School of Public Health Management, Nicolae Testemitanu State University of Medicine and Pharmacy, Chișinău, Republic of Moldova.
WHO European Office for Investment for Health and Development, Venice, Italy.
PLoS One. 2024 May 30;19(5):e0303821. doi: 10.1371/journal.pone.0303821. eCollection 2024.
The government of the Republic of Moldova, endorsed the principle of Health in All Policies (HiAP) through its health sector reforms to address the rising burden of non-communicable diseases and health inequalities. Territorial Public Health Councils (TPHCs) were created to ensure the coordination and management of the population's health in their respective district. This study assessed the capacities of the TPHCs to identify areas in need of support for strengthening their intersectoral collaboration role in public health at local level.
A mixed-method approach, using qualitative and quantitative techniques, was used to compare the perceptions of all TPHC members (n = 112) and invitees (n = 53) to council meetings from 10 districts covering all geographical areas of Moldova. The quantitative information was obtained using a cross-sectional survey, while the qualitative aspects were assessed within focus group discussions (FGDs).
Half of all TPHC members, including 75% from groups with a non-medical background, did not attend a public health course within the last three years. Overall, groups with a medical background were more aware of the legislation that governs TPHC activity and intersectoral collaboration compared with those with a non-medical background. The FGDs of TPHC meetings revealed that members had an insufficient level of understanding of intersectoral collaboration to solve public health issues and lacked clarity about their place and role within the TPHC.
HiAP implementation was found to be suboptimal with insufficient capacity at local level. TPHC members' ability to deal with public health issues were severely impaired by a general lack of knowledge and understanding of how to utilize the TPHC platform for maximum benefit. Reforming TPHC regulation is required in addition to extensive capacity building for TPHC members to increase member understanding of their roles as intended by TPHC regulations, including the facilitation of intersectoral collaborations.
摩尔多瓦共和国政府通过其卫生部门改革，支持健康全纳入政策（HiAP）原则，以应对非传染性疾病负担增加和卫生不平等问题。设立了地区公共卫生理事会（TPHC），以确保协调和管理各自地区的人口健康。本研究评估了 TPHC 确定需要支持的领域的能力，以加强其在地方一级公共卫生方面的部门间合作作用。
采用定性和定量技术相结合的混合方法，比较了来自覆盖摩尔多瓦所有地理区域的 10 个地区的所有 TPHC 成员（n=112）和理事会会议邀请者（n=53）的看法。使用横断面调查获得定量信息，而在焦点小组讨论（FGD）中评估定性方面。
所有 TPHC 成员中有一半，包括 75%来自非医疗背景的群体，在过去三年中没有参加过公共卫生课程。总体而言，与非医疗背景的群体相比，具有医学背景的群体对管理 TPHC 活动和部门间合作的法规有更高的认识。TPHC 会议的 FGD 显示，成员对解决公共卫生问题的部门间合作理解不足，并且对他们在 TPHC 中的地位和角色缺乏清晰认识。
发现 HiAP 的实施情况不佳，地方一级的能力不足。TPHC 成员处理公共卫生问题的能力受到普遍缺乏知识和理解如何利用 TPHC 平台获得最大利益的严重影响。除了对 TPHC 成员进行广泛的能力建设以增加成员对 TPHC 法规规定的角色的理解外，还需要改革 TPHC 监管，包括促进部门间合作。
