Achievements in the "Health promotion and health education" in the Republic of Moldova

1. Achievements in the "Health promotion and health education" in the Republic of Moldova Grigore Friptuleac, Angela Cazacu-Stratu The Hygiene Department of SUMPh “Nicolae Testemițanu” Chișinău, the Republic of Moldova

2. A great attention is given to the reformation of the health system from the Republic of Moldova. There were recently adopted strategic documents at the national level: TheNational Health Policy 2007-2021; The Health System Development Strategy 2008-2017;TheLaw about the State Supervision of Public Health; The National healthy lifestyle promotion program 2007-2015 . Some risk factor are monitored for the communicable and non-communicable diseases in the population through the implementation of social-hygienic monitoring [1, 2]. It was ratified Framework Convention on Tobacco Control. Being recognized as cost-effective priority global strategies, health promotion and disease prevention occupy an important plays in strategic documents and national programs, in budget support programs and technical assistance.

3. Health promotion is considered an essential element in the health development and was defined by WHO as "the process of empowering people to have control over their health and improve it". By the end of the XXthcentury, both health promotion and health education were treated as "sanitary education". Between these two terms there are some similarities making them a subject of a significant confusion. In the 50’s 60’s of the XXthcentury the sanitary education service was organized in the Ministry of Health of the Ex-MSSR along with several Houses of Sanitary Enlightenment.

4. After 1990, new approaches in the health promotion domain, established by the Ottawa Charter for Health Promotion in 1986 become popular in the Republic of Moldova. The Charter established five fundamental strategies for the success of health promotion: − The development of the public health policy; − The creation of a favorable environment; − The intensification of the community action; − The development of individual skills; − The reorientation of health services.

5. In 1995, the National Scientific Practical Center of Preventive Medicine was created which merged the Moldovan Scientific Research Institute of Hygiene and Epidemiology and the House of Sanitary Enlightment. The Department of Sanitary Education, with the role of a methodological forum for the regional centers of Preventive Medicine. Thanks to the EU project “Health promotion and Disease prevention” in NSPCPM (now the National Centre for Public Health - NCPH) the Center for Health Promotion and Health Education was established in 2005. Medical specialists in Public Health, sociologists, psychologists, philologists, and nurses began to be employed within the Center. In the same time the staff of the NCPH and the one from the regions began to learn new health promotion and education approaches of.

6. In the Moldovan Law on the State Supervision of Public Health, the concept of health promotion is defined as a "process of information dissemination, training and education for the formation of healthy individual knowledge and consultation skills and public involvement, creation of partnerships that provide opportunities for the individual and communities to control and improve the physical, mental and social health as well as to contribute to the reduction of inequities in the health area."

7. Given these conditions, the basic principles that ensure the success of health promotion activities, are: 1. Adoption of several strategies for health promotion - using different approaches, including policy development, organizational changes, community development, legislation, support, training and communication in combination with each other. 2. Cooperation with more partners - intersectoral cooperation; 3. The active participation of the population; 4. Empowering people - a process through which people achieve greater and efficient control over their decisions and actions which affect her health; 5. Integration of activities for more partners in a form of complex programs of health promotion; 6. Individual contribution of community members for the achievement of activities.

8. Within the teaching plan at the Faculty of Public Health, the Sanitary Education is taught since 1997. Other faculties were not studying this discipline at that moment. From 2003-2005 in the Republic of Moldova, the European Union accomplished "The Health Promotion and Disease Prevention Project, Moldova" project. Based on the recommendations of the project, on 12 June 2007 the Government of the Republic of Moldova adopted the Resolution no. 658 "About the national program on healthy lifestyles promotion for 2007-2015", through which training activities have been provided for the medical and non-medical staff in the health education area.

9. 7. The review and implementation of the professional, academic and postgraduate training programs for the teachers from the health education area and the promotion of a healthy lifestyle, with the introduction of a module with the duration of 12-18 hours. 8. Introducing a training course for the employees of the preschool institutions in the health education area. 9. The academic training of teachers for teaching the discipline "Health Education" as a compulsory subject: − Colleges and professional schools − 4000 people; − Universities − 4000 people; − Primary schools − 3000 people; − Annual training of teachers in pre-university institutions − 5,000 people.

10. The Ministry of Health and the Ministry of Education had the task to improve the vocational, academic and postgraduate training system of the medical staff regarding the health education and healthy lifestyle promotion of the population by: a) Including in the training programs for students of the State University of Medicine and Pharmacy "NicolaeTestemiţanu" the study module "Promotion of health and education for the health of population" with a duration of 28-30 hours within the Faculty of Medicine, Dentistry, Pharmacy and 110 hours within the Faculty of Public Health; b) Including in the training programs the module "Promotion of health and education for the health of population” with a duration of 18-20 hours for all resident physicians and 60 hours for family medicine residents and pediatric residents; c) Including in training programs of medical colleges the module "Promotion of health and education for the health of population” with a duration of 18-20 hours for the assistants of hygienists and epidemiologist doctors − 36 hours; d) Organizing health education modules to improve the knowledge of physicians from the preventive medicine centers and specialists from the public medical-sanitary institutions;

11. In accordance with the requirements of this decision, since 2007 in the Faculty of Medicine and since 2008 in the Faculty of Dentistry the discipline "Health promotion and health education".is taught.. For the accomplishment of these modules there were developed respective programs, in which provided lectures and hours of practice activities. For the residents/ master students in Public Health there are taught 105 hours, including: lectures − 30 hours, seminars/practical work − 75.

12. Conclusion In the Republic of Moldova there are accomplished important measures for the implementation of the European priorities for health promotion and health education. It is developed the legislative framework as well as the postgraduate training program of residents in Public Health is developed and implemented. There is a necessity for the development and implementation of all Government decisions and training programs in health promotion and health education at all levels.