Country Programme (2007-2011/2012) evaluation - UNFPA Moldova

Available data suggest significant rural-urban inequities in the availability of contraceptives - condoms,
oral contraceptives, IUDs and injectables are found in significantly fewer rural health facilities compared
to their availability in urban facilities 37 .
Although the use of modern contraceptive methods has increased, there is still an unmet need as
evidenced by the number of unwanted pregnancies and consequent resort to induced abortion. Despite the
fact that legislation in the Republic of Moldova permits abortionuponrequest, unsafe abortions account for
37.5% of maternal deaths 38 and abortion remains amajormethodofbirthcontrol. Availability of trained
medical staff, thereby providing better access to services, has to be complemented by easy and
appropriate access to supplies, especially for vulnerable groups.
Thus, having trained large numbers of family doctors under various UNFPA supported initiatives, as well
as having supported the procurement of modern contraceptives; theUNFPA supported in 2010 the first
rapid review of the present status of Reproductive Health Commodity Security (RHCS) in Moldova. 39 The
review found that the most significant change since the June 2005 mission is the initiation of UNFPA
programme activities to support RH/FP services, including procurement and distribution of contraceptives
free of charge in the Transnistria region. Furthermore, the importance of having a LMIS in place was
recognized by the review. However, the authors criticised that the FP training offered to primary health
care providers had not addressed how to use it; hence users do not necessarily understand the need for the
data collection and have difficulties in completing forms and using the system in general.
Through its concentration of improve service quality via medical staff training outside the Chisinau area,
UNFPA efforts reach the more vulnerable population in small urban or rural areas and specifically in
Transnistria. Commodity security by providing free of charge commodities are targeted to low-income
groups of population.
RH education and YFHS
Even if reproductive health education has not been successfully included in official school curricula as a
mandatory subject forteaching 40 , peer education has been scaled-up to try andreach out to the same target
group outside institutional teaching. Taking a look at peer education alone, the activity can be considered
as a 100% success. Peer education has been institutionalized from the Ministry of Health. Already back in
2005, peer education was included in the Reproductive Health Strategy as an approved method for health
education. The Ministry of Education has also indorsed it as an alternative outreach method. In response
to this, peer educators frequently address school directors asking for permission to offer their peer-to-peer
training activities inside schools. Frequently this permission is granted. Performing peer educators have
also been created for outreach activities on RH and youth. There are some critical voices in Moldova who
37 Review of Experience of Family Medicine in Europe and Central Asia: Moldova Case Study - World Bank, May
2005
38 UNFPA Moldova – Rapid review of commodity security, June 2010.
39 UNFPA Moldova, June 2010 (Mission Report of Katy J Shroff and Mihai Corciova)
40 We are referring to a LSBE approach for reproductive health education, which includes modern concepts and
content delivered to adolescents of both sexes in an understandable language, which they themselves address with
openness and interest. Of course, there are aspects of reproductive health included in the current curricula, but these
are not up to date in scope, approach, concepts and the way they are being communicated.
UNFPA Moldova Extended Country Programme (2007-2011/12)
Outcome Evaluation
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