Health and Nutrition
Health and nutrition starts from before conception. In Romania, many rural women have little access to pre-natal care or family planning advice. Sometimes this is because they are unaware they are entitled to free check-ups; sometimes itis for logistical reasons, for examplethey live far away from the doctor’s general practice facility or cannot reach it due to snowy or muddy conditions. For many, the first time they see a doctor is when they give birth. A study from 2009 found that around 5% of women give birth without a single prenatal visit. This means that every year 10,000 pregnancies are not medically attended.
The lack of an outreach programme means that the most vulnerable women often fall through the gaps in the system. This is exacerbated by a shortage of community nurses and Roma health mediators, and the tendency of GPs working in rural areas to seek better working conditions in the city or abroad, with an estimated 12,000 Romanian medics having left. According to WHOdata, in 2009 Romania had the lowest number of physicians per 100,000 inhabitants in the EU and the second lowest number of nurses per 100,000 people, after Greece. A study in 2007 by the CoPh (a formal interest group for physicians) found that 54% of physicians would like to work abroad, with the main reasons being poor working conditions and low wages. Doctors are partially paid on a per capita, rather than per service, basis, which means that once a woman is registered, there is no incentive to make sure she turns up for check-ups and treatment. However, the patient has the incentive of low-cost or even free prescriptions.
Romania’s breastfeeding rate is almost three times lower that in the EU, with only 12.6% of babies exclusively receiving breast milk at six months old.This deprives both mother and child of the numerous health and psychological benefits that nursing confers, from increased protection against disease for both parties to greater bonding that reduces the likelihood of abandonment.
Many international studies have revealed that a mother will breastfeed more successfully and for longer periods of time when she is permitted to have early contact, an opportunity for suckling in the first hour, and rooming-in with her infant. UNICEF incorporates these initiatives into a 10-point program called “The Baby-friendly Initiative”. This UNICEF initiated large-scale change in care has been accompanied by an unexpected positive observation in several countries.