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Home    Pilot regions and pilot work    Poltava

Poltava

Demographics
Healthcare system dynamics in the Poltava region

The Poltava region, one of Ukraine’s 25 administrative regions, lies in the midchannel lowlands to the east of the Dnipro river. With an area of 28.8 thousand sq. km., it stretches 213.5 km from north to south and 245 km from east to west.

Demographics

As of December 1st 2007, the estimated population of the city of Poltava was 303,696 persons. Within January – November 2007, there have been 2,351 births and 3,830 deaths in the city, both figures showing a decline of 2.4% and 0.4% respectively compared to January – November 2006.

With a total population of 1,700 thousand inhabitants, the Poltava region is the 11th most populous region in Ukraine. Its population is ethnically homogeneous (90% Ukrainian). Population density is around 60 persons per sq km. 1,000 th. of the region’s population are city and town dwellers. Population ageing is prevalent in both urban and rural areas. The female population exceeds the male one. The region comprises 1,858 villages and 36 urban communities.

Demographic development, January - November 2007

 

Persons, total

January – November 2007 as % of January – November 2006

Per 10,000 persons

January – November 2007

January – November 2006

January – November 2007

January – November 2006

Births

2351

2409

97,6

8,4

8,6

Deaths,

3830

3847

99,6

13,7

13,7

including infant deaths

22

20

110,0

2

2

Natural population decline

1479

1438

102,9

5,3

5,1

Number of new marriages

3122

2773

112,6

11,2

9,9

Number of divorces

1341

1318

101,7

4,8

4,7

________________
1 The figures calculated on a 12-month basis
2 Calculation of infant mortality coefficient is inexpedient here due to low birth rates

Healthcare system dynamics in the Poltava region

The region’s healthcare facilities operate to attain the strategic objectives outlined in the Presidential Decrees, Acts of the Parliament of Ukraine, MoH Decrees and Instructions of the local healthcare department in the region, as well as in other legislative documents.

The region’s healthcare establishments and HR potential in healthcare have been preserved in their full capacity.

As of 01.07.06, the region’s populace receive the required medical services in full through the network of 47 specialized regional medical facilities, 14 city hospitals, 2 children’s city hospitals, 2 maternity hospitals, 3 polyclinics, 8 dentistries, 5 independent emergency aid stations and 33 hospital ER departments, 25 central district hospitals, 9 local hospitals, 60 local district hospitals, 172 outpatient facilities (including 100 family establishments), 746 feldsher-midwide posts and 61 first aid posts.

The network of treatment and prevention facilities provides a total of 12,994 beds (as of 01.07.06), making the population bed ratio 84.0 per 10,000 persons (cf. 87.16 across Ukraine in 2005).

More than 320,000 patients were treated within the network in the past year. More than 76,000 surgeries were performed.

Inpatient healthcare retains its capacity and availability due to widespread use of day stationary treatment in polyclinics, and of home-based inpatient care.

The staffing of village healthcare facilities is a top priority consistently followed in the region. Meetings of local healthcare administrators and medical institution graduates, organized jointly by the Ukrainian medical dentistry academy and the Poltava basic medical college, contribute to the selection of professionals to work in the district healthcare network.

As a result, more than 50% of university graduates and 80% of training school graduates set out to work locally on a year-to-year basis.

The physician staffing level across the region amounted up to 84.1% (cf. 80.7% across Ukraine in 2005), junior medical positions are 99.9% occupied (97.6% across Ukraine).
It is noteworthy that, despite the above, salaries in healthcare are still among the lowest across the country. On average, they are half as small as the average industrial worker’s salary (UAH 564 versus UAH 1067.5).

With assistance from local executive authorities and local self-government, considerable effort is being made in introducing preventive technologies into real-life practice. For one thing, healthcare is being brought closer to the consumers through the opening of outpatient stations in settlements over 1000 persons large. Once larger local hospitals are optimized, the same undertaking will concern settlements with over 500 persons as well.
Enhancing the quality of medical services depends, in the first line, on a strong and viable primary sector with family medicine as its centerpoint. Economically efficient healthcare forms will be fostered, together with a growth in the scope of medical services and improvement of resource and legislative backup, as primary medical assistance is reorganized and gradually channeled into the practice of family medicine.

At the time being, there are 320 professional family doctors and 669 nurses in the region. 178 family healthcare facilities offer their services across the region, including 152 (85.3%) in rural areas. Another 20 similar establishments were opened this year. Population catchment has increased from 41.6% in 2005 to 49.3% in 2006.

A number of further requirements must be met if we are to foster the further development of family medicine. Accommodation for staff must be provided, equipment for village outpatient facilities must be purchased. There is also the National program of family medicine development which would have primary facilities equipped on a centralized basis, introduce pivotal legal changes into the patterns of payment in family medicine (at the moment, growth of family healthcare practice in rural areas is hampered by the provisions of the Budget Code), help draw distinctions between separate budgets and, finally, introduce economic incentives that would encourage better performance in primary healthcare employees.

The 7.2 index of mortality among children in the region is in positive contrast compared to the all-state index. There have been no maternal mortality cases.

Innovation technologies are being introduced in the region on a large scale, including evidential medicine protocols, day inpatient units at outpatient-polyclinic institutions, home-based inpatient units, one-day inpatient facilities etc.

The TB epidemic situation, however, remains tense. The resource backup of the regional TB dispensary is desperately poor, in fact, it is the worst in Ukraine. Construction works that started in 1993 finally yielded a polyclinic with a 240 visits a day capacity in 2004. However, the construction of a 210-bed inpatient unit has been put on hold due to lack of financing. UAH 27.8 mil are lacking for buildings’ completion, and a further UAH 13.5 millions’ worth of equipment are required.

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This project is funded by European Union This project is implemented by Consortium EPOS Health Consultants with ECORYS and NICO
     

The views in this publication do not necessarily reflect the views of the European Commission.