MOLDOVA: Healthcare System readiness and COVID-19 pandemic response evaluation

Apr 27, 2020

This report was prepared based on the publicly available information on April 10, 2020, is valid and relevant in accordance with this timeline.

The preparedness stage for this pandemic was covered by the fragmented actions and did not ensure a fast and full response to this emergency outbreak.

The collective responsibility approach, the lack of defined timelines, the lack of designated resources creates difficulties in the crisis management process and generates multiple undesired outcomes.

The health authorities need to be prepared to communicate with their populaces about health issues and protective actions that they can take.

The Country Pandemic Plan as a pre-event tool is required for a better execution of preparedness stage and fast response to any disease outbreak.

The quality of the response to this pandemic outbreak was influenced on a large scale by the low level of awareness of the pandemic emergency on the top level of management of the healthcare sector.

The delay in the elaboration of the response country pandemic plan leaded to the delay in the decision-making process and generated several delays in execution of many important action items.

All these actions limited the power of control over pandemic spread in some geographies and increased the risk for population, and specifically for the healthcare workers, police, custom staff.

An epidemiologic investigation and the accompanying response are the backbone of outbreak control.

Technological advances are needed to modernize our diagnostic capabilities to become faster and nimbler at the onset of outbreaks, particularly around novel pathogens. Diagnostic tools are required in settings beyond centralized laboratories.

To adequately prepare for and respond to outbreaks, health facilities would need to increase their capacity for large-scale isolation of patients with highly transmissible respiratory diseases. The biological safety and security require holistic approach and proper resources.

It is recommended to increase the community engagement through dialogue, power sharing, collaborative decision making, and combined actions among a community. Doing this, its leaders can strengthen readiness, response, and recovery in the case of pandemic outbreak.

The communication with the public, partners, and intermediaries as well as between key organizational stakeholders continues to be an important area for strengthening preparedness and response. Without strong, accurate communication efforts, no amount of planning, intervention, or response is likely to be highly effective in the response to a pandemic.

The communication and the establishment of the trusted lines of communication between the community and public health is a vital component of effective public health response.

The application of the travel restrictions, movement restrictions, quarantine, and social distancing, is efficient in conditions of the strong adherence to the rule and require the high level of trust between community and state institutions.

In the event of a rapidly moving pandemic, the Government would need to be able to quickly deploy sufficient resources in order to protect the population and reduce the fatality rate.

Moldova needs support to develop the core public health capacities to prevent, detect, prepare for, and respond to any disease outbreaks.

With this purpose, the country needs a robust national process and a system to enable the collection, analysis, and dissemination of surveillance data, an essential tool for identifying and understanding patterns and drivers behind a wide range of health threats.

The processes and the systems used to conduct risk communication and national surveillance can be multipurpose, serving everyday health priorities, but then tapped, and modified or expanded, if necessary, during emergencies.

The estimated demand for resources, in order to support the actions mentioned in Article 3 are presented in the annex 1. The focus was concentrated to the most urgent and important items, such as PPE insurance for HCP, renovation of the infectious diseases department in the district hospitals, and upgrade of the Intensive Care Units (ICU), by increasing the number of the ICU beds across the country.

The needs for PPE are calculated based on the daily needs for 35000 HCP, in order to cover 100 days of pandemic outbreak.

The need for renovation of the departments for infectious diseases as a primary measure to be prepared for the next wave is calculated for 36 hospitals.

There is a gap of 800 ICU beds in Moldova and urgent need to cover this gap. In the annex 1 is mentioned the full list of equipment required to support this action. The McKenzie company mentioned in their report about pandemic outbreak, as one of mandatory criteria for the country reopening – the presence of >5 ICU beds for 10 000 population. Currently in Moldova there are only 500 ICU beds for 2,6 M people. It is urgent and important to focus on the upgrade of ICU in Moldovan hospitals.

See the entire report HERE

Image : WHO_Europe

Author: Ala Tocarciuc

This report was produced in the scope of the project “Fostering the Adoption and Implementation of Key Reforms”, implemented with the support of National Endowment for Democracy. The conclusions and the recommendations belong to the author and do not necessarily represent the opinion of National Endowment for Democracy”.

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