Graphics

 

Birth rate, mortality rate and population growth

[graphic]

 

Various graphics on health in Romania

[graphics]

Further information

 

Romanian Ministry of Public Health

[www.ms.ro]

 

Romanian National Institute of Statistics

[www.insse.ro]

 

World Bank's Mission in Romania

[www.worldbank.org.ro]

 

Migration Policy Institute

[www.migrationinformation.org]

 

Reproductive Health Survey, Romania, 2004

[RH Survey]

The State of Health in Romania

During the last three decades of the communist era, the general health indicators of the Romanian population have suffered from a lack of investment. The economic transition process following the fall of the Ceausescu regime in 1989 had severe consequences for the public sector, and consequently for the health system, chronically under founded. The reduction of public spending in the health sector induced a decline in access to health services with significant inequalities among regions and population groups. Since 1989, the process of social and economic reform has been gradually implemented.

The most recent census (in 2005) counted in Romania a population of 21.62 million people of whom approximately 55% live in urban areas. The annual natural population growth has been negative since 1992 (-2.1 per 1000 inhabitants in 2005) and the migration balance has also been negative (-0.5/1000 population in 2005), which set the total population change at above -2.5/1000 population in 2005.

Socio-economic factors have an obvious impact on the health status of the Romanian population, in particular the high levels of poverty, unemployment and social inequities. According to World Bank Report from September 2003, the moderate absolute poverty was estimated at 27% in 2002 (less than 2US$ per day, PPP), and the extreme poverty at 11% (less that 1US$ per day). The most affected area is the north-east region of Romania, where the moderate poverty rate is estimated to be higher than 40%.

The birth rate steadily declined from 16 births/1000 inhabitants in 1989 to 10 births/1000 inhabitants in 2004. The all-cause mortality rate showed a constant increase from 10.7 deaths/1000 inhabitants in 1989 to 11.9 deaths/1000 inhabitants in 2004 (a slight reduction from 12.4 deaths/1000 inhabitants in 2002).

The main causes of death in 2004 in Romania were cardiovascular disease (62%), followed by malignant tumors (17%), digestive diseases (6%), accidents, injuries and poisoning (5%), and respiratory diseases (5%) (Table 1.8). Deaths from external causes and from infectious and parasitic diseases are more common in Romania (4–5%) than in other EU Member States.

The infant mortality rate declined from 49.43 deaths per 1000 live births in 1970 to 16.8 in 2004, but Romania still has the highest rate among countries from the European Region. Most infant deaths are related to perinatal conditions and malformations (57%), but a high proportion is due to diseases of the respiratory system (37%). Under-five mortality has followed the infant mortality trend, decreasing from 58.53 deaths per 1000 live births in 1970 to 19.69 in 2004.

Mortality rates among women are on the increase, in particular those related to breast and cervical cancer. Between 1990 and 2000, breast cancer mortality has increased by 7%. Moreover, Romania has the highest cervical cancer mortality rate in the region. The 1993 Reproductive Health Survey done by UNDP showed that an average of 69% of Romanian women aged 15-44 had never been tested for cervical cancer. High cancer rates among Romanian women are mainly due to lack of information on the need for testing or reluctance to be tested.  Other studies, like the National Oncology Surgical Society Survey, cited by the UN System in Romania Common Country Assessment Report from 2003 indicate that the real figure may be closer to 90%, particularly among women of low socio-economic status and in rural areas where women are much less likely to be tested.