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The Third
Millennium Development
Goals Report.
Republic of Moldova
ERADICATE EXTREME ACHIEVE UNIVERSAL PROMOTE GENDER REDUCE CHILD
POVERTY AND HUNGER PRIMARY EDUCATION EQUALITY AND EMPOWER MORTALITY
WOMEN
IMPROVE MATERNAL COMBAT HIV/AIDS, ENSURE ENVIRONMENTAL GLOBAL PARTNERSHIP
HEALTH MALARIA AND OTHER SUSTAINABILITY FOR DEVELOPMENT
DISEASES
The Third
Report on Millennium
Development Goals.
Republic of Moldova
Chisinau, 2013
This Report was produced by the Government of the Republic of Moldova with the as-
sistance of the UN Agencies in Moldova. Opinions expressed in this publication do not
necessarily reflect the official views of the United Nations.
ACKNOWLEDGEMENTS
The authors of the Report are: Valeriu Prohnitchi Curasov (Positive Initiative), Valeriu Sava (SDC),
(MDG 1 and MDG 8), Valentina Bodrug-Lungu Ala Negruta, Elena Vutcarau (National Bureau of
(MDG 2 and MDG 3), Arcadie Astrahan (MDG 4, Statistics), Maria Nagornii, Veronica, Lopotenco
MDG 5 and MDG 6), and Valentin Cibotaru (MDG Tatiana Plesco (Ministry of Environment), Vladimir
7). Valeriu Prohnitchi has provided the general co- Girnet (Ecology Agency from Cahul), prof. Nicolae
ordination of the process at its initial stages, being Opopol (State University of Medicine and Pharma-
succeeded later by Adrian Lupusor. The develop- cy “Nicolae Testemitanu”, NCPM), Alexandru Coro-
ment of the Report has benefited from the sup- novschi (Agency “Apele Moldovei”), Tatiana Tugui
port provided by a number of public authorities (Waste Governance within the IEVP East), Rodica
and agencies of the Republic of Moldova, includ- Iordanov (PA EcoContact), Andrei Isac, indepen-
ing the State Chancellery, National Bureau of Sta- dent consultant, expert in environmental poli-
tistics, National Bank of Moldova, Ministry of Re- cies), Alexei Andreev, (PA “BIOTICA”), Elena Bivol
gional Development and Constructions, Ministry (PA BIOS), Mihai Mustea (National Environment
of Labour, Social Protection, and Family, Ministry Centre), Victor Cimpoes (PA Cutezatorul), Valentin
of Education, National Commission of Financial Sascov (National Famers’ Federation from Mol-
Market, Ministry of Finance, Ministry of Health, dova), Valentina Gak (PA “Territorial Association of
National Agency for Regulation in Electronic Com- Mayors from Hincesti Rayon”), Alexandru Lesan,
munications and Information Technology, Border (mayor, Cosnita village, Dubasari rayon), Nicolae
Police Department, Ministry of Economy, and Min- Rusu (Irrigation Water Users’ Association “Cosnita”,
istry of Environment. A number of relevant and Dubasari rayon), Arcadie Barbarosie (Institute for
useful comments were received from the mem- Public Policies), Eugenia Ganea (Millennium Chal-
bers of the four thematic working groups, which lenge Account Moldova), Catinca Mardarovici
were established to ensure the broad participa- (Women’s Political Club 50/50), Olga Nicolenco
tion in developing this Report (“Poverty”, “Educa- (gender expert), Ludmical Ceaglic (Mayor, Calfa vil-
tion and Gender”, “Health”, and “Environment”), as lage), Mhitarean Cristina (Gender Center), Mariana
well as from the UNDP Moldova staff. In particular, Ianachevici (Asociaţia pentru Abilitarea Copilului şi
the Report has benefitted from the valuable sug- Familiei “AVE Copiii”), Galina Lavraniuc (Directoare,
gestions provided by Alexandru Oprunenco and Gimnaziu, s.Voloviţa), Vera Bivol (pensioner, Cost-
Dumitru Vasilescu (UNDP Moldova), Ghenadie Cre- esti village, Ialoveni rayon), Rimofei Bivol (farmer,
tu (International Organisation for Migration), Sil- Costesti village, Ialoveni rayon).
viu Ciobanu, Larisa Boderscova (WHO Moldova),
The authors are sincerely grateful to all those who
Elena Laur, Angela Capcelea, Larisa Virtosu and
provided data and feedback for developing this
Ludmila Lefter (UNICEF Moldova), Oxana Lipcanu
Report. However, the responsibility for all inter-
(International Labour Organisation), prof. Petru
pretation of the data, the analysis, the conclusions,
Stratulat and conf. Stelian Hodorogea (Institute
and recommendations provided in the report lies
of Mother and Child), Liliana Caraulan (PAS), Mar-
with the authors.
cela Tirdea, Rodica Scutelnic (Ministry of Health),
Stela Gheorghita and Anatolie Melnic (NCPH), This Report was produced by the Government of
Liliana Domente (Phthosioneumology Institute the Republic of Moldova with the assistance of the
“Chiril Draganiuc”), Lilia Pascal and Diana Doros UN Agencies in Moldova. Opinions expressed in
(Ministry of Labour, Social Protection and Family), this publication do not necessarily reflect the of-
Galina Gavrilita (Ministry of Education), Alexandru ficial views of the United Nations.
CONTENTS
LIST OF ABBREVIATIONS ............................................................................................... 5
FOREWORD ...................................................................................................................... 6
EXECUTIVE SUMMARY................................................................................................... 8
MDGS AND TRANSCENDING DEVELOPMENT CHALLENGES AT A GLANCE .... 13
INTRODUCTION ............................................................................................................ 25
NATIONAL CONTEXT: GLOBAL TURBULENCE AND INTERNAL CHALLENGES . 26
MDG 1 “Reduce extreme poverty and hunger”:
hunger”
a small and still uncertain success .................................................................................
.................................................................................30
MDG 2 “Achieve universal access to general compulsory education”:
education”
quality ....................................................................34
problems related to access and quality.
MDG 3 “Promote gender equality and empower women”:
women”
a real chance to speed up development ...................................................................40
MDG 4 “Reduce
Reduce child mortality”:
mortality important progress
maintained .................................................................................................
that should be maintained. .................................................................................................46
MDG 5 “Improve maternal health”:
health” sinuous evolution,
uncertain perspectives ...........................................................................................................
...........................................................................................................52
MDG 6 “Combat HIV/AIDS,, tuberculosis and other diseases”:
diseases”
a very difficult objective ........................................................................................................
........................................................................................................58
MDG 7 “Ensure sustainable environment”:
environment” better balance
between society and nature is needed ......................................................................64
MDG 8 “Create a global partnership for development”
development”: towards a more
advantageous integration into the global economy .......................................70
MDG: A finished agenda, or not yet? ..........................................................................................
..........................................................................................74
POST-2015 DEVELOPMENT AGENDA ....................................................................... 78
LIST OF REFERENCES AND SOURCES ....................................................................... 81
ANNEX A: MDG Monitoring Indicators.................................................................................
.................................................................................83
ANNEX B: Share
hare of women employed in economy by types
of economic activities, % .......................................................................................
.......................................................................................88
ANNEX C: Forest Vegetation in the Republic of Moldova ..............................................89
ANNEX D: Share of area covered with forests in different countries of europe ....90
The Third Report on Millennium Development Goals. Republic of Moldova 3
List of TABLES:
Table 1. Evolution of MDG 1 indicators, period 2006-2012
intermediary and final targets .........................................................................................................................
.........................................................................................................................31
Table 2. Indicators on children’s enrolment in education, % of the total, period 2003-2012.......36
Table 3. Women in decision-making positions at the local level, % of the
total number of position holders ....................................................................................................................
....................................................................................................................41
Table 4. Women in decision-making positions at the central level, % of the
total position holders .............................................................................................................................................
.............................................................................................................................................41
Table 5. Gender disaggregation of civil servants by administrative levels and types
of held position, january 1, 2013 .....................................................................................................................
.....................................................................................................................42
Table 6. Evolution of salary earnings based on gender .......................................................................................43
Table 7. Evolution of HIV/AIDS incidence, cases per 100,000 population
during 2000-2012, final and intermediary targets................................................................................59
Table 8. Evolution of mdg 7 indicators, period 2006-2011 and intermediary and final Targets .....65
Table 9. Feasibility of the possibility to achieve MDG intermediary (2010)
and final targets (2015) ........................................................................................................................................
........................................................................................................................................76
List of FIGURES:
Figure 1. Gross enrolment rate of children aged 3-6 years old in preschool institutions,
2003-2012, % ...............................................................................................................................................................
...............................................................................................................................................................35
Figure 2. Infant mortality rate (IMR)
( ) and under-5 mortality rate per 1,000 live births ........................47
Figure 3. Share of under-2 children vaccinated against measles ....................................................................49
Figure 4. Maternal mortality rate per 100 000 live births (MDG
( 5 Target 1) ..............................................54
Figure 5. Rate of abortions per 1000 women of reproductive age ................................................................55
Figure 6. Distribution of new cases of HIV infection by the probable routes of transmission
in Moldova 1995-2011 ...........................................................................................................................................
...........................................................................................................................................60
Figure 7. Evolution of MDG 6 indicator for TB TB, period 2006-2011 and intermediary
and final targets .........................................................................................................................................................
.........................................................................................................................................................61
Figure 8. Status of persons with TB,, 2012, % of global incidence....................................................................62
Figure 9. Share of inhabitants with permanent access to improved water sources, % .....................66
Figure 10. Share of inhabitants with access to sewerage, % .................................................................................66
Figure 11. Sustainable development: compensation of the vicious cycle by the virtuous circle ..67
List of BOXES:
Box 1. Moldovan emigrants build their future at home ..................................................................................33
Box 2. Lessons to be learned for the Moldovan Educational System .....................................................39
Box 3. Promotion of women in decision-making and political positions – the voice
of a female mayor .....................................................................................................................................................
.....................................................................................................................................................44
Box 4. The modernization of the healthcare system saves human lives ...............................................51
Box 5. About the importance of adequate monitoring of pregnant women ...................................57
Box 6. Poverty and tuberculosis......................................................................................................................................
......................................................................................................................................63
Box 7. Elderly and tap water..............................................................................................................................................
..............................................................................................................................................69
Box 8. Migrants’ expectations regarding moldova’s development perspectives.............................73
4 The Third Report on Millennium Development Goals. Republic of Moldova
LIST OF ABBREVIATIONS
AIDS – Acquired Immunodeficiency Syndrome
DOTS – Directly observed treatment, short course – strategy recommended by WHO
GFATM – Global Fund to Fight AIDS, Tuberculosis and Malaria
HBS – Household Budget Survey
HIV – Human Immunodeficiency Virus
IBBS – Integrated Bio Behavioural Survey
IMCI – Integrated Management of Childhood Illness
KAP – HIV Knowledge, Attitude, Practice
MDG – Millennium Development Goal
MOH – Ministry of Health
MEc – Ministry of Economy
MEn – Ministry of Environment
MFin – Ministry of Finance
NARECIT – National Agency for Regulation in Electronic Communication and Information Technology
NBM – National Bank of Moldova
NBS – National Bureau of Statistics
NCFM – National Commission of Financial Market
NCPH – National Centre for Public Health
NGO – Nongovernmental Organizations
STI – Sexually Transmitted Infections
TB – Tuberculosis
UNGASS – United Nations General Assembly Special Session for HIV/AIDS
WSS – Water and Sewerage Supply
WHO – World Health Organization
WSS Strategy – Water and Sewerage Supply Strategy
The Third Report on Millennium Development Goals. Republic of Moldova 5FOREWORD
The Millennium Develop- The report’s utility is its emphasis on areas where the
ment Goals established mini- Government should seek to strengthen its efforts to
mum standards, for each achieve faster and more qualitative changes. In par-
state to reach, to ensure a ticular, progress made in combating tuberculosis is
decent standard of living for currently very slow, while the incidence of HIV / AIDS
its population. In partner- has become an increasing problem in rural areas,
ship with 189 countries, who especially in the Transnistrian region where the to-
signed the declaration at the tal prevalence of HIV infection is almost three times
United Nations Millennium higher, in comparison to the right side of the River
Summit in 2000, the Moldo- Nistru. When it comes to promoting gender equal-
van Government made a commitment to ensure in- ity, by providing women with equal opportunities to
clusive and sustainable development for its people. engage in social, professional, and political spheres
The country’s long term future and competitiveness compared to men, clearly much remains to be done.
depend on the ability to create the conditions for ev- Finally, the question of environmental quality remains
ery citizen, individually and professionally, to be able a pressing concern, and in this respect Moldova seeks
to reach their full potential. However, a fundamental to increase forested areas and to continue efforts to
prerequisite of this goal is ensuring the greatest pos- increase access to larger numbers of people in rural
sible access to basic goods and services such as safe areas to sewerage systems and quality water.
drinking water and proper sewage systems, quality
In recent years, the Government has embarked on a
healthcare, a clean environment, modern roads as
number of systemic reforms to modernize the coun-
well as equal opportunities regardless of gender.
try and improve the quality of life of all citizens. We
These criteria are included in the eight Millennium
realize that we follow a long and difficult path, and
Development Goals, which ultimately define quality
the Millennium Development Goals serves as our
of life and serve as pillars to modernize the country.
guide on this ambitious journey. In this context, we
The Third National MDG Report offers an objective remain partners in implementing the MDGs, and we
analysis of Moldova’s progress towards reaching the acknowledge the importance of enlisting the sup-
objectives which were established for 2010-2013, port of the entire population in this process, as well
and the natural progression of efforts to measure as the need of an open dialogue and communica-
implementation of the MDG agenda. Moldova has tion during the implementation process. At the same
made tangible progress in reducing poverty and in- time, we rely on the support of our friends and part-
fant mortality, and in ensuring access to compulsory ners from the international community who provide
education. Hence, from 2006-2012 the poverty rate an indispensable contribution to the transformation
decreased from 30.2% to 16.6%, the child mortality of the country from a transitional state into a pros-
rate decreased from 11.8% to 9.8%, and preschool perous, and dynamic one, that has a clear European
enrolment for children increased from 90.3% to perspective. However, to successfully reach these ob-
93.5%. All these indicators reflect an improving stan- jectives we must actively harness the cooperation of
dard of living and are the product of reforms which key stakeholders and institutions, at both the central
are currently underway. At the same time, the Gov- and regional levels. And last, but not least, develop-
ernment acknowledges the discrepancy in develop- ment which meets the interests of all the people can-
ment between urban and rural areas, and the all too not be achieved without their active involvement in
frequent marginalization of small towns in terms of this transformation, which the country is currently
access to economic opportunities and access to clean witnessing. Therefore, we are committed to attract-
water, healthcare and quality education. A number ing as large a number of people, as is possible, in
of strategic planning documents, such as the Nation- the consultative and decision-making processes, be-
al Decentralization Strategy adopted in 2012, have cause, ultimately, the Millennium Development Goals
sought to address these problems in conjunction are designed to ensure a decent life for all citizens of
with The Strategy of Agriculture and Rural Develop- this country. In this respect, we will seek to improve
ment of Moldova which will be implemented starting the quality of life of the rural population, including
in 2014.
6 The Third Report on Millennium Development Goals. Republic of MoldovaTransnistria, where the development discrepancies reforming and modernizing the country lies in our
are significant. own hands, and in our own homes, in partnership
with the Moldovan people, not only can we leverage
We acknowledge that it is impossible to completely
our current opportunities, but we can also overcome
address all of Moldova’s development challenges by
the challenges outlined in this report.
2015. But with the initial premise that all Moldova’s
citizens deserve a decent living, in truth the Govern-
ment’s policies aim far beyond this near term horizon.
Together these sustained efforts will support our im-
plementation of the National Development Strategy,
“Moldova 2020”, in conjunction with other recently- Iurie LEANCA,
developed sectoral strategies. The key to success in Prime Minister of the Republic of Moldova
The Third Report on Millennium Development Goals. Republic of Moldova 7EXECUTIVE SUMMARY
MDGs’ importance for development
development. When the National Development Framework. After the
Moldovan Government signed the Millennium stagnation witnessed in 2012 by the Moldovan
Declaration at the Millennium Summit in 2000, economy, reflecting the mixed effect of the Eu-
along with other 189 countries, they made a com- ropean economic crisis and the severe drought
mitment to a comprehensive process of reform to affecting the agricultural sector, economically
address poverty, ensure peace and security, and 2013 looks rather promising. Agriculture contin-
observe human rights and democratic principles. ues to be the most vulnerable sector, but also
The MDGs are vitally important, because they serve the sector with the biggest potential to increase
as useful tools to define policy priorities, monitor turnover, farmers’ revenues and living standards
the impact of reforms implemented by each of the of rural communities’. Economic modernization
countries which signed the Declaration, as well as together with entrenching the path to European
mobilizing new domestic and international re- integration, the creation of jobs, and combating
sources to address poverty reduction. All these corruption are the core priorities that the Govern-
aspects make a contribution to increasing pub- ment has adopted to ensure development for the
lic accountability, and in comparison with other people. The key constraints which limit the Gov-
countries allows the international community ernment’s room for manoeuvre and to speed up
and donors to target their programs more effec- development relates to the inefficient use of pub-
tively to meet domestic needs. In general, moni- lic financial resources, insufficiently developed
toring the implementation of the MDGs progress policy capacities, and a deficit of qualified people
highlights key successes, as well as development drawn to public service. All these constraints have
challenges, which should be dealt with through influenced the way in which the country has pro-
further systemic reforms. The main drawback ob- gressed toward achieving the Millennium Devel-
served across all of the 8 Goals is the gap between opment Goals (MDG).
the rural and urban living standards, which has
actually increased in recent years. Hence, in spite MDG 1. Reduce extreme poverty and hunger.
of the remarkable progress witnessed in poverty For MDG 1, the Republic of Moldova has made
reduction, rural populations continue to have lim- remarkable progress. In 2012, the country already
ited access to basic assets and services, such as reached the final targets set for 2015. The inci-
water and sewerage supply, health and education dence of poverty according to the international
services. In this way, the fiscal poverty of the ru- threshold of 4.3 dollars per day decreased from
ral population is magnified by a lack of economic 34.5% in 2006 down to 20.8% in 2012 (the final
and social infrastructure, which together with the target – 23.0%). The share of the population living
absence of viable economic alternatives forces under the absolute poverty line decreased from
the population to migrate. The discrepancies be- 30.2% to 16.6% (the final target: 20.0%), while the
tween the urban and rural areas are also apparent share of population suffering from hunger – from
in terms of visible social inequities, in terms of so- 4.5% to 0.6% (the final target: 3.5%). The main
cial exclusion of the poor. Thus, children from the factors which favour progress include: economic
less financially well-to-do families are less likely growth, the increase of revenues remitted by the
to be enrolled in kindergartens, and poorer peo- emigrants and the social assistance provided by
ple face limited access to quality health services, the Government according to a specific formula,
water and sewerage supply. Another important which allows for a better targeting of the resourc-
problem refers to the significant differences in es to assist the really poor families. In spite of all
opportunities between women and men. Hence, these successes, special concerns are raised by
the report highlights the modest participation of the pronounced inertia of rural poverty: in big cit-
women in the decision-making process, especially ies absolute poverty has decreased by more than
at the higher levels, as well as fewer economic op- two times from 2008 to 2012(from 10.9% to 4.3%),
portunities for women compared to men. The per- while in villages the decrease was slower (from
petuation of these development problems could 34.6% to 22.8%). The gap between rural and ur-
magnify emigration trends in the near future, ban living standards increased: in 2006, 75.7% of
which in spite of short-term advantages, actually the population living in poverty were in villages,
carries long-term risk: a brain drain from both a while in 2012 this percentage increased to 79.1%.
qualitative and quantitative point of view. The main causes of rural poverty include: the vul-
8 The Third Report on Millennium Development Goals. Republic of Moldovanerability of the agricultural sector, the lack of al- between rural and urban areas; lower access to
ternative occupations in other economic sectors, education for children with disabilities and Roma
and emigration. All these have created a vicious children, including to preschool education. On the
cycle of poverty, in which the vast majority of basis of all these drawbacks, the main priorities re-
Moldovan villages are still trapped. This was also fer to the efficient use of technical-material basis
affected by the transition to means tested allow- and financial resources allocated to the educa-
ances. If state resources were fully allocated based tional system, re-evaluation and re-design of the
on the principle of means testing, they would be staffing policies in education, and improving the
almost be enough to completely eradicate the quality of training. Moldovan Government policy
poverty. Nevertheless, besides fiscal poverty, rural on educational reform aims to tackle both the
populations also faces other forms of poverty, re- quality and access to education as indispensable
lated to limited access to a number of basic servic- elements in addressing poverty in a sustainable
es and products (water and sewerage, health and way. Respectively, provision of quality preschool,
education services), as a result of insufficient in- primary, and secondary education for all the chil-
frastructure. The Government acknowledges eco- dren is a key strategic objective.
nomic growth is a vital component in maintaining
MDG 3. Promote gender equality and empower
and strengthening long-term progress in allevi-
women. Gender disparities are not evident in pre-
ating all forms of poverty, as is model of growth
school and compulsory education, but neverthe-
which is more environmentally sustainable, and
less, they start appearing as people start entering
socially and geographically more equitable. Both
the labour market and participating in economic
national and sector strategies developed over the
and political life. Among elected mayors, the
last years have targeted this goal.
share of women is still very small and stagnant,
MDG 2. Achieve universal access to general com- increasing only marginally from 18.15% in 2007
pulsory education. to 18.51% in 2011; at the rayon counsellors’ level
the increase is from 16.48% in 2007 to 18.39% in
The reduction in fiscal poverty reflected in the 2011. At the same time, the increase in the num-
MDG 1 correlates with the increased access to bers of women on the MP candidates’ list has not
education, but discrepancies between the rural influenced the proportion of women among MPs,
and urban areas, as well as the problems with rela- it stayed at 19.8% in November 2010 and 2011.
tion to social exclusion still persist. Although the Thus, in spite of some progress, reaching the ul-
target set for 2015 in relation to preschool educa- timate target is still uncertain in terms of promot-
tion coverage was met in 2011, many rural chil- ing women to key positions. The lack of affirma-
dren continue to face marginalisation, and about tive action (quotas) legislation, the persistence of
30% of them do not go to kindergartens. It is un- gender stereotypes – all these significantly reduce
likely to reduce fundamental disparities in access opportunities for women’s participation in the de-
to preschool education between urban and rural cision-making process. The reform of legislation to
areas, and by income groups. At the same time, institute quotas, has promoted further progress
residential disparities in access to education play towards reaching the MDG targets, and helped to
a significant role in shaping the differences be- create preconditions for more solid political em-
tween poverty rates in rural and urban areas. The powerment of women. Implementation of some
developments for compulsory education are also gender education programs for youth, as well as
mixed. While a number of surveys reveal that the in the general and university education system
target set for 2015 for gross school enrolment had could facilitate the transformation of women’s and
already been reached, people are still not satisfied men’s gender roles in the society and in the fam-
with the quality of formal education, and this is ily. But, besides gender differences in terms of par-
reinforced by the results of the final exams from ticipation in the decision-making process, women
2013 school session. The main causes are associ- are also at a disadvantage on the labour market.
ated with the precarious legacy of educational Although provisions for ensuring equal payments
materials and school staff – which is an acute for equal work are stipulated in law, gender dis-
problem in villages, which far from attracting crepancies are registered in women’s and men’s
teachers, discourages them from staying, particu- salaries. At the same time, the employment rate is
larly younger teachers. This situation risks endan- constantly lower in comparison with men’s rates,
gering enrolment in general secondary education. and this fact reveals the existence of some major
The following can be noted among the other key barriers to the integration of women on the labour
constraints: significant demographic differences market. Thus, ensuring basic conditions for wom-
The Third Report on Millennium Development Goals. Republic of Moldova 9en’s political empowerment (through affirmative individualised recovery could be more efficiently
actions and training programs) and economic em- provided on a regional basis to increase access for
powerment (through training and entrepreneur- vulnerable populations, and this would reduce
ship programs) is one of the relevant priorities for these children’s disability. Further joint efforts to-
the post-2015 period. gether with international development partners
are major preconditions to ensure sustainability
MDG 4. Reduce child mortality. The final targets and increase the prospects for successes.
set for 2015 for infant mortality and the under-5
mortality rate have already been reached, this was MDG 5. Improve maternal health. The high level
one of the areas in which the greatest progress of access to perinatal health has been maintained
has been made. Nevertheless, social exclusion over the last few years. The same thing character-
has also influenced and marked this area as well. ises access to medical services and this has con-
Hence, there are marked inequities in cases of tributed to maintaining a high rate of medically
child mortality, which disadvantages poor chil- assisted deliveries. At the same time, inequalities
dren, and especially Roma children. This fact again are still apparent in terms of access to and qual-
reveals discrepancies between rich and the poor, ity of services – inequalities between rural and
as well as drawbacks in relation to social equity. urban populations, insured and uninsured in the
Moreover, sometimes cases of child neglect are population, general population and marginalised
still identified, and in some cases may not receive groups (Roma women, persons with disabilities,
the assistance they need. Another challenge is migrants). The maternal mortality rate has regis-
vaccinating children against measles by 2015, tered a sinuous development with a slight wors-
which is in some doubt, as in recent years the ening trend, reflecting a number of structural fac-
number of children who have been vaccinated tors in the health and social-economic sector. It is
decreased for different reasons. The problem is obvious that the low number of mortality cases
especially acute in rural areas and, mainly, among is caused by significant and unpredictable varia-
the Roma children, due to low levels of knowledge tions, whenever reported per 100000 live births.
about the benefits of vaccination. The Ministry of It is very important to mention that effective tools
Health acknowledges these issues and actively were implemented over the last years to identify
promotes, maternal and child health, and is im- the underlying causes and to develop cost-effi-
plementing a series of reforms in this area. Free cient measures to address the situation. In this
and comprehensive health care coverage and free context, concerns are raised related to focus on
medicines, in conjunction with the introduction indirect factors (unrelated to pregnancy) of ma-
of compulsory health insurance, all served as cru- ternal mortality, inducing drawbacks in the ante-
cial elements in combating infant and maternal natal surveillance and gaps in the quality of the
death. There are specific national health policies provided health services. Although a regionalised
and programs which focus on mother and child and perinatal services’ referral system has been
health. The development of a regionalised peri- implemented, the professionalism and efficiency
natal assistance system, strengthening paediatric of many interventions, especially in emergen-
emergency health care and the regional reanima- cies, could benefit from considerable improve-
tion and intensive therapy departments, as well ments. The implementation of modern teaching
as an increase in the level of knowledge through methods based on simulation of emergency situ-
continuous medical training all represent some ations in the multidisciplinary teams of special-
examples of the major efforts which have already ists in the maternity hospital is crucial. The level
had visible impact. The implementation of Inte- of knowledge among women and training about
grated Management of Childhood Illness (IMCI) the needs and importance of early medical sur-
and the system of individual evaluation of the veillance in case of pregnancy represents a very
neonatal mortality cases allows for the collection important factor, which can reduce the incidence
of some relevant data for developing effective in- of complications and deaths. The improvement
terventions. Although efforts were undertaken to of access for vulnerable groups and the increas-
implement a mechanism for inter-sector collabo- ing quality of family planning services provided
ration in the medical-social area, the lack of social to these groups are also essential in achieving the
assurance is one of the major factors driving child targets set in the MDG 5. These firm actions un-
mortality cases. Neurodevelopmental surveillance dertaken by the authorities and the commitments
services for children from the high risk groups assumed to continue investing in this area provide
(especially the extremely premature new-borns) some optimism for future developments, without
for neurological disorders, early intervention and any major risks. At the same time, the Government
10 The Third Report on Millennium Development Goals. Republic of Moldovaacknowledges that it is impossible to ensure that The country mechanism for coordinating national
absolutely all deliveries are assisted by medical programs (the National Coordination Council) has
personnel, and that the maternal mortality rate both qualitative and comprehensive data to sup-
decreases to zero, because there are causes be- port the development of efficient policies based
yond the control of the authorities’. on epidemiological evidence.
MDG 6. Combat HIV/AIDS, tuberculosis and oth- MDG 7. Ensure a sustainable environment. The
er diseases. None of the targets set for 2010 was country has made some progress towards reach-
achieved, and it is not possible to reach them by ing the indicators of the MDG 7, but additional ef-
2015. The fight against socially-conditioned infec- forts are needed in all areas. Hence, although the
tious diseases – a major health priority – has not final target related to state protected natural areas
produced any major results, and the near future (4.65%) was achieved in 2006, nevertheless insuf-
will bring new challenges, because of the finan- ficient resources are being allocated to develop
cial constraints caused by the revision of financing management systems, ensure the maintenance
mechanisms and countries’ eligibility conditions for such areas, and with respect to their protec-
to the Global Fund to fight AIDS, Tuberculosis and tion. The number of forested areas has increased
Malaria (GFATM). Although it is still concentrated only by 0.2% and the intermediary target (12.1%
in the key groups – injectable drug users, com- of the country area) was not reached. The share
mercial sex workers, and men having sex with of the population with access to improved sew-
other men - the HIV/AIDS infection has shown a erage has increased from 43.3% in 2006 to 56.6%
clear trend towards infection of their partners. The in 2012 and this has exceeded the intermediary
mode of transmission has changed, in the main target (50.3%), but the majority of these systems
it is now sexual. The infection has feminised and are in poor condition. The share of the popula-
has shown a tendency to spread in the rural areas. tion with permanent access to improved water
The Transnistrian region and the largest cities are sources has increased, but the intermediary target
leading in HIV prevalence, although the GFATM was not met. Many water supply systems are not
resources for prevention and treatment measures functional. The data suggest that it will be difficult
are provided throughout the country. In this re- to achieve the final targets set by 2015 for all the
spect, the Government collects relevant data for indicators, except for the state protected natu-
the MDG 6 from the both sides of the River Nistru, ral areas and the population’s permanent access
including Transnistria, to monitor progress of UN- to improved water supply. Gaps are qualitatively
GASS across the country. Over the few last years apparent for all these indicators. In the context of
trends have stabilized for TB-associated mortal- the MDG 7, the most vulnerable inhabitants are
ity, reflecting a decrease of 29% by 2012 in com- those who live in from rural communities, who
parison to 2007, a decrease of the DOTS (Directly have no sanitary infrastructures and no access to
Observed Therapy) treatment drop-outs to 8.5% improved systems of water and sewerage supply.
and an increase of the success rate up to 62.2% as The main risks related to these failures are the fol-
compared with the previous years, when the fig- lowing: environment pollution, the worsening
ures did not exceed of 58%. The success of treat- health status of the population, land degradation,
ment depends partly on clinical factors, but also and reduction of agricultural crops’ harvests and
on economic factors and patients’ level of knowl- farmers’ incomes. The main opportunities to serve
edge about TB and its treatment. TB continues to as catalysers for achieving the MDG 7 would be:
affect mainly socially vulnerable groups – unem- better cooperation among the entities working
ployed people, persons with disabilities, home- in the area of sustainable development, promo-
less people, and persons suffering from alcohol- tion of deep and active participation of the entire
ism. The main problems identified in fighting HIV population in environmental protection, foster-
and TB include the rigidity and unattractiveness ing a green economy, and use of EU experience
of the services provided to patients, service provi- to streamline environment requirements in eco-
sion which is limited to the big cities, the system’s nomic development activity.
incapacity to tackle the multifaceted needs of the
sick people, including stigmatization and discrimi- MDG 8. Create a global partnership for develop-
nation. However, the existence of a consolidated ment. Moldova has made satisfactory progress, al-
and participatory response of the stakeholders though not all the relevant indicators have shown
from the civil society, authorities, specialists, and positive trends. The Republic of Moldova has made
development partners, is a source of optimism. good progress in building an information society
The Third Report on Millennium Development Goals. Republic of Moldova 11(Target 6). Hence, in 2012 the penetration of mo- efforts should be intensified and more resources
bile phones has achieved 114.6%, as compared should be granted. These include, health, includ-
to 37.8% in 2006, while the final target was set at ing maternal health, combating HIV/AIDS and TB,
the level of 75.6%. The penetration rate registered and objectives that refer to ensuring environmen-
for PCs in 2012 was 65% higher than the level tal sustainability. There is much to be done for
achieved in 2006, for the Internet – a level 75%, women’s economic and political empowerment.
with real chances to achieve the targets set for Nevertheless, the rural-urban inequality is the
2015. There is prudent management and control red thread which is mainstreamed through all the
of external debt (Target 3). The unemployment rate eight Goals for which Moldova has established
among youth aged 15-24 years old remains to be a development objectives and which represent a
problem (13.8%), but the reaching the final target general challenge for the development policies to
(10.0%) is possible if the efforts for improving the be set for what remains of the MDG period, and for
investment climate are made. A negative trend was the post-2015 period.
registered for Target 1 “Further develop a transpar-
ent, predictable and non-discriminatory trade and A prospective view on the post-2015 Develop-
financial system based on rules through promoting ment Agenda: people’s expectations for the
exports and attracting investments”, as it declined country’s long-term development, identified
due to external economic shocks and the internal within the national post-2015 consultation cam-
problems encountered by the business environ- paign “The Future Moldova Wants” (supported
ment. The Government is dedicated to allocate by UN Moldova ), refer to the following areas: 1)
more resources to attract strategic investors in the economic development (education, jobs, sustain-
economic sectors with a potential to generate jobs able economic growth), 2) social development (a
and extend the networks of local suppliers, and for more inclusive, tolerant and solidary society) and
harnessing fully the new opportunities provided 3) environment and health. The good governance
by the Deep and Comprehensive Free Trade Area and human rights were identified by the consulta-
which will be established as part of the Association tion participants as a central priority, which, in a
Agreement signed with the European Union. way, unify those three specific areas. At the same
time, the decrease in rural-urban discrepancies,
MDG: a finalised agenda or not yet? The Repub- which are manifested by inequality of incomes
lic of Moldova has successfully reached several and opportunities, by educational performance
of the objectives set at the beginning of the new gaps, as well as gaps in attitudes and values, has
millennium: absolute and extreme poverty has become be the fifth major development priority.
decreased, access to preschool education has People’s expectations are reflected in the official
improved, and success was achieved in women’s long-term development vision expressed in the
political representation at the local public admin- National Development Strategy “Moldova 2020:
istration level. The health condition of infants and seven solutions for economic growth and poverty
under-5 children has improved significantly. Sev- reduction”. The seven identified solutions are: 1)
eral recent surveys suggest that the situation has education relevant for a career (focusing on voca-
also improved in relation to enrolment in com- tional and technical education); 2) roads in good
pulsory education of the Republic of Moldova. condition, anywhere; 3) cheap and affordable fi-
On the other hand, it cannot be ascertained that nancing; 4) business with clear rules of the game;
development efforts have achieved the set goals 5) an equitable and sustainable pension system;
and brought benefits to all people, as a number 6) safely delivered and efficiently used energy; 7)
of critical drawbacks still remain, for which policy responsible and incorruptible justice system.
12 The Third Report on Millennium Development Goals. Republic of MoldovaMDGs AND TRANSCENDING DEVELOPMENT
CHALLENGES AT A GLANCE
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24 The Third Report on Millennium Development Goals. Republic of Moldova
INTRODUCTION
In 2000, together with other 189 countries, Moldo- The Report follows a simple and reader-friendly
va signed the Millennium Declaration adopted at structure, which aims to promote MDGs and to
the Millennium Summit from New York. Hence, it inform the wider national and international audi-
committed to contribute to the accomplishment ence. The first chapter of the Report takes an over-
of eight Millennium Development Goals (MDG). view of the most important internal and global
Those eight goals, revised and adjusted to the na- factors influencing the national development
tional development priorities, are the following: policies and processes.
Eradicate poverty and hunger; Eight chapters follow per each MDG, highlighting
Achieve universal access to general the main trends over the recent period of time, as-
compulsory education; sessing the quality of the achieved progress, and
Promote gender equality and empowering
identifying the main constraints and opportuni-
women; ties that could serve to “speed up” the MDGs.
Reduce child mortality; The tenth chapter refers to the “unfinished agen-
da”, offering a brief feasibility study on MDGs’ and
Improve maternal health;
what they will have achieved by 2015, identify-
Combat HIV/AIDS and tuberculosis; ing systemic causes which need to be addressed
Ensure environmental sustainability; to maintain the same pace of development. This
chapter seeks to highlight a way to escape the
Develop a global partnership for development. vicious cycle of under development and how to
The first National Report on progress towards avoid multidimensional poverty traps, by looking
reaching the MDGs was developed in 2004. Three at the interrelationship between the MDGs.
years later, in 2007, after a progress analysis and The last chapter of the Report tries to answer the
organizing a number of consultation sessions following question “what will follow after 2015?”,
with civil society and country’s development part- elucidating the main results of the post-2015 na-
ners, many of the objectives were revised. The tional consultations “The Future Moldova Wants”,
second National Report related to MDG progress carried out with the support of the United Nations
was developed in 2010. This document is the third Development Programme in Moldova, and it seeks
National Report used by the Government of the to corroborate these results with the Moldovan
Republic of Moldova to assess honestly and objec- Government’s vision for the country’s long-term
tively the progress made in fulfilling the Millenni- development.
um Development Goals from 2010-2013, to iden-
tify the problems encountered by the country, and Due to the lack of statistical data and comparabil-
to outline the eventual solutions and available op- ity problems regarding the data on social and eco-
tions to accelerate the positive evolutions and to nomic life in the Transnistrian region, the authors
reverse the negative ones. At the same time, the have mainly sought to analyse developments in
third National Report also aims to provide a view the Republic of Moldova regions from the right
beyond the 2015 timeline, so as to identify the pri- side of the River Nistru, except for the MDG 6,
orities that will remain on the national develop- where the data reflects the situation on both sides
ment agenda. of the River Nistru1.
1
The monitoring of the developments occurred in the Transnistrian region for the given MDG is motivated by the existence of comparable data, due to the cooperation between the
institutions from Chisinau and Tiraspol, as well as due to the externalities induced by HIV/AIDS and TB on the population on the both sides of the River Nistru. At the same time, it should be
pointed out that the dynamics of the indicators monitored within the MDG 6 cannot be used for assessing the performance in relation to the MDGs’ fulfilment in the Transnistrian region.
The Third Report on Millennium Development Goals. Republic of Moldova 25NATIONAL CONTEXT:
GLOBAL TURBULENCE AND
INTERNAL CHALLENGES
Political framework Government, European Integration: FREEDOM,
DEMOCRACY, WELLBEING 2013-2014 targets three
European integration is the strategic path that essential goals: ensuring the irreversibility of the
the Moldovan Government has chosen as the European integration process, creating new well-
most compatible with its desire for long-term paid jobs, and preventing and combating corrup-
economic growth, and its social, and democratic tion.
development priorities. Thus, Moldova seeks to
ensure a higher level of living standards for all A long-term development vision is expressed
the citizens, through modernization of infrastruc- in the National Development Strategy “Moldova
ture, improving public services, and increasing 2020: seven solutions for economic growth and
economic opportunities in urban and rural areas. poverty reduction”2, which served as basis for the
Deeper European integration and the harmoni- Government Activity Program and a series of sec-
sation of key aspects of national legislation with tor strategies. The seven solutions identified in
European standards have already yielded visible “Moldova 2020” actually represent horizontal in-
results. Thus, new economic branches emerged as tervention priorities, which it is hoped will benefit
a result of investments made by European compa- all the sectors of the economy equally, all social
nies who are now present in the Moldovan econ- groups, and every person. These solutions include:
omy. The Government also adopted fundamental 1) education relevant for a career (focusing on vo-
human rights legislation, to ensure the non-dis- cational and technical education); 2) roads in good
crimination, tolerance, and mutual respect prin- condition, anywhere; 3) cheap and affordable fi-
ciples. nancing; 4) business with clear rules of the game;
5) an equitable and sustainable pension system;
The unsettled Transnistrian conflict is an essen- 6) safely delivered and efficiently used energy; 7)
tial factor hindering the development on the right responsible and incorruptible justice system.
and the left sides of the River Nistru. The conflict
impedes human and economic contacts, magni- The low level of revenues has also resulted in a
fies country risks and external financings costs, re- limited flow of public resources for public expen-
duces Moldova’s attractiveness as a destination for diture to implement development policies and
investment and as a place to live place for people projects. This weakness is magnified by the ex-
from other countries, and creates a background tended informal economy with untaxed incomes
of permanent stress, which impedes the ability of and consumption. According to some estimates,
the authorities to focusing on long-term develop- the share of the informal economy accounts for
ment agenda. At the same time, the Transnistrian about 45% of the official one (Schneider, Buehn
region represents a high risk zone in relation to and Montenegro, 2010), creating a high degree of
the development goals and targets referring to dependency on external support.
HIV / AIDS, which is the only target measured in
this report. Social and demographic factors
Governance After a decade of negative natural population
growth, in 2011-2012 the Republic of Moldova
In comparison with 2000, when the MDGs were registered zero natural population growth, as a
adopted as a guide to policy, the current gover- product of an increased birth rate and decreased
nance agenda encompasses a wider and more death rate. The disaggregated indicator reflects a
comprehensive vision of development. Hence, worsening situation in the rural areas in compari-
the Activity Program of the Republic of Moldova son with urban areas: in 2008-2012, the average
2
Approved by Law No. 166 dated July 11, 2012.
26 The Third Report on Millennium Development Goals. Republic of Moldovabirth rate in urban areas accounted for 9.96 per 2012 they were lower by 33%. This inequality also
1000 population and the death rate – for 8.84 per reflects visible differences registered in the quality
1000 population; while in the rural areas, during of life: in urban areas, income exceeds the calcu-
the same period of time, a higher birth rate (12.02 lated minimum subsistence level by 15%, while
per 1000 population) was accompanied by a high- in villages – the average income is 13% under the
er death rate (13.54 per 1000 population). The dif- average subsistence level.
ference in attitudes towards health, lifestyle and
food, as well as the unequal access to health care A key factor explaining the increasing gap in em-
services are the main causes of an increasing rural- ployment opportunities is the level of develop-
urban gap. ment of the private sector. Moldovan villages are
highly dependent on agriculture (employing half
The alarming demographic situation in the rural of the rural population); the main alternative to
areas is even worse when emigration is taken employment in the agricultural sector is employ-
into account
account, which represents a real population ment in the public sector (21%). But the agricul-
drain for villages. Data from the National Bureau tural sector is extremely feeble: in 2000-2012, the
of Statistics suggest that about 7% of urban stable gross value added (GVA) generated by the agri-
population aged 15 years old and over has left cultural sector increased on average only by 2.6%
abroad for work in 2012, while for rural area – this annually, while the GVA generated by the non-ag-
indicator was double that, at 14%. ricultural economic sector increased by 5%3. In the
same period of time, the volatility of agricultural
The intense migration of labour represents a key production was ten times higher than that for the
constraint for regions’ and local community’ de- non-agricultural production4.
velopment. Although, in short term, emigration
contributes to poverty reduction, over the longer
term, it erodes – human capital – which could be
Global factors
used for the sustainability development of Moldo- Climate change is a key factor reducing the im-
van communities and regions, and of the country pact of Government’s anti-poverty policies, espe-
as a whole (UN Moldova, 2013). Emigration has cially in rural areas. Increasingly frequent periods
caused a significant depopulation of many rural of drought are a consequence of global warming
communities, generating innovative policy chal- and may generate problems related to accessibil-
lenges for the Republic of Moldova. ity of food products and forage for animals, as the
drought in 2007 demonstrated. About 90% of the
Economic situation country’s territory and 80% of the rural popula-
tion dependent on agriculture were affected by
During 2010-2012, economic growth in Moldova poor harvests. Much of the rural population lost
was rather rapid with an annual average GDP their savings and income and the total losses ac-
growth rate of 4.6%. However, growth was vola- counted to 1 billion USD, according to the official
tile and jobless, reflecting the wider vulnerability estimates (UNDP Moldova, 2009, p. 85). Along-
of the economy to external and climate shocks. side the decrease in remittances, the drought was
Official statistical data showed that the percent- the major cause for poverty in 2007 (MEc, 2009).
age of the population employed in the Moldovan In 2012 the country witnessed a severe drought
economy in 2012 was 25% lower than the number again, accompanied by a dramatic decrease in ag-
registered in 2000. Again a large rural-urban gap ricultural productivity. And again, the small and
is apparent: in this period, the share of urban em- medium producers represented the group that
ployed population decreased by 4%, while the ru- has suffered the most as a result of this drought
ral employed population decreased by 37%, with (MAFI, August 2012, p.24).
no signs of recovery sign.
The global economic crisis from 2009 revealed
This rural-urban inequality in employment op- the extreme vulnerability of the country and the
portunities is reflected in sharp income inequality fragile nature of an economy based on emigration.
throughout the country. If during 2006-2007, the As an immediate effect, the crisis resulted in a de-
average incomes of the rural population were 25% crease in exports, remittances, and foreign direct
lower than those for urban population, in 2011- investments. If exports and remittances recovered
3
In this report, the non-agricultural economic sector was defined as the amount of all the economic activities identified in the National Classifier of Economic Activities with the codes
from C (mining industry) to K (real estate transactions, rent activities, and services provided to enterprises) and does not include public administration and services (codes L-O).
4
Measured as a standard average deviation for the GVA increase rates.
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