specific needs of children and elderly left behind as a ... - IOM Moldova

CHAPTER II
pulsory medical insurance but without specific provisions for this group
of elderly. It is important that all the elderly receive the necessary medical
care and the concern for population’s health is among the priorities of National
Health Policy (Government’s Decision no.886 of 06.08.2007, issued
in the Official Monitor no.127-130 of 17.08.2007).
In terms of improving the quality of service provision, to identify various
diseases and to treat the disease at its incipient stages “at present there is
a mechanism of financial motivation for family doctors so that they will
proactively identify the elderly in the territory and will keep their health
under supervision. It is a very good mechanism as the doctor controls the situation
and is acquainted with problems the inhabitants are confronted with.
Apart from caring for their direct duties, the doctors are interested in keeping
the record and supervising all the elderly living in their sector as depending
on this they will get bonuses on top of the salary. All are content, the doctor is
motivated and the patients receive appropriate care” (III_EE_9).
The only problem in providing quality medical care services is the fact that
the elderly address the doctor too late: “speaking about the elderly left behind,
they seem to be more protected as they are mature and realize the danger
and they can ask for help themselves when they need it. It does not depend on
the system’s capacity but on human factors” (III_EE_9). At the same time, the
experts in the territory call to attention the limited access to medical services:
“the medical nurse and doctor visit the beneficiaries only when they are called
and then with difficulty”, the explanation reveals the reason: “the number of
beneficiaries per medical nurse is too big and he/she can not cope with the situation
as he/she has a large number of people to examine...there are certain circumstances
that hinder those poor elderly from seeing the doctor”; “neither doctors
or social workers have personal means of transport to pay visits to beneficiaries”
(FG_EE_urban_rural). We also specify that mixed services (medico-social or
socio-medical) are more effective in the case of elderly.
According to the research data, the development of services is problematic,
as dynamics, needs and living conditions of the elderly are very diverse:
”probably they need social services but they do not entirely depend on
these services. Here already, the issues of social canteen services are not relevant.
For home-care services they could also employ by themselves a woman
or someone to look after them” (III_EE_7). The solution in this regard is
the strategic planning based on thorough analysis of the situation and
identification of needs: ”when I was involved with the Social Investment
Fund of the Republic of Moldova’s 2nd programme, we drew up a map of
social services with the support of a counselling company. We had defined
existing resources and those that are covered and as a result 6 centres and
one small centre for the temporary placement of elderly with a capacity of 8
people were opened in the country. From my experience I know this is too lit-
216