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Выпуск № 1 (2), 2016 год
ACCESS TO HEALTH CARE IN HEALTH SYSTEMS AND POLICY IN CENTRAL ASIA: A CASE OF GENDER
Tatiana Chubarova, Natalia Grigorieva
The paper deals with gender dimension of health system and health policy in modern societies. The five countries in Central Asia ? Kyrgzstan, Kazakhstan, Uzbekistan, Turkmenistan, and Tajikistan ? provide a good example to investigate the problem for several reasons. These countries have made a commitment to reform their health-care systems though are at varying stages of implementing changes involving financing and provision of health care during the transition from a centrally planned to a market economy. The existing evidence suggests that today population in countries in question experience problems in access to equitable healthcare. Besides, these countries find themselves at a crossroads in terms of their cultural identity as most of political aims of health reforms are based on values and mechanisms of the Western developed countries.
The paper investigates in what instances women across the region face barriers in assess to health care and how it affects their health status, what measures are undertaken by governments to address the situation. Particular attention is paid to maternal health and services as maternal mortality rates are still quite high in the countries in question.
The analysis revealed that the issue is poorly researched and definitely the potential of taking into account gender dimension is underestimated. The authors argue that gender approach should become an integral part of health care polices in the countries of Central Asia based on understanding of importance of gender issues for the development of their societies. The idea of "gender points" is suggested to stress that gender approach in health system involves addressing health needs of both men and women as a way to increase the overall efficiency of health care systems.
NEW APPROACHES IN THE ASSESSMENT OF PHYSICAL DEVELOPMENT OF STUDENTS
Valeriy Plotnikov, Boris Polyayev, Maxim Panyukov, Vitaly Levkov
Objective: The purpose of the study was to develop the method for integral assessment of physical development (PD) of college students. Participants and methods: The study was conducted in 1979 and 2001 through 2011 and involved 1492 students of Pirogov Russian National Research Medical University. Anthropometric methods were applied in the research. Length (L), body mass (M), moment of force (MF) which measures the strength of the back extension muscles, and vital lung capacity (VLC) were transformed into body mass index (BMI), strength index (SI), and vital index (VI). The percentage distribution of the acquired results was scored on a scale of 0-5. The sum of each VI, SI and BMI divided by 3 represented the quantitative integral assessment of physical development (PD). Results: PD of students in 1979 estimated as 3.30+/-0.12 conventional units and was considerably higher than that of their peers in 2001-2011, p<0.01. Conclusions: Separate anthropometric features do not give objective characteristic of PD. Quantitative integral assessment of PD based on values of BMI, SI and VI best reflects the essence of PD, physical potential of an individual.
FORMATION OF LEGAL RELATIONS IN HEALTH SERVICES OF RUSSIA, THE USSR AND RUSSIAN FEDERATION
Vadim Tsybulsky
By the the end of XIX - the beginning of XX century the health care system in Russia practically was absent, there was no also a legal regulation. The first legal certificates have been connected with creation in 1864 of institute doctors applied by zemstvas for serving peasants at the expense of means of local governments - zemstvases, and with development of factory medicine, thanks to the law from 26th August, 1866 obliged factories to arrange clinics with number of places depending on number of the workers. Medical care in these clinics have been provided free of charge. As the industry charter forbade to raise a payment from workers not only for treatment, but also for hygienic and dietary maintenance of the patient. Later according to Cities Regulation of 1870 and 1892 the duty of the organisation of medical care has been assigned to a municipal government to the population similar to those which was provided by zemstvas doctors on village.
ASSESSING THE CONTRIBUTION OF DIABETES IN THE COST OF MEDICAL SERVICES FINANCED BY INSURANCE COMPANIES
Denis Roshchin
Most health care managers are well aware of the problem of latent flowing of undiagnosed diabetes which greatly exacerbates the diseases of various organs and systems, masked in the structure of morbidity and mortality taken into account as from various causes [3]. Planning for financing preventive events in the field of diabetes is carried out in many ways. According to the author this work will provide a formal picture of the economic losses caused by diabetes in Russian Federation which can be a breeding ground for a more long-term research for several years including the correlation with the volume of planned activities on prevention. Goals of this study are to analyze the registers that provided by medical organizations within the framework of the program of "state guarantees" (financed by insurance companies) in order to establish the presence and degree of influence of diagnosed diabetes in a patient in the cost of services provided, including in other nosology, with outpatient and inpatient treatment. A more accurate calculation of the costs of health system resources to assist persons suffering from diabetes, should be used the health managers to reassess the need for diabetes prevention programs, including in terms of their cost-effectiveness.
THE MODEL OF SOCIAL SUPPORT OF STUDENTS WITH DISABILITIES IN TERMS OF INCLUSION
Olga Kozyreva
Inclusive education and training are a long-term strategy, considered not as a local area of work, but as a systematic approach to organization of activities of the system of general education in different aspects as a whole. The inclusive form of education covers all subjects of educational process: children with disabilities and their parents, typically developing students and their families, teachers and other educational specialists, administration, institutions of additional education.
Tatiana Chubarova, Natalia Grigorieva
The paper deals with gender dimension of health system and health policy in modern societies. The five countries in Central Asia ? Kyrgzstan, Kazakhstan, Uzbekistan, Turkmenistan, and Tajikistan ? provide a good example to investigate the problem for several reasons. These countries have made a commitment to reform their health-care systems though are at varying stages of implementing changes involving financing and provision of health care during the transition from a centrally planned to a market economy. The existing evidence suggests that today population in countries in question experience problems in access to equitable healthcare. Besides, these countries find themselves at a crossroads in terms of their cultural identity as most of political aims of health reforms are based on values and mechanisms of the Western developed countries.
The paper investigates in what instances women across the region face barriers in assess to health care and how it affects their health status, what measures are undertaken by governments to address the situation. Particular attention is paid to maternal health and services as maternal mortality rates are still quite high in the countries in question.
The analysis revealed that the issue is poorly researched and definitely the potential of taking into account gender dimension is underestimated. The authors argue that gender approach should become an integral part of health care polices in the countries of Central Asia based on understanding of importance of gender issues for the development of their societies. The idea of "gender points" is suggested to stress that gender approach in health system involves addressing health needs of both men and women as a way to increase the overall efficiency of health care systems.
NEW APPROACHES IN THE ASSESSMENT OF PHYSICAL DEVELOPMENT OF STUDENTS
Valeriy Plotnikov, Boris Polyayev, Maxim Panyukov, Vitaly Levkov
Objective: The purpose of the study was to develop the method for integral assessment of physical development (PD) of college students. Participants and methods: The study was conducted in 1979 and 2001 through 2011 and involved 1492 students of Pirogov Russian National Research Medical University. Anthropometric methods were applied in the research. Length (L), body mass (M), moment of force (MF) which measures the strength of the back extension muscles, and vital lung capacity (VLC) were transformed into body mass index (BMI), strength index (SI), and vital index (VI). The percentage distribution of the acquired results was scored on a scale of 0-5. The sum of each VI, SI and BMI divided by 3 represented the quantitative integral assessment of physical development (PD). Results: PD of students in 1979 estimated as 3.30+/-0.12 conventional units and was considerably higher than that of their peers in 2001-2011, p<0.01. Conclusions: Separate anthropometric features do not give objective characteristic of PD. Quantitative integral assessment of PD based on values of BMI, SI and VI best reflects the essence of PD, physical potential of an individual.
FORMATION OF LEGAL RELATIONS IN HEALTH SERVICES OF RUSSIA, THE USSR AND RUSSIAN FEDERATION
Vadim Tsybulsky
By the the end of XIX - the beginning of XX century the health care system in Russia practically was absent, there was no also a legal regulation. The first legal certificates have been connected with creation in 1864 of institute doctors applied by zemstvas for serving peasants at the expense of means of local governments - zemstvases, and with development of factory medicine, thanks to the law from 26th August, 1866 obliged factories to arrange clinics with number of places depending on number of the workers. Medical care in these clinics have been provided free of charge. As the industry charter forbade to raise a payment from workers not only for treatment, but also for hygienic and dietary maintenance of the patient. Later according to Cities Regulation of 1870 and 1892 the duty of the organisation of medical care has been assigned to a municipal government to the population similar to those which was provided by zemstvas doctors on village.
ASSESSING THE CONTRIBUTION OF DIABETES IN THE COST OF MEDICAL SERVICES FINANCED BY INSURANCE COMPANIES
Denis Roshchin
Most health care managers are well aware of the problem of latent flowing of undiagnosed diabetes which greatly exacerbates the diseases of various organs and systems, masked in the structure of morbidity and mortality taken into account as from various causes [3]. Planning for financing preventive events in the field of diabetes is carried out in many ways. According to the author this work will provide a formal picture of the economic losses caused by diabetes in Russian Federation which can be a breeding ground for a more long-term research for several years including the correlation with the volume of planned activities on prevention. Goals of this study are to analyze the registers that provided by medical organizations within the framework of the program of "state guarantees" (financed by insurance companies) in order to establish the presence and degree of influence of diagnosed diabetes in a patient in the cost of services provided, including in other nosology, with outpatient and inpatient treatment. A more accurate calculation of the costs of health system resources to assist persons suffering from diabetes, should be used the health managers to reassess the need for diabetes prevention programs, including in terms of their cost-effectiveness.
THE MODEL OF SOCIAL SUPPORT OF STUDENTS WITH DISABILITIES IN TERMS OF INCLUSION
Olga Kozyreva
Inclusive education and training are a long-term strategy, considered not as a local area of work, but as a systematic approach to organization of activities of the system of general education in different aspects as a whole. The inclusive form of education covers all subjects of educational process: children with disabilities and their parents, typically developing students and their families, teachers and other educational specialists, administration, institutions of additional education.