Community Integrated Health and Social Services” Conference February 21 - 22, 2014, Bucharest, Romania

As in many countries in Eastern Europe, the Romanian Health care system was characterised by hospital-based, specialised and centrally managed health care services up to the 1990s.Decentralisation, the introduction of compulsory health insurance and the development of family health services were major steps towards improving access to curative and preventive health services at community level.However, community nursing, which had previously provided outreach to the rural poor, was practically abandoned in the mid-1990s when the salaried general practitioners providing primary health care services for a catchment population were transformed into private practice family doctors with health insurance fund service contracts, providing care based on lists of insured patients.Hence, the community nurses/ health visitors that had been hired previously within the public primary health care setting found themselves unemployed.Community level health prevention and public health services, as well as services for pregnant women, mothers and children, were subsequently stopped.A few mother and child health programmes tried to redress this problem during the early 2000s and some good practices have been documented.The new vision for Romania, The Romanian Government National Strategy for Health 2014 -2020 [1], addresses this service gap and foresees the development of sustainable integrated socio-medical services at community level

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