Abstract:
Introduction
Noncommunicable diseases (NCDs) pose global health
challenge and are the main cause of premature mortality in
Moldova. Primary health care (PHC) centers hold the key to
the prevention and management of NCDs. The WHO
Package of Essential Noncommunicable (PEN) disease
interventions was adapted to the local context and then
rolled out at PHC level. The Healthy Life Project supported
training of PHC staff in PEN 1 and 2 across 2020-2024. In
2025 a last round of training was targeted to 15 districts
where the level of coverage, especially of medical assistants
(MAs) of Family Doctors (FD), was below an agreed
minimum, acceptable (30%).
Aim of the study
To assess the perceptions of PHC personnel that experienced
the new training approach for PEN 1 and 2.
Material and methods
The new training was conducted by local trainers (FDs and
MAs) in their own districts, at the staff’s workplace, in a flexible manner, without affecting clinical activity. The quality of
the teaching process was monitored by national trainers
through on-line and onsite visits. In the last round, 746
personnel were trained, including 129 family doctors (FDs)
and 617 MAs. The perceptions of the staff trained were
assessed based on a standardized data collection tool. The
evaluation form was completed by 558 participants, of which
442 were MAs and 116 FDs. The forms were filled in digitally
through Google Forms (using links and QR codes), and the
collected data was processed and analyzed.
Results
The findings highlighted a very high level of satisfaction with
all the educational dimensions evaluated: 85% of
participants mentioned the achievement of the program
objectives, 82.6% - the fulfillment of personal expectations,
83.6% - the efficiency of the training. In the analysis of the
specific thematic responses, a significant focus on diabetes
mellitus is noted. Subthemes such as diabetes treatment and
diabetic foot management were frequently associated with
the need to strengthen practical skills. Another aspect of
interest was effective communication and motivational
interviewing, relevant to the doctor-patient relationship.
Cardiovascular risk assessment and the promotion of a
healthy lifestyle were perceived as fundamental elements of
prevention and integrated care.
Conclusion
Cascade districts training provided by local trainers
contributes to the creation of a district-level network that
provides support for the subsequent implementation of
PEN. The use of PEN tools was perceived as one of the most
useful and applicable components of the training. The
practical and interactive nature of the training, the applied
activities, teamwork and case studies were extremely useful
for consolidating knowledge.
