Scaling emergency care capacity during
concurrent public health and humanitarian
crises: outcomes of WHO-ICRC basic
emergency care course implementation in the
Republic of Moldova

Scaling emergency care capacity during
concurrent public health and humanitarian
crises: outcomes of WHO-ICRC basic
emergency care course implementation in the
Republic of Moldova

Basic emergency care, Emergency preparedness, Emergency care, Health system resilience, Workforce
training, Humanitarian response, Ukraine refugee crisis, Republic of Moldova, Capacity building

Abstract
Introduction The Republic of Moldova, an upper-middle-income nation in Eastern Europe, has encountered
overlapping public health and humanitarian challenges that have tested the resilience of its health system.
Following the COVID-19 pandemic and 2022 influx of refugees from neighbouring Ukraine, the Ministry of Health

(MoH) identified an urgent need to upskill healthcare providers in emergency care. The World Health Organization-
International Committee of the Red Cross Basic Emergency Care (BEC) course was selected as a rapid solution to train

a range of providers in managing acute patients. This study assessed BEC’s effects on emergency care knowledge and
confidence in Moldova.
Methods From February 2023 to December 2024, 15 BEC courses were taught in Moldova. Participants completed
pre- and post-course knowledge tests, confidence self-assessments, and feedback forms. Quantitative scores were
assessed using descriptive statistics and nonparametric testing, and qualitative responses were analysed thematically.
Results Of 371 enrolled participants, 312 (84%) completed all course requirements. Post-course knowledge scores
were significantly higher than pre-course (mean score: +20.2%, p<0.001). Self-reports also improved, with mean
scores (ranging from 1 - least - to 4 - most) increasing from 1.85 (SD: 0.91) to 2.17 (SD: 0.67) for confidence (p<0.001)
and 1.58 (SD: 0.79) to 2.07 (SD: 0.61) for competence (p<0.001). Most (89%) found the course highly relevant to
their work and rated instructors as excellent (97%). Participants valued the symptom-based approach, hands-on
simulations, short course duration, and interactive teaching, while suggesting more time for hands-on skills practice.
Conclusion National BEC implementation in Moldova showed that a standardized short course can generate
significant gains in emergency care knowledge and confidence across diverse provider cadres in a matter of days.
Participants gained significant emergency care knowledge and confidence, even though the healthcare system

Ion Chesov1,2, Jennifer Pigoga Hart1*, Miljana Grbic1

, Ion Prisacary4

, Iuliana Garam1

, Ihor Perehinets5
,

Emilie J. Calvello Hynes3

, Dina Pfeifer5

and Vitalii Stetsyk1

https://doi.org/10.1186/s12245-025-01111-y

2026

peri irawan

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