Some Aspects of Public Health from the Point of View of the Work of Center for Primary Medical and Sanitary Care
Authors: Havrysh Taras , Symchych Khrystyna , Chaplynska Nataliia , Burak Olha , Ostrovska Maryna , Rudnyk Viktoriia , Skrypnyk Liubov , Komissarova Olha 
Published: November 2024

In 2018, the principle of preserving the population health was introduced in Ukraine, according to which all decisions adopted by the Cabinet of Ministers of Ukraine will be analyzed from the point of view of their impact on public health. To realize this vision, an approach is used where primary care workers can play a key role in disease prevention and health promotion.
The objective: to analyze the activity of the center for primary medical and sanitary care according to some aspects of public health.
Materials and methods. Based on the data of the medical documentation and the electronic healthcare system (EHS), an analysis of individual areas of activity of the communal non commercia enterprise “Center for Primary Medical and Sanitary Care” (PMSC Center) of the Yamnytsia village council (Ivano-Frankivsk region) was carried out.
Results. The implementation of the medical reform in Ukraine involved a change in the legal status of health care institutions. Thus, during the first half of 2018, the Yamnytsia Rural Health Clinic (RHC), as a primary medical care institution, underwent reorganization from a budget institution to a communal non-communal enterprise “PMSC Center”. In 2021, in connection with the new administrative-territorial system in the state and region, the creation of the Yamnytsia United Territorial Community (UTC), three paramedics and obstetrics stations joined the PMSC Center.
Four family doctors work in the “PMSC Center” of Yamnytsia Village Council of UTC. The appointment is conducted by specialized specialists: an obstetrician-gynecologist and a neurologist. There is an opportunity for the population to receive consultations from scientists of the Ivano-Frankivsk National Medical University, as the Center is the clinical base of the Department of Therapy, Family and Emergency Medicine of postgraduate education. There are a laboratory, rooms for ultrasound diagnostics and fibrogastroduodenoscopy, electrocardiographs in Yamnytsia RHC, and it is possible to perform physiotherapeutic procedures.
The number of patients who have signed the declaration with family doctors of communal non communal enterprise “PMSC Center” of the Yamnytsia village council UTC grows from year to year – from 2018 to May 2024, their number increased from 5,522 to 7,967 persons. However, from 2018 to 2023, disappointing demographic indicators were recorded: the birth rate is progressively decreasing and the mortality rate is increasing. A similar situation has been observed in our country in recent years in general. The percentage of children aged 0–5 years also decreased during this period, namely: from 7.42% to 4.11%.
During the war, the Center’s specialists sign declarations and provide primary medical care to internally displaced persons. Since November 2023, community patients have been able to receive early diagnosis and basic psychological assistance free of charge as part of the package “Support and treatment of adults and children with mental disorders at the primary level of medical care”. The highest number of visits was in February and March 2024, with depression (41.4%) and post-traumatic stress disorder (20.7%) prevailing among the reasons for doctor’s consultations.
Conclusions. Communal non-commercia enterprise “Center for Primary Medical and Sanitary Care” (PMSC Center) of the Yamnytsia village council established itself as a successful institution of primary medical care at the stage of medical reform and taking into account such difficult tests of recent years challenges of recent years as the coronavirus pandemic and martial law in the country.
Taking into account the full provision of preventive, treatment and diagnostic services, the number of patients who are registered to the family doctors of communal non-communal enterprise “PMSC Center” of Yamnytsia village council is growing every year. During the last year, community residents also received access to psychological support and palliative care.