Contribution to Confidence Building Measures Program in Transnistria – Promoting Confidence in the Health Sector

Population living in Transnistria has limited access to quality maternal and child health care. The vaccination coverage rate is declining and the number of premature and underweight newborns is increasing. The project aims to approximate maternal and child health care in Transnistria to international standards, as well as to improve the access to and quality of maternal and child health services at secondary and primary level. A special focus is put on nutrition and immunization. The project offers good opportunities for building trust across borders through common trainings of professionals and concerted efforts on immunization.

Country/region Topic Period Budget
Infectious desease
Primary health care
Health systems strengthening
01.03.2016 - 31.12.2021
CHF 2'921'000

Transnistria is a breakaway region, which de jure belongs to the Republic of Moldova but is de facto independent and the most deprived region of Moldova. Transnistria has experienced a deepening economic crisis for the past two years, exacerbated by the depreciation of the Russian rouble and the armed conflict in eastern Ukraine. As a result, public expenditure was reduced, leading to significant delays in the payment of salaries and social indemnities and also resulting in spending cuts for health programs. Health professionals from the Transnistrian region lack access to international standards and evidence in healthcare. Public health, in general, and maternal and child health and immunization in particular, stayed high in the agenda of health authorities both in Chisinau and Tiraspol (“capital” of Transnistria) over the years. Despite some good progress in certain population health outcomes, most health indicators have shown steady decline (e.g. vaccination rates). There is thus a need for continued reform efforts and development of policies and interventions in this specific health sector.


The population of Moldova, especially the part living in Transnistria (approximatively 500’000 people), has access to comprehensive quality maternal and child health services and improved immunization.

Target groups

Health professionals at hospital, outpatient and primary health care levels, including managers and emergency medical care staff, and health sector authorities.

The final beneficiaries are mothers, new-born babies and children, as well as fathers.

Medium-term outcomes
  • Newborns and mothers from Transnistria benefit from qualitative integrated perinatal services, including nutrition (breastfeeding)
  • Vaccine coverage and immunization rates for traditional and new or underutilized vaccines are improved on both banks of Nistru River
  • The population on both banks of Nistru River has increased their maternal and child -related health literacy and awareness about availability of services and their right to access them

Results from previous phases:  

5 (out of 7) perinatal centres in Transnistria have been endowed with required medical equipment. Two of these institutions were also refurbished. The capacity to deliver the necessary emergency care for pregnant women and new-borns of 95% of paediatricians, neonatologists, obstetricians and nurses from 5 districts and 2 municipalities of Transnistria has been improved through simulation training.   

As a result, about 68% of pregnant women benefited from improved quality of services.

An adequate equipment for vaccines cold chain has been distributed to the regional and district level and training in cold chain technology use, vaccine management and injection safety has been provided to health professionals.

The health authorities, mid-level managers and clinicians better understand the GAVI Vaccine Alliance graduation process and eligibility criteria, vaccine stocks / planning and national immunization program costing / financing issues, as well as important vaccine indications and contraindications issues, due to capacity building workshops conducted by WHO.

Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
United Nations Organization (UNO)
  • United Nations Development Programme

Budget Current phase Swiss budget CHF   2'921'000 Swiss disbursement to date CHF   2'920'115
Project phases Phase 2 01.03.2016 - 31.12.2021   (Current phase) Phase 1 01.11.2013 - 29.02.2016   (Completed)