Moldova has a low standard of state funded healthcare.

Healthcare in the country is

available to all citizens and registered long-term residents. The Ministry of Health oversees
the health service in the country and all citizens are entitled by law to equal access to a
minimum amount of free healthcare.

The State System

The basic package of free healthcare is limited to emergency assistance and treatment and
treatment for acute illness. However, different medical organisations take varied views on what
procedures are offered and where.
Financing of Moldovan healthcare is predominantly done through taxation, but there are pilot
plans in operation whereby employers pay a flat rate contribution to a healthcare fund for each
person they employ. There is no option for opting out of the state scheme. Vulnerable groups like
retired citizens, the disabled or those who have lost the income from the breadwinner have their
contributions paid by the state, as long as long as there are no other possible means of making
the contribution i.e. no other member of the family can afford to pay the contribution for them.
When healthcare contributions are paid by the state, the beneficiary only receives a minimal
amount of healthcare.
Fees
In addition to taxation, one third of healthcare finance comes from out-of-pocket payments from
the patient. Citizens have to pay for prescription medicine (children under five are exempt) and
medical treatments deemed nonessential, like cosmetic surgery, dental care, massage and some
laboratory investigations. Patients also make under-the-table payments to doctors, consultants
and nursing staff. Such payments may be in the form of a gift or actual monetary payments.
Private Healthcare
There is a private health system in Moldova; however, the system is used by a limited number of
people like MPs and wealthy entrepreneurs because the treatments are extremely expensive.
Patients who use private doctors make out-of-pocket payments directly to the doctors to pay for
the cost of their treatment. Private practice is still limited to a small number of consultancies,
which offer diagnostic rather than curative services. Fees for private healthcare are fixed
centrally, but doctors make up their money through additional out-of-pocket payments.

Health Posts
All communities in Moldova have access to healthcare. In rural areas, there is a network of 1011
health posts. They are staffed by a feldscher, a midwife and general assistants and they offer a
basic package of care including general cover, maternal and child health services, comprehensive
developmental checks, immunisation, health education and a basic 24-hour emergency cover.
Health Centres
There are 189 health centres in rural areas, each staffed by three doctors. Some health centres
have facilities for inpatient care. Many of the services provided by the health centre are similar to
those provided by the polyclinics in more densely populated areas.
Polyclinics
Towns and districts with a population over 3,000 people are served by polyclinics, which are
staffed by doctors of internal medicine, paediatrics, obstetrics, gynaecology and dentistry.
Nurses, midwives and medical assistants also operate from the polyclinics. Each doctor is
assisted by two medical nurses. Polyclinics in densely populated areas also offer some medical
and surgical treatments on an outpatient basis.
Consultants
Consultants are senior doctors who have completed a higher level of specialised training. In
Moldova, there are 15,700 specialist doctors throughout, who are highly trained. Consultants
regularly accept under-the-table payments in lieu of services provided. There are numerous
specialist fields of medicine in Moldova like gynaecology, oncology, paediatrics and
dermatology. There is often a waiting list to see consultant doctors.
General Hospitals
Hospitals and clinics exist in all major towns and cities of Moldova; there is usually at least one
hospital per district or municipality. In total, there are 100 hospitals across the country (which
includes rural hospitals and Central District Hospitals), five Outpatient Clinics, a Dentistry, a
Psychiatric and a Dermatology Hospital in the capital city of Chisinau. Additionally, there is a
railway, a military and a trade union hospital. Waiting lists are long and facilities and equipment
are poor. Some hospitals in the capital cannot even afford running water between the hours of
8pm and 6am. General hospitals provide services to patients referred from district and municipal
health institutions. Patients are referred to general hospitals by doctors and consultants.
Rural Hospitals
Rural hospitals offer a limited service, which includes basic specialist treatment and some

surgery. Cases that are more complex are referred to the regional hospital. All rural hospitals
offer a 24-hour emergency service with doctors operating an emergency rota system from their
homes.
Central District Hospitals (CDH).
The CDH cover most surgical eventualities but Moldovas declining economic conditions have
meant that surgical activity in CDH is now limited. In many areas, CDH can now only carry out
surgery in emergency cases and much of the need for non-emergency surgery goes unmet.
Emergency Care
Emergency care is available free for everyone including those without state health insurance.
Emergency departments are open non-stop all year. You may use their services if you need
immediate attention, or if your GP refers you to them, or if there is no GP service available.
Private Clinics
Whilst there are a small number of private GP practices, there are no private clinics or hospitals.
Dentists
Dental care is deemed a non-essential service and all treatment must be paid for by the patient
directly to the dentist.
Pharmacies
Medicines are in short supply; shortages exist for antibiotics, anaesthetics, analgesics, medicine
to treat tuberculosis and drugs used in oncology amongst others.
Pharmacies in Moldova are not stocked to western standards, labels are not in English, and there
is a chance that the medicines are not approved, and could have been tampered with on the black
market.
There are private and state pharmacies, although most of the state pharmacies are in the process
of privatisation. Within the private pharmacies, there are security measures in place to make sure
all products are not tampered with and are approved. Children under five years old qualify for
free prescription medicine.
Moldova has been working on developing its own standards for health care. As of 2004, there
were an estimated 35 physicians per 100,000 people. Total health care expenditures were 6.4% of
GDP.
The birth rate was 14 per 1,000 people and the maternal mortality rate was 34 per 100,000 live
births in 2003. Average life expectancy was 65.18 years in 2005. The infant mortality rate for
that year was 40.42 per 1,000 live births. The overall death rate was estimated at 12.6 per 1,000
people as of 2002. In 1992, there were approximately 1,000 deaths from ethnic conflict within

the country. Nearly the entire urban population (96%), but only 9% of the rural population, had
access to sanitation.
Moldova's immunization rates for children up to one year old were: tuberculosis, 99%;
diphtheria, pertussis, and tetanus, 97%; polio, 98%; and measles, 99%. Despite immunization
rates, epidemic diphtheria has spread throughout the new independent states of the former Soviet
Union. The HIV/AIDS prevalence was 0.20 per 100 adults in 2003. As of 2004, there were
approximately 5,500 people living with HIV/AIDS in the country. There were an estimated 300
deaths from AIDS in 2003.
The Moldovan state has a universal healthcare system. Healthcare in Moldova is generally poor
by European standards, and access is limited in certain rural areas. However, the healthcare
system in Moldova has improved immensely over the years but still there is less availability of
modern equipments in the hospitals of Moldova. The Soviet government has helped in building
many Moldova healthcare units to provide better service to patients. In the year 1990, Moldova
had 129 hospital beds and there were only 40 doctors.
During 1991, the Moldovan government had spent 12% of the total budget in improving the
healthcare system in the country. Presently, there has been a lot of improvement in the Moldovan
healthcare sector with the assistance of various non-governmental organisations working there.
The American International Health Alliance aided by the USAID has introduced new programs
in controlling the spread of tuberculosis in Moldova. This organisation has also taken up various
projects to prevent the spread of HIV and Hepatitis B and C.

Life expectancy at birth in the Republic of Moldova shows patterns similar to the ones observed
in neighboring countries and in some Eastern Europe countries. Although the decrease of this
indicator has been reversed and presently it constitutes 68.4 years, it continues to register values
much lower than the average for the EU states. 6. The Republic of Moldova has made
considerable progress in the area of essential health indicators, such as decrease of the infant
mortality and maternal mortality rates. Over the period 2001-2006, for example, infant mortality
rate has decreased by 26% (from 16.3 deaths per 1000 new-borns in 2001 to about 11.8 deaths
per 1000 new-borns in 2006). The maternal mortality rate is now 16.0 maternal deaths per
100,000 live births as compared to 43.9 in 2001. However, these indicators are still higher than
the average European figures. 7. The mortality of the economically active population is higher
than in the EU countries. The most important death causes in the Republic of Moldova include
diseases of the circulatory system, traumas and poisonings and malignant neoplasms. The
diseases of the digestive system are also an important cause of deaths in the country. During
2006 about 66.0% of the total number of deaths of economically active population was caused
by diseases of the circulatory system, respiratory system, digestive system and malignant
neoplasms. Even if we take into consideration the age differences, the general death causes
would be the same. 8. The consumption of alcohol and tobacco are also significant risk factors
that determine the epidemiologic profile of the country due to the fact that these practices are
closely connected with many chronic diseases, such as the diseases of the circulatory system,
malignant neoplasms, and especially, diseases of the liver. 9. The healthcare system of the
Republic of Moldova shows a double epidemiological pattern, which features, primarily, the
presence of diseases typical of developing countries, such as infectious and parasitic diseases, the
diseases conditioned by HIV/AIDS and TB epidemics and, secondarily, the increase of the noncontagious chronic diseases typical of the states in which epidemiological transition has reached
advanced stages, such as cancers and diseases of the circulatory system. The prevalence rates for
high blood pressure are higher in the Republic of Moldova than in Great Britain and the United
States. Similarly, diabetes shows patterns similar to the ones mentioned above. Only for

malignant neoplasms and, to a smaller extent, for myocardial infarction, the Republic of
Moldova shows prevalence rates similar to the ones of the abovementioned countries. 10. The
outcomes achieved by the healthcare system in the light of the Millennium Development Goals
point out to the following: the mortality and morbidity rates in the Republic of Moldova are
The people of Moldova mainly suffer from cardiovascular diseases, cancer and respiratory
diseases. The consumption of alcohol is so high among the Moldova citizens that it has turned
into a major reason behind the deaths occurring in Moldova. The extensive use of different kinds
of herbicides as well as pesticides by the people of Moldova has helped in the growth of deadly
diseases.
Today, Moldova has more or less 18 local hospitals and five clinics for outpatient treatment in
Chisinau. The University of Moldova Hospital is a chain of hospitals situated all over the capital
of Moldova. The Trinity Hospital, St Michael and Urgenta Hospital are the most well known
medical care units in Moldova. The standard of medical care in these Moldovan hospitals is
moderate. The buildings are not well maintained and thus have resulted in the non-functioning of
various life-saving equipments. There are about 264 physicians per 100,000 people.
Public expenditure on health was 4.2% of the GDP and private expenditure on health 3.2%.
Health expenditure was $138 (PPP) per capita in 2004.