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Giving reasons for reorganization of the laboratory network of the service for state supervision of public health

Author: Grama Octavian
Degree:doctor of medicine
Speciality: 14.00.33 - Social Medicine and Management
Scientific adviser: Constantin Eţco
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Ion Bahnarel
doctor habilitat, professor
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova


The thesis was presented on the 26 October, 2022 at the meeting of the Scientific Council and now it is under consideration of the National Council.


Adobe PDF document11.24 Mb / in romanian


CZU 616-074/-078:614.2(043.2)

Adobe PDF document 16.00 Mb / in romanian
250 pages


state supervision service of public health, laboratory service, laboratory network, highperformance laboratories, model of reorganization, mechanism of mplementation, management quality, laboratory service users


Structure of the thesis: introduction, 4 chapters, general conclusions and practical recommendations, literature references of 101 sources, 27 figures, 14 tables, 24 annexes,113 pages of the main text. The results of the thesis have been published in 8 scientific works and have been used for development of many normative acts.

Field of study: Social Medicine and Management.

The purpose of the research: Evaluation of laboratory system of the Service for State Supervision of Public Health for giving reasons for the managerial measures in order to increase his quality and performances.

Objectives of the study:
1. Estimation of the particularities of laboratories in state supervision of public health.
2. Assessing the functionality (regulatory, technical and professional resources) of the existing laboratory network of the SSSPH/ NPHA in the perspective of reduction of inequities in distribution and use of public health services.
3. Giving reasons for harmonization of laboratory network of SSSPH reorganization with the reform of the Service for State Supervision of Public Health, as a whole.
4. Developing a model of a high-performance laboratory and a mechanism of reformation of laboratory network of SSSPH/ NPHA, according with the national legislation and European Directives, as well as with current and future tasks of the SSSPH/ NPHA.

Scientific novelty: This study traced a major task to develop and implement an innovational model for the development of the network of high-performance/regional laboratories, subject to application of the mechanisms relating to environmental factors, in conditions of austere budgetary financing, but so that this model will be able to respond properly to the major public health emergencies. That was the first time when there was determined the satisfaction of employees and users of laboratory services in the field of public health.

Theoretical significance and applied significance of this thesis: There was analyzed the situation in the laboratory services sphere of the SSSPH/NPHA before and after the reform; there was assessed the role of (regional) high-performance laboratories; there was estimated the satisfaction of staff and laboratory services users in the public health sector. This study provides new approaches to research, which may be also used in other researches in the laboratory services sphere.

Solved scientific problem in this thesis consist in consolidation of functional capacities of the laboratory network of SSSPH/NPHA, through elaboration and use of a model of modernization and a mechanism of reformation of laboratory service of SSSPH/ NPHA.

Practical value of the thesis: The results of research, conclusions and practical recommendations served both for planning the laboratory service activities of the SSSPH/NPHA and for optimizing such activities when it comes to the risk factors existing within the territory serviced. Argumentation and development of a model of SSSPH/NPHA laboratories organization may serve as a basis for issuing a range of branch-wise directives, regulatory and methodological instruments by the MHLSP/MH.

Implementation of results: The results of this study have been used to develop regulatory and methodological support for modernization of SSSPH laboratory services and have been implemented at 39 establishments: MHLSP/MH, ,,Nicolae Testemițanu” State University of Medicine and Pharmacy, NPHC/NPHA and 36 PHC.