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Guidebook-To-The-Communitybased Guidebook to the community-based healthcare model for civil society networks The guidebook was printed with the financial support of World Jewish Relief. This publication is available in English and Romanian languages at www.helpage.org in Publications section. Editor: Tatiana Sorocan, Country Director, HelpAge Moldova Published by “Pontos” Printing House Registered charity number: 288180 Copyright © HelpAge International 2012 Front cover photo: Ion Pascal, from Pascani, Cahul Photographer: Dorin Goian Any contents from this publication may be reproduced without permission for non profit and educational purposes. Please clearly credit HelpAge International and send us a copy of the reprinted article or a link to it on the web. HelpAge International Moldova HelpAge International Banulescu-Bodoni Str., #57/1 PO Box 70156 Of. 431 and 433 London WC1A 9GB, UK Chisinau, MD-2005, R. of Moldova [email protected] [email protected] www.helpage.org tel: +373 22 225098 Tel: +44 (0)20 7278 7778 fax: +373 22 224672 Fax: +44 (0)20 7387 6992 HelpAge International helps older people claim their rights, challenge discrimination and overcome poverty, so that they can lead dignified, secure, active and healthy lives. 1 Table of Contents 1. Time to volunteer: Moldovan perspective ..................................................................... 4 1.1 Development of volunteer groups .................................................................................... 4 1.2 Recommendations for the development of volunteering in the Republic of Moldova ................. 5 2. Primary healthcare in Moldova: challenges and opportunities ...................................... 6 3. Community-based healthcare support model for older people: opportunities for the engagement of civil society networks .......................................................................... 7 3.1 Programme methodology ........................................................................................... 8 3.2 Building the capacity and confidence of volunteers ......................................................... 9 3.3 Medical kit provision .................................................................................................10 3.4 Beneficiary identification and selection ........................................................................12 4. Volunteer home-based health care ............................................................................. 13 5. Monitoring the health status of older people .............................................................. 15 6. Campaigning, information dissemination and advocacy ............................................. 16 7. Developing partnerships and ensuring support from local authorities ........................ 18 8. Concluding remarks .................................................................................................... 20 Chisinau – 2012 2 Guidebook to the community-based health-care model for civil society networks Acknowledgements This guidebook is designed for civil society Moldova and HelpAge has been doing this organisations working with older people work successfully since 2003. In this context in Moldova or other countries with similar HelpAge International expresses profound contexts, wishing to develop community-based respect for the work of older volunteers and healthcare services for older people. It has partner organisations: Pro-Democratie”, been elaborated in direct consultations with civil “Avante”, Women’s Club “Comunitate”, society networks, medical service providers and ”Artizana”, Womens’ Club ”Speranta”, “Hope local public authorities in six rural communities of Older People from the North of Moldova” of Moldova: Satul Nou/Cimislia, Cazangic/ and wishes them much health and energy to Leova, Carabetovca/Basarabeasca, Manta/Cahul, multiply and replicate their work. HelpAge Lapusna/Hincesti, Trinca/Edinet. The outcomes International strongly believes that with the of the work have been widely shared with the active involvement of peer-to-peer volunteer national level line ministries and international groups the health and well-being of older people organisations. Special thanks to the Ministry of in Moldova can significantly improve. Health for its receptiveness and appreciation of the innovative model of healthcare and the Separate thanks are expressed to the tireless work of civil society organisations and consultants who shared their expertise to older people volunteer groups in complementing develop this guidebook – the Nursing Association the health-service delivery with their community of Moldova, Mrs. Elena Stempovscaia and the based healthcare work throughout the regions, experts who contributed to enhancing the having limited capacity of family doctors. capacity of older people groups – Mr. Aurel Saulea and Mrs. Aurelia Strajescu. Many thanks At the time when Moldova is building and also to the HelpAge International EECA office aligning its policies to European standards, it and its communication team. is good to discuss the values of volunteering. Volunteering is well developed and widely spread HelpAge International gratefully acknowledges in neighbouring countries such as Slovenia, the financial support of the World Jewish Relief Serbia, Great Britain, Netherlands, Israel and who is funding two consequent healthcare many others. People of different ages commit projects in Moldova. It is thanks to their direct their time, energy and compassion to support contributions that this programme has been their peers. Today, there is a real opportunity made possible. to introduce a culture of peer-to-peer groups to provide support to vulnerable people in Tatiana Sorocan Country Director HelpAge International Moldova 3 Background promotion, prevention and awareness-raising about diabetes and hypertension in old age. We live in a century of ageing. We are ageing not just as individuals or communities but as This guidebook is a result of these projects. a world. In the context of Moldova, population It has been developed in consultations and ageing is rapid. Officially, people aged over 60 participatory meetings with local partner in Moldova represent over 14 per cent of the organisations, older volunteers, beneficiaries total population1. In reality the figure is higher and other stakeholders by HelpAge because an estimated 25 per cent of the working International Moldova. The guide gives a set age population works outside of the country as of recommendations to organisations working labour migrants. with older people who are willing to replicate the model of community-based healthcare in The Moldova Government Social Report 2011 different communities across Moldova. indicates a poverty level of 22 per cent, however, the gap between the rich and the The projects were designed to contribute to poor is widening at a staggering speed. Poverty wider, cross-cutting questions of healthcare increases with age: for those 65 and above the provision by particularly including gender absolute poverty rate is reported as 35.5 per equality and rights of older men and women, cent whilst poverty incidence is 43 per cent children affected by migration and living without amongst 70-75 year old living alone in urban parental care as well as lonely older people areas.2 Women suffer multiple vulnerabilities as abandoned as a result of migration. The project a result – they typically live longer, have lower also included other vulnerable groups such as pensions than men, and lose their husband’s older people with disabilities and demonstrated pension support when he dies, as well as their their vulnerability in accessing medical care or life partner. social services. Poverty and bad health have been the main Methodology problems raised by older people across Moldova in consultations with HelpAge International. The methodology used for this guidebook HelpAge research in 2007 showed that nine out is based on the participatory review of of ten older people suffer from at least one non- programme impact with main stakeholders and communicable disease, and that 4 out of 10 programme coordinators. During the course of respondents suffer from more. the programme implementation, a collection of case studies and a database of beneficiaries From 2010 HelpAge International in Moldova with types of support offered was gathered to in the framework of its healthcare programme record progress, best practices and challenges. has developed several projects to address the The information was also gathered during low capacity of family doctors by mobilising programme activities at national and community volunteer groups of older people. The projects levels, as well as different public campaigns. were undertaken in six rural locations of Interviews were held with both the older Moldova during 2010-2012 and had an overall volunteers and older people beneficiaries during goal to improve the health and well-being of monitoring support visits, two household visits poor and vulnerable older people. Specifically were undertaken and a practical demonstration they focused on increasing awareness among was provided of the equipment used by the older people on prevention and management of volunteers. Meetings with representatives from non-communicable diseases such as diabetes the health service and social service providers and hypertension, and strengthen existing working with the programme were also held to community-based support mechanisms through encourage direct communication, information
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