.
Gruaja Fermere’s experience shows that real change comes from empowering communities while also strengthening institutions. By providing women with knowledge of their rights and creating reliable mechanisms to enforce them, tangible improvements in access and quality of health care were achieved. The initiative proves that when patients are informed and institutions are held accountable, even the most underserved communities can experience meaningful and lasting transformation.
Gruaja Fermere initiative “Promotion of primary health care for Rahovec’s women” was carried out with support from the Kosovo Women’s Network’s (KWN) Kosovo Women’s Fund (KWF), financed by the Austrian Development Agency (ADA) and co-financed by the Swedish International Development Cooperation Agency (Sida), in the amount of €9,930, from January to December 2024. The initiative contributed directly to KWN’s Programme “Right to Health”.
