The meeting of the Collegium of the Ministry of Health of the Pridnestrovian Moldavian Republic was held with an expanded membership. Heads of state authorities and administration, heads of state administrations of towns and regions of the republic, representatives of specialized educational institutions and public organizations were invited to the discussion with the participation of top officials of the department and chief doctors of medical institutions of the republic. The main issue is summarizing the activities of the Ministry of Healthcare in 2022 and designating work plans for 2023. The Speaker was the Minister of Healthcare Kristina Albul. After listening to the information provided, the President of the Pridnestrovian Moldavian Republic Vadim Krasnoselsky assessed the work of the department.
There are certain figures and facts from the minister's report. The permanent population of the PMR is 459782 people (minus 3800 compared to 2021). The average life expectancy is 72.17 years: 67.48for men, 74.41 for women. The birth rate for the year was decreased by 10.3%. 2820 children were born in the conditions of medical institutions of the republic. Another 28 young Pridnestrovians were born abroad. The highest birth rate is in Tiraspol, the lowest is in Slobodzeya district. The overall mortality rate in the country as a whole decreased in the reporting period compared to the previous year by 27.4%, becoming the lowest in five years. The highest death rate was recorded at the end of 2022 in Kamenka district, the lowest is in the capital. The mortality rate of citizens of working age has been reduced by 25%. Diseases of the circulatory system (54.6%) are in the lead among the reasons for the death of Pridnestrovians, neoplasms are in second place, and infectious and parasitic diseases are in third place. The percentage of lives lost in traffic accidents has increased. There was a decrease in child mortality rates in all age groups, as well as the absence of maternal deaths.
There was an increase in the incidence of the population and general morbidity in the republic in 2022, according to the speaker. Respiratory diseases predominate on both counts. The growth in indicators is due to an increase in the number of visits to doctors by citizens (2919865 visits in 2021, and 3156287 in 2022).
The number of HIV carriers identified in the reporting period is lower than in 2021, and more patients with AIDS were taken under observation. Active work is underway to detect and register tuberculosis patients. A state program for the prevention of viral hepatitis is being implemented. The incidence of oncology was increased by 17.4%. Early detection of many diseases has increased thanks to the practice of medical examinations: 91300 people underwent periodic and preliminary medical examinations in 2022 – 98.6% of those who were supposed to undergo it.
Kristina Albul paid attention to the topic of vaccination of the child population. Immunization is carried out as a prevention of 11 infections. The incidence remains at a low level. Pridnestrovie is a territory free from poliomyelitis, not a single case of diphtheria has been detected during 10 years, there have been no patients with tetanus, rubella, measles for several years, the minister stated. She said at the same time that the 95% immunization coverage recommended by WHO has not been achieved, which is fraught with a deterioration in the epidemiological situation in the future. Influenza vaccination was more active than before (20808 people were vaccinated) in 2022. More than 145000 people were vaccinated as part of the launched in March 2020 vaccination campaign against the spread of coronavirus and 61670 Pridnestrovians underwent revaccination. COVID-mortality in 2022 is 0.7% (317 cases).
As for high-tech specialized medical care: 46 hip and knee arthroplasty operations were conducted at the Republican Clinical Hospital.
Narrow specialists of two commercial medical institutions conducted consultations with children as part of the state order. The list of underage users of state-paid medical services has been expanded. 7000 examinations, 1500 functional and 6680 laboratory tests were conducted by Medin and Tiramed in the course of a socially significant program during the year.
The number of patients referred for treatment abroad has doubled compared to 2021. The special commission made 1090 positive decisions, 834 patients underwent treatment, both urgently and in a planned manner. Kristina Albul drew attention to a noticeable increase in the number of people in need of pacemaker implantation (14 people in 2021, and 40 in 2022).
The Head of the department paid special attention during the reporting speech to the topic of staffing. The staffing of medical organizations with doctors was 83.12%, 88.8% with paramedical personnel, 94.2% junior. 182 doctors, 504 specialists with secondary medical education and 467 orderlies were hired during the year, 200, 675 and 661 were fired during the same period, respectively. Medical staff, informed about interaction with the public, noted a decrease in the number of complaints and appeals of citizens to the department. The speaker did not go unnoticed by the law-making activities of the Ministry of Health, the work carried out in 2022 as part of the Year of Health declared by the President, as well as control and verification activities. It was noted that in 2022 the list of essential medicines was revised. It has 659 titles now. The “Health Truck” project, the route of which was laid through four dozen settlements of the republic, has become an effective treatment and preventive practice, said Kristina Albul.
An important block of the report is devoted to reorganization measures. Tiraspol and Bendery medical colleges are united. The Republican Dispensary for the Prevention and Treatment of HIV Infections and Chronic Viral Hepatitis was established on the basis of the Republican Clinical Hospital. District dentistry united into a single structure, which will be called the "State Regional Dental Clinic". The hospital bed fund of hospitals was reduced by 709 units as part of the optimization measures, the minister said, recalling the essence and goals of the ongoing optimization. A special place in the three-level system is occupied by the provision of primary health care. The network of feldsher-obstetric stations, rural outpatient clinics and polyclinics is expanding. There are 37 rural outpatient clinics today, 58 feldsher-obstetric stations, each city has a polyclinic. Day hospitals are designed for the simultaneous stay of 545 patients. The number of maternity hospitals and gynecological departments has been reduced.
Information regarding the financing of the healthcare industry has been announced. The 2022 budget provided for the allocation of about a billion rubles, 92% used. The capital investment program covered 11 facilities of the Ministry of Health. The cost of repair and construction work is about 15 million rubles. 6.5 million were spent on the purchase of equipment, 2.3 million on the repair of existing medical equipment. The Minister drew attention to the fact that income from the provision of paid medical services is noticeably lower than expected in the reporting year: 44 million out of the planned 79 million were received.
The minister concluded the report with a list of tasks facing the Ministry of Healthcare.
The PMR Government Chairman and the PMR Prosecutor made a speech at the end of the reporting speech of the head of the Ministry of Healthcare. Alexander Rosenberg focused on the priority of preventive work, the purpose of which is to prevent the disease. The Government Chairman assigns an important role to familiarizing the population, especially children and youth, with a healthy lifestyle. Another point mentioned by Alexander Rosenberg was the effective use of finances and control of their movement. Anatoly Guretsky paid attention to specific facts of the life of the health department, citing some examples of citizens' appeals.
The President emphasized in his speech the necessity to clearly distinguish between point shortcomings and systemic shortcomings. It is the latter that need to be eliminated at the state level, Vadim Krasnoselsky considers. The PMR President called on the Ministry of Healthcare to cooperate more closely with educational institutions specializing in the training of healthcare workers. The President noted that not only the staff of the ministry, but also the chief doctors, employees of medical institutions should be more proactive and actively involved in the work to improve the mechanisms for providing medical care and the functioning of the healthcare system as a whole. The President focused on the issue of personnel qualification, emphasizing that certification of medical staff is a obligatory practice. Vadim Krasnoselsky said that healthcare is an area where it is necessary to constantly improve the level of professionalism. The President called on the leadership of the Ministry of Health to inform the staff of medical institutions in a timely manner about the possibility of taking advanced training courses, both in the republic and abroad, in the Russian Federation in particular.
The President focused on the topic of providing medical assistance to Pridnestrovians outside the republic at the expense of the state. The mechanism is debugged and allows saving the lives of citizens. More than four hundred people were referred for stenting in the reporting period. The PMR President expressed gratitude to all those involved in this work. Vadim Krasnoselsky urged at the same time to intensify work in those areas where surgical intervention is possible through the efforts of local specialists, for example, in terms of arthroplasty. The President considers the implementation of targeted programs aimed at the prevention of specific diseases to be an important aspect, especially those classified as social.
Taking into consideration a number of recommendations and instructions, Vadim Krasnoselsky emphasized the importance of the activities of the Ministry of Healthcare. There are much fewer negative reviews from the population, and words of gratitude to individual medical institutions and specific doctors are heard more often, the President stated. He thanked the administration of the department and the staff of medical institutions for their work, the result of which is saved lives.
