Local plan for sustainable development for tulcea county

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HEALTH
Strengths	Weaknesses
Emergency County Hospital in Tulcea County with an emergency department and a specialised out-patient clinic Operational ambulance service Specialised staff in healthcare institutions Available qualified and un-qualified human resources	Weak development and furbishing of healthcare units Deficient healthcare and medical services in rural areas in Tulcea County Lack of an integrated IT system to connect all medical services providers, and health institutions, to allow for better management of funds, and at the same time, to allow for synchronised analyses to enable better adaptability of the system to meet population needs Deficient continuing education system in healthcare Lack of local NGOs active in the sector
Opportunities	Threats
De-centralisation and providing autonomy to health and medical assistance authorities, making them objectives in the governance programme Implementation of private health insurance services, in order to relieve the social system, and to relieve the pressure on those insured Increased medical care competency and quality Facilities for medical staff who wish to work in rural areas Attract external funding for programmes in this area	The de-centralisation and providing autonomy to health and medical assistance authorities can have non-beneficial impacts Deficient institutional managerial capacity to carry out all functions specific to the healthcare system Reduced financial sustainability in the county, which is the basis of the system, due to autonomy Social imbalance between those who can afford private healthcare and those who cannot Emigration of medical staff due to the opening of the market Risk of epidemics, transmittable diseases, and chronic diseases constantly rising, without a coherent intervention programme Increased medical assistance costs, which can lead to an increase in the imbalance between those with good incomes and those living in poverty when it comes to access to healthcare

CULTURE
Strengths	Weaknesses
Valuable and diverse cultural heritage, with elements which are unique in the country Cultural and local traditions which are well maintained Outstanding potential for the capitalisation of existing historical monuments Existence of many national minorities with own cultural identities Existence of cooperation / brotherhood agreements with cultural exchanges as one of the main objectives Cultural manifestations well known and important at national and international level (i.e. Anonimul International Film Festival)	Decreased interest in cultural and local traditions and events in one sector of the population Weak promotion of cultural events Weak financing of cultural institutions, which restricts their activities Decreased number of cinemas and of other spaces for cultural activities Insufficient promotion of cultural objectives, historical monuments, and local customs in the county Decreased number of persons active in cultural associations Lack of an adequate law regarding the protection of the cultural heritage, aspects of recent legislation, and litigations regarding the preservation of historic buildings and museums Exclusion of municipality and county museums from the tourism offer Difficulty in establishing national and international partnerships Lack of strategy
Opportunities	Threats
Non-governmental organisations interested in cultural activities Tourist interest in exploring the cultural heritage of the county Opportunity to establish cultural exchanges through brotherhood and collaboration agreements between localities in the county and those in other countries	Closing down of cultural institutions due to lack of funds Degradation of historical monuments due to lack of funds for their conservation and restoration

EDUCATION
Strengths	Weaknesses
Existence of strategies for the development of education in Tulcea County Running of modernisation and restoration programmes for school infrastructure Good relationship between education units and local authorities, county authorities, NGOs, police, constabulary, church School – community partnerships in the ongoing development of rural projects Implementation of national / county projects and programmes (Rural Development Programme, “Milk and bread” and “High school money” social programmes, scolarships, educational programmes, PHARE, Leonardo, Socrates etc.) Strong scientific and metodological teaching staff in urban areas Functioning centre of excellence	Large number of teachers who have not completed any professional development in the past 10 years Unqualified staff in some rural postings Existence of simultaneous education with negative impact on learning in many localities Large school network in areas with poor access roads, on dry land and wetland Inadequate educational spaces (work in 2-3 shifts, lack of auditoria, gymnasia, pre-school playgrounds, middle schools integrated in school groups) In some areas, the educational infrastructure does not have the minimum utilities (running water, toilets) Lack of correlation between the educational market and workforce demands Weak family involvement in school life Decreased interest of students to schooling Migration of qualified teachers to other professions Lack of private educational institutions Insufficient number of pre-schools Deficient counselling programmes and professional orientation
Opportunities	Threats
Existence of development programmes for teachers Initialising partnerships between the universities in Bucharest and Constanţa and the CCD for the implementation of accreditation programmes EU financing De-centralisation and implementation of a quality assurance system	Lack of access to accreditation programmes due to their location Decrease in the school population (demographics and through emigration) Lack of a strategy for continued education for youth from disadvantaged areas Prejudice of families regarding real employment opportunities for graduates, choice of profession by subjective criteria Social environment which favours school abandonment and school drop-outs Lack of knowledge of foreign languages limits access to European programmes

SOCIAL ASSISTANCE
Strengths	Weaknesses
Local authority and responsible institutions concern with the implementation of social protection reform Large number of specialised services for persons in difficult situations Functional partnerships between authorities and NGOs in social services Acquired experience through the application for an important number of PHARE or World Bank projects regarding services for children at risk	Increased number of persons who require or receive social protection Decreased awareness of the population in certain areas, and lack of responsibility towards their own children Insufficient number of specialised staff Lack of some specialised services, such as those aimed at domestic violence or minors exhibiting severe behavioural disturbances Lack of homecare or alternative services for the disabled Resistance to change of staff and of the local community Lack of legislation for the protection of youth over 18 years of age, and of delinquent children Prevention is secondary to protection
Opportunities	Threats
Current legislation prioritises the professionalization of social services Internal and external financing available through different social programmes and projects Existence of NGOs who can be involved Promotion of volunteering as a way for active participation in community problems Public-private partnerships in view of creating social services Existence of specialist teams offering consultancy in order to obtain financing and to implement existing programmes	Increased number of persons at risk: abandoned, abused, neglected, delinquent children, adults with problems, disabled Successive legislative changes which prevent the coherent and balanced implementation of activities Economic pressure – increased degree of poverty Limited and poorly prepared staff in alternative services, located in isolated communities, far from Tulcea Municipality Increased number of separated families Increased number of families where abuse is present (alcoholism, street begging, vagrancy) Poor and fragmented resource management Lack of coherent strategies for other institutions in the social assistance domain Migration of specialists in social protection to other institutions where they are offered better opportunities

I.3.8. OBJECTIVES
STRATEGIC DIRECTION FOR THE SOCIAL DOMAIN

Increased standard of living
Efficient workforce management in the county
Access for medial assistance and healthcare for all citizens of the county
Preservation and promotion of the cultural heritage, and maintenance of the identity of ethnic communities
Fighting social marginalization
Equality in opportunities

Specific Objectives for the Workforce

Promotion of a more flexible workforce
Development of active measures for the employment of unemployed persons through the implementation of job search assistance and market orientation, and through continuing professional education programmes
Increased institutional and organisational capacity for the support of disadvantaged persons (Rroma ethnicity, disabled, youth from placement centres, long term unemployed persons) and for the development of programmes aimed at re-including these persons in the workforce
Orientation and counselling for unemployed persons and for others interested in qualifications or re-qualifications to meet market demands, and other realities of the economy

Specific Objectives for Healthcare

Development and modernisation of the health infrastructure, especially in rural areas, while at the same time increasing the quality and diversity of medical services
Improvement and/or implementation of medical necessary medical and health services

Improved management of emergency situations in Tulcea County
Development of the management of health units in view of optimal fiscal management for medical activities
Development of partnerships with NGOs for the implementation of programmes aimed at disadvantaged or disabled persons
Motivation of health staff wishing to move to rural areas to carry on with medical activities
Improved continuous medical education system at county level for doctors, nurses, and assistants
Improved awareness of the citizens regarding preventative programmes for diseases and other health programmes
Monitoring of environmental quality for the protection of public health and for the reduction of diseases associated with pollution

Specific Objectives for Culture

Efficient capitalisation and management of the offer of cultural goods and services
Diversify the cultural offer with interdisciplinary cultural actions, to meet European and international cultural evolution standards
Promote cultural activities and permanent visibility at local, national, international level
Cultural offer to meet public needs, attract particular categories of the public, increased audiences, improved quality and diversity of offered services
Identify alternative financing sources, participation in national, international, European programmes
Efficient management of finances and human resources for public cultural institutions
Participation in professional education programmes in cultural management

Specific Objectives for Education

Modernisation of educational system
Equal access to education
Restoration and modernisation of school infrastructure

Support in twinning between educational institutions as an alternative to state-funded education
Access to educational funding programmes
Continuing education for teachers and staff
Motivate qualified teachers to relocate to rural areas
Reduce school abandonment and illiteracy

Specific Objectives for Social Assistance

Improvement and diversification of social assistance and protection programmes for persons and families whose daily needs are not met by their own capacity, rights, and means
Development of a preventative social assistance strategy to avoid risk situations for disadvantaged individuals and families, and to avoid their marginalisation
Development and diversification of intervention methods to prevent school abandonment and to reduce the number of institutionalised children

Promotion of a civic culture aimed at the involvement of citizens, groups, organisations, and communities in general in order to resolve problems causing the need for social assistance
Prevent abuse and negligence of children in any form
Increase and development of specialised services and integrative practices for special needs children and for institutionalised youth aged 18 years, in order to improve their chances for social integration and education
Encourage internal adoption
Integrate Rroma families into communities
Reduced degree of institutionalisation for the elderly and for the disabled by introducing home services
Establishment of integration centres through occupational therapy
Identification of new work places for the disabled
Awareness and changed public opinion regarding the disabled
Continued residential institution restructuring through the decrease of numbers of beneficiaries and establishment of alternative services
Professional development of the staff in the system
Strengthen partnerships

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