Management in healthcare
  • 2022 № 5 Child mortality in different countries during the COVID‑19 pandemic

    At the beginning of the pandemic, COVID‑19 deaths were relatively higher among older children than in younger age groups, although there was a high likelihood of life-threatening cases of COVID‑19 in children with underlying medical conditions. Low child mortality from COVID‑19 is attributed by the authors of the study to the use of protective measures by children from high-risk groups and isolation measures. However, the COVID‑19 pandemic has led to serious disruptions in the work of health services in various countries, to interruptions in the provision of maternal and child health services (medical examinations, vaccinations, prenatal and postnatal care, and others), to a shortage of medical personnel.
    Purpose: to analyze the data of scientific studies on the characteristics of child mortality in various countries with the allocation of risks in the system of maternal and child health care.
    Materials and methods: bibliographic and analytical methods were used in the work.
    Findings: Premature newborns are particularly vulnerable to the COVID‑19 pandemic, especially in low- and middle-income countries where the impact of health system failures is significant. Restrictions during the COVID‑19 pandemic exacerbate the risks of stillbirth, including delayed delivery. The drop in preterm birth rates seen in high-income countries is attributed by researchers to the indirect effects of the response to the COVID‑19 pandemic, and data on stillbirths are not taken into account, which may make it difficult to explain the decline.

    Authors: Mingazova E. N. [18] Tliashinova I. A. [3]

    Tags: child population1 covid-19 pandemic6 maternal and child health service1 mortality20 perinatal risks1 stillbirth1

    Read more >

  • Public health
  • 2022 № 3 Global social challenges in infertility problems

    The problem of infertility remains a global problem of mankind according to WHO and today, infertility affects about 10–
    25% of couples of reproductive age worldwide, estimates vary from 48 to 186 million. When developing recommendations for the diagnosis and treatment of infertility in 2020, WHO did not revise the definition of infertility given in 2009, together with the International Monitoring Committee on Assisted Reproductive Technologies (ICMART) in the “Glossary of Definitions of Infertility and Treatment of Infertility”, where infertility is considered a disease reproductive system, defined as the inability to achieve clinical pregnancy after 12 months or more of regular unprotected intercourse. The same is the definition of male and female infertility in the International Classification of Diseases (ICD11). Higher rates of infertility are found in less developed countries/regions such as sub-Saharan Africa, South Asia, North Africa/Middle East, Central/Eastern Europe and Central Asia. At the same time, the researchers note that geographical differences in the level of infertility are associated with environmental, cultural and social factors. The etiology of infertility has different epidemiological characteristics depending on the region.
    Purpose: to review foreign scientific literature containing information on the prevalence of infertility in countries around the world, the role of social factors in its formation, and the availability of treatment assistance.
    Materials and methods: bibliographic, information-analytical methods and methods of comparative analysis.
    Results: in modern research in the field of studying the social factors of childlessness, special attention is paid to the description and clustering of groups of childless women. The global problem of infertility is associated with adverse physical and mental health outcomes, financial hardship, severe social stigma, increased risk of domestic violence, and marital instability. It has been shown that women with less than secondary education are less likely to seek help for infertility treatment than women with higher education. In high-income countries, immigrant women, uninsured women are less likely to have access to fertility treatment, and they are less informed about their rights, even if they seek treatment at a later age.
    Findings. Geographic differences in the prevalence of infertility in different countries are largely determined by social factors. The study of social factors of infertility in women showed that infertility is associated with a low quality of life. Although the likelihood of infertility in men and women is the same, and male infertility is responsible for more than half of all childlessness in the world, infertility remains primarily a social burden for women, especially in pronatalist societies. Women from wealthy backgrounds are more likely to have access to quality fertility treatment.

    Authors: Tliashinova I. A. [3] Mingazov R. N. [8]

    Tags: access to treatment1 childlessness1 female infertility1 infertility2 male infertility1 population groups1 social factors1

    Read more >

  • 2021 № 8 Psychological aspects in the problems of infertility among the population of various countries.

    The problem of infertility in the 21st century has become extremely important for public health in various countries, affecting the birth rate of the population and the number of humanity. Infertility, affecting approximately 8–12% of the world’s population, is associated with factors such as unwillingness to conceive, the age of the female partner, the number of diseases that affect fertility, etc. Questions of the influence of psychological problems, often regarded as the causes of idiopathic infertility, such as stress, depression, sleep disturbances, are of particular interest to researchers. A review of works on the potential impact of stress and depression on reproductive function showed not only a definite relationship, but also the difficulty of determining causal relationships due to the lack of a single assessment tool.
    P u r p o s e o f t h e s t u d y : to review foreign scientific literature containing information on the role of psychological factors in the formation of reproductive health disorders of the population, including infertility.
    M a t e r i a l s a n d m e t h o d s : bibliographic, information and analytical methods and the method of comparative analysis were used.
    R e s u l t s . Mental health issues are often viewed as the causes of female and male infertility. To improve the quality of life of patients with infertility, it is necessary to address the issues of a causal relationship between psychological health and infertility, psychological health when using IVF and ways to solve the problem of psychologically induced infertility. The risk of developing depression and the relationship of a higher degree of anxiety with clinical pregnancy after IVF are shown. Due to the inaccurate data on the relationship between psychological stress and a decrease in male reproductive function, psychological stress is considered in studies as a risk factor for erectile function and ejaculation in men against the background of a high level of stressful life events, compared with women.
    Findings. Research has proven the effectiveness of psychological support and cognitive-behavioral group therapy in fertility treatment programs, including interventions accompanying IVF. Studies of psychological ways of correcting depression and positive IVF results have shown the importance of programs for influencing the mental state of couples undergoing treatment for infertility reasons.

    Authors: Mingazova E. N. [18] Tliashinova I. A. [3]

    Tags: causal relationships1 cognitive-behavioral group therapy1 infertility2 psychological disorders1

    Read more >