Building a More Resilient Health System through Strengthening the Health Surveillance System in Iran

#### Acknowledgements

#### Introduction

### **Health Promotion for Non-Communicable Disease Prevention in Moldova**

**Constantin Rimis1, Oleg Lozan2, Serghei Cebanu3, Raisa Deleu3, Daniela Demișcan<sup>4</sup> , Ion Șalaru<sup>5</sup> , Natalia Silitrari5, Nelea Tabuncic5, Ala Curteanu1,6, Helen Prytherch7,8, Diana Berari1, and Lilia Onea1** <sup>1</sup> Healthy Life Project: Reducing The Burden Of Non-Communicable Diseases In Moldova, Chisinau, Moldova


Department, Moldova


<sup>7</sup> Swiss Tropical And Public Health Institute, Switzerland

<sup>8</sup> University Of Basel, Switzerland

Moldova has made strong commitments to address risk factors for non-communicable diseases. SDC's Healthy Life Project, implemented by the Swiss TPH Institute, is supporting the Ministry of Health and the National Agency for Public Health in Moldova to roll out the health promotion for behavior change through individual empowerment and community engagement for NCDs prevention. Evidence-based health planning, using health profiles, promoting Health in All Policies, and intersectoral collaboration for health promotion have been addressed. The baseline assessments of health promotion practices and perceptions were conducted with different groups of stakeholders. A holistic understanding of Health Promotion concepts was almost absent. There was a general perception that Health Promotion is the responsibility of the health sector. There was no multisectoral coordination for health promotion and limited tools used by health practitioners, low capacity for data management and analysis, and scarce use for decision-making. To improve inter-sectorality, the representatives of Local Public Administrations (mayors, specialists from health, social, educational, cultural, and sports domains), Governmental decentralized services (police, food safety, ecology, emergency, and other services) were trained on WHO "Healthy Communities" and "Health in All Policies" initiatives in collaboration with the Moldovan School of Management in Public Health (more than 400 people).

For capacity building on health promotion of Moldovan specialists in designing, conducting, monitoring, and evaluating health promotion interventions, a practical tool COM-B (Capability, Opportunity, Motivation, and Behaviour change) to help identify the sources of behavior that can be the targets of intervention was developed and institutionalized at the SUMP "Nicolae Testemitanu" for continuing medical education.

Capacity-building of practical specialists, raising awareness of the population, and engagement of Local Public Authorities and local stakeholders increased health promotion interventions for non-communicable disease prevention and control, taking into account the local evidence and context and specific needs of the community.

*Figure 1. Example health profile of the Causeni district for health promotion.*

#### Results and Discussion

A holistic understanding of Health for Promotion concepts addressing risk factors was close to absent in Moldova. There was a general perception that Health Promotion is the responsibility of the health sector. There was no multisectoral coordination for health promotion and limited tools used by health practitioners, and a low capacity for data management and analysis and scarce use for decision-making.


#### Authors

Constantin Rimis1, Oleg Lozan2, Serghei Cebanu3, Raisa Deleu3, Daniela Demișcan4, Ion Șalaru5, Natalia Silitrari5, Nelea Tabuncic5, Ala Curteanu1,6, Helen Prytherch7,8, Diana Berari1, and Lilia Onea1

1Healthy Life Project: Reducing The Burden Of Non-Communicable Diseases In Moldova, Chisinau, Moldova

<sup>2</sup> School Of Management In Public Health, Moldova

<sup>3</sup> State University Of Medicine And Pharmacy "Nicolae Testemitanu", Prevenitive Medicine Department, Moldova

<sup>4</sup> Ministry Of Health, Moldova

5National Agency For Public Health, Moldova

<sup>6</sup> Mother And Child Institute, Chisinau, Moldova

<sup>7</sup> Swiss Tropical And Public Health Institute, Switzerland

8University Of Basel, Switzerland

#### Introduction

Moldova experiences a high NCD burden, and particularly high rates of cardiovascular diseases. In recent years, Moldova has made strong commitments to address risk factors for non- communicable diseases, but during the COVID-19 pandemic, the ability to address NCDs has been impacted. There is a strong need for the strengthening of intersectoral collaboration and community empowerment for health promotion and NCDs prevention.

#### Methodology

Evidence-based health planning, the use of health profiles, promoting Health in All Policies to strengthen intersectoral collaboration and health promotion for behaviour change approaches have been addressed.

*Figure 2. Training on health promotion for behavior change (COM-B Model, Michie et al, 2011; adapted visualization) in Moldova, 2019 (left picture) and 2021 (right picture).*

#### Conclusions

Capacity building of practical specialists; raising awareness of the population and improving intersectorial collaboration by engaging Local Public Authorities and local stakeholders in planning and implementing health promotion interventions, taking into account the local evidence and context and specific needs of the community; increasing local capacity for non- communicable disease prevention and control.

#### References

Michie, S., van Stralen, M.M. & West, R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Sci 6, 42 (2011). https://doi.org/10.1186/1748-5908-6-42
