HEALTH OF CHILDREN IN DIFFICULT LIFE SITUATIONS

Abstract

Improving health care system for children is one of the priorities of the state, and children in difficult life situations require special attention. The aim of this study is to assess the health status of children in this group, based on the data of medical preventive examinations conducted in 2017 on the territory of the Arkhangelsk region. Methods: an observational analytical retrospective cohort study. A cluster sampling procedure was applied. Altogether, 2 929 children from substitute families and 2 099 children from state institutions comprised the study base. Results: More than 90 % of children were covered by prophylactic medical examination according to the orders 216н and 72н of Ministry of Health. Indicators of physical development generally correspond to the average data for the Arkhangelsk region, although in the group of pupils of closed institutions their alignment is gradual, as the proper care of children and implementation of the recommendations of specialists. In the distribution of children by health groups, attention is drawn to the low percentage of practically healthy children with a clear predominance of persons with chronic somatic pathology (with a large number of children with group V health in public institutions explained by the participation in the study of specialized institutions). Recommendations for additional screening are implemented in about 50 % of children; this figure is higher only in children from orphanages (> 90 %). Conclusion: The health status of children in difficult life situations differs from that of children raised in biological families: the majority of children belong to groups II and III of health with a low percentage of healthy children (group I) and a relatively high percentage of children with disabilities (group V). Leading places in the structure of pathology are diseases of the musculoskeletal and digestive systems.