Republic of Moldova holds national policy dialogue on strengthening public health services
On 28 April 2015, the Ministry of Health with WHO/Europe and the WHO Country Office in the Republic of Moldova jointly hosted a national policy dialogue on strengthening public health service in the Republic of Moldova. The participants were representatives of the Ministry of Health, Parliament and managers of public health institutions working at national and subnational levels.
The policy dialogue aimed to take stock of the institutional capacity of public health institutes to deliver essential public health functions and services in a timely manner, and to explore opportunities and mechanisms for strengthening public health organizations. Participants debated the challenges of public health systems in terms of their governance, the organization of public health services and financing, and discussed options to strengthen the national public health service.
In his opening speech, Minister of Health, Mircea Buga, highlighted the importance of having strong national public health services, and encouraged all participants to identify opportunities and bottlenecks from their perspectives. He urged participants to propose options for transforming the public health service to better meet population health needs.
Jarno Habicht, WHO Representative in the Republic of Moldova, emphasized the importance of public health adding, "We have to ask ourselves if we are fully satisfied with public health services now and what we need to change to have a strong public health system to address noncommunicable diseases, efficiently coordinate health programmes and integrate further the individual health services."
Elke Jakubowski, Head, public health services programme in WHO/Europe stated, "The public health system in the Republic of Moldova is well-equipped to protect peoples' health and control communicable diseases. Yet, too many people die comparatively young from cardiovascular diseases. Public health institutions and the workforce need transformation to meet these current and future needs of the Moldovan population".
The objectives of the policy dialogue were:
- to inform participants on common public health challenges in Europe and the experiences of Slovenia in reorganizing public health institutions;
- to discuss the main barriers for reorganizing and strengthening public health institutions in the Republic of Moldova;
- to identify strategic priorities and possible mechanisms for reorganizing and strengthening the Moldovan network of public health institutions; and
- to make recommendations to the Government for improving the organizational architecture of public health institutions.
In May 2015, a study visit to Slovenia will take place to familiarize Moldovan public health specialists and managers with the Slovenian public health system, its functions and responsibilities at national and local levels, and the collaboration within the health sector and with other sectors.
In the next few years and with support of WHO, the Ministry of Health will develop a new organizational structure for its public health service in 2015 to strengthen institutions in their core mandates and capacities at all levels to deliver essential public health operations. The Ministry will seek out recommendations for changing the legal basis of the public health service. The structural reform has benefitted from earlier experience exchange with Estonia, Finland and Romania, and the Moldovan public health service is well connected to similar structures in other European countries.
This policy dialogue and the next steps to be undertaken are part of the activities envisaged under the biennial collaborative agreement between WHO/Europe and the WHO/Swiss Agency for Development and Cooperation project on support to strengthening governance and policy dialogue in the health sector.
Background and rationale
The Republic of Moldova is facing similar population health challenges as many other European Member States. These include a high burden of diseases through rising prevalence of noncommunicable diseases, in particular cardiovascular and cancer diseases, leading to premature mortality and morbidity. At the same time, incidence and prevalence of some communicable diseases remain a concern; yet there is scope for improving health indicators for specific population groups.
Intensive work has been undertaken in recent years to adjust the public health system to meet the contemporary population health challenges faced in the Republic of Moldova. This includes an assessment of the essential public health functions, the development and adoption of a national public health strategy 2014–2020 and an action plan on public health. In addition, a laboratory reform was initiated to streamline services and improve the efficiency of the services infrastructure.
Yet, some challenges still exist, such as financial constraints on public health funding, which limits the efforts towards population health improvement. In addition, the European Union Association Agreement, which aims to provide better access to improved health services, needs to be implemented.