Providing Quality And Accessible Health Services

Moldova Health Investment Fund Project

"I’m quite relieved regarding the health of my children; I no longer have to travel long distances to the capital city whenever they get sick,” said Elena Castrasan from the district center in Ialoveni, mother of three children. Two years ago, when one of Elena’s children got sick, she had to travel a long distance to Chisinau and wait several days for the lab results, even when the child was in need of urgent care. Today, the family and the rest of the community benefit from quality services provided by the local health center, which was recently supplied with modern medical equipment delivered under the World Bank-funded Health Investment Fund Project.

“We have been hoping for these improvements for a long time,” said Victoria Leanca, head of the diagnosis laboratory facility at the Ialoveni Health Center. One year ago, the range of tests was quite limited, medical equipment was outdated, and all lab tests in Ialoveni were done manually.

The World Bank’s Health Investment Fund Project financed the new equipment, which included biochemical and blood analyzers and a one-year supply of reagents. The equipment received from the Fund has the capacity to perform 100 tests per hour on 18 characteristics, far beyond the previous capacity. One blood sample can yield simultaneous clinical, serologic, and biochemical tests. As a result, misdiagnoses are virtually impossible, with an accuracy rate of almost 100% versus 50-60% reported before.

“Had it not been for the World Bank aid, we would have waited many years for the equipment,” said Lidia Hanganu, head physician of the Ialoveni district. The health centers in the villages of Razeni, Puhoi, Horesti, and Costesti have also received similar sets and one-year supplies of reagents, with equipment specialists providing hands-on training. As many as 12 out of 16 health centers received primary-care physician kits, and the Ialoveni center also received two brand-new ambulances.

The economic decline that Moldova endured during the first years of transition had a severe impact on health care and thus individual health. Medical equipment was decrepit, limiting the capacity of physicians to provide quality health care services. The working conditions were unfit, with no heating or centralized water supply at health care facilities.

In order to overcome these challenges, the Government of Moldova received a $US 20 million loan from the World Bank for the Health Investment Fund Project, which was implemented in May 2001. The funds were earmarked to refurbish primary care facilities, purchase medical equipment, provide emergency facilities with ambulances, and to train family physicians, nurses, and health care managers.

By the end of 2006 when the Project closes, the improvements will be marked: all family doctors will have primary-care physician kits, 360 out of the 431 health centers in the country will have a “basic kit” containing essential equipment, and all district-level hospitals will have received medical equipment for the admissions and surgery wards.

All districts have benefited from a set of information equipment. Each district will have a gastroscope, colposcope, spirograph, ultrasonography machine, and ultrasonographic stethoscope, thus significantly expanding the availability of essential equipment.

As many as 136 sets of lab equipment have been purchased under the World Bank-financed project. Each district has 3 to 5 sets, and therefore patients have more options for laboratory tests at their local health center, reducing travel to distant locations. As many as 75 ambulances were purchased for the emergency service, so that one in four ambulances are brand-new. Additionally, a radio communication system was purchased for the municipality of Chisinau, while the procurement for another four regional stations is pending.

Another component of the Project is renovating health centers to provide heating and water supply systems, sewers, and new roofing. The renovations have been completed in 53 centers, while another 46 are outstanding under the approved Phase III to follow. Altogether, 22 percent of health centers in Moldova will be renovated.

The Project is also strengthening the management skills of health care staff. According to official data, there were 2,096 family physicians and 5,966 nurses working in the country within the primary care sector as of 2005. As many as 750 family physicians, 1,500 nurses, and 300 managers will be trained by the end of 2005.

“There is no doubt about the role the Project has played in significantly improving the situation in the health care sector in Moldova during its first five years, but we still have a lot of work ahead of us,” stressed Victoria Catanoi, Project Coordinator.