Parteneri
4. Current situation of reproductive health in Moldova
4. Current situation of reproductive health in Moldova
The reproductive health is a priority of increasing interest to Moldova. The measures taken in the past few years on a governmental level are oriented towards reproductive health improvement and ensure the citizens of the Republic of Moldova with the possibility to accomplish their sexual and reproductive function, in order to get to a healthy sexual development and maturation and have safe sexual intercourses, to have the wanted number of children in safe and healthy conditions; to avoid the sexuality and reproduction related diseases, to benefit from quality services in case of reproductive and sexual function disorders; in order to avoid violence and other abusive practice related to sexuality and reproduction.
In 1998 the health care in family planning was provided at three levels: level 1 – the family doctor; level 2 – the family planning office of the regional hospital, and level 3 - the National Scientific and Practical Center of Reproductive Health, Medical Genetics and Family Planning.
The participation of the local public organizations and volunteer groups in the educational and informative process on the reproductive health protection subject is very welcomed. With support from the international organizations there have been organized national and local training seminars on reproductive health for the health personnel.
Thanks to the international assistance the socially-vulnerable groups have been provided with contraceptives, the health personnel has been trained in family planning and multilateral development of the informational-educational-communicational element.
As a result of the undertaken measures the reproductive health indicators have improved. The use of the hormonal contraception is in continuous growth. Both the populations’ access to quality reproductive health services and their information level on reproductive health protection have increased.
It is worth mentioning that, though there have been achieved certain positive results, there are still several problems to be settled. In 2003, in 37.5 % of the cases, the maternal mortality was induced by abortion complications. Although the perinatal mortality has a general decreasing trend, we are worried by the high level of perinatal mortality of infants with a weight above 2500 g and congenital anomalies, deformations and chromosomal aberrations.
As a peculiarity of family planning in Moldova we should mention the insufficient use of modern contraceptive methods, such as hormonal contraception and surgical sterilization. At the same time, the exaggerate use of the intrauterine devise is ungrounded, considering the high level of sexually transmitted infections and iron deficiency which is currently established to be present in many women of this country.
The access of young people to medical specialized services, in conformity with the friendly health services’ principles, is very low, especially in the rural environment. Young people are provided sexual and reproductive health services within the family planning offices (free counseling, partially free contraceptives, paid abortion); limited quality access (non-observed confidentiality and anonymity, low level of health/sanitary culture of the population), especially in rural environment. There is no national conception on youth-friendly clinics, related to reproductive health youth care quality standards and protocols. The legislative and normative framework regarding the teenager’s reproductive health is imperfect (the parents’ consent to abortion, respecting confidentiality and anonymity, especially when speaking about sexually transmitted infections and abortion). More and more young persons become victims of violence and trafficking in human beings. In the same time, the existing services pay insufficient attention to psychological and medical counseling of the victims.
The epidemical situation of the HIV/AIDS situation continues to be tense. It is regrettable the fact that the information, education and communication in the field of sexually transmitted infections and the HIV infection does not have a mass character, most of the times doesn’t reach the population, is not promoted and supported by the mass-media.
The social-economical decline, increased incidence of the sexually transmitted infections, the tendency to a belated set-up of a family makes the infertility in marriage to take proportions. Taking into consideration the decrease of the birthrate, with growing emigration as background, this is becoming more and more alarming.
The genital and breast cancer has a high enough frequency and puts women of reproductive age under considerable risk. The sexual problems of elderly persons remain disregarded. The health services do not pay proper attention to solving men’s sexual and reproductive problems.
Resulting from the above mentioned, and in order to offer the couples and individuals possibilities to meet their reproductive needs, to prevent unwanted and high-risk pregnancies, to have an abortion in safe conditions, as well as to have access to quality services that would contribute to solving the sexual and reproductive problems the implementation of the present Strategy is needed.