Thus, in accordance with EUMAP objective 80, “Increase the level of health security and epidemiological safety in Moldova in line with EU legislation and in cooperation and with the support of the WHO”, the following steps were made:
– The National Strategy of Reproductive Health was approved.
– The draft Law on the Prevention of HIV/AIDS was developed.
– The National Program for TB Control and Prevention for 2006-2010 was approved.
– The draft State Program for the Development of Emergency Care in 2006- 2010 was prepared.
– The Emergency National Antiepidemiological Commission was set up due to the spread of bird-flue pandemic in the world, including in neigh- bouring countries.
– The National Program for Iodine-Deficiency Diseases Elimination un- til 2010, the Regulation on Conducting Expertise of Foodstuff’s Safety for Health, and the Regulation on Approving New Types of Foodstuff were approved.
In accordance with EUMAP objective 17, “Take significant steps to address poverty, notably by improving targeting and effectiveness of social assistance”, the following has been done:
– The Concept on Making the Social Assistance System More Efficient and the Action Plan to Make Nominative Compensations More Efficient were approved.
– The Decision on the Pilot Project to Test the Nominative Compensations Mechanism in Four Regions of the Country was approved; under the pro- ject the incomes of 32 000 beneficiaries of nominative compensations will be tested in February-October 2006.
– The relevant ministries approved the draft Law Amending the Law on Social Assistance, which will allow local public authorities to add to their respective personnel the position of a social worker.
– The draft Law Amending the Law on State Social Allowances for Some Categories of Citizens was prepared, which provides for an increase in the allowance for uninsured persons to 600 lei, in case of death.
– A legislative initiative was launched to improve the method by which is established the amount of care allowances for disabled children under the age of 16 and for visually impaired persons both of grade I of disability.
According to EUMAP objective 18, “Redirect public expenditure to signifi- cantly address child poverty and to increase primary school enrolment”, the fol- lowing has been done:
– A MEY Order was issued concerning the establishment of financial norms for child nutrition in educational establishments (pre-school institutions, orphanages, the national boarding sports school) for the purpose of im- plementing the relevant requirements regarding the eradication of poverty and social security identified by the EU Food Security Program.
– A GD was passed amending the Regulation on the Method of Calcula- tion and Payment of Allowances to Families with Children; it changed the amount and the way in which some allowances are calculated in order to optimize the benefits addressed to children and render more effective assistance addressed to families in need.
– A GD was approved whereby some child centres were transferred to the MHSP in order to make their management more efficient.
The measures implemented
In the period under study, the actions undertaken by the MHSP and other relevant bodies in the area of Public Health have focused on the implementation of the following EUMAP provisions:
1) Health information and knowledge. The information campaign continued regarding the content and method of implementation of the National Programs of Immunization; prevention and control of HIV/AIDS and Se- xually Transmitted Infections; prevention of hepatitis B, C and D; preven- tive harm-reduction programs for drug users for 2006; and the National Population Education and Healthy-Lifestyle Program. At the same time, significant steps have been made towards enhancing the skills of health- care facilities staff.
2) Collecting information on health indicators.
3) Controlling transmitted diseases and health security.
4) The healthcare reform focused mainly on the primary healthcare system, emergency care system, hospital care, etc.
The public system of social protection in Moldova is divided into two separate elements: social assistance and social insurance. In the case of the former, the state and civil society undertake to prevent, limit or eliminate the permanent or tempo- rary effects of events deemed to be social risks (illness, accident, disability, ageing, maternity, unemployment, death), which can lead to the marginalization or social exclusion of individuals and families in need. The latter element concerns only in- sured individuals who are entitled to payments under specific contract provisions (ageing, disability, death, etc.). Therefore, in order to improve the national social protection system both elements have to be addressed.
In 2005, the relevant administrative bodies (MHSP, MET, MF, etc.) prepared draft laws on the new principle of distributing nominative compensations depen- ding on the family/individual’s global income, with certain filters, as well as the following draft laws: Law on Subsistence Minimum and Law on Need-Based (Po- verty) Allowance.
February 2006 saw the start of a pilot project aimed at testing the new mecha- nism of distribution of nominative compensations, based on the family/indivi- dual’s global income and employing certain filters; the pilot is to last till October 2006. This project is being implemented in the northern, southern and central parts of Moldova (raions of Soroca, Orhei, Leova, and the Râşcani district of Chi- şinău). The incomes of 32 000 beneficiaries of nominative compensations will be evaluated during the project. Its outcomes will be used to develop a new principle of transfering nominative compensations.
Considering the annual growth of the consumer price index and the annual growth of the average salary in the country, the Government decided on the in- dexation of social insurance payments and some of the state social allowances by 15.7% in 2006. Thus, the indexation of all pensions proceeded as of 01.04.2006—
the pensions calculated as per Law on State Social Insurance Pensions, Length- of-Service Pensions, Civil Servant Pensions, Customs Officer Pensions—as well as the disability allowances set up according to the Law on Accidents at work and Occupational Diseases, and the Pensions for Victims of the Chernobyl Disaster.
The average monthly pension as of 01.01.2006 was 383.2 lei, which is 17.8%
higher than in the same period of the previous year, while in real terms (adjusted for the consumer price index) the average pensions increased by 5.3%. However, the average pension covers only 59% of the minimal subsistence level of this group of population.
In order to reduce the level of poverty among families with children, the fol- lowing amounts were raised as of 1 January 2005, in accordance with the relevant laws and regulations:
– one-time allowance upon the birth of a child, from 420 to 500 lei in the case of insured persons and from 380 to 500 lei in the case of uninsured persons;
– monthly child allowance until the age of 1.5 (3), in the case of uninsured persons from 75 to 100 lei, and for insured persons by 20% from the calcu- lated social insurance allowance base, but not less than 100 lei.
– in February 2006 the MHSP submitted to the Government a draft Deci- sion amending some laws, which provides for an increase in the one-time birth-of-child allowance to 800 lei.
One should mention however that, although the monthly allowance for child- care has increased to 100 lei for uninsured individuals and on average to 149.9 lei
for insured individuals, these social allowances cover only 24.6% and 36.6% res- pectively of the monthly needs of a child, which places children into the category of vulnerable persons.
In order to provide protection to children left without parental care, step-fa- milies and foster families for minors are entitled, as of 01.01.2005, to allowances of 200 lei per month for each adopted or foster child. Also, in order to support disabled children, the social allowances for disabled children under 16 were in- creased in 2005. And in order to provide meals in schools for children from vul- nerable families, financial norms were adopted as of 01.01.2006 for nutrition in educational institutions.
In terms of EUMAP objective 23, “Strengthen dialogue and co-operation on social matters. Ensure a closer approximation of the country to EU standards and practices in the area of employment and social policy”, a procedure was adopted whereby employers are encouraged to employ graduates of higher-education in- stitutions whose studies were funded by the state budget. The incentives to emplo- yers involve monthly payments in the amount of one minimum salary, during 12 calendar months for each budget-funded graduate employed, provided that he/she is employed for at least three years. For the employment of disabled graduates, the payment is made during 18 months.
In accordance with objective 8, “Ensure equal treatment”, the Parliament passed the Law on Providing Equal Chances to Men and Women, which forbids discrimination based on sex and ensures equal chances in the public area, social- economic area, in education and health, etc. Also, in order to eliminate all forms of domestic violence, a draft Law on Preventing and Eliminating Domestic Vio- lence was prepared. And in order to prevent, curtail and punish trafficking in hu- man beings, especially of women and children, the Parliament of Moldova passed on 20.10.2005 the Law on Prevention and Control of Human Trafficking and the Law Ratifying the Council of Europe Convention on Action against Trafficking in Human Beings.
Conclusions
The actions undertaken in the area of healthcare are acceptable in terms of their content. Even though sometimes the steps planned may be somewhat general, the context as a whole of healthcare reform yields a clear picture of the priority areas. Unfortunately, the same could not be said about social protec- tion in Moldova.
Nevertheless, the actions undertaken by the relevant authorities in the period under study confirm the fact that the implementation of EUMAP pro- visions is an incontestable priority. The element which raises certain concern is the relationship between the scope of the problems at hand and the time planned for their solution. It will be very difficult to carry out in three years all the commitments subscribed to. There are too many problems to be solved in healthcare and social protection; moreover, these problems are too impor- tant—given the deep impact they produce on human beings—to be handled in a superficial manner.