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World Bank Technical Paper No. 404. The health of Russian women has suffered during the economic crisis of recent years. Morbidity and mortality from chronic and infectious diseases have increased. Women's reproductive health has been compromised by an increase in the incidence of sexually transmitted diseases and by lack of access to up-to-date, high quality maternity and family planning services. This paper summarizes this current situation and reports on the findings of one element of the World Banks assistance to improve health care in the Russian Federation: a field testing of revised protocols for the care of women and infants.
Russia's maternal health crisis and postsocialist transition examined through ethnographic observation in clinics and hospitals.
This volume explores the nature of health and health-care experiences in Russia by comparing societies and communities with different socio-cultural conditions. The unique use of longitudinal data collected over ten years, allows the authors to address key questions on Russians individual experiences of health care and their understanding of its influencing factors. They explore the methods of self treatment and illness prevention in combination with the effects poverty and treatment availability can have on the standards of living for the people surveyed. This pertinent issue follows a time of rapidly worsening health status amongst the Russian population and a grave decline in male life expectancy. The findings are set within the context of experience from Finland and the UK, allowing the authors to explore the challenge of the Russian health-care crisis to Western European models of health status and health care.
This book provides a theoretically and empirically grounded examination of the struggle for maternity care in contemporary Russia, framed by changes to the healthcare system and the roles of its participants after socialism. The chapters consider multiple perspectives and interactions between women and professionals and the structural and institutional pressures they face when striving for better conditions and treatment. Russian maternity care is characterized by the vivid mix of legacy of Soviet paternalism and medicalization, bureaucratic principles of state regulation (with high level of centralization and lack of professional autonomy) and global neoliberal tendencies. Maternity care professionals have to satisfy not only the growing needs and demands of women, but also deal with increasing state regulative control, market demands and new professional standards of care. Navigating these multiple and various challenges, maternity providers have to perform in multiple roles, bridge the organizational gaps and inconsistencies. Thus, the field of struggle for good care becomes not only professional, but political one. Highlighting the opportunities and barriers for good care in the context of post-socialist Russia, this book will be of particular interest to medical anthropologists and sociologists as well as midwives and other health professionals.
Also available in Russian Stock No. 13015 / (ISBN 0-8213-3015-2) / $6.95 / Price code 006 Women will contribute greatly to Russia's economic transformation, given the right social and labor reforms. The author suggests policy changes that wou
Fragmentation in organization and discontinuities in the provision of medical care are problems in all healthcare systems, whether it is the mixed public-private system in the USA, national health services in the UK, or insurance-based ones in Western Europe and Russia. In all of these countries, a major challenge is to improve integration in order to improve efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination, and continuity of care. It then presents a summary of integration problems in Russia and presents the results of a large survey of physicians concerning the attributes of integration. It is argued that the characteristics of the national service delivery model do not ensure integration. The Semashko model of service delivery, although designed as an integrated model, has been distorted under pressure of the process of specialization of care. It is also argued that larger organizational forms of service provision, like policlinics and integrated hospital-policlinics, do not have higher scores of integration indicators than smaller ones. Proposals to improve integration in Russia are presented with the focus on the regular evaluation of integration and fragmentation, regulation of integration activities, enhancing the role of PHC providers, and economic incentives.
The WHO Regional Office for Europe launched the investing in women's health initiative in 1993 in pursuit of its commitment to improving the health status of women in the WHO European Region. The commitment focuses particularly closely on the women living in the difficult circumstances faced by the countries of central and eastern Europe and the newly independent states of the former USSR. The investing in women's health initiative is exploring ways to encourage politicians to cooperate with people in the areas of public health and public policy by building and using networks to improve the health of women in the European Region.