http://repository.usmf.md:80/xmlui/handle/20.500.12710/874 2026-04-09T14:18:53Z 2026-04-09T14:18:53Z Lozan, Oleg Mîța, Valentin Demișcan, Daniela Buzeti, Tatjana Beznec, Peter Sava, Valeriu Curteanu, Ala Rîmiș, Constantin Canavan, Robert Prytherch, Helen http://repository.usmf.md:80/xmlui/handle/20.500.12710/30384 2025-04-16T14:16:51Z 2024-01-01T00:00:00Z

Assessing capacities to strengthen intersectoral collaboration in Territorial Public Health Councils in the Republic of Moldova Lozan, Oleg; Mîța, Valentin; Demișcan, Daniela; Buzeti, Tatjana; Beznec, Peter; Sava, Valeriu; Curteanu, Ala; Rîmiș, Constantin; Canavan, Robert; Prytherch, Helen Background. The government of the Republic of Moldova, endorsed the principle of Health in All Policies (HiAP) through its health sector reforms to address the rising burden of non-communicable diseases and health inequalities. Territorial Public Health Councils (TPHCs) were created to ensure the coordination and management of the population’s health in their respective district. This study assessed the capacities of the TPHCs to identify areas in need of support for strengthening their intersectoral collaboration role in public health at local level. Methods. A mixed-method approach, using qualitative and quantitative techniques, was used to compare the perceptions of all TPHC members (n = 112) and invitees (n = 53) to council meetings from 10 districts covering all geographical areas of Moldova. The quantitative information was obtained using a cross-sectional survey, while the qualitative aspects were assessed within focus group discussions (FGDs). Results. Half of all TPHC members, including 75% from groups with a non-medical background, did not attend a public health course within the last three years. Overall, groups with a medical background were more aware of the legislation that governs TPHC activity and intersectoral collaboration compared with those with a non-medical background. The FGDs of TPHC meetings revealed that members had an insufficient level of understanding of intersectoral collaboration to solve public health issues and lacked clarity about their place and role within the TPHC. Conclusions. HiAP implementation was found to be suboptimal with insufficient capacity at local level. TPHC members’ ability to deal with public health issues were severely impaired by a general lack of knowledge and understanding of how to utilize the TPHC platform for maximum benefit. Reforming TPHC regulation is required in addition to extensive capacity building for TPHC members to increase member understanding of their roles as intended by TPHC regulations, including the facilitation of intersectoral collaborations.

2024-01-01T00:00:00Z Sane, Jussi Schmidt, Tanja Isla, Nicolas Rawi, Ibrahim Boshevska, Golubinka Mayigane, Landry Ndriko Perriat, Delphine Stauke, Janina Esquevin, Sarah Fehr, Angela Brajovic, Mina Bajić, Borko Galic, Igor Humolli, Isme Bunjaku, Dafina Gexha Gheorghița, Stela Kuli, Arta Manevska, Suzana Stavridis, Kristina Demişcan, Daniela Capmari, Dumitru Mengistu, Abebayehu Assefa http://repository.usmf.md:80/xmlui/handle/20.500.12710/30383 2025-04-16T14:06:42Z 2023-01-01T00:00:00Z

Key lessons learnt from COVID-19 intra-action reviews in the Republic of Moldova, Montenegro, Kosovo and North Macedonia 2020-2021: a qualitative study Sane, Jussi; Schmidt, Tanja; Isla, Nicolas; Rawi, Ibrahim; Boshevska, Golubinka; Mayigane, Landry Ndriko; Perriat, Delphine; Stauke, Janina; Esquevin, Sarah; Fehr, Angela; Brajovic, Mina; Bajić, Borko; Galic, Igor; Humolli, Isme; Bunjaku, Dafina Gexha; Gheorghița, Stela; Kuli, Arta; Manevska, Suzana; Stavridis, Kristina; Demişcan, Daniela; Capmari, Dumitru; Mengistu, Abebayehu Assefa Objectives Our study described how the WHO intra- action review (IAR) methodology was operationalised and customised in three Western Balkan countries and territories and the Republic of Moldova and analysed the common key findings to inform analyses of the lessons learnt from the pandemic response. Design We extracted data from the respective IAR reports and performed a qualitative thematic content analysis to identify common (between countries and territories) and cross- cutting (across the response pillars) themes on best practices, challenges and priority actions. The analysis involved three stages, namely: extraction of data, initial identification of emerging themes and review and definition of the themes. Setting IARs were conducted in the Republic of Moldova, Montenegro, Kosovo and the Republic of North Macedonia between December 2020 and November 2021. The IARs were conducted at different time points relative to the respective pandemic trajectories (14- day incidence rate ranging from 23 to 495 per 100 000). Results Case management was reviewed in all the IARs, while the infection prevention and control, surveillance and country- level coordination pillars were reviewed in three countries. The thematic content analysis identified four common and cross- cutting best practices, seven challenges and six priority recommendations. Recommendations included investing in sustainable human resources and technical capacities developed during the pandemic, providing continuous capacity- building and training (with regular simulation exercises), updating legislation, improving communication between healthcare providers at all levels of healthcare and enhancing digitalisation of health information systems. Conclusions The IARs provided an opportunity for continuous collective reflection and learning with multisectoral engagement. They also offered an opportunity to review public health emergency preparedness and response functions in general, thereby contributing to generic health systems strengthening and resilience beyond COVID- 19. However, success in strengthening the response and preparedness requires leadership and resource allocation, prioritisation and commitment by the countries and territories themselves.

2023-01-01T00:00:00Z Șalaru, Ion Demișcan, Daniela Țurcan, Lilia http://repository.usmf.md:80/xmlui/handle/20.500.12710/30382 2025-04-16T13:01:04Z 2023-01-01T00:00:00Z

Strengthening the strategy to sustain optimal iodine status in the Republic of Moldova: Assessing the use of iodized salt in industrially processed foods Șalaru, Ion; Demișcan, Daniela; Țurcan, Lilia Background. Although national legislation in the Republic of Moldova includes the use of iodized salt in processed food industry as well as household (cooking and table) salt, little is known of the actual use of iodized salt in the food industry and its contribution to the overall iodine intake of the population. This study has helped to address the gap in understanding about how much iodized salt is used in the production of different foods and to identify where more information is still required in order to more fully characterize the contribution of food industry salt to population iodine intake. Methods. Using the available food consumption and production data, the assessment introduces a novel modelling technique, based on the methodology of the IGN Programme Guidance to assess the use of iodized salt in industrially produced foods (IPF). The method included the identification of key salt containing IPF and modelling of the salt and potential iodine intake in two groups of the population, non-pregnant adults and pregnant women. The findings were synthetized to develop a list of recommendations for adjustment or strengthening the existing salt iodization strategy. Main results. In RM, the salt used for industrially produced bread and household use provide almost 80% of all salt intake for adults. The intake from iodized salt at household level and the 8 key salt- containing IPF is estimated to currently meet 89% and 53% of the recommended nutrient for adults and pregnant women, respectively. If all salt used at household level and industrial bread baking would be iodized, then, potentially, it could ensure 181% and 109%, respectively, of the required iodine intake. Conclusions. Use of iodized salt in the processed food industry is of growing significance and universal use of iodized salt at household level and in bread production could result in a desirable increase in iodine intake. The national salt iodization strategy should include strengthened regulatory monitoring of iodized salt use in the bread baking industry.

2023-01-01T00:00:00Z Enache, Mariana Gramma, Rodica Dumitraș, Silvia Moisă, Ştefana Maria Iov, Cătălin Ioan, Beatrice http://repository.usmf.md:80/xmlui/handle/20.500.12710/27089 2024-05-27T12:25:14Z 2013-01-01T00:00:00Z

A comparative study on the palliative care in Romania and France Enache, Mariana; Gramma, Rodica; Dumitraș, Silvia; Moisă, Ştefana Maria; Iov, Cătălin; Ioan, Beatrice The palliative care has old tradition, as the single support and relief of suffering in terminally ill patients form, until the release of antibiotics and the development o f modern medical technologies, investigation, diagnosis and treatment. In the 1960s the palliative care was officially recognised as a medical field, focused on the psycho-emotional and spiritual aspects without neglecting, however, the physical aspects o f care. Further evolution differed on a country basis. The health insurance systems in Romania and France are based on the same principle o f solidarity. The history o f the two palliative care systems has close start. In this context, we propose a comparative study to identify the differences and similarities between the systems o f palliative care in the two countries. Certain evaluation criteria were selected for this purpose, in order to ensure a complex approach for this type o f service. We have used the methods o f study documentation and direct observation through an internship performed in a clinic in France, Groupe Hospitalier Saint Augustine-Malestroit. In spite of the chronic low funding of the health system, non-challenging and lean health legislation, the system of palliative care has developed slowly, hut progressively, in Romania. Though, the level of services is far below the needs. This is imposing a rigorous analysis o f the factors affecting the quality o f life o f patients and the development of services strongly dependention these. The French health care system is an example of good practice regarding availability of health care, health care related services, accessibility to the patient, and the legal frame: national policies, legislation, financial planning models and quality control, training and human resources, including the emotional and spiritual support like patient special needs, family support, support for' pediatric patients and their families, religious and psychological assistance, staff issues.

2013-01-01T00:00:00Z