MEDICAL AND SOCIAL ASPECTS OF MEDICAL SERVICE OF THE GROUP OF TEMPORARY INTERNALLY DISPLASED PERSONS

Lekhan V. M., Kriachkova L. V., Borvinko E. V., Kolesnik V. I.

SOCIAL MEDICINE AND ORGANIZATION OF HEALTHCARE PROTECTION

Scentific article

An important condition for ensuring health care sensitivity is the sufficient response of the system to the needs of vulnerable groups of the population. Such vulnerable groups include people who, because of Ukraine’s loss of control over a part of the territory, left their permanent residence and moved to other territories with the status of internally displaced persons (IDPs). Objective:there was an analysis of the provision of health care sensitivity for the group of internally displaced persons and the definition of health care problems for IDPs to improve the provision of medical care for this group. Object and methods. A sociological survey was conducted among 102 managers of health institutions in Dnipropetrovsk region on a self-developed questionnaire. Statistical processing of the results was performed using STATISTICA 6.1 software (StatSoftInc., serial No. AGAR909E415822FA) using descriptive and analytical medical statistical methods. Results and discussion. Managers of health facilities consider that the health care system of Ukraine adequately responds to the needs of this population group – internally displaced persons is not a neglected social group in responding to their demands, and the average level of responsiveness for their requests is 8.25 (95.0% CI 7.48 – 9.02) points. Taking into account the contingent of respondents –managers of health facilities, it could be asserted that there is a certain overestimation of the assessment of the health system responsiveness. In addition there are a number of existing problems in servicing IDP has been pointed out by the managers. According to the interviewed managers, health care of internally displaced persons is not based on sufficient funding and social legal regulation, what leads to a number of cases, among which are mainly mentioned financial (29.41%) and psychological (35.2%) problems. There were identified the reserves of increasing responsiveness to internally displaced persons, first of all, it is the autonomy of patients in decision-making, the choice of providers of medical services and access to social support systems during treatment. These aspects of responsiveness correlate with the feedback of the health care problems of the contingent of internally displaced persons, which faced practically every manager of health facilities among the respondents. According to the respondents, measures for elimination/reduction of identified problems should be: additional financing for medical care of IDP; the establishment of patient registries and, above all, the integration with social workers, lawyers and psychologists of the health care of this contingent. Conclusions. According to the results of the survey, despite the fact that managers highly appreciate the health system responsiveness to internal migrants, they recognize the existence of a number of problems, primarily psychological and financial, which they believe can be overcome through an integrated provision of medical care.

health system responsiveness, internally displaced persons, health care problems

1. Doklad o sostojanii zdravoohranenija v mire 2000 g. Sistemy zdravoohranenija: uluchshenie dejatel’nosti. Kopengagen: VOZ; 2000. 232 s. [in Russiаn].
2. Krjachkova LV. Puty obespechenyja otzyvchyvosty systemy zdravoohranenyja k trebovanyjam, predjavljaemym naselenyem (na prymere Ukrayny). Medyczne zeszyty naukowe. Uczelni Warszawskiej im. Marii Skłodowskiej-Curie. 2016;1:137-57.[in Russiаn].
3. Lehan VM, Krjachkova LV, Borvinko EV, Zajars’kyj MI. Dosvid rozrobky ta vprovadzhennja systemy zabezpechennja chutlyvosti ohorony zdorov’ja do ochikuvan’ naselennja. Visnyk problem biologii’ i medycynу. 2014;4(115):305-9. [in Ukrainian].
4. Libanova EM. Vymushene pereselennja z Donbasu: masshtaby ta vyklyky dlja Ukrai’ny (za materialamy naukovoi’ dopovidi na zasidanni Prezydii’ NAN Ukrai’ny 8 zhovtnja 2014 r.). Visnyk Nacional’noi’ akademii’ nauk Ukrai’ny. 2014;12:15-24. [in Ukrainian].
5. Predstavnyctvo Upravlinnja Verhovnogo komisara u spravah bizhenciv (UNHCR) v Ukrai’ni. Informacijnyj bjuleten’ filii’ UVKB OON u Dnipri. Dniep: UNHCR; 2016. 4 s.[in Ukrainian].
6. Pro zabezpechennja prav i svobod vnutrishn’o peremishhenyh osib: Zakon Ukrai’ny № 1706-VII vid 20 zhovt. 2014 r. Vidomosti Verhovnoi’ Rady (VVR). 2014;1:1. [in Ukrainian].
7. Letkovicova H, Prasad A, Vallée RLa, Valentine N. The Health Systems Responsiveness. Analytical Guidelines for Surveys in the Multi-country Survey Study. Switzerland: WHO; 2005. 143 р.

«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 334-338 pages, index UDK 614.2 : 613.9 (477)

10.29254/2077-4214-2018-1-1-142-334-338