Abstract
The aim of the study was to determine the compliance of the existing medical care system in Ukraine for pregnant and married couples planning a pregnancy (its organizational and financial capabilities), the need to reduce the high level of reproductive losses. Materials and methods. Methods of statistical and system analysis are used. The national programs of reproductive health, demographic data, data on morbidity (received from the national medical statistics for the period 2017–2018), reports of the national survey “Health Index of Ukraine” (2018), data on appeals for obstetric-gynecological, genetic care (in connection of reproductive losses, fertility) are analyzed. A comparison between the indicators of Ukraine and the Kharkiv region, as well as with other countries, according to the cost of the survey, requests for medical care for the examination of genetic and infectious diseases associated with reproductive losses, was made. The organization of outpatient care for pregnant and married couples who are planning a pregnancy has been analyzed in terms of availability and sources of payment for services. Results. The number of Ukrainian women planning their first pregnancy aged 35 and over is increasing. Naturally, the number of genetic pathologies increases. Indicators of infectious pathology remain high. At the same time, women visit less gynecologists and family doctors, which is due to the high cost of the part of medical care that patients have to pay for themselves. Insufficiently developed genetic screening programs for genetic diseases. The professional contacts of physician of various specialties need to be improved. These facts negatively affect the level of reproductive losses, complicate their prevention. Conclusions. To reduce reproductive losses, it is necessary to create a national disease monitoring center, increase the availability of obstetric-gynecological and genetic care for the population, increase coverage of genetic screening programs, and give birth to children at the optimal age of 20–34.
Highlights
A key paradigm of the world health concept transformation is the transition from a responsive work model to a preventive, towards the so-called "4Ð medicine" model ("Predictive, Personalized, Preventive and Participatory approach to medicine"), where medicine proclaims, personalizes, prevents and requires patient involvement [1]
The health care system is primarily aimed at treating patients rather than preventing diseases and detecting them early
Miscarriages, developmental disabilities incompatible with life, spontaneous abortions and other reproductive losses (RL) causes are actively studied in developed affluent countries of Western Europe, in the United States, but not enough in the poorer countries of the world
Summary
A key paradigm of the world health concept transformation is the transition from a responsive work model to a preventive, towards the so-called "4Ð medicine" model ("Predictive, Personalized, Preventive and Participatory approach to medicine"), where medicine proclaims, personalizes, prevents and requires patient involvement [1]. In such circumstances, the responsibility for maintaining. The health care system is primarily aimed at treating patients rather than preventing diseases and detecting them early This approach leads to an increase in primary disability and preventable mortality. The strange situation is in Ukraine: according to the declarations, the approaches to the study are modern, in practice, even statistical data are not fully collected
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