Support to the Reform of Mental Health Services in Moldova
Mental health disorders represent a high burden of disease in Moldova. In 2010, the Ministry of Health (MoH) took systematic and adequate steps to launch a profound reform in this health sub-sector, showing a strong political commitment. With this project, Switzerland is supporting the efforts of the Republic of Moldova towards the improvement of the well-being of mental health service users through access to functional community level Primary Mental Health Care Services.
Primary health care
- Access to services: Men and women with mental health problems in 4 districts have equitable access to functional and sustainable community-based mental health services (primary care, community-based care, acute inpatient mental health services in district hospitals) according to their needs
- Inter-sectorial cooperation: decision- and policy-makers in relevant sectors at national level and local stakeholders (local authorities, managers of institutions) in 4 project-districts, in close cooperation, implement integrated care for people with mental health problems and the new model of care in the community.
- Advocacy & awareness raising: policy- and decision-makers at national level and relevant stakeholders at local level in 4 project-districts (local authorities, managers and professionals, as well as community members) are supportive of community-based mental health services and create an enabling environment for people with mental health problems and their care-givers, in order to exercise their rights.
- Other international or foreign NGO North
Mental health disorders are accountable for 19.6% of all Disability-Adjusted Life Years (DALYs) in Moldova. The challenges posed by the burden of disease are enhanced by the limited abilities of the current mental health system to adequately respond to them. As a former Soviet Union country, Moldova continues to struggle with legacies of the past, leading to mass institutionalisation of people affected by mental health problems. In 2010, the MoH took systematic and adequate steps to launch a reform in this field and developed the “Strategy for the Development of Community-Based Mental Health Services (2012-2021)” and its action-plan. This approach is encouraged by the World Health Organization (WHO), as community mental health services are more accessible and effective, lessen social exclusion, and are likely to have less possibility for the neglect and violations of human rights. External support is needed to sustain the reform implementation.
The project’s overall goal is the improved wellbeing of mental health service users (men and women) through access to effective mental health services at the community level, closer to their homes.
For phase 1, the overall objective is that the mental health system reform is initiated nationwide with revised legal and regulatory framework and financial mechanisms, and built on the model of community-based mental health services developed, tested and implemented in 4 districts.
The main beneficiaries consist of people with common mental health disorders and people with severe mental health problems who require ongoing treatment and care.
There is a particular focus on vulnerable groups (e.g. young people, the elderly, people living under the poverty line, and women).
At the health system level, the primary target group is the MoH, as the project clearly supports the Ministry to implement its national mental health strategy. The secondary target groups are: i) the organisations related to mental health and social care in the country and ii) the professionals working in the health and mental health sectors.
During phase 1, the project will concentrate its efforts on 4 selected districts concerning the services delivery. However, training will benefit to the health professionals throughout the country. As well at the policy level, the activities of the project during phase 1 will also have a nationwide impact (i.e. revision of legislation and development of the legal framework, development of national protocols, etc.).
Results from previous phases:
From 2005 to 2010, the SDC supported the “Development of Community Mental Health Care Services in Moldova” project which was of a piloting nature and limited to punctual assistance, but succeeded in having some impact on the mental health system. However, it was obvious that only very little systemic change can be achieved without a high level of commitment on the side of the Moldovan Government. As this condition was met, in May 2013, SDC engaged in a tender process to identify an international consortium able to support the efforts of reform of the MoH. The consortium was selected in autumn 2013 and then worked together with Moldovan partners on the project document which was approved by all partners in a validation workshop in April 2014.
|Directorate/federal office responsible||
Swiss cooperation with Eastern Europe
International or foreign NGO
|Budget||Current phase Swiss budget CHF 6’050’000 Swiss disbursement to date CHF 5’279’521|
Phase 1 15.05.2013 - 31.07.2018 (Completed)