The Ministry of Health of the Pridnestrovian Moldavian Republic held an expanded meeting of the board dedicated to summing up the results of 2021. The reporting event was held via videoconference. The information provided by the Minister was heard and discussed by the heads of state authorities and administration. The President took part in the work of the board.
Kristina Albul in her report presented statistical data and analytical information characterizing the activities of the department in the reporting period. She noted a decrease in the population of the republic and the birth rate. The number of births in 2021 is 3013, and 3144 children were born. The highest birth rate is in Tiraspol, the lowest is in the Kamenka district. Kamenka at the same time has the highest mortality rate. In general 8680 people died in the republic during the year (more than a year earlier). The Minister of Health focused on the fact that more people of working age began to die. Naturally, the epidemiological situation affected. Mortality from infectious diseases increased by 53.7% in 2021 compared to 2020. At the same time, decrease in the level of mortality from circulatory diseases, malignant neoplasms, and tuberculosis was recorded. The Head of the department connects this with increase in the effectiveness of the provision of specialized medical care, including high-tech. She considers the introduction of innovative methods of diagnostics, prevention and treatment, an increase in the level of detection in the early stages of the disease, the timely provision of medicines and medical devices to be important aspects. The structure of the causes of death looks like this at the end of 2021: diseases of the circulatory system are in the first place (46.5%), infectious and parasitic diseases are in the second place (19.2%), and oncological pathologies are in the third place (12.5%). The last decade has seen a downward trend in infant and child mortality, but the figures for 2021 are slightly worse than in 2020. No cases of maternal death were recorded. The rates of morbidity and morbidity of the population have increased.
Kristina Albul focused on such diseases as HIV, AIDS, and tuberculosis. 162 HIV-infected people were registered in 2021 (a total of 2354 people in the republic), 68 people diagnosed with AIDS (641 patients are on the medical examination), 246 patients with tuberculosis were detected (the incidence in this area is lower than in 2020). The detection rate of oncology in the reporting period was 3.7% lower than a year earlier (the diagnosis was confirmed in 1523 cases). More than half were detected at stages I and II, 3.6% of tumors were detected during preventive examinations. Mortality of the working-age population from malignant neoplasms was decreased by 16.4%. Targeted state program was put into effect last year for the prevention of viral hepatitis. 2214 Pridnestrovians were ill with hepatitis B and C in the reporting period.
The speaker paid special attention to COVID-19. 58165 cases of infection were registered in 2021 (almost two and a half times more than in 2020). 42965 people received hospital treatment. Women were more susceptible to coronavirus and if we talk about age gradation, then people over 70 years old. The mortality rate among carriers of the new virus was 2.7% in 2021. Most of the deaths are in Tiraspol (440), the lowest COVID-mortality is in the Kamenka district. All deceased carriers of coronavirus infection had concomitant chronic diseases, Kristina Albul stated. She emphasized that ongoing work continued in the reporting period despite the forced adjustments in the activities of medical institutions and the healthcare system as a whole. 85666 medical examinations were carried out. During medical examinations of children, pathologies were detected in 2725 minors (1232 had speech defects, 955 had a decrease in visual acuity, 46 had hearing, 253 children had a violation of posture, 152 had scoliosis, and 87 had a lag in physical development).
Speaking about the level of medical services, Kristina Albul emphasized that high-tech assistance has become more accessible and diverse. It covers 88 areas in the ophthalmological, traumatological, urological, surgical, gynecological fields now. The Minister recalled that children with disabilities are received at the expense of the state budget by narrow specialists of non-state medical institutions if necessary (in the absence of such in state institutions). Under this program, advisory assistance was provided to 1311 young patients, 110 functional and 264 laboratory tests were carried out. Pupils of social institutions also got into it. It was decided later to expand the list. The program included children from low-income families and minors with socially significant diseases.
The speaker focused on the implantation of artificial lenses. 223 of them were held in 2021, 102 of which were on a preferential basis, 20 were free of charge. Kristina Albul spoke about the categories of citizens sent for treatment outside Pridnestrovie at the expense of the republican budget, noting that the list has been expanded by three positions. 580 Pridnestrovians in total were sent for foreign treatment in the reporting period.
Speaking about the staffing of the healthcare system, Kristina Albul noted a decrease in the provision rate per 10000 people. Staffing of medical institutions with doctors – is at the level of 85.3%, nurses – 92.4%, juniors –96.5%. 1669 doctors, 3496 nurses, 2378 representatives of junior medical personnel were employed in the PMR healthcare system at the beginning of this year (the number of employees in all positions is less than a year earlier).
The minister informed that doctors improved their qualifications both at the expense of budgetary funds and at their own expense in 2021. Courses were available on the basis of the Peoples' Friendship University of Russia, the Volga Research Medical Institute, the Moldovan State University of Medicine and Pharmacology, PSU named after Shevchenko and Tiraspol Medical College. The plans include cooperation with the Nizhny Novgorod Medical Academy and the Bryansk Medical and Social College.
Speaking about the work of the Ministry of Health with citizens, Kristina Albul noted that in the reporting period there was an increase in the number of applications addressed to the department (1642 were received in total). Half of the requests were related to the provision of medical or financial assistance for treatment. The minister focused on activities aimed at preventing a healthy lifestyle and educating the population on health issues.
As for the financing of the industry: more than 975 million rubles were allocated for healthcare in 2021, 283 million of which were directed to combat the spread of coronavirus. Income from the provision of paid services was almost half the planned (44 million). This is due to quarantine restrictions. 41.5 million rubles allocated from the Capital Investment Fund 2021 were spent on the construction and repair of 71 medical facilities. The renewal of the ambulance service fleet is significant. Humanitarian aid includes 20 new carriages.
Among the tasks facing the Ministry of Health for the future, Kristina Albul singled out the introduction of integrated information system, the fight against COVID-19 and the organization of post-coronavirus rehabilitation, the opening of a high-tech cardiology center and a department for knee arthroplasty, and the creation of a training (simulation) center. The implementation of target state programs of the medical profile, as well as the implementation of plans within the framework of the capital investment program, remains relevant. The Minister recalled that 2022 was declared the Year of Health in Pridnestrovie.
Sergey Sherstyuk, Head of the youth wing of the All-Pridnestrovian Popular Front expressed gratitude for the work of representatives of the Pridnestrovian healthcare on behalf of the public. Deputy Prosecutor of the PMR Valery Starodub also thanked the doctors for their work. At the same time, he pointed out that the prosecutor's office revealed many violations of the law on citizens' appeals committed in the healthcare system.
The President in his speech focused on the importance of high-quality interaction not only of doctors, but also of officials of the Ministry of Health with citizens. He devoted a part of his speech to the appeals coming to him that are related to the medical industry. Specific complaints and suggestions were voiced. All documents were submitted for work.
Analyzing the information provided by the Minister, Vadim Krasnoselsky drew attention to the voiced data related to demography. The President noted that, speaking about the number of newborns for example, it is important not only to indicate births registered in the republic, but also to take into consideration the number of Pridnestrovian children born outside the country in the reporting period. The PMR President paid special attention to the topic of staff shortages experienced by the healthcare system in terms of providing medical institutions with highly specialized pediatric doctors. Another important area that requires increased attention in the opinion of the President is the interaction of the Ministry and the administrations of medical institutions with senior students of the specialized faculty of the Pridnestrovian State University. The PMR President is sure that the dialogue organized on a systematic basis will be useful to all participants.
Speaking about the implementation of the capital investment program, Vadim Krasnoselsky recalled that the healthcare sector remains a priority. Plans have to be adjusted according to the situation. The process of improving the infrastructure of medical institutions may slow down, but will not be stopped, Vadim Krasnoselsky emphasized. The President also mentioned targeted state programs aimed at maintaining the health of citizens and preventing diseases, noting their significance, effectiveness and expediency of further implementation.
The President touched upon the topic of a possible reform of the healthcare system, noting that any progress in this direction is admissible only after a broad discussion and agreement by all interested parties. If we are talking about financially costly projects, then there is no time for them in the current period, Vadim Krasnoselsky considers. The chosen option will not affect the entire healthcare system overnight in any case: the changes should be tested pointwise in individual areas.
The contribution of doctors to the fight against the spread of coronavirus did not go unnoticed by the President. Vadim Krasnoselsky considers that Pridnestrovian doctors and everyone who assists them adequately cope with this test.
Summing up, Vadim Krasnoselsky noted that the shortcomings encountered are more often related to the activities of the apparatus of the Ministry of Health than to the medical staff. In general, the PMR President highly appreciated the work of the Ministry of Health of the Pridnestrovian Moldavian Republic and its subordinate institutions.
