IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v124y2020i1p83-88.html
   My bibliography  Save this article

Mental health system reform in Moldova: Description of the program and reflections on its implementation between 2014 and 2019

Author

Listed:
  • Petrea, Ionela
  • Shields-Zeeman, Laura
  • Keet, Rene
  • Nica, Raluca
  • Kraan, Karel
  • Chihai, Jana
  • Condrat, Victoria
  • Curocichin, Ghenadie

Abstract

In 2014, the Republic of Moldova started a systematic process of reforming its mental health system, implementing priority actions set out in the National Mental Health Programme. The reform entailed a service delivery re-design, instituting mechanisms for collaboration across health and social sectors, and revision of the policy framework. Outcomes of the first 4 years of the reform included: 1) the establishment of a network of mental health services in 4 pilot districts embedding mental health diagnosis, treatment and referral in primary and specialized mental healthcare; 2) creation of an enabling policy environment at the national and district level; and 3) strengthened community support and acceptance of mental health issues. Objectives of the first Phase were achieved and the reform is now in its second Phase (2018–2022). The implementation strategy in Phase 1 focused efforts on 4 pilot districts, whereas Phase 2 harnesses lessons learned from Phase 1 and facilitates local leaders and actors to scale-up the model to all 32 districts and municipalities in Moldova. Ownership over the reform process shifted from project-led in Phase 1 to national and local government-led in Phase 2. We reflect on the process and contents of the mental health reform, discuss lessons learned and implementation challenges encountered. We conclude with learning points for policymakers and researchers considering mental health reform in other countries.

Suggested Citation

  • Petrea, Ionela & Shields-Zeeman, Laura & Keet, Rene & Nica, Raluca & Kraan, Karel & Chihai, Jana & Condrat, Victoria & Curocichin, Ghenadie, 2020. "Mental health system reform in Moldova: Description of the program and reflections on its implementation between 2014 and 2019," Health Policy, Elsevier, vol. 124(1), pages 83-88.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:1:p:83-88
    DOI: 10.1016/j.healthpol.2019.11.007
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851019302751
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2019.11.007?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. World Bank, 2016. "Moldova Poverty Assessment 2016," World Bank Publications - Reports 26041, The World Bank Group.
    2. Crick Lund & Mark Tomlinson & Mary De Silva & Abebaw Fekadu & Rahul Shidhaye & Mark Jordans & Inge Petersen & Arvin Bhana & Fred Kigozi & Martin Prince & Graham Thornicroft & Charlotte Hanlon & Ritsuk, 2012. "PRIME: A Programme to Reduce the Treatment Gap for Mental Disorders in Five Low- and Middle-Income Countries," PLOS Medicine, Public Library of Science, vol. 9(12), pages 1-6, December.
    3. World Bank Group, 2016. "Poverty and Shared Prosperity 2016," World Bank Publications - Books, The World Bank Group, number 25078, December.
    4. Nicaise, Pablo & Dubois, Vincent & Lorant, Vincent, 2014. "Mental health care delivery system reform in Belgium: The challenge of achieving deinstitutionalisation whilst addressing fragmentation of care at the same time," Health Policy, Elsevier, vol. 115(2), pages 120-127.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jona J Frasch & Ionela Petrea & Jana Chihai & Filip Smit & Matthijs Oud & Laura Shields-Zeeman, 2020. "Taking steps towards deinstitutionalizing mental health care within a low and middle-income country: A cross-sectional study of service user needs in the Republic of Moldova," International Journal of Social Psychiatry, , vol. 66(1), pages 49-57, February.
    2. Sumaiyah Docrat & Donela Besada & Susan Cleary & Crick Lund, 2020. "The impact of social, national and community-based health insurance on health care utilization for mental, neurological and substance-use disorders in low- and middle-income countries: a systematic re," Health Economics Review, Springer, vol. 10(1), pages 1-23, December.
    3. C. H. Hanumantha Rao, 2018. "Rising Income Inequalities in the Wake of Globalization: Emerging Challenges," Indian Journal of Human Development, , vol. 12(2), pages 127-133, August.
    4. Hill, Daniel, 2020. "Technology heterogeneity and poverty traps: A latent class approach to technology gap drivers of chronic poverty," 2020 Conference (64th), February 12-14, 2020, Perth, Western Australia 305253, Australian Agricultural and Resource Economics Society.
    5. Sujit D Rathod & Mary J De Silva & Joshua Ssebunnya & Erica Breuer & Vaibhav Murhar & Nagendra P Luitel & Girmay Medhin & Fred Kigozi & Rahul Shidhaye & Abebaw Fekadu & Mark Jordans & Vikram Patel & M, 2016. "Treatment Contact Coverage for Probable Depressive and Probable Alcohol Use Disorders in Four Low- and Middle-Income Country Districts: The PRIME Cross-Sectional Community Surveys," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-15, September.
    6. David J. Price & Jae Song, 2018. "The Long-Term Effects of Cash Assistance," Working Papers 621, Princeton University, Department of Economics, Industrial Relations Section..
    7. Claus Brand & Marcin Bielecki & Adrian Penalver, 2019. "The natural rate of interest: estimates, drivers, and challenges to monetary policy," NBP Working Papers 308, Narodowy Bank Polski.
    8. Martin Rama, 2019. "Challenges in Measuring Poverty and Understanding its Dynamics: A South Asian Perspective," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 65(S1), pages 2-32, November.
    9. Sumaiyah Docrat & Susan Cleary & Dan Chisholm & Crick Lund, 2019. "The household economic costs associated with depression symptoms: A cross-sectional household study conducted in the North West province of South Africa," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-22, November.
    10. Pierce O’Reilly, 2018. "Tax policies for inclusive growth in a changing world," OECD Taxation Working Papers 40, OECD Publishing.
    11. Susana Costa e Silva & Paulo Duarte & Joana César Machado & Carla Martins, 2020. "Cause-related marketing in online environment: the role of brand-cause fit, perceived value, and trust," International Review on Public and Nonprofit Marketing, Springer;International Association of Public and Non-Profit Marketing, vol. 17(2), pages 135-157, June.
    12. Hiroaki Hayakawa & Yannis P. Venieris, 2019. "Duality in human capital accumulation and inequality in income distribution," Eurasian Economic Review, Springer;Eurasia Business and Economics Society, vol. 9(3), pages 285-310, September.
    13. Koblianska Inna & Pasko Oleh & Hordiyenko Mykola & Yarova Inessa, 2020. "Are Peasant Households Feasible in Terms of Policy? The Debate on the Future of Semi-Subsistence Households in Ukraine," Eastern European Countryside, Sciendo, vol. 26(1), pages 127-179, December.
    14. Dina Chhorn, 2018. "Effect of Microfinance on Poverty and Welfare: New Evidence from 9 provinces in Cambodia," Post-Print hal-02147272, HAL.
    15. Fanzo, Jessica & Haddad, Lawrence & Schneider, Kate R. & Béné, Christophe & Covic, Namukolo M. & Guarin, Alejandro & Herforth, Anna W. & Herrero, Mario & Sumaila, U. Rashid & Aburto, Nancy J. & Amuyun, 2021. "Viewpoint: Rigorous monitoring is necessary to guide food system transformation in the countdown to the 2030 global goals," Food Policy, Elsevier, vol. 104(C).
    16. Brand, Claus & Bielecki, Marcin & Penalver, Adrian, 2018. "The natural rate of interest: estimates, drivers, and challenges to monetary policy JEL Classification: E52, E43," Occasional Paper Series 217, European Central Bank.
    17. Rachel Kidman & Hans-Peter Kohler, 2020. "Emerging partner violence among young adolescents in a low-income country: Perpetration, victimization and adversity," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-16, March.
    18. Burkey, Matthew D. & Ghimire, Lajina & Adhikari, Ramesh Prasad & Wissow, Lawrence S. & Jordans, Mark J.D. & Kohrt, Brandon A., 2016. "The ecocultural context and child behavior problems: A qualitative analysis in rural Nepal," Social Science & Medicine, Elsevier, vol. 159(C), pages 73-82.
    19. Stevan Merill Weine & Scott Langenecker & Aliriza Arenliu, 2018. "Global mental health and the National Institute of Mental Health Research Domain Criteria," International Journal of Social Psychiatry, , vol. 64(5), pages 436-442, August.
    20. Binyan Wang & Junfeng Tian & Peifeng Yang & Baojie He, 2021. "Multi-Scale Features of Regional Poverty and the Impact of Geographic Capital: A Case Study of Yanbian Korean Autonomous Prefecture in Jilin Province, China," Land, MDPI, vol. 10(12), pages 1-20, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:124:y:2020:i:1:p:83-88. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.