Moldova: Continuity of care in case of catastrophic health events – Care4Living


Switzerland will support Moldovan health authorities in reforming the emergency care system and in building rehabilitation services in order to ensure timely medical care in cases of medical and public health emergencies. The program will contribute to enhancing the chances to survival and recovery for patients who are at risk or have suffered catastrophic health events (stroke, heart attack, multiple trauma). The program will use the development of healthcare services as a vehicle to foster dialogue between Moldova and its breakaway region of Transnistria. 

Country/region Topic Period Budget
Moldova
Health
Health systems strengthening
Medical services
Basic health infrastructure
Non-communicable diseases
Health education
01.10.2024 - 30.09.2028
CHF  9’943’200
Background Moldova's premature mortality due to non-communicable diseases remains among the highest in Europe and Central Asia. Strokes and health attacks are the main causes of premature mortality. Over the past decade, Switzerland and other development partners supported Moldovan health authorities in strengthening the health system, promoting healthy behaviours and enhancing early disease detection. Nevertheless, the healthcare sector still faces significant challenges in ensuring appropriate response to medical emergencies and public health crises. The COVID-19 pandemic and the war in Ukraine with the subsequent refugee crisis have put additional pressure on Moldova’s healthcare system and highlighted the need for improved emergency preparedness.
Objectives In Moldova (including Transnistrian region), people at risk or with urgent, life-threatening conditions have increased chances of survival and recovery in situations of medical emergencies and public health crises.
Target groups

Health authorities (Ministry of Health, National Health Insurance Company, National Agency of Public Health and Agency of Medicines and Medical Devices); health service providers responsible for emergency, primary health care and rehabilitation; stakeholders outside of the health system (police, rescue service).

Final beneficiaries: Present and future patients (incl. refugees) suffering from or at risk of developing life-threatening conditions (strokes, heart attacks) or with severe multiple traumas, and those in need of rehabilitation.

Medium-term outcomes

Outcome 1: Moldovan health authorities and de-facto authorities in Transnistrian region create favourable conditions for developing an integrated, responsive and efficient emergency care system and rehabilitation services.

Outcome 2: Healthcare providers ensure equitable access to early, quality, and safe emergency care and rehabilitation services.

Outcome 3: People across Moldova (incl. professionals outside of the healthcare system, general population and refugees) have increased awareness and literacy to act adequately in medical emergencies and know how to use the emergency services appropriately.

Results

Expected results:  

  • Moldovan Health authorities have the necessary regulatory and payment mechanisms and capacities to manage the emergency healthcare system and the new rehabilitation services. They develop evidence-based clinical guidelines, procedures and quality assurance tools for healthcare providers
  • Hospitals and health centers have upgraded facilities and modern medical equipment. Health professionals have enhanced capacities to provide emergency care and rehabilitation services
  • General population and stakeholders outside of health system (police, rescue services) are informed about life-threatening medical emergencies and have basic knowledge and skills to provide by-stander emergency care (first aid and cardio-pulmonary resuscitation)


Results from previous phases:   In cases of catastrophic health events, the patients’ chances for survival and recovery depend on the geographical location, because specialized care is concentrated in the capital city and modern medical transport is lacking. In addition, the emergency care services are overused for non-urgent cases. Rehabilitation should be initiated concomitantly with acute care in order to prevent complications, support recovery, and reduce disability. However, many patients are discharged from hospitals without rehabilitation. About 60% of Moldova’s population needs rehabilitation services; two-thirds of these needs remain unmet. Health inequalities leading to delayed or inadequate medical care with serious consequences are much more visible in the breakaway region of Transnistria, where the survival rate in cases of catastrophic health events is very low.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
International Financial Institution (IFI)
Private sector
United Nations Organization (UNO)
  • Swiss Private Sector
  • United Nations Development Programme
  • World Bank - International Bank for Reconstruction and Development
  • World Health Organization


Coordination with other projects and actors With this program, Switzerland contributes to larger WB, WHO and UNDP implemented projects, co-financed by other donors (EU, the UK, Sweden). The program will complement the range of past and ongoing Swiss-supported interventions addressing different health needs across the lifespan. The program builds on the results of the single-phase STROKE project (humanitarian aid) and is designed to close the gaps in continuity of care, being complementary to the “Healthy Life” project, which is focused on primary prevention and long-term management of Non-Communicable Diseases. It is also synergetic with the governance and policy work of the Universal Health Coverage project.
Budget Current phase Swiss budget CHF    9’943’200 Swiss disbursement to date CHF    1’391’996 Total project since first phase Swiss budget CHF   43’200
Project phases Phase 1 01.10.2024 - 30.09.2028   (Current phase)