Republic of Moldova

Progress in reproductive health

The Republic of Moldova has a national reproductive health strategy (2005–2015) and aims to make further progress with its implementation. Moldova has done much work in recent years on reproductive health. Services are provided by family doctors and specialized out-patient health facilities through reproductive health, centres for women's health and youth-friendly health clinics, as well as the services developed and offered with partners' support.

Since 1993 the United Nations Population Fund (UNFPA) has provided free contraceptives for vulnerable groups, and the abortion rate has decreased consistently from 1200 per 1000 live births in 1993 to 400 per 1000 in 2008. The quality of abortion services was improved using the methods suggested by WHO, and 35% of obstetricians and gynaecologists have received extra training. The standard of youth-friendly health services has been raised, and services were evaluated in 2009. Many seminars and training workshops have been held on topics related to violence against women and girls, male sexual and reproductive health, and cervical cancer screening.

Challenges

The financial crisis in the country imply changes will be made to the services included in the package covered by national insurance. The health statistics are not complete especially from rural areas and about the access of  vulnerable groups to reproductive health (RH) services. There are still opportunities to strengthen the counselling and research skills of RH professionals. The RH services for men are limited (specialized care is offered by urologists only) and not well known by the public.  

In 2010, WHO/Europe and the United Nations Population Fund (UNFPA),  supported by the Ministry of Health conducted a mid-term review of the National Reproductive health strategy 2005-2015. The mid-term review was complemented by an analysis on the gender-responsiveness of sexual and reproductive health policies. The analysis was supported by WHO, UNFPA and UN Women. Based on the recommendations , the national programme to ensure gender equity  was intensified.

WHO's "Using human rights to advance sexual and reproductive health (SRH): a tool for examining laws, regulations and policies" was pilot-tested in the Republic of Moldova and the report, prepared by researchers and national team members led by health ministry representatives and human rights professionals, was presented to a muliti-stakeholder group in early 2011. It was presented at the same as the legal environment for further improvement of sexual and reproductive health and access to services  was discussed.

Recommendations

• WHO/Europe continues to support the monitoring for the implementation of the national reproductive health strategy.
• The Ministry of Health should identify the role of the out-patients' specialized SRH services, to find ways to integrate them within the primary health care services based on universal health coverage, cost efficiency and cost benefit principles. Especially those from rural areas and vulnerable groups.
• Health system capacity should be strengthened to implement the national strategy, with particular emphasis on ensuring equitable access to high-quality maternal, newborn and other reproductive health services.