Some of the new problems affect women particularly badly. For example, more than half of registered unemployed people are women and two-thirds of pensioners living below the subsistence minimum are women. The legacy of central planning has resulted in an unresponsive and inefficient service with excess, poorly-maintained stock. The Soviet health service was free and universal, a huge employer of staff. Now hospitals are decaying and doctors are moving into private care.
Disadvantaged groups suffer from lack of access to adequate public health and social services.
There has been a resurgence of communicable diseases such as malaria, TB and sexually-transmitted diseases and the number of registered people with HIV has doubled since 1998. Young people are particularly affected by the uncertainties of the transitional period. One-third of all Russians between the ages of 15 and 17 years are in such poor health that they are limited in their choice of profession. Young people are particularly exposed to crime, violence and abuse, and drugs. Especially at risk are those brought up in children s homes, whose life chances are thwarted by inadequate education and training.