IMPACT OF AVAILABILITY OF MEDICAL CARE ON INFANT MORTALITY RATES IN A REGION WITH HIGH FERTILITY
Authors:   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia, Ivanov Dmitry , Moiseeva Karina ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia, Mezhidov Kazbek ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia,   National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russia, Yuriev Vadim ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia, Shevtsova Kseniya ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia, Alekseeva Anna ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia, Kharbediya Shalva ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia, Yakovlev Aleksey ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, St. Petersburg, Russia
Published: August 2024

Significance. In order to develop measures aimed at reducing deaths of viable children in the Russian Federation and its regions, it is necessary to analyze the relationship between medical and demographic indicators and availability of medical care for pediatric population. The purpose of the study was to assess the impact of medical care availability for children on infant mortality rate in a region with high fertility. Material and methods. The study used Rosstat data, statistical materials of the Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation and Form No. 32 “Information on medical care for pregnant women, women in labor and postpartum” for 2018-2022 to analyze fertility rates, infant mortality rates, incidence of prematurity and number of doctors and pediatric beds. To assess the relationship between indicators, the nonparametric Spearman rank correlation method was used. Statistical data processing was carried out using the MS Office-2016 and StatSoft-Statistica 10.0 software packages. Results. The Chechen Republic has a high rate of decline in infant mortality rates, however, it belongs to the regions with a high level of infant mortality (5.9‰ in 2022). In 2018-2022, against the background of high birth rates in the republic, a low incidence of prematurity was registered. At the same time, in comparison with the Russian average, this constituent entity of the Russian Federation is characterized by a lower number of doctors and pediatric beds. While there is a positive upward trend in the indicators, over the past five years the number of neonatologists was about 1.7-time lower than the country average, pediatricians - 2.4 times, and district pediatricians - 1.8 times. And the number of pediatric beds is 1.6-time lower than the national average, specialized beds - 1.5 times, and neonatal pathology beds - 2.9 times. The republic has reported a decrease in the number of pediatric beds and neonatal beds and an increase in the number of specialized beds. There is an inverse strong and moderate relationship between the number of neonatologists, pediatricians, district pediatricians, specialized beds and infant mortality rate in the Chechen Republic (rxy = -0.41-0.93). Conclusion. In the Chechen Republic, a high level of infant mortality is largely due to insufficient availability of medical care for pediatric population. Despite the trend towards a decrease in mortality rates among children of the first year of life, the problem of staffing in pediatric services of the region remains relevant, requiring management decisions.