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Community-based monitoring in action: how REAct helps to detect human rights violations and solve systemic gaps in the provision of health services

In 2020, thanks to the REAct system, 234* reports of violations of the rights of PLHIV and representatives of key groups were recorded in Moldova. 27 cases out of that were violations of the right of opioid substitution therapy patients to health services in the city of Orhei. There is no OST site in Orhei, so patients were forced to travel 106 km (2 hours way to and back) every day to get their medicines in Chisinau. The situation was further exacerbated during COVID-19 quarantine restrictions on movement.

“The REAct system helps us to understand the scale and the nature of abuse against key populations in a country and enables us to directly influence systemic gaps in health services provision. In Orhei people were trapped by quarantine, so thanks to teamwork, prompt measures were taken to solve the problem. We reached an agreement with the Ministry of Health, and the OST-site in this city will be opened in the nearest future” – says the “Positive Initiative”, the partner of Alliance for Public Health for  REAct system implementation in Moldova.

However, the COVID-19 pandemic has partially helped to resolve this issue. Thanks to the decision on prolonged dispensing of drugs for 7 days, patients no longer had to travel to Chisinau every day. The transition to the dispensing of drugs for a long period has shown its advantages both in terms of logistical expediency and in terms of a wider geographical coverage of patients.

Nevertheless, a new complexity has emerged: it is economically unprofitable for OST sites to issue drugs for a long period, since funding is charged for each patient visit. Less visits – less funding.

That is why, the partner organization of the #SoS_project in Moldova is developing and will soon submit a proposal to the State Insurance Service on the feasibility to change the approach of calculating funding for OST sites, due to the dispensing of drugs for a longer period.

REAct system is being implemented in the EECA region, within the framework of the regional project “Sustainability of services for key populations in the EECA region” (aka #SoS_project) by the Public Health Alliance in cooperation with national partners in Georgia, Kyrgyzstan, Moldova and Tajikistan.

* as for the beginning of  December 2020