Parteneri
Foreword
Strategical Assessment of
Policies, Quality of and Acces to
Contraception and Abortion Services
in the Republic of Moldova
Report
ACRONYMS
FDC – Family Doctor Center
NHIC - National Health Insurance Company
NSPCRHMGFP- National Scientific Practical Center of Reproductive Health, Medical Genetics and Family Planning
FPO – Family Planning Office
HC – Health Center
IUD – Intrauterine device
CCA – Comprehensive Care in Abortion
MCHCRI - Mother and Child Health Care Research Institute
IEC – Information, Education, Communication
Ministry of Health and Social Protection
NGO – Non-Government Organization
FP – Family Planning
RH – Reproductive Health
Foreword
The maternal and infantile mortality represent indices of national health and social welfare. To enhance the mother and child health, including the sexual and reproductive health, is a top priority for the Moldovan Government.
In Moldova the women’s access to perinatal care is secured by the law and this service is provided free of charge. The perinatal care has three components: preconceptional, prenatal and postnatal care. The 1997-2003 National Program on Enhancing the Perinatal Health Care was launched in 1997, as a reply to the structural changes. It has the goal to approach the poor situation in the field of mother and child health care. Thus, the Republic of Moldova was selected as the trial European country for the implementation of the Safe Pregnancy global initiative, launched in January 2002
The high rate of maternal mortality caused by abortion complications (about 30% over the past 10 years), the low quality of abortion services and limited access to these services forced the Moldovan leadership to carry out the appropriate measures aimed at improving the abortion quality. In November 2001 a WHO/Euro consultant organized a seminar entitled: “Quality of abortion-related care and counseling in the Republic of Moldova”, with the goal to train the national personnel as to continue the monitoring and assessment of health care in reproductive health. At the seminar they formulated the following recommendations:
- Development of evidence-based guidelines and standards on abortion, to be used in Moldova;
- Prepare and carry out, together with representatives of Moldova, an abortion care study;
- Standardize the data collection process;
- Assess the barriers that hinder women’s access to safe abortions,
- Improve the quality of family planning and abortion services;
- Revize the legal framework and minister orders in force.
To support these initiatives, a team consisting of representatives of the Moldovan Ministry of Health, the National Scientific Practical Center of Reproductive Health, Medical Genetics and Family Planning, Mother and Child Health Care Research Institute, "N.Testemiteanu” State University of Medicine and Pharmacy, participated in the seminar: “Implementation of a Strategic Approach to the Enhancement of the Quality of Abortion and Prproductive Health Services”. The seminar was organized by the staff and consultants of the WHO Department for Reproductive Health and Research in June 2003, in Riga, Lithonia. The Moldovan representatives, that participated in this seminar, agrees its was crucially important for the Republic of Moldova to carry out a Strategic Assessment of policies, program and research problems related to fertility regulation services. During the seminar the Moldovan team formulated and submitted the draft project primary version. When returned home, the team presented its ideas to the Ministry of Health and was permitted to develop and submit this project to WHO.
The National Strategy on Reproductive Health for 2005-2015, developed by a national team, expertized by WHO and approved by the Ministry of Health in 2004, then by the Moldovan Government in 2005. stipulates that the abortion and fertility regulation services are priority directions in the field of reproductive health improvement. The Strategy has the main goal to diminish the demand for abortion as a family planning method, with specific objectives to decrease the abortion-induced morbidity and mortality and improve the access to quality abortion services. To meet this goal the MoH decided to adopt the WHO Strategic Approach, starting with the strategic assessment of the abortion and family planning services in Moldova.
This project has the primary goal to carry out a cooperative assessment, that would approach the key strategic problems related to the development of appropriate recommendations on specific policies and program interventions. The assessment targets at developing recommendations for new policies and interventions aimed at enhancement of the fertility regulation services.