Support to the Reform of Mental Health Services in Moldova (MENSANA)


Since 2014, Switzerland supports Moldova in the implementation of a systemic reform of mental health (MH) services, aiming at promoting proximity and patient-centred community-based provision, reducing stigma against people with mental health problems and limiting expensive and unnecessary hospitalizations. The third four-year (exit) phase will focus on shifting the project’s key functions to local stakeholders / institutions, in order to guarantee the continuity on the gains achieved so far beyond Swiss support.

Paese/Regione Tema Periodo Budget
Moldova
Sanità
Salute mentale & benessere
Assistenza sanitaria primaria
Rafforzamento dei sistemi sanitari
01.10.2022 - 30.06.2026
CHF  5’844’500
Contesto Despite the ongoing reform, MH patients in Moldova have substantially greater care needs and lower quality of life compared to the overall European average. This is mainly due to a medicalized MH care approach and the difficulty to implement community-based care models in the face of a chronically underresourced healthcare and welfare system. The highly volatile political context, system-wide constraints, coupled with the consequences of Covid-19 pandemic and the spillover effects of the war in neighboring Ukraine hindered the progress. Anxiety and depressive disorders among the population, continuously on the rise in the face of a still largely unripe care system, undermine coping mechanisms and further fuel an already intense outmigration (incl. within the health sector). The pandemic-related restrictions and repurposing of resources have disrupted treatment and contributed to modifying promising patients’ healthcare seeking behavior, as well as to the increase in social isolation of stigmatized and marginalized groups.
Obiettivi People in Moldova have access to suitable supports, resources and services to experience and maintain mental health and mental well-being.
Gruppi target

Ministries of Health, of Labour and Social Protection, of Education and of Interior; health and non-health sector professionals providing MH services; National Health Insurance Company and other public funds targeting patients with MH issues; local public authorities; National Employment Agency; relevant civil society organizations / community based organizations (incl. various professional associations and constituency-based organizations).

Final beneficiaries are people with existing MH issues and the general population living in Moldova.

Effetti a medio termine

Outcome 1 (service delivery level): The existing network of MH services is able to strengthen and further develop its service provision without support and intermediation of MENSANA.

Outcome 2 (societal level): Population (incl. professionals in various sectors, service users and general population) have increased awareness, literacy and tolerance, promote MH, and support people with MH issues in their recovery and inclusion.

Risultati

Risultati principali attesi:  

  • The MH system has the knowledge, skills, tools, processes and mechanisms in place to enable all key actors to deliver MH care according to the model of care
  • Evidence and insights are available to inform decision-making and policy processes in MH
  • The content for MH promotion and prevention programs is developed for different settings (workplaces, care settings, schools) and targeting different age groups (children, youth, adults, older adults)
  • Local communities are supported and equipped to be more accepting of people with MH issues and use opportunities for social inclusion and participation of people with MH issues
  • Models are developed and tested for supportive employment of people with MH problems


Risultati fasi precedenti:  

The community-based model of MH care was piloted in phase 1 and, in phase 2, it was rolled out to cover the whole country with a network of 40 Community Mental Healthcare Centres (CMHCs). CMHCs operate within primary health care (PHC) facilities and are contracted by the National Health Insurance Company (NHIC). Currently, NHIC funding for the functioning costs of the CMHCs network amounts to ~ CHF 1.6 million / year. The regulatory framework on the work and roles of MH professionals and CMHCs is in place. Relevant health professionals have been trained to work with people suffering from MH problems. And an interdisciplinary coordination mechanism has been initiated and includes relevant non-health sector services.

The project has supported the shift from centralised and stigmatising hospital care to better coordinated, community-based and patient-centred services, which resulted in rationalization of resources, while making the available services more fit to users’ needs. The unnecessary and preventable hospitalizations of people with MH disorders decreased by ~37%, while the demand for alternative care at the community level among patients, general population, as well as concerned professionals increased.

During the pandemic, the project has become the go-to source for MH information and expertise in the country, which clearly speaks about the high relevance and timeliness of the intervention, both during stable times, and during times of crisis.


Direzione/Ufficio responsabile DSC
Partner del progetto Partner contrattuale
ONG internazionale o straniera
Instituzione statale straniera
  • Central State of South East
  • Other international or foreign NGO North
  • Trimbos Institute (Netherlands)


Coordinamento con altri progetti e attori Synergies with other Swiss projects in health, but also in local governance and economic development & employment domains will be fostered, especially on topics related to accessibility and affordability of various health and non-health sector services (esp. social protection/welfare, education and employment), participation, social inclusion/ ”leave no one behind”. Collaboration with humanitarian interventions in the area of MH in emergencies, work with refugees and displaced populations.
Budget Fase in corso Budget Svizzera CHF    5’844’500 Budget svizzero attualmente già speso CHF    4’650’000 Progetto totale dalla prima fase Budget Svizzera CHF   8’508’821 Budget inclusi partner del progetto CHF   14’353’321
Fasi del progetto Fase 3 01.10.2022 - 30.06.2026   (Fase in corso) Fase 2 01.08.2018 - 30.09.2022   (Completed) Fase 1 15.05.2013 - 31.07.2018   (Completed)