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Audit activity Modernization of the health sector in the Republic of Moldova

  • 04.07.2023
  • 573

The operation "Modernization of the health sector in the Republic of Moldova" was initiated with the aim of reducing the key risks related to non-communicable diseases, increasing the efficiency of health services offered to the population, reducing disability and incapacity for work, as well as improving health indicators in the Republic of Moldova.

In this context, the Court of Accounts of the Republic of Moldova examined today, July 4, the results of the audit of the financial reports of the Operation "Modernization of the health sector in the Republic of Moldova" completed on December 31, 2022.

The financing agreement was signed in 2014 and provides for the granting of a loan in the amount of 20 million Special Drawing Rights (SDR), equivalent to 30.8 million US dollars. The financing of the Program was granted in the form of budget support, and the amount was disbursed based on the achievement of the indicators established between the World Bank, the Ministry of Health and the National Medical Insurance Company (NMIC).

The purpose of the audit was to provide reasonable assurance regarding the fact that the financial statements of the Operation "Modernization of the health sector in the Republic of Moldova" in 2022 do not contain significant distortions, caused by fraud or error, with the issuance of an opinion. As a result of the audit, the Court of Accounts issued an unqualified opinion.

In 2022, for the implementation of the program, 4 indicators were to be achieved and disbursed as follows:

  • Increasing the percentage of people with cardiovascular disease (CVD) who benefit from reimbursed drugs for treatment
  • Design and pilot of performance based incentive scheme for all hospitals
  • Consolidation of departmental hospitals under the administration of the Ministry of Health
  • Integrating lessons learned into population behavior change communication campaigns and assessing vaccine readiness.

With reference to the first indicator, the data presented established that the number of beneficiaries of compensated medicines increased by 9.26 percentage points. In the context, it is certified that the indicator was validated at a level of 92%, and the disbursement of financial means in the amount of 2.9 million SDR amounted to 2.7 million SDR in the NMIC budget.

With reference to the 2nd indicator "Design and piloting of the performance-based incentive scheme for all hospitals", it is certified that 485 thousand SDR were disbursed for the review of the performance payment scheme, in May 2022. At the same time, financial means in the same amount were provided for the piloting of the revised methodology in at least 7 hospitals. Thus, NMIC carried out the piloting of performance indicators within 7 hospital medical institutions and established 9 piloting indicators of the performance payment mechanism, covering 5 clinical areas.

Regarding the indicator with reference to "Consolidation of departmental hospitals subordinated to the Ministry of Health", it is confirmed that the State Hospital and the Clinical Hospital of the Ministry of Health have merged. Therefore, the indicator was partially achieved, which provided for the establishment of joint management at 3 hospitals in Chisinau and for which 404 thousand SDR were disbursed in advance. In August 2022, 258,750 SDR were allocated and disbursed, thus, this indicator was assessed as having been achieved in proportion to 50%.

With reference to the 4th indicator, the audit shows that it was validated and disbursed in May 2022, in the amount of 3.3 SDR, for the completion by WHO of:

  • the study to evaluate the knowledge, behaviors and attitude of people in relation to slowing down the transmission of COVID-19;
  • assessing the degree of preparation for the COVID-19 vaccine;
  • revision of the National Communication Strategy for COVID-19.

Finally, the Court of Accounts reiterated some of the recommendations from the previous year's audit report, aimed at improving the achievement of the mentioned indicators and adding value to the audited aspects.


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