Accelerating hospital reform in the Republic of Moldova


Participants at a policy dialogue meeting on hospital reform, Chisinau, Republic of Moldova

A policy dialogue on health care services delivery with a focus on hospital reforms was organized in Chisinau on 1–2 October 2012 by the Ministry of Health with WHO support. The event brought together over 90 representatives of the Ministry, National Health Insurance Company, National Centre of Health Management, National Centre of Public Health, Medical and Pharmaceutical University, health care providers of different levels, international organizations, nongovernmental organizations and independent local and external experts. 

Dr Andrei Usatii, Minister of Health, welcomed participants and stated in his opening speech: "The time for analysis and debates around hospital reform is over. We've accumulated enough knowledge and evidence in this area and we should use the current dialogue as a milestone to take further concrete actions at different levels, including hospital governance and autonomy, strategic planning of services and capital investments, new financing mechanisms and selective contracting, developing partnerships with private sector, etc." Dr Usatii also expressed his gratitude to WHO for the organization's continuous support in improving the hospital system in the country. 

The two-day policy dialogue covered a variety of topics, including: 

  • the current situation and plans for hospital sector reforms; 
  • levels of care and future needs;
  • regional planning and options for a hospital network;
  • expectations of hospital mergers; 
  • contracting providers and payment;
  • capital investments and potential solutions; 
  • review of resources available in the medium term for investments in the country;
  • hospital efficiency;
  • governance and management.

WHO support for the reform effort

"The policy dialogue is a good opportunity to discuss the situation in the health service delivery area broadly and allow us to identify priorities for short and medium-term actions," said Dr Jarno Habicht, WHO Representative in the Republic of Moldova. "There are no ready solutions for the optimization of the hospital network, however there are enough lessons to be learned from those countries in the region that have implemented hospital reforms or are in the process of implementing such reforms."

The main objective of the policy dialogue was to provide Moldovan decision-makers with an overview of the current status of and developments in health care service delivery with a particular focus on the hospital sector, with a view to identifying lessons and options for the Republic of Moldova. This event was a continuation of earlier policy dialogues hosted by the Ministry of Health and WHO in May 2011 and April 2012 to debate options for hospital sector reforms. The policy dialogues aim to bring together initiatives such as study visits, consultancies and local-level dialogue in a consolidated reform effort. 

This most recent dialogue constitutes an important milestone in the overall assistance provided by WHO in the reform of the hospital sector in the country. WHO contributed to the event by bringing top external expertise to the country level and by providing direct financial and logistical support. 

The dialogue was organized as part of the biennial collaborative agreement (BCA) 2012-2013 between the Ministry of Health of the Republic of Moldova and WHO/Europe. The objectives of the two-year agreement include strengthening stewardship of health sector investments, better performance monitoring, and ensuring greater use of evidence for policy decisions.