Better Health Care for Moldovans

Moldovans' health declined in the aftermath of the Soviet Union's collapse. Life expectancy decreased while premature mortality increased. There was a spike in tuberculosis and HIV/AIDS cases, and a heavy burden of social problems added to deteriorating health indicators across the board.

Poor economic performance in the past decade, and the inefficiency of the health care system that Moldova inherited from the Soviet Union, led the country to downsize health facilities. Yet, the primary health care system was underdeveloped and preventive medical care non-existent.

Health care reforms launched by the Government of Moldova in 2004 included the creation of a national health insurance scheme and a different way of financing the entire sector. These changes were supported by World Bank financing. The Health Services and Social Assistance Project aims to increase access to good quality and efficient health services. It also wants to increase coverage for recipients of health services with the ultimate goal of decreasing premature mortality and disability rates.

To achieve those goals, the project is starting by rehabilitating a network of 65 primary healthcare facilities, and by bringing health services into communities. This effort also reforms how medical institutions are financed, making managers and medical staff responsible for how they manage financing and prioritize investment needs. To date, 39 such new centers have opened across Moldova, with many under construction.

"The government has made the rehabilitation of primary healthcare facilities a priority," underlined Viorel Soltan, Deputy Minister of Health.

Coscodeni has a newly built and equipped clinic, housing physicians as well as an ophthalmologist, pediatrician, and dentist. The physicians are local; the specialists travel to the community a few times a week. Coscodeni's residents appreciate not having to travel to the county seat for medical care.

"It is much better today," said Vasile Banari, Chief Medical Officer at the Coscodeni Primary Health Care Center. "People are very pleased with the fact that they have a health center in the village. We serve smaller villages in the area as well."

Improving Moldova's primary health care system is only part of the solution. There are too many hospitals and hospital beds in an inefficient secondary health care system. In-patient facilities and hospitals have not been upgraded, renovated or re-equipped in decades, because of lack of funds.

The World Bank is helping the Ministry of Health and the National Republican Hospital identify potential public-private partnerships that are upgrading the country's public hospital system step-by-step so that quality is gradually becoming a norm and not a luxury.