HEALTH
|
Special Precautions |
Certificate Required? |
| Yellow Fever |
No |
No |
| Cholera |
Yes |
No |
| Typhoid and Polio |
1 |
N/A |
| Malaria |
No |
N/A |
Immunization against typhoid is sometimes recommended.
The health system in Moldova possesses many
features common to the Semashko model of the
Soviet Union, but some important changes have
occurred during the transition period. In response
to a profound fiscal crisis, the health care system
went through dramatic consolidation in the last 5
years with reductions in the number of hospital
beds, activity levels and personnel.
The health care system consists of three distinct
tiers: primary, secondary, and tertiary care. The
Primary Health Care sector has seen significant
reform since 1996 and is now based on general
practitioners, called family doctors (FD). Secondary
care is provided by general hospitals. Their scope
and structure changed in 1999, when judets were
introduced. The former district hospitals were
scaled down to an average of 215 beds and to 4-5
basic specialities, whereas the central judet
hospitals (with 550 beds on average) provide a
broader range of specialties and serve as referral
institutions at the judet level.
The Moldovan health care system is predominantly
a public system: central government or local hospitals since it is largely made on an ad-hoc
basis, depending on the amount of financial
resources available.
Out-of-pocket payments at the point of delivery are
significant
11
and represent one of the biggest issues
in the Moldovan health system. There are services
for which patients pay officially according to the
regulation in force (for example, an amount per
bed-day, laboratory tests, X-ray films etc). These
payments accounted for 19% of total health
spending in 2002.
12
However, patients having to
use private pharmacies incur the biggest share of
out-of-pocket health expenditure, since they have
to buy all of their ambulatory drug treatments and
most of the medications required during a hospital
stay. These individual expenditures are difficult to
trace and they are not included in the aggregated
figures of health spending.
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