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The Court of Accounts presented the results of the Health Sector Modernization Program to the Public Finance Control Committee

  • 06.10.2021
  • 2004

On October 6, the Court of Accounts of the Republic of Moldova (CoARM) presented within the Public Finance Control Committee (PFCC), the Audit Report of the financial statements of the Operation “Modernization of the health sector in the Republic of Moldova” concluded on December 31, 2020, approved by throughout the CoARM’s Decision no. 44 from July 28, 2021.

Marina Covali, Member of the CoARM and Irina Rogaciov, Head of the audit team, presented the main conclusions and findings of the financial report.

Thus, in the opinion of the Court of Accounts, the financial statements of the Operation "Modernization of the health sector in the Republic of Moldova" provide, in all significant respects, a fair and accurate picture, according to the specific financial reporting requirements of the World Bank and the budget system. The audit also assessed some compliance issues.

The project "Modernization of the health sector in the Republic of Moldova" was initiated in order to reduce key risks related to non-communicable diseases, to increase the efficiency of health services provided to the population, to reduce disability and incapacity for work and to improve health indicators in the Republic of Moldova. The financing agreement was signed in 2014 and provides for a loan of 20 million special drawing rights (SDRs), equivalent to 30.8 million USD. The financing of the program was granted as a budget support, and the amount is disbursed based on the achievement of indicators established between the World Bank, the Ministry of Health, Labor and Social Protection (MHLSP) and the National Medical Insurance Company.

According to the Financing Agreement between the Republic of Moldova and the International Development Association, the Modernization Operation of the health sector was to be completed within 5 years, the end date being March 30, 2019, but because not all indicators were met, the extension of the deadline was accepted with 21 months, until December 31, 2020.

The Court of Accounts informed that out of the four indicators, planned within the Program, two indicators were not reached in 2020 as well, and two other indicators were not validated, fact for which no financial means were disbursed.

The first indicator was reached at the end of 2017. As a result, all cigarette packs contain warning messages about the negative impact on health. The second indicator "Increasing the percentage of people with cardiovascular disease (CVD) who receive compensated drugs for treatment", established that the number of beneficiaries of compensated drugs for the treatment of cardiovascular diseases increased in 2019 by 9.26 percentage points compared to year 2017.

Concerning the indicator "Introduction of performance-based incentives to improve the efficiency and quality of healthcare in hospitals", it is attested that, as a result of the analyzes, changes have been agreed and some of the previously provided financial sources will be reallocated and rescheduled for 2021 to other indicators.

Regarding the indicator “Consolidation of departmental hospitals under the authority of the Ministry of Health, Labor and Social Protection (MHLSP)”, it is attested that, at the moment, the State Hospital and the Clinical Hospital of MHLSP are in the process of merging. However, with the COVID-19 pandemic and the overburdening of hospital beds, the role of hospitals is being revised. Thus, the National Strategy previously planned and the General Plan for the consolidation and rationalization of hospitals, are to be re-examined once the pandemic situation is resolved. Thus, the amounts will be reallocated to funding for a new indicator, such as "Integrating lessons learned in communication campaigns on changing population behavior and assessing vaccine readiness".

Regarding the Technical Assistance component, during 2020, it is indicated that no progress has been registered in the implementation of the planned actions, the cause being the pandemic situation. Therefore, for the Automated Information System "Primary Health Care", remained uncontracted and unrealized the amount of 714.5 thousand SDRs, reallocated for the development of additional functionalities and interconnections of the Automated Information System "Primary Health Care" (electronic prescription - E-Prescription ); Electronic Medical Leave Certificate (E-Certificate); Electronic birth certificate; Electronic death certificate; Diabetes Registry; National renal registry.

At the end of the hearing, the Court of Accounts concluded that the pandemic situation caused by the COVID-19 virus had a major impact on the implementation activities of the Program "Modernization of the health sector in the Republic of Moldova" carried out in 2020, and on both internal and external cooperation with other institutions and authorities of different levels, which for reasons of confrontation with the pandemic spread of the virus, have reorganized their activity under special conditions. This situation also directly influenced the process of disbursement of indicators. Thus, the progress towards the implementation of the Project is maintained at a moderate level, without substantial changes in the disbursement coefficient.

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