Situational analysis of the problem of maternal mortality in Ukraine and ways to solve it

N.Y. Zhylka, O. Shcherbinska, I.P. Netskar
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Abstract

The maternal mortality (MM) rate is considered an integrated indicator of women’s reproductive health, which reflects not only the state of general health, including reproductive one, the quality of medical care for pregnant women and the level of organizational work of maternity institutions, but also the combined interaction of these factors with economic, ecological, sanitary-cultural, social-hygienic and other ones.The objective: to highlight the current problem of MM in Ukraine and the world, finding its main factors and ways to solve it.Materials and methods. Bibliosemantic, analytical, statistical and conceptual methods were used. The research period is 2010–2022.Results. The MM rate is currently an extreme problem worldwide. The World Health Organization (WHO) emphasizes that MM is unacceptably high. In 2020, almost 287,000 women died during and after pregnancy and childbirth. Almost 95% of all maternal deaths in 2020 occurred in low-income and lower-middle-income countries, and most of them were preventable.Conclusions. In Ukraine, there is a negative wave-like situation with the MM indicator, that is fluctuations from decrease to increase. And even the decrease in the MM indicator does not reach its level in developed countries. In 2022, 19.3 per 100,000 live births were registered. The main reasons for the high rates of MM in Ukraine are: the imperfection of the health care system in relation to the formation of reproductive health in adolescents, the loss of the potential of the family planning system, the insufficient level of accessibility of Ukrainian women to reproductive health care services, the low level of organization of perinatal assistance and its effectiveness, lack of a monitoring system for compliance with quality criteria of clinical protocols, as well as an insufficient level of socio-economic support of the population.The implementation of measures of the WHO Global Strategy and goals for the prevention of maternal mortality by 2030 will contribute to the reduction of the MM indicator, namely, the increase in the availability and quality of medical and sanitary services in the health care system of adolescents, mothers and newborns, in reproductive health, for the prevention of maternal mortality, improving the efficiency of the health care system.
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乌克兰产妇死亡率问题的情境分析及解决方法
产妇死亡率被认为是妇女生殖健康的综合指标,它不仅反映了包括生殖健康在内的一般健康状况、孕妇医疗保健的质量和妇产机构的组织工作水平,而且还反映了这些因素与经济、生态、卫生文化、社会卫生和其他因素的综合相互作用。目的:突出当前乌克兰和世界MM的问题,找出其主要因素和解决方法。材料和方法。使用了文献语义学、分析、统计和概念方法。研究时间为2010 - 2022年。MM率是目前世界范围内的一个极端问题。世界卫生组织(世卫组织)强调,死亡率高得令人无法接受。2020年,近28.7万名妇女在怀孕和分娩期间及之后死亡。到2020年,近95%的孕产妇死亡发生在低收入和中低收入国家,其中大多数是可以预防的。在乌克兰,MM指标呈负波动状,即从减少到增加的波动。甚至MM指标的下降也没有达到发达国家的水平。2022年,每10万例活产中有19.3例登记在册。乌克兰MM感染率高的主要原因是:保健系统在青少年生殖健康的形成方面不完善,计划生育制度的潜力丧失,乌克兰妇女获得生殖保健服务的机会不足,围产期援助的组织水平低下及其有效性,缺乏遵守临床协议质量标准的监测系统,以及对人口的社会经济支助水平不足。实施世卫组织《全球战略》的各项措施和到2030年预防孕产妇死亡的目标将有助于降低产妇死亡率指标,即在青少年、母亲和新生儿的保健系统中增加医疗和卫生服务的可得性和质量,在生殖健康方面,预防孕产妇死亡,提高保健系统的效率。
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