30 March 2012

Official Development Assistance to the Moldovan Health Sector – 2011

Fourth Edition

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

AimTo provide a full picture of the external official development assistance to the health sector thus highlight gaps of donor’s assistance across the priorities laid down in the national strategic policy documents and to provide forecasts on future foreign assistance on short and medium term perspectives

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Objectives1. To picture donors activities in the larger framework of the health system

functions and donors alignment towards the Moldovan health system strategies

2. To improve quality of information available for sector coordination and strategic decision-making for strategic planning of financial resources in health sector

3. To illustrate donors’ short and medium term commitments to the Moldovan health sector

4. To review the coordination mechanisms in place

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Differences with previous editions

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1. Measurement of aid alignment with health system priorities and functions

2. Measurement of aid alignment to the Paris Declaration on Aid Effectiveness

3. Web-based interface for data collection

4. Validation process

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Methodology

• The study design compelled two phases: questionnaire development and identification of the eligibility criteria.

• The data collection was conducted through an online interface and strengthened through validation interviews.

• Data analysis was conducted by the research team in close collaboration with the software developer

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Eligibility criteriaThe assistance provided by the agencies covered by this enquiry had to fulfill both sets of criteria given by:

1. OECD DAC definition of ODAGrants or loans to countries and territories on the DAC List of ODA Recipients (developing countries) and to multilateral agencies which are: (a) undertaken by the official sector; (b) with promotion of economic development and welfare as the main objective; (c) at concessional financial terms (if a loan, having a grant element of at least 25 per cent). In addition to financial flows, technical co-operation is included in aid. Grants, loans and credits for military purposes are excluded. Transfer payments to private individuals (e.g. pensions, reparations or insurance payouts) are in general not counted.

2. The State Chancellery of Moldova Annex I of Government Decision no. 246 of 8th April 2010: “List of the technical assistance projects that qualify for international treaties, for tax exemptions, custom taxes and 0% VAT for goods and services provided by them”

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BilateralBilateralMultilateral Multilateral

The Global Fund to Fight AIDS, Tuberculosis and Malaria 

(GFTAM)

The Global Fund to Fight AIDS, Tuberculosis and Malaria 

(GFTAM)

GAVI AllianceGAVI Alliance

United Nations Development Program (UNDP)

United Nations Development Program (UNDP)

International Atomic Energy Agency(IAEA)

International Atomic Energy Agency(IAEA)

Austrian Agency for Development(ADA)

Austrian Agency for Development(ADA)

German Agency for International Cooperation (GIZ)

German Agency for International Cooperation (GIZ)

Government of RomaniaGovernment of Romania

United Nations Children’s Fund

(UNICEF)

United Nations Children’s Fund

(UNICEF)

United Nations PopulationFund

(UNFPA)

United Nations PopulationFund

(UNFPA)

United Nations Office on Drugs and Crimes

(UNODC)

United Nations Office on Drugs and Crimes

(UNODC)

The World Bank Group (WB)

 

The World Bank Group (WB)

 

Joint United Nations Programme on HIV/AIDS

(UNAIDS)

Joint United Nations Programme on HIV/AIDS

(UNAIDS)

Japan International Cooperation Agency (JICA)

Japan International Cooperation Agency (JICA)

World Heath Organization(WHO)

World Heath Organization(WHO)

Government of the People’s Republic of China

Government of the People’s Republic of China

Swiss Agency for Development and Cooperation

(SDC)

Swiss Agency for Development and Cooperation

(SDC)

Turkish Agency for Development and International Cooperation

(TIKA)

Turkish Agency for Development and International Cooperation

(TIKA)

Official Development Assistance in Health Sector implemented in 2011 External Development Partners

United States Government (USG)

United States Government (USG)

European Union Delegationin the Republica Moldova

European Union Delegationin the Republica Moldova

KEY RESULTS

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Donors and programs/projects

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EU Delegation

1 Sector Policy Support Programme Health2 Capacity assessment and modernization of the Republican Clinical Hospital in Chisinau

3 Developing and piloting sheltered housing service for people with mental illness in Moldova

GAVI Alliance 4 New vaccine for Penta Vaccine

GFATM

5 Strengthening Tuberculosis Control in the Republic of Moldova, 6 Empowerment of People with Tuberculosis and Communities in Moldova

7 Reducing HIV - related burden in the Republic of Moldova, 2010 - 2014, Scaling up Access to Prevention, Treatment and Care under the National Program for Prevention and Control of

8 Reducing HIV - related burden in the Republic of Moldova, 2010 - 2014GIZ 9 CIM Expert - Hospital System Planning

Government of China10 Support to a Traditional Chinese Medicine Center11 Supplying a lot of 114 medical ventilators for equipping the departments of reanimation and intensive care

Government of Romania 12 Rehabilitation of Blood Transfusion Center in Cahul

SDC

13 Modernising the Moldovan Perinatology System Project 3rd Phase

14 REPEMOL – Regionalization of Pediatric Emergency and Intensive Care Services in Moldova

15 Healthy Generation (Scaling-up Youth Friendly Health Services in Moldova)

16 Development of Community Mental Health Care Services in Moldova (CMH Center in Chisinau)

TIKA17 Ambulance cars for the Republic of Moldova18 Reconstruction of the Vulcanesti Regional Hospital

UNAIDS 19 Support to the National AIDS Programme

UNDP20 NHDR and Policy Analysis21 MDG Governance in Action:Catalyzing Human Rights Change in Social Policy22 e-Governance

UNFPA23 Mechanisms strengthened for supervisory and monitoring systems, including for quality assurance in comprehensive reproductive health service

delivery, and for reproductive health commodity security

24 MDA1R303 "Increased availability of counselling and information services on sexual and reproductive health, and HIV/AIDS/STIs prevention for young people"

UNICEF25 Equitable access to quality services26 Social Policy and Data for Children

UNODC 27 Strengthening national capacities in Eastern Europe and Central Asia to address HIV/AIDS in vulnerable populations

WB28 Health Services and Social Assistance Project29 Preventing Hepatitis B and C in Moldova

WHO 30 Biennial Collaborative Agreement (BCA) between the Ministry of Health of the Republic of Moldova and the Regional Office for Europe of the World Health Organization 2010/2011

ODA projects or programs per donor

10# of programs or projects

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Geographic coverage National, targeted regional and pilots

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Aid modalities

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% of total funds disbursed in 2011

Grants and loan

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

% of total funds disbursed in 2011

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Type of funding

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% of total funds disbursed in 2011

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Investments

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% of funds disbursed for Investments in 2011

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Technical Assistance

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% of funds disbursed for Technical Assistance in 2011

Health System Core Functions

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

% of total funds disbursed in 2011

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Health Service Provision, by components

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% of funds disbursed for Health Service Provision in 2011

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Program priority areas

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% of total funds disbursed in 2011

Alignment to national health policies

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Name of policy # Names of AgenciesKey National Health Policies

National Health Policy, 2007-2021 11 EU, GFATM, Government of Romania, SDC, TIKA, UNDP, UNFPA, UNICEF, UNODC, WB, WHO

State Policy on Pharmaceuticals 1 WHOHealth Systems Development Strategy, 2008-2017 8 EU, GFATM, GIZ, SDC, TICA, UNICEF, WB, WHO

National Strategy for Reproductive Health, 2005-2015 4 SDC, UNFPA, UNICEF, WHONational Anti-Drug Strategy, 2011-2018 2 GFATM, UNODCPrimary Health Care Development Strategy, 2010-2013 6 EU, GFATM, SDC, UNAIDS, WB, WHO

Key National Programs

National Program for Viral Hepatitis B, C and D Control, 2007-2011 3 WB, WHO

National Program for Health Lifestyle Promotion, 2007-2015 3 UNFPA, UNICEF, WHO

National Program for Mental Health, 2007-2011 3 EU, SDC, WHO

National Blood Transfusion Safety Program, 2007-2011 2 Government of Romania, WBNational Immunizations Program, 2011-2015 3 GAVI, UNICEF, WHO

National HIV/AIDS and STI Prevention Program, 2011-2015 8 EU, GFATM, UNAIDS, UNDP, UNFPA, UNICEF, UNODC, WHO

National TB Prevention and Control Program, 2011- 2015 4 EU, GFATM, UNDP, WHO

National Program for Diabetes Control, 2011-2015 0 -National Programme for Emergency Care Development, 2011-2015 2 SDC, TIKA

Hospital Healthcare Development Program, 2010-2012 4 EU, SDC, WB, WHONational Program for Eradication of Iodine Deficiency Disorders 2011-2015 1 UNICEF

Other priorities 2 UNDP, WB

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Donor perceptions about MTEF

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Number of donors

Aid Predictability Intention to continue support to health sector, short-term, 2012-2013

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Number of donors

MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Findings • In 2011 external donors have disbursed an equivalent of US$ 51.7 mln to health sector in

Moldova, which represents a total 14% compared to the public expenditure on health in equivalent of US$ 363 mln.

• Among core health system functions, most donor assistance supports activities related to Health Systems Delivery and Resource Generation, while Stewardship and Governance and Health Financing receives less financial allocations.

• Funds are disbursed unevenly in the different health service delivery component: Public Health Sector and Emergency Care is receiving far less attention than Primary Health Care and Hospital Care.

• Funds are disbursed unevenly in the different program priority areas: communicable disease are receiving the largest share of the disbursements, while burden of disease lies in non-communicable diseases.

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Findings• Geographic coverage is not uniform, Chisinau and Balti receiving most attention in

targeted regional coverage. Some districts receive focused support from more donors.

• In health sector, donors aligned well to support priorities in national health policies and national programs, however programs related to HIV and TB and Hospital Health Care Development received attention from more donors compared to other health priorities.

• Due to limitations of MTEF relevance to donor strategic programming, alignment to MTEF categories is far more complicated.

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

FindingsChecked against the “Results of the 2011 Survey on Monitoring the Paris Declaration -Moldova” and Paris

Declaration general target indicators

• Only 14% of the 2011 health sector commitments were recorded in the sector budget (versus 85% Paris Declaration target value).

• Donors are concentrating on technical assistance more than they do in other sectors (average 20%).

• Funds disbursed in 2011 topped the scheduled ones by 18% points.

• The number of donors who could not provide the exact amount of pledged funds for 2012-13 was high (10/15). On the timeframe 2014-2020 none of the donors interviewed was able to give the amount pledged.

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MINISTERUL SĂNĂTĂŢIIAL REPUBLICII MOLDOVA

Thank you for your attention

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