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11POLITICAL SCIENCES
PRESERVATION OF POPULATION HEALTH AS AN IMPERATIVE OF PUBLIC ADMINISTRATION OF THE MEDICAL INDUSTRY OF UKRAINE
Makarenko M.
Candidate of Medical Sciences, Director of MM-Dental Clinic, candidate for the degree of Doctor of Science, Taras Shevchenko National University of Kyiv ORCID: 0000-0001-8677-8670
ABSTRACT
The article examines the issue of preserving the health of the population as one of the main areas of public administration in the medical field of Ukraine. The problems we had to face with the beginning of the reform of the national health care system are analyzed. It is substantiated that the formation of priorities in the field of health care is based on the fact that the health of the nation is ensured primarily by primary prevention and sanitary and epidemiological well-being of the population, and only then by modern technologies and treatment of identified diseases with subsequent rehabilitation. It has been proved that the main imperatives of public policy on health protection, ensuring the epidemic well-being of territories and populations are a number of measures related to preventive work of stakeholders, epidemiological and sanitary examinations, compliance with sanitary legislation and more. It is also important to strengthen control over the level of air pollution, water and land resources, the condition of forest plantations, etc. The lack of own coronavirus production also remains a serious problem.
Keywords: public administration, health care, pandemic COVID-19, provision of medical services, health care, medical industry.
Formulation of the problem. Public health is one of the priorities of any state's public policy, and maintaining it at a high level is a cornerstone of its national security. It is known that human health is defined as a state and form of life that provide physiologically determined life expectancy, sufficient satisfaction with the state of his body and acceptable social capacity; implies the responsibility of the individual and society in the formation, maintenance and correction of individual health and the health of others. According to modern notions, public health is a measure of socio-cultural development of society and quality of life and cannot be considered as an object of isolated influence of the health care system alone [1].
Presentation of the main material of the study with a full justification of scientific results. In 1979, the UN General Assembly (UNGA34 / 58) adopted a resolution reaffirming the crucial importance of public health as the sole criterion for the expediency and efficiency of all economic sectors. This document has become a key factor in the work of the WHO, according to which the countries of the world community were tasked with revising national policies for the further development of health care [2].
According to these documents, the primary responsibility for the health of the people should lie not only with the health authorities but also with the government as a whole; in turn, the population must be involved in the process of improving health. This involves the development by states of the necessary measures to raise public awareness of their health, understanding the consequences of the impact of social, economic, environmental factors, and so on.
Since then, the WHO has been discussing the idea of revising the priorities of states to preserve and improve the health of the population through conferences, seminars and workshops. Its goal is a gradual transition
from intensive medical technology to primary care. It is here, according to the WHO, that public health control and management is possible and should be carried out, provided that the needs of the population in receiving quality medical services are generally available and adequately met.
However, the reform of the health and social protection system that has begun around the world is based not only on professionally sound WHO recommendations, but also on purely economic reasons. It was assumed that the larger the share of the budget allocated to health needs, the higher the level of health of the population and the associated social well-being.
However, the experience of many countries has shown that this share has an upper critical limit (about 17% of the budget) and most developed countries have already reached it. With the creation of public health and social protection systems, the development of the medical services industry, today the authorities are unable to provide them with the population in the same amount (and on the same terms) and this gap continues to widen [3].
It is possible to change the situation only if the foundations of a new philosophy of health care are created in accordance with modern transformational realities.
The main stimulus for the development of global health care and medical care WEF identified in its work "The Future of Jobs Report 2018" (Reports on the future of jobs 2018) [4]:
- population aging (due to increased life expectancy);
- achievements in the field of AI;
- improving the well-being of people in developing countries;
- increase in the middle class;
- increasing the number of new technologies;
- increase access to Big Data;
- global macroeconomic growth; growth of national economies;
- achievements in the mobile Internet;
- popularity of education.
And the most promising for the introduction of the latest technologies in the medical field (according to the share of surveyed companies), according to the same analytical report of the World Economic Forum identified: Big Data analysts of users and organizations -87%; biotechnology - 87%; machine learning (ability of computers to "self-learn" from data) - 80%; application and web application markets - 80%; portable electronics (devices that are comfortable to wear) - 73%; cloud computing ("Cloud") - 73%; Internet of Things (I o T) - 67%; encryption - 67%; distributed register (blockchain) - 67%; augmented and virtual reality -67%; new materials - 60%; digital trade - 53%; 3D printing - 53%; stationary works - 47%; non-humanoid ground works - 40%; quantum calculations 33%; autonomous transport - 20%; humanoid robots - 13%; air and underwater works - 0% [5] .
It is known that the beginning of the reform of national health care took place against the background of deteriorating public health. The demographic situation was characterized by stable trends in declining birth rates, rising mortality, and declining life expectancy. The sanitary and hygienic and epidemic situation, the natural, industrial and social environment of human habitation, and the living conditions of people have deteriorated. For a long time, Ukrainian health care has been in a deep crisis, which has manifested itself in a decline in the quality of health care, a weakening of prevention work, a reduction in scientific and medical research, and growing public dissatisfaction with health care and access to health care.
In 2002, Ukraine joined the WHO Capacity Building Program for National Laboratories Controlling Infectious Diseases with Epidemic Spread, the main goal of which is to increase the readiness of national epide-miological control systems to respond quickly to epidemic outbreaks. For example, international laboratory networks dealing with polio and diphtheria are currently operating successfully. However, the speed and consequences of the spread of COVID-19 in the world and in Ukraine have shown that such measures are too few to combat such a pandemic. At the present stage, the real need for Ukraine to join the international laboratory network on control over the spread of particularly dangerous viruses and infections is more acute than ever, for which the WHO should develop appropriate projects [6].
The formation of priorities in the field of health care is based on the fact that the health of the nation is ensured primarily by primary prevention and sanitary and epidemiological well-being of the population, and only then by modern technologies and treatment of identified diseases with subsequent rehabilitation.
The ideology of modern approaches to health prevention is developed in WHO documents [], which states that one of the defining principles of health policy strategy is to preserve the health of healthy people,
which allows to prioritize state and public activities in this area. in terms of disease prevention, including the development of modern medical and rehabilitation technologies [7].
The main imperatives of public policy on ensuring the epidemic well-being of territories and populations are a number of measures related to preventive areas of work of interested structures, the implementation of ep-idemiological and sanitary examinations, compliance with sanitary legislation and more.
Due to the changing epidemic situation in Ukraine and the world, the issue of strengthening control over other indicators, such as the level of air pollution, water and land resources, the state of forests, etc. is relevant. Another serious problem is the lack of own production of the coronavirus vaccine, as foreign supplies of drugs do not always meet the needs.
Conclusions and prospects for further research. Thus, when carrying out measures at the state level aimed at improving the health of the nation, the priority areas should include the following areas:
- unity of the entire health care system, regardless of territorial and departmental boundaries;
- unity of treatment-and-prophylactic and economic efficiency;
- unity of the doctor and the patient in achievement of the maximum efficiency of results of preventive work and medical activity. This area of activity of the health care system will be facilitated by the development and introduction of new technologies for prevention, diagnosis, treatment of diseases and rehabilitation of patients;
- formation and economic stimulation of the conscious attitude of the society and the citizen to preservation and strengthening of own health;
- strengthening the attention of medical and social bodies to increase preventive work in the medical field on the health of mother and child, adolescents, etc.;
- wide informing of the population about the most accessible measures on prevention and treatment of viral infections, non-communicable diseases, reduction of premature mortality from them.
Increasing the priority of primary health care should include the revival of preventive health care, the formation of a culture of health in the population, increasing motivation to maintain it, in-depth medical examination, the formation of so-called health passports for every citizen, raising children health culture skills. A special place in improving the health of the nation is occupied by training in the basics of health, medical examination of the working population, as well as people living in rural areas. The most important area of evaluation of medical institutions should be indicators of preventive work.
The main activities for the prevention of the most important diseases that affect the duration and quality of life should be carried out by creating motivation in the population to promote health, promoting healthy behavior, counseling and educating the population on the impact of risk factors on their own health, monitoring indicators public health, the creation of a single in-
formation space in this area of public policy. The strategy of prevention of diseases that affect the duration and quality of life of the population should be aimed at medical institutions and government agencies concerned with the problems of the medical sector of Ukraine, to create effective intersectoral cooperation and create a balance between preventive measures and efforts to promote health citizens.
References
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4. The Future of Jobs Report 2018. [Online], available at:: http://www3.wefo-rum.org/docs/WEF_Future_of_Jobs_2018.pdf (Accessed 18 May 2021).
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