Progressing towards Universal Health Coverage in Moldova
Through this project, Switzerland will support the Moldovan government's efforts to ensure access to healthcare services for all and to protect the population against impoverishing health expenditures. This will be achieved through making services more affordable and more accessible for the poorest and the most vulnerable. The population will be empowered to demand transparency and accountability in the healthcare system.
Health systems strengthening
- Central State of South East
- Swiss Red Cross
- World Bank - International Bank for Reconstruction and Development
|Background||Moldova formally meets the basic preconditions to achieving, by 2030, the SDG target 3.8: universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. Around 86% of the population are covered by mandatory health insurance. Moldovan health authorities attempt to reduce out-of-pocket payments by gradually increasing salaries of health workers, extending the list of compensated medicines, and changing the practices related to prescription of medicines. However, the existing health benefit package (which includes emergency, primary, inpatient and specialized outpatient services, and a limited number of fully or partially compensated medicines) under mandatory health insurance is not adequately designed to match the existing needs and available financial resources. The machanism of strategic purchasing in the health sector is not appropriately used to create incentives for better performance of health care service providers. Inefficient use of the scarce public budget resources for the health sector imposes an additonal financial burden on the population, especially the poorest. Corruption, including persisting practices of bribing ("thanking") doctors, undermines people's trust in the usefulness of the reforms and reduces willingness to be enrolled in the mandatory health insurance scheme.|
|Objectives||Moldovan population enjoys quality healthcare with adequate financial protection.|
Target groups include health authorities, institutions and professionals involved in the provision of health services at all levels; the National Health Insurance Company, public health institutions and other relevant entitites, and professionals involved in financing of health services; members of the Parliamentary Commission for Social Protection, Family and Health, as well as of civil society organizations.
End of project beneficiaries are health care service users and specifically those from the poorest quintile, currentyl suffering the most from catastrophic health expenditures.
The geographical coverage is nationwide, since the project addresses the reform of the health sector and supports the implementation of national strategies.
Outcome 1. Financial resources of the Mandatory Health Insurance are appropriate to cover an evidence-based Health Benefit Package.
Outcome 2. Moldovan health authorities improve coordination and distribution of resources and services in health care at local level.
Outcome 3. The service users / clients and civil society are involved in governance and oversight of health care system reforms, with special focus on health expenditures.
1. Shared strategic vision on Universal Health Coverage strengthening and long-term health financing between the main national stakeholders.
2. The Health Benefit Package under the Mandatory Health Insurance is re-defined in line with medico-demographic transitions and population needs.
3. Policy and programmatic recommendations developed to address bottlenecks in healthcare coordination and continuity.
4. Strategic purchasing mechanisms revised for improved efficiency and transparency.
5. Relevant stakeholders put in place mechanisms for increased transparency and social accountability in the health sector.
6. Health care users / clients and civil society are enabled to hold health authorities and service providers accountable.
Results from previous phases: In the opening phase, the shortcomings of health sector governance, health financing and service provision were identified. The main findings, as well as the lessons learnt from all other Swiss interventions in the health sector, provided the basis for designing the present project.
|Directorate/federal office responsible||
Swiss cooperation with Eastern Europe
International Financial Institution (IFI)
Foreign state institution
Swiss Non-profit Organisation
|Coordination with other projects and actors||Synergies with all ongoing Swiss supported projects in health and local governance domains will be ensured. With a growing number of development partners interested in supporting health reforms in Moldova, Switzerland will put a strong focus on policy dialogue and donor coordination, in order to ensure harmonized and consequent international support.|
|Budget||Current phase Swiss budget CHF 4’644’000 Swiss disbursement to date CHF 3’689’713 Total project since first phase Budget inclusive project partner CHF 11’000’000|
|Project phases||Phase 1 01.11.2017 - 30.04.2023 (Current phase)|