Ensuring sustainability of Integrated Community Care Model in Moldova through education of health and social care professionals

Background: The sustainability of Moldova’s Integrated Community Care (ICC) model—piloted by the Healthy Life Project (HLP)—depends on collaborative workforce capable of addressing chronic and social vulnerabilities. Health and social care systems continue to face structural challenges, workforce shortages, and high outbound migration. Despite the recognized need for community care, many primary health care (PHC) providers fail to differentiate the role of community nursing in outreach work to prevent disease and promote health, including with at-risk groups (Stanescu 2019). Conversely, only 40% of community social assistants have formal or ongoing professional training in social work (MLSP 2023). Fragmentation within and between sectors and limited interprofessional education further hinder coordination and efficiency.

 

Approach: The HLP strengthened interprofessional education as a key mechanism for implementing the ICC model. Training focused on building competencies in integrated care (Stein 2016, 2021) among community nurses and social workers enhancing practical abilities in case management, teamwork, and communication. The concept of health and wellbeing across the life course, together with an understanding of social determinants of health and behavioral risk factors guided curriculum design.

 

Capacity-building followed two complementary lines. First - sectoral to improve application of national protocols and strengthen the underdeveloped community nurse role, especially in outreach and early detection. Second - on multidisciplinary health and social collaboration, enabling joint assessments, interventions, case management, and link with LPAs and civil society.

 

The cascade training was applied by national network of trainers in Integrated Care and community nursing. It combined international and national expertise. Training topics, based on analytical work in PHC and social sectors and lessons from intersectoral cooperation, were consulted with practitioners.

To ensure sustainability, ICC principles were embedded in initial and continuous professional education for health and social workers.

Results: Interprofessional learning improved communication, information sharing, and task distribution within community teams, educing professional strain and enhancing service efficiency. Collaboration between sectors improved understanding of roles, use of common tools, and engagement with community resources.

Between 2019 and 2025 years, national Integrated Care facilitators trained 112 multidisciplinary teams from 35 districts, 2 municipalities and 75 communities, involving over 1,581 decision makers and practitioners from LPA, PH, PHC, social assistance, NGOs. Practical training modules on improving abilities for prevention and community-based chronic reached 2,630 professionals from 260 PHC facilities.

Drawing from HLP experience, the community nursing training modules have been institutionalized at the University of Medicine and are to be included at the medical (nursing) college. Efforts are currently made to include integrated care principles in the bachelor’s and master’s programs in four main universities teaching social work.

 

 

Conclusion: Sustained investment in interprofessional education underlines the importance of multidisciplinary approach as a base for maintaining quality, continuity, and equity of care in a resource-constrained context. Embedding ICC competencies into training programs marks a significant transition from project-based interventions to a system-wide approach, ensuring that collaboration becomes a permanent component of workforce development.