Press Release WHO/61WHO JOINT EFFORT TO ASSIST HEALTH POLICY DEVELOPMENT AND HEALTH CARE REFORMS IN MOLDOVA: AN EXAMPLE FOR OTHER COUNTRIES IN TRANSITION
2 September 1998
The World Health Organization Regional Office for Europe, WHO's Headquarters and the Ministry of Health of the Republic of Moldova have undertaken an unprecedented joint effort to improve the health of the Moldovan People through a comprehensive national health policy and health care reforms. Three important events took place at the end of August 1998 in the capital, Chisinau: a workshop on the role of a national health communication network to make the country's population aware of health issues, an inter-agency technical meeting on co-ordinating international support to health sector reforms, and finally a high level consensus meeting, with the participation of various international agencies, in the presence of the Head of State of Moldova, President Petru Lucinschi.
The deteriorating health status of the country's population caused by the difficult socio-economic situation and inability of the health system to respond adequately to the challenges of transition calls for «strong and decisive action», as the participants in the technical meeting pointed out. Better health of the population requires broad intersectoral action, strong political support and should be the centre of the overall development. The highest authorities responded in participating actively in last week's events and in committing themselves to take the necessary measures.
In his very detailed analysis of the health situation in the country, Dr Eugen Gladun, Minister of Health, drew the attention of participants to alarming factors such as high rates of child and maternal mortality, decrease in life expectancy and the growing incidence of socially conditioned and infectious diseases such as tuberculosis, alcoholism, Aids and intestinal parasitic infections. He stressed that the main cause of this negative trend is the extremely limited financial resources available for health care services. «During the last years the financing of the health system has decreased six times, while the demand of the population for medical services increased by 30% », Dr Gladun said.
"Moldova's commitment, in spite of its most difficult situation, to enacting a broad ranging health policy sets a bold example for the Region as a whole", stated Dr Jo E. Asvall, WHO Regional Director for Europe. "By emphasizing low cost practical actionsaimed at better informing and educating people about lifestyle choices, shifting resources from expensive hospital based care to community based primary health care, rigorously sticking to essential drug use, and focussing resources on ensuring a basic package of services for all, many improvements in the state of health of the population will be reached".
WHO Headquarters was represented by Dr Michel Jancloes, Director of the Division of Intensified Cooperation with Countries and People in Greatest Need, who expressed his firm intention to further develop the close collaboration with the Regional Office to assist the Republic of Moldova. "This assistance could include developing the collaboration with the mass media on critical health issues like maternal health, family planning, sexually transmitted diseases, food safety and sanitation", explained Dr Jancloes. "Considering the seriousness of the problem in the country, immediate provision of support to improve the quality of drinking water is, in my opinion, one of the top priorities", he added.
Before the consensus meeting, which took place on 26 August 1998, around 40 specialists, both national and international, had participated on 24 and 25 August 1998, in Chisinau, in an International Meeting on Health Sector Reform in the Republic of Moldova. Their purpose was to identify priorities for international assistance and perspectives for inter-agency co-ordination. The participants included senior decision-makers from the Ministries of Health, Finance, Economy and Reforms, as well as officials from central and regional health authorities, the National Centre for Public Health and Health Management, and the State Medical University. International organizations represented were the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the International Bank for Reconstruction and Development (World Bank).
As a practical measure to facilitate the change process and to assist the work of the Ministry of Health, they suggested the establishment of an informal technical advisory body called the Task Force on Health Care Reform. This Task Force would consist of both national authorities and representatives of international agencies operating in the area of concern and serve as a functional structure to facilitate change in the health sector. Increasing the role of family practitioners and introducing health insurance are part of the proposed reforms.
Participants in the three meetings, in which many local journalists were actively involved, agreed that investment in the health of the population is an investment in the future, without which economic development and prosperity are neither possible nor meaningful. WHO hopes that the new national health policy developed in Moldova will serve as an example for other countries in transition facing similar problems.
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