Republic of Moldova
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Health systems in transition
14 October 2012
Republic of Moldova: health system review 2012
Health Systems in Transition, Vol. 14 No. 7
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Country overview
The health system of the Republic of Moldova is organized according to the principles of universal access to basic health services, with mandatory health insurance for other health services and equity and solidarity in health care financing. However, over 10% of the population lacks health insurance coverage.
The Ministry of Health and its subordinated institutions have full responsibility for the organization, functioning and regulation of health services provided to individuals and the public, and for ensuring the state surveillance of population health. The Ministry of Health addresses the major challenges in the health sector and promotes the principle of Health in All Policies through multi- and intersectoral collaboration, including the coordination of public health activities within the sector and beyond it.
The main source of revenue for the health system is currently mandatory health insurance funds, which are raised through payroll contributions for employees, transfers from the national budget to cover the non-working population (14 categories of people, such as pensioners, students, children and registered unemployed) and direct contributions from self-employed workers. OOP payments account for over a third of current health expenditure and are dominated by spending on medicines.
The Republic of Moldova has had significant success in reorienting the health system towards primary care, and the primary care system functions wholly on a family medicine basis. In rural areas, primary care services are provided by family doctor offices and health centres while in urban areas, services are provided through big family health centres (formerly the polyclinics). Family doctors act as genuine gatekeepers to specialist and inpatient services for insured patients. Inpatient care is provided at the municipal and district (secondary care), and republican (tertiary care) levels.
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