Data and statistics
The Republic of Moldova became independent in 1991. Since that time the country has become a parliamentary republic and has embarked on an ambitious programme of economic reform. Agriculture and food processing dominate the economy and the country is dependent on imports for its energy needs. Economic transition has caused great socioeconomic hardship in the country and the health status of the population has fallen. There has been a steep rise in the death rate and there has been large-scale labour migration – currently 40% of the working age population works abroad and remittances account for 30% of GDP (World Bank, 2011).
Notwithstanding recent growth, the Republic of Moldova remains the poorest country in the WHO European Region, with an estimated per capita gross national income of US$ 1810 in 2010 (World Bank, 2011). The Republic of Moldova is experiencing negative population growth in spite of a slight increase in the birth rate.
Despite the Republic of Moldova being the poorest country in the WHO European Region, life expectancy estimates are 2–5 years higher than similar estimates for considerably richer countries in the Commonwealth of Independent States (CIS), namely 69.13 years in 2010. Mortality rates are particularly high for the working age population – and the reduction of life expectancy through death before 65 years of age was 12 years for men and 6.4 years for women in 2010. This has contributed to a significant and growing gender gap in life expectancy: 64.86 for males and 73.5 years for females in 2010. This is also reflected in disability-adjusted life expectancy (DALE), which was 58 years for men and 63 years for women in 2007.
Main causes of death
The Republic of Moldova has a double epidemiological burden as rates of both communicable and noncommunicable diseases have steadily increased since independence. The main causes of death in the Republic of Moldova are diseases of the circulatory system followed by cancer and diseases of the digestive system. Many of these deaths can be attributed to very heavy alcohol and tobacco consumption – 57.6% of total male mortality and 62.3% of female mortality in 2010 could be attributed to smoking-related causes while 18.8% of male mortality and 13.7% of female mortality were related to alcohol consumption. Though incidence of chronic liver disease and cirrhosis has decreased over the last five years, this remains a very significant overall cause of mortality in the Republic of Moldova (118.95 per population of 100 000 men and 89.82 per population of 100 000 women in 2010).
The economic and social crises have negatively influenced the population's mental health: a continuous increase in the incidence of mental health disorders has been registered (500.22 per 100 000 general population in 2005 and 576.13 per 100 000 general population in 2009).
Infant mortality and immunization
The infant mortality rate has been falling steadily since the mid-1990s reaching 11.8 per 1000 live births in 2010, which is close to average for countries of the CIS (11.7 per 1000 live births in 2010), but still more than double the European Union average of 4.2 per 1000 live births in 2010. Maternal mortality levels have fluctuated widely, reaching a low of 16 per 100 000 births in 2006 and a high of 44.5 maternal deaths per 100 000 live births in 2010. This is almost double the average for countries of the CIS (20 per 100 000) and more than seven times the average for countries of the European Union, which was 6.1 in 2010. However, actual numbers are low (18 in 2010, 7 in 2009) and as there are only around 40 000 births annually each tragic death increases the maternal mortality rate substantially.
Child immunization levels have been consistently high in the Republic of Moldova for all vaccine-preventable diseases, and in 2010, 97.1% of children were immunized against measles. Sexually transmitted infections also sharply increased following independence, with syphilis showing one of the biggest increases (71.51 per 100 000 population in 2008).
HIV/AIDS and tuberculosis
However, the key challenges in communicable disease control in the Republic of Moldova are tuberculosis (TB) and HIV/AIDS. Incidence of TB has been rising since 1990 and has more than doubled, reaching 182 per 100 000 population in 2010, the most dramatic increase being registered in children. The TB mortality rate increased from 16.9 per 100 000 people in 2000 to 23 in 2010, and rates in prisons are even much higher.
Source: Health for All database, WHO/Europe, http://data.euro.who.int/hfadb/, accessed January 2012