Coordination of response measures to the COVID-19 pandemic at the territorial level: Summary of the doctoral thesis in medical sciences: 331.03 - Social medicine and management

Abstract

Relevance of the Research: The COVID-19 pandemic affected health, the economy, and society. In the Republic of Moldova, the first case (March 7, 2020) tested the healthcare system, highlighting the importance of strong institutional structures and intersectoral cooperation. Evaluating CTESP is crucial for future public health emergencies. Purpose: To analyze the functionality of CTESP in the COVID-19 response and to develop recommendations for improving coordination mechanisms. Objectives:1. Analyze international practices and recommendations for COVID-19 response. 2. Study theoretical models of health emergency coordination (centralized, decentralized, hybrid). 3. Evaluate national coordination mechanisms in the Republic of Moldova. 4. Assess the functionality of CTESP in the COVID-19 response. 5. Develop recommendations for optimizing coordination mechanisms in public health emergencies. Scientific novelty and originality: One of the first analyses of the interactions between central and local authorities in managing COVID-19, with a focus on the role of CTESP. Main Results: The hybrid CNESP–CTESP model functioned with legislative limitations; efficiency was higher at the central level (3.4) than territorial (2.7). Role clarity and intersectoral cooperation increased local efficiency, and the perception of CTESP responsibility rose between 2022–2024 (47.8% → 52.1%). Theoretical significance: Development of a conceptual framework for intersectoral coordination in health crises, with a diachronic perspective on the transformation of coordination mechanisms. Practical Value: Provides solutions to optimize coordination and improve CTESP decisionmaking. Implementation of scientific results: Recommendations can enhance and adjust territorial coordination. Thesis structure: The study is structured in 118 pages, including 5 chapters, 152 bibliographic sources, CV, 5 tables, and 16 figures. Results are published in 11 scientific papers.