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11PUBLIC GOVERNANCE IN THE INCIDENT OF THE EMERGENCY SITUATION: ESSENCE AND
BASIC CATEGORIES
Makarenko M.
Candidate of Medical Sciences, oral surgeon & prosthodontist, co-founder and CEO of IStomatolog Family Dentistry Center.
Founder & owner of MM-Dental clinic. ORCID: 0000-0001-8677-8670
ABSTRACT
The article examines the essence and basic categories of public administration in an emergency epidemiological situation in modern conditions, in particular the concepts of «epidemiology», «emergency epidemiological situation», «zone of emergency epidemiological situation». Improving the health and well-being of all people as the ultimate goal of social and economic development has been identified as one of the priorities of public health policy. It has been established that the legislative interpretation of many terms and concepts is still uncertain. It is proposed to legally define the concepts of «epidemiology», «emergency epidemiological situation», «zone of emergency epidemiological situation».
Keywords: public administration, health care, epidemiology. Epidemiological emergency situation, epide-miological emergency zone.
1. Introduction
One of the main tasks of the Sustainable Development Strategy "Ukraine - 2020", approved by the Decree of the President of Ukraine of January 12, 2015 № 5 and part of the obligations under the Association Agreement between Ukraine and the EU is to create appropriate conditions for realizing the potential of every citizen throughout life, achieving adequate standards of quality of life and well-being of the population. The "WHO" Regional Office for Europe's "Health for All in the 21st Century" also identifies improving the health and well-being of people as a priority in health policy for all and sets out its achievement as the ultimate goal of social and economic development [1].
In this context, the issue of improving public administration in an emergency epidemiological situation is the fundamental basis without which it is impossible to build a qualitatively new health policy in the modern country.
2. Analysis of recent publications on the issue and identification of previously unresolved parts of the overall problem
Issues of improving the mechanisms of public administration in the field of health care are reflected in the studies of N.V.Avramenko, T.P.Avramenko, M.M.Bilynska, N..Ovasyuk, L.I.Zhalilo, V.M.Knyazevych , J.F.Radysh and others.
Studies of state regulation in the field of sanitary and epidemic well-being of the population, namely the public health system, presented in the works of domestic scientists Y.V. Voronenko, O.P.Gulchiy, I.V.Gush-chuk, V.F.Moskalenko, I. V. Rozhkova, N.O. Ringach, I.M.Solonenko and others.
3. The purpose of the article
The purpose of the article is to study the nature and basic categories of public administration in an emergency epidemiological situation in modern conditions.
4. Presentation of the main material of the study with a full justification of the obtained scientific results
The study of the problem of public management of health care in an emergency epidemiological situation necessitates the analysis of a number of scientific interpretations of the main categories, concepts and terms in this area.
The importance of normatively defining key terms in health care is difficult to overestimate. Article 1 of the Constitution of Ukraine defines that Ukraine is a sovereign and independent, democratic, social, legal state [2].
It is known that a quality legal framework is the legal basis of any rule. Therefore, it is obvious that the key to effective legislation is continuous improvement in accordance with social needs. At the same time, the modern realities of its application sometimes demonstrate the ambiguity of interpretations in both scientific and law enforcement terminology [3].
Public policy in the field of health care, in particular in the event of an epidemiological emergency, uses a significant terminological apparatus. However, it should be noted that the legal interpretation of many terms and concepts is still uncertain.
Obviously, this is largely due to the specificity of the health sector, given that the legal regulation of its activities takes place on the border of social relations, which are formed in the areas of health, social policy, environmental protection, environmental safety and more. Therefore, it seems quite clear to borrow concepts from the natural sciences, humanities, which in turn highlights the need for legislative definition of basic categories and concepts in the field.
The right to sanitary and epidemic welfare is one of the defining human rights. The Law of Ukraine "On Ensuring Sanitary and Epidemic Welfare of the Population" regulates public relations that arise in the field of ensuring sanitary and epidemic well-being, defines the relevant rights and responsibilities of state bodies, enterprises, institutions, organizations and citizens, establishes the procedure of state sanitary and epidemiological supervision in Ukraine [4].
Sanitary and epidemic well-being of the population in the mentioned law is interpreted as the state of health of the population and human environment, in which morbidity rates are at a fixed level for the area, living conditions are favorable for the population, and environmental parameters are within sanitary norms. This law covers the rights to a safe environment. Drinking water, food, working conditions, etc.
However, this law does not contain an interpretation of the basic concept of "well-being". Moreover, the analysis of the legislative field regulating the activity in the researched sphere revealed the lack of definition of this concept. In the process of rule-making, public policy entities that regulate health care use this term without disclosing its essence.
For example, the Resolution of the Cabinet of Ministers of Ukraine "On approval of criteria for assessing the degree of risk from economic activity in the field of sanitary and epidemiological well-being and determines the frequency of planned measures of state supervision (control) by the State Service for Food Safety and Consumer Protection" contains a number of indicators that determine the risks that could harm the health, ability to work and human life or the health of future generations and due to the influence of biological, physical, chemical or social factors of the human environment. However, the essence of the concept of "well-being" is not defined in this resolution [5].
Thus, the lack of a legal definition of the term under study actualizes the need to find interpretations of this concept in scientific developments and encyclopedic publications.
The Large explanatory dictionary of the Ukrainian language contains the concept of "well-being", which is defined as a life of prosperity and peace, well-being, happiness. In addition, this dictionary also contains a definition of "welfare" as a synonym for well-being and explains it as "material and household support, wealth" [6, p. 193]. The Oxford Dictionary of English interprets the concept of "well-being" as a state of comfort, health or happiness [7]. The Cambridge Dictionary contains a synonym for welfare and also interprets it as a state of health and happiness [8].
The concept of "well-being" is accepted by the World Health Organization as the main criterion of health, which is considered as a state of complete physical, mental and social well-being [9].
In addition, according to the Director-General of the World Health Organization, Dr. Tedros Adhanom Gebrejesus, health is a right, not a privilege.
It should be noted that the essence of the concept of "well-being" is quite multidimensional. Social well-being is defined by the World Health Organization as a central component of overall human health [11].
The National Association for Social Work Education in the United States defines economic well-being as the presence of financial security today and in the future.
The American Encyclopedia of Research on Quality of Life and Well-Being explains that emotional well-being correlates with and complements physical well-being [13].
Claudia Trudel-Fitzgerald notes that psychological well-being is associated with a lower risk of disease and mortality and can be improved through relatively inexpensive interventions [14].
Thus, the concept of "well-being" contains a balance of key elements and has the following components: social, economic, emotional, physical, psychological well-being and so on.
The study of the essence and basic categories of public management of health care in an epidemiologi-cal emergency in modern conditions also highlights the need for analysis of the concepts of "epidemiology", "epidemiological emergency".
Ryabokon O.V. believes that epidemiology is a method used to identify the causes of deteriorating health and disease of the population, patients are a community, people are considered collectively. According to the scientist, epidemiology is a study (scientific, systematic and data-based) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related conditions and events (not just diseases) in certain population groups [15, p. 24].
B.M. Dykyi and T.O. Nikiforov under epidemiology understand the science that studies the epidemic process, the patterns of spread of infectious diseases, develops measures to prevent and reduce the incidence and elimination of certain infections. The subject of epidemiology, in contrast to clinical medicine, these scientists do not consider the disease itself, but the incidence of this disease. Morbidity reflects the population (superorganismic) level of life organization, and the disease - the organismic, suborganismal level [16, p. 58].
"WHO" refers to the term "epidemiology" as a set of approaches to assessing the health of the population to identify the factors that determine it. This is achieved by analyzing the specifics of the distribution of morbidity in the territories, in groups and by time of spread.
In defining this concept, "WHO" operates in two approaches. The first - epidemiological - in which we are talking about any disease (infectious or non-infectious). This approach has a vector of analysis from the consequences (health, morbidity) to the cause (environmental factors). On the contrary, the second approach -hygienic - has the inverse vector of analysis: from cause (environmental factors) to consequences (quality of public health, morbidity).
Thus, the combination of the two approaches allows more clearly formulated hypotheses about risk factors and provides a quantitative assessment of the relationship of risk factors with morbidity, the definition of relative and immediate risk. That is why the law defines "sanitary and epidemiological well-being" as a state of health and the environment (simultaneously), and the tasks of sanitary and epidemiological surveillance primarily include assessing the health of the population, identifying the causes and conditions that shape the overall picture of morbidity [17, c. 115].
It should be noted that the concept of "epidemio-logical emergency" is not defined in domestic legislation. The Civil Protection Code of Ukraine, which entered into force on October 16, 2020, provides only a definition of an emergency situation, which is interpreted as a situation in a particular territory or business
entity, characterized by violation of normal living conditions caused by an "epidemic" or other dangerous event. Which has led (may lead) to a threat to life or health of the population [18].
In the same Code of Civil Protection of Ukraine there is another definition - "emergency zone" - is a separate territory, the water area where the emergency occurred.
In this regard, given that the Code was adopted in autumn 2020, during the long periodic quarantine restrictions caused by the COVID-19 pandemic, and whereas the discussion among scientists on the final and generally accepted definition of these concepts is not over, the concept of "epidemiological emergency" and "epidemiological emergency zone" should be defined by law.
In addition, given the diversity of interpretations of the term "well-being" by scientists and the lack of its definition in the legislation, we consider it necessary to enshrine its definition in Art. 1 of the Law of Ukraine "On ensuring the sanitary and epidemiological well-being of the population" by making appropriate amendments to it. After all, the problems associated with the inadequate provision of sanitary and epidemiological well-being of the population can endanger the preservation and strengthening of the nation's health as one of the important factors of socio-economic stability and national security in general.
5. Conclusions
In the process of research, we found that today there are many definitions of the terms "well-being ", "wealth", "welfare". However, the discussion between scientists on the final and generally accepted definition of these concepts is not over. Under the category of "welfare" (or Ukrainian analogue - "well-being") we propose to understand the state-guaranteed, legally defined sustainable level of security of the population, a particular social group, family, person with vital (most important) material and intangible benefits. Ensuring "well-being" involves compliance by relevant entities with established standards and other regulatory requirements. Given the diversity of interpretations of the term "well-being" both in academia and in legal practice, we propose to legislate its definition.
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