USAID Romania Family Health Initiative Romania Family Health Initiative

Country Information

Demographic and socio-economic information · History and culture · Health and health system · Reproductive health and family planning services · Romania Statistical Data

Demographic and socio-economic information

Romania, with a population of about 21.7 million, is the most populous country in Central and Eastern Europe. The ratio of the population living in urban to rural areas is 54.9: 45.1. The crude natural growth rate per 1000 population has decreased in Romania, and the rate has been negative since 1992. According to Center for Sanitary Statistics, the average life expectancy was 71.76 years (75.47 for women and 68.19 for men) during 2003-2005.

Since 2000, the GDP growth in Romania has reached 5% per annum, in real terms. In 2005, the GDP was $98.7 billion with a forecast for 2006-2007 of 7.2% increase. However, the GDP growth is not accompanied by a corresponding trend in the employment rate, which had been almost constant in 2002-2005, reaching 57.6%¹ in 2005. The unemployment rate is 7.2%, one of the lowest in Europe.

Romania's transition to a market economy placed a burden on the health and welfare of people living in rural areas, children, elderly women and the Roma population. Poverty and income inequalities have increased in Romania during the years of transition, with 12% of population living in severe poverty (large and persistent want that prevents people from functioning normally in society)².

History and culture

Romania is situated in the northern part of the Balkan peninsula and its territory is marked by the Carpathian Mountains, the Danube and the Black Sea. With its temperate climate and varied natural environment, Romanian territory has long been inhabited. In its long history, Romania has confronted socio-economic turnover, wars, and an enriched culture due to the contact with different civilizations.

Modern Romania was formed after World War I, when its territory was more than doubled. Changes and turmoil continued: after World War II, the monarchy was abolished and, with the backing of the Soviet Union, the Communist Romanian People's Republic was proclaimed. Five decades of communist rule led the country to its worst state ever. The Romanians revolted in 1989, putting an end to the brutal Ceausescu regime. Thereafter, free elections brought democracy, and since 1990, Romania has experienced economic and social reforms that led to membership in European Union, which Romania joined on January 1st, 2007.

Health and health system

In Romania, 10 health conditions account for 90% of the burden of disease among men and women, in different proportions. However, cardiovascular disease and neuropsychiatric conditions are the first two causes of disability for men and women and represent most of the burden of diseases in the population. Similarly, main conditions of mortality in Romania are: cardiovascular disease (61% of total deaths), malignant neoplasm (15.5%), respiratory disease and external causes (unintentional and intentional).

Following the general pattern in the region beginning in 1990, Romania's health system went through a complex reform which was supported by major donors. In 1997, it issued the first law of health insurance and the health system transformed into a social health insurance system. This begat a new entity– the National Health Insurance House (known as 'the House'), in charge with collecting funds and paying providers. The Ministry of Public Health's (MOPH) responsibilities are developing and implementing national health policies and programs, allocating and managing funds for specific activities (mainly prevention programs), that are not covered by the House, and ensuring overall coordination of the national health system.

Reproductive health and family planning services

Romania's pronatalist policy under communist regime resulted in serious health consequences for the Romanian population. During this period, abortion was illegal and modern contraceptives were unavailable and prohibited. Romania experienced the highest rate of maternal mortality and one of the highest rates of infant mortality in Europe.

In the 1990s, health policies and services tried to address the changes experienced in Romania during the period of social and economic transition, which included the availability of modern contraceptives and legalization of abortion. Contraceptive use has increased and abortion rates are on the decline (see Facts and figures). Family planning services are also included in both the basic and minimal package of services provided to insured and uninsured population, respectively, by the family doctors within the health insurance system. In addition, people in rural areas and the following categories are eligible for free contraceptives: the unemployed, students, social security beneficiaries, women who had an abortion within a public health facility, and people without financial means.

Facts and figures

Population (2005): 21,623,849 inhabitants, out of which 11,879,897 (54.9%) are living in urban areas (Center for Sanitary Statistics – CSS)
Birth rate (2005): 10.2 births/1,000 population (CSS)
Total fertility rate (2004): 1.3 (Reproductive Health Survey - RHS)

Contraceptive prevalence
rates (2004)

Modern methods prevalence (2004):

Abortion rate (2005):

58.1% (RHS)

33.9% (RHS)

33.9 /1,000 WRA  (National Statistical Institute)

Birth rate (2005)

General mortality rates (2004):

10.2 /1,000 inhabitants

Male: 13.1 deaths/1,000 male population
Female: 10.8 deaths/1,000 female population

Maternal mortality ratio (2005):

Maternal mortality rates (2005):

0.17 /1,000 live-born

Due to abortion: 0.07/1,000 live-born
Due to obstetrical risk: 0.10/1,000 live-born

¹ Calculated as percentage of working age population (15-64 years), National Statistical Institute

² United Nations Common Country Assessment, 2003, UNDP

The Romanian Family Health Initiative (RFHI) is implemented by JSI Research & Training Institute, Inc.
Copyright 2008 JSI All Rights Reserved
Financial support for this website was provided by the U.S.Agency for International Development,
Romanian Family Health Initiative (RFHI) Cooperative Agreement #186-A-00-01-00103-00.
The views expressed herein do not necessarily reflect those of the U.S. Agency for International Development.
For more information, please contact: