Health systems in action: Republic of Moldova
Health Systems in Action insight series (2022)
Overview
The Republic of Moldova has mandatory health insurance that covered approximately 88% of the population in 2021. The benefits package is relatively broad for insured people, but out-of-pocket (OOP) payments accounted for 36% of health spending in 2019. In 2016, 17% of households experienced catastrophic OOP spending and nearly 7% had impoverishing health spending.
Primary care has been strengthened through financing reforms that have encouraged gatekeeping for specialist services, while also covering the cost of primary care consultations for the uninsured population. However, outmigration of health workers reduces access to health services, particularly in rural areas.
Life expectancy at birth, standing at 73.4 years in 2018, has improved considerably in the last two decades, but remains among the lowest in the WHO European Region. The COVID-19 pandemic has resulted in additional challenges, with substantial excess
mortality, exceeding the WHO European Region average. Antimicrobial resistance has been recognized as a challenge, but development of a national action plan was delayed by the COVID-19 pandemic.