Naşterile în Republica Moldova: situaţia actuală şi tendinţele pentru următoarele decenii

Abstract

Background: The article includes the presentation and analysis of births` statistics in the hospitals of the Republic of Moldova for the period 2005 – 2014, with the aim to evaluate the achieved results, identify the trends for the next few decades and the necessary activities, in order to improve the health indicators and increase the quality of medical perinatal assistance. Materials and methods: The statistical data were collected and analyzed on the basis of the statistical surveys of the National Center for Management in Health of the Ministry of Health, and the National Bureau of Statistics for the period 2005-2014. Results: In the Republic of Moldova the absolute majority of births – 98.4% - are taking place in the public institutions. The number of deliveries during the last ten years (2005–2014) has not changed signifi cantly and varies between 38 000 – 40 000 deliveries annually. In the municipalities (Chisinau, Balti) the number of deliveries increased by 4069 births or with 29.2%. While in the districts of the country there is a decrease of deliveries with 10.9% (2418 births). In 26 perinatal centers of level I there is a number of deliveries less than 2 in 24 hours, the number of doctors obstetricians-gynecologists is small, with an average age of specialists quite advanced. According to the demographic forecasts, the number of births in Moldova by the year 2035, annual births` number could reach 26 000 (medium scenario). Conclusions: The number of deliveries in the Republic of Moldova is small, being conditioned both by migration of the population and low fertility of women. In the perspective of the following decades there is an expected decrease of the birthrate. The present situation requires the reassessment of existing maternity network, relating to cost-effecBackground: The article includes the presentation and analysis of births` statistics in the hospitals of the Republic of Moldova for the period 2005 – 2014, with the aim to evaluate the achieved results, identify the trends for the next few decades and the necessary activities, in order to improve the health indicators and increase the quality of medical perinatal assistance. Materials and methods: The statistical data were collected and analyzed on the basis of the statistical surveys of the National Center for Management in Health of the Ministry of Health, and the National Bureau of Statistics for the period 2005-2014. Results: In the Republic of Moldova the absolute majority of births – 98.4% - are taking place in the public institutions. The number of deliveries during the last ten years (2005–2014) has not changed signifi cantly and varies between 38 000 – 40 000 deliveries annually. In the municipalities (Chisinau, Balti) the number of deliveries increased by 4069 births or with 29.2%. While in the districts of the country there is a decrease of deliveries with 10.9% (2418 births). In 26 perinatal centers of level I there is a number of deliveries less than 2 in 24 hours, the number of doctors obstetricians-gynecologists is small, with an average age of specialists quite advanced. According to the demographic forecasts, the number of births in Moldova by the year 2035, annual births` number could reach 26 000 (medium scenario). Conclusions: The number of deliveries in the Republic of Moldova is small, being conditioned both by migration of the population and low fertility of women. In the perspective of the following decades there is an expected decrease of the birthrate. The present situation requires the reassessment of existing maternity network, relating to cost-effecBackground: The article includes the presentation and analysis of births` statistics in the hospitals of the Republic of Moldova for the period 2005 – 2014, with the aim to evaluate the achieved results, identify the trends for the next few decades and the necessary activities, in order to improve the health indicators and increase the quality of medical perinatal assistance. Materials and methods: The statistical data were collected and analyzed on the basis of the statistical surveys of the National Center for Management in Health of the Ministry of Health, and the National Bureau of Statistics for the period 2005-2014. Results: In the Republic of Moldova the absolute majority of births – 98.4% - are taking place in the public institutions. The number of deliveries during the last ten years (2005–2014) has not changed signifi cantly and varies between 38 000 – 40 000 deliveries annually. In the municipalities (Chisinau, Balti) the number of deliveries increased by 4069 births or with 29.2%. While in the districts of the country there is a decrease of deliveries with 10.9% (2418 births). In 26 perinatal centers of level I there is a number of deliveries less than 2 in 24 hours, the number of doctors obstetricians-gynecologists is small, with an average age of specialists quite advanced. According to the demographic forecasts, the number of births in Moldova by the year 2035, annual births` number could reach 26 000 (medium scenario). Conclusions: The number of deliveries in the Republic of Moldova is small, being conditioned both by migration of the population and low fertility of women. In the perspective of the following decades there is an expected decrease of the birthrate. The present situation requires the reassessment of existing maternity network, relating to cost-effectiveness, the possibilities of quality assurance and low risk of mortality and maternal death severe proximity. Given the decreased number of deliveries in a substantial part of the maternity hospitals in Moldova, on the background of human resources crisis within the health care system, it is necessary to reorganize the network of maternities within the country, both in quantity and quality, by stopping the activity of maternity hospitals with a low delivery number and redirecting these births to other medical profi le institutions, located in the neighboring districts. Введение. Статья включает представление и анализ статистики родов в родильных домах Республики Молдова в течение периода 2005–2014 годов, с целью оценки полученных результатов, идентификации тен- денций следующих десятилетий и необходимых действий для улучшения основных показателей, увеличения ка- чества медицинского перинатального обслуживания. Материалы и методы. Статистические данные были собраны и проанализированы на основе статисти- ческих обзоров Национального Центра Управления в секторе здравоохранения Министерства здравоохране- ния и Национального Бюро Статистики в течение периода 2005–2014. Результаты. В Республике Молдова абсолютное большинство родов 98.4% происходят в общественных медицинских учреждениях. Число родов в течение последних десяти лет (2005–2014) значительно не измени- лось и составляет 38 000 – 40 000 родов ежегодно. В муниципиях (Кишинев, Бельцы) количество родов увеличи- лось на 4069 или на 29,2%. В районах страны отмечается уменьшение количества родов на 2418 или на 10,9%. В 26 перинатальных центрах первого уровня суточное количество родов составляет менее 2, сократилось число акушеров-гинекологов, многие у которых с весьма пожилым средним возрастом специалистов. Соглас- но сделанным прогнозам количество родов в Молдове к 2035 году составит 26 тысяч в год (средний сценарий). Выводы. В Республике Молдова количество родов небольшое, что обусловлено миграцией населения и низ- кой фертильностью женщин. В перспективе следующих десятилетий ожидается уменьшение рождаемости в стране. Учитывая уменьшение числа родов в существенной части родильных домов Молдовы, необходимо реструктурирование сети этих медучреждений, и в количестве и в качестве, путем остановки их деятельно- сти с отправлением родов из отмеченных районов в другие профильные медицинские учреждения, располо- женные в соседних районах.