During 23-25 May 2022, two experts from the Moldovan-Swiss project "Healthy Life: Reducing the Burden of Noncommunicable Diseases" are attending the International Conference on Integrated Care, in Denmark. On 24 May, Tatiana Dnestrean, the project integrated care and social assistance Expert, presented to the scientific community and practitioners how to develop capacities for implementing the Integrated Community Assistance (IC) in the Republic of Moldova.
The learnings and experiences from districts that pioneered the implementation of integrated care models in the Republic of Moldova ware presented. These early experiences revealed issues and challenges that largely relate to intersectoral cooperation. Although IC in the Republic of Moldova is positively valued by policy makers, health workers (doctors and nurses) (65.5%) and social workers (72.4%), these two groups of professionals continue to approach people with NCDs separately, providing little information and support, and have wide differences in their understanding of the nature of intersectoral collaboration, which they treat as a series of referrals between sectors rather than joint care.
The focus on solutions applied by the project and its partners - the Ministry of Health, the Ministry of Labor and Social Protection, the National Agencies for Public Health and Social Assistance, the Local Public Authorities, and the civil society - in overcoming these problems was made:
• The main principle for extending the IC approach is to ensure multidisciplinary collaboration at all stages, community nurse and the social worker ensuring the collaboration.
• In order to respond to the needs of people with NCDs and vulnerabilities, other relevant sectors, such as: education, police, civil society with local NGOs and volunteers, representatives of Local Public Authorities are being mobilized;
• To prevent, monitor patients with NCDs and support vulnerable groups, workshops are held to transfer knowledge, develop unique visions on the IC concept and strengthen the role of the community nurse;
• In order to strengthen practical skills and new approaches, peer training and study visits between districts and communities with experience in providing IC services and multidisciplinary teams are being supported;
• Practitioners applying IC are supporting new districts to develop their own model based on the analysis of data from district health profiles and the evaluation of existing resources.
IC means collaboration between sectors and aims to eliminate step by step the gaps, vulnerabilities, and limited access to medical and social services for people with chronic diseases. This means that the services are complex and avoid fragmentation and discontinuity of the of delivery way, eliminating the bureaucracy of referral cases between sectors, the "walking from door to door" of the person to get the complex needs solved.
At this stage, the project and its partners continue to strengthen the capacity of the sectors involved in the implementation of the IC and of institutionalizing the training modules for community nurses and members of multidisciplinary teams. The process is complex and includes the transfer of the theoretical and practical knowledge, of the application of common tools and working procedures.
The IC development and implementation of is one of the objectives of the national partners being facilitated by the Moldovan-Swiss project "Healthy Life: Reducing the Burden of Noncommunicable Diseases", implemented by the Swiss Tropical and Public Health Institute of and financed by the Swiss Government. Switzerland is one of the biggest development partner in the health sector of the Republic of Moldova.