Youth Friendly Health Services in Moldova


Switzerland has supported Moldova in developing its youth friendly health services (YFHSs) and scaling them up to cover the entire country. The improved access to quality healthcare led to better health outcomes in adolescents, such as decreased alcohol use and incidence of sexually transmitted infections. The two-year exit phase of this project will focus on ensuring the sustainability of YFHSs and transferring the responsibility for matching the supply and demand for such services to relevant national and local institutions.

Country/region Topic Period Budget
Moldova
Health
Vocational training
Reproductive health & rights
Sexually transmitted diseases incl. HIV/AIDS
Advanced professional training
01.11.2018 - 31.10.2020
CHF 1'092'000
Background Young people of Moldova face multiple challenges regarding their health and access to healthcare services. Avoidable causes (incl. intoxication and suicide) account for the majority of adolescent deaths in Moldova (47%), affecting young men (59%) more than young women (35%). Non-communicable diseases (cancer, mental disorders, substance abuse, etc.) are the second highest cause of youth mortality (34.8%). The absence of comprehensive health information in schools, including on sexual and reproductive health, reduces young people’s access to credible sources of quality information and increases their vulnerability. HIV/AIDS prevalence among youth is of particular concern. Alcohol and tobacco consumption remain higher than the EU average. Policy and structural constraints (social and political uncertainty, high level of out-migration resulting in shortage of health professionals and lack of parental supervision, gender related stereotypes and hostile reaction to the promotion of sexual education) continue to impede the equitable access to youth friendly services as part of the integrated package of health services.
Objectives Young men and women in Moldova (particularly those vulnerable and most-at-risk) adopt safer behaviours and seek assistance from health services when needed.
Target groups

Target groups include providers of youth friendly health services (staff of YFHCs, social workers, family doctors and nurses) and national and local authorities / policy- and decision-makers (Ministry of Health, labour and Social Protection, National Health Insurance Company, and Local Public Authorities).

Final beneficiaries are girls and boys and young men and women aged 10-24, with a particular focus on vulnerable and most-at-risk groups, including poor, returning migrants, and ethnic minorities.

Medium-term outcomes

Outcome 1: Sustainable and accountable provision of youth friendly health services provided countrywide is institutionalized.

Outcome 2: Young men and women in Moldova are more resilient to health risk factors, have safer health behaviors, seek necessary health care and participate in youth health services governance.

Results

Expected results:  

(1) Relevant policy and regulatory instruments, related to youth health and development, updated.

(2) The quality management tools for YFHCs developed and applied and the institutional capacities of YFHSs network consolidated.

(3) Relevant national and local institutions gradually take over the responsibilities for YFHSs provision and promotion and work in a coordinated manner.

(4) Youth (volunteers, peer educators, beneficiaries) participation in designing, promoting and monitoring of YFHSs institutionalized.


Results from previous phases:  

The youth friendly health services (YFHSs) have been scaled to cover the entire country (except Transnistrian region): the network of 41 Youth Friendly Health Centres (YFHCs) has been established, they are currently fully functional and integrated into the Moldovan health care system. The YFHCs operate according to norms and standardized procedures within the existing primary health institutions and with a distinct dedicated budget contracted by National Health Insurance Company. Integration of YFHSs into the mandatory health insurance package guarantees their sustainability.

The access to health services for adolescents and young people aged 10-24 increased from 5% in 2009 to 25% in 2017. Outreach efforts resulted in a higher number of most vulnerable service users and male beneficiaries accessing the services.

The quality of YFHSs has been improved, resulting in better health outcomes in adolescents: decrease in incidence of sexually transmitted infections and alcohol use, and stabilized suicide rate.  In districts where YFHCs have been operating for more than five years, the adolescent fertility rate is twice lower than in other districts.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
International or foreign Non-Governmental Organization


Other partners
Moldovan Non-Governmental Organization “Health for Youth”
Coordination with other projects and actors Synergies with SDC projects in the health and local governance domains. Synergies with UN organizations (UNFPA, WHO and UNICEF).
Budget Current phase Swiss budget CHF   1'092'000 Swiss disbursement to date CHF   780'543
Project phases Phase 3 01.11.2018 - 31.10.2020   (Current phase) Phase 2 01.11.2014 - 31.10.2018   (Completed) Phase 1 01.06.2011 - 31.10.2014   (Completed)