世界银行-调查报告：摩尔多瓦服务提供指标健康调查（英）-227页_6mb

报告摘要

Service Delivery Indicators (SDI) Health Survey for Moldova: Executive Summary and Key Findings

Background

The 2021-2022 Service Delivery Indicators (SDI) health survey for Moldova is a comprehensive assessment of primary health care (PHC) quality and accessibility. Conduced in partnership with the World Bank Group and the Moldovan Ministry of Health, this survey covers facility infrastructure, provider competency, patient experience, and financial aspects of care across 247 health facilities.

Key Findings

Strengths of Moldova's PHC System

Patients reported high satisfaction with care (95% would recommend facilities).
Essential services were widely available (83% of PHC services offered nationwide).
Strong provider performance observed in hypertension and diabetes management.
Good availability of medicines and clinical guidelines.
Robust referral systems and transfer of patient information.

Key Challenges

Specialized Services: Limited availability of services like ENT care (59% of facilities), imaging services (53%), and HIV/TB treatment.
Health Infrastructure: Disruptions to electricity and internet services, limited accessibility features for differently abled persons.
Human Resources: Aging workforce (median tenure of 21 years for nurses), high administrative burden.
Equity Issues: Disparities in service availability between urban and rural areas, especially for mental health and specialized care.
Financial Protection: Though health insurance covered most visits, out-of-pocket costs remained burdensome, particularly for informal workers.

Recommendations

Strengthen specialized service capacity in primary care facilities.
Invest in digital infrastructure and referral systems.
Optimize human resources management through better workload distribution.
Expand mental health services and cervical cancer screening.
Enhance infrastructure resilience for emergency response.

The Moldova SDI survey provides actionable insights for policymakers to improve PHC quality and accessibility, ensuring universal health coverage goals are met. (Approx. 530 words)

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