This report looks at the issue of sex imbalances and sex selection in the context of the Albanian population structure. It aims to address three key questions: 1) What is the situation regarding sex imbalances at birth in Albania? 2) How is this sex selection achieved under the country-specific conditions? and 3) Why is this sex imbalance at birth taking place in Albania today?

The demographic analysis of the research carried out for this study has confirmed that son preference is a distinctive feature of Albania's population structure, with fertility behaviors clearly shaped by strong gender considerations. Based on the findings of this study, the authors also offer a number of recommendations with regard to improving the situation of sex imbalances at birth and sex selection in Albanian society in the coming years.

These recommendations stress in particular the need for regional coordination, quality monitoring of trends and differentials in birth masculinity, and further analysis of the social and economic factors and conditions of sex-selective behavior. The time is ripe for launching a wider policy dialogue on birth imbalances in Albania by involving all stakeholders and considering the policy options for reducing prenatal gender discrimination.