Tulegenov MA

Graduate School of Public Health, Almaty, Republic of Kazakhstan

SYSTEMIC HEALTH AND HEALTH BEHAVIOR OF WOMEN IN THE EVALUATION OF REPRODUCTIVE HEALTH

Abstract. In the course of the survey conducted by the specific features of health and pregnancy and labor of women of reproductive age in Almaty. Studied the ratio of women of reproductive age and their families in the level and volume of obstetrical and gynecological care.

Keywords: women of reproductive age, medical and social assessment, socio-economic characteristics, reproductive behavior.

Introduction

In the present socio-economic conditions of the reproductive health of the population of Kazakhstan is one of the most serious health and social problems. Thus, in recent years all over the place was a rapid increase of gynecological diseases among women of reproductive age. Along with a significant increase in inflammatory diseases of the genitals experienced higher incidence of tumors of the uterus and its appendages women.

Several authors have pointed out that one of the socially important determinants of women's reproductive health, sexual relations are, the weakening of family relations, the lack of positive attitudes to the preservation of health, poor reproductive culture. The studies found inadequate health literacy, a low level of cultural and national values.

In modern conditions, a group of high medical and social risk are girls, students, women, those in rural areas, women from socially disadvantaged and socially-disadvantaged population.

Study of the health of women of reproductive age (female soldiers, teenage girls, and others) devoted a significant amount of research. However, with changing social, economic and cultural change, and particularly the formation and preservation of reproductive health.

Material and methods.

With a view to obtaining detailed medical and social characteristics of women's reproductive health survey was conducted of health and pregnancy and delivery in 532 women.

Results.

The largest contribution to the structure of the prevalence of gynecological diseases respondents make menstruation disorders: their share in total amounted to 42,7%. On the second and third most common were salpingitis, oophoritis, erosion and ectropion of cervix, which shares were 23,1% and 22,8%, respectively. In fourth place is the rank infertility (6,1%), the share of endometriosis was 5,3% (fifth place).

Adverse trends in the growth of gynecological diseases contribute to poor reproductive health of women and increase the frequency of pregnancy pathology. As a result, much of the labor presently complicated by a disease or a combination thereof.

The highest level of somatic and gynecological pathology was observed in pregnant women in the age group 20-24 years (52,1 per 100 subjects) and in women up to 20 years – 50,8 per 100 patients. At the same time somatic diseases more common in women under the age of 20 years (35,2 per 100 subjects), gynecological - in women aged 25-28 years (28,9 per 100 subjects). It should be noted as a significant level of somatic diseases in women 30-34 years (28,0 per 100 subjects).

Almost all women, regardless of age, had a history of abnormal pregnancy: from 94,6 to 74.2 per 100 surveyed, which is more common in women under 20 years of age (94,6 per 100 subjects).

One objective of methodological approaches to health care needs is served by the voices of the contingents. Therefore, as part of ongoing research studied the ratio of women of reproductive age and their families in the level and volume of obstetrical and gynecological care.

Almost all (98,0%) respondents were able to assess the condition of their reproductive health. In this case, 32,2% of respondents considered themselves to be in good health and it is suitable for the implementation of childbirth, 52,6% - they are satisfied, and 13,2% rated their reproductive health as poor. Chronic pathology that prevents procreation, noted at 27,7% of the respondents.

The study of the distribution of respondents according to their attachment to the obstetric organization found that more than half of the 518 attendees. (54,6%) of which are attached to the territorial women's clinic: 338 people. (35,6%) - do not know where they are attached, and 93 people. (9,8%) - not at all attached.

Analysis of the answers of the respondents to the question about the causes and frequency of reference to the obstetrician-gynecologist has shown, that the greatest part of them (40,7%) goes to the obstetrician-gynecologist at the gynecological diseases, almost equally often about pregnancy and contraception (respectively preliminary and periodicheskih19,2% and 18,1%), at least about preventive medical examinations (from 10,2% to 11,8%).

The average number of references concerning gynecological diseases was 2,83 to 1 of those polled during pregnancy – 1,34, in connection with the need for contraception 1,26 and preventive preliminary and periodic inspections, respectively, 0,82 and 0,71 visits per year.

The results indicate that, despite the known difficulties women still manages to provide the necessary volume of obstetric care. However, it is clear that the level of attendance is not fully characterize the quality of care, which depends on a complex clinical and technological and resource capabilities of obstetric services.

The nature of the relationship between the staff of medical institutions and patients depends on the impression of the service in general. Staff working antenatal met only 29,7% of women. At the same time completely negative assessment of the staff of this type of units expressed 28.8% of female respondents and 41,5% although satisfied attitude and the work of the medical staff, noted the indifference and formalism.

Still less satisfied patients work and treated the staff in the gynecology department. Were pleased with the 24% of the respondents, and dissatisfaction with the performance of doctors and nurses were of 38.8% of respondents. In general, satisfied with the medical staff, while noting the indifference and formalism, 37,2% of women.

The study of the views of respondents on the work of the staff at the maternity hospital obstetric units showed that 39% were satisfied with its employees, 37,9% are satisfied with the staff, but note the indifference and formalism. Not satisfied 23,1% of patients.

This is reflected in the character of proposals for improving the work of women obstetrical institutions. 28,4% of all patients were proposals relating to the rules of ethics, promoting a culture of communication, etc. To some extent, this group of proposals can be attributed to the qualification requirements of the respondents and the appropriate medical personnel recruitment (9,2%).

The second group of proposals related to the ordering of the system of organization of the institution (fine-tune the registry, reduce waiting times, choosing the right doctor, etc. – 21%). The same group (with certain reservations) include proposals to improve the quality of treatment and diagnosis, the organization of examinations (6,6%).

Talk.

Thus, the study of certain features of the health status and health behaviors among women of reproductive age in Almaty we have identified patterns:

1) in the structure of female gynecological disorders most often inflammatory pathology (45,9%) and menstrual disorders (42,7%), less infertility (6,1%) and endometriosis (5,3%);

2) the highest level of somatic and gynecological pathology was observed in pregnant women under the age of 20 years (50,8 per 100 subjects) and 20-24 years (52,1 per 100 subjects). At the same time somatic diseases more common in women under the age of 20 years (35,2 per 100 subjects) and 30-34 years (28,0 per 100 subjects), and gynecological - in women aged 25-28 years (28,9 per 100 subjects);

3) almost all women, regardless of age, had a history of abnormal pregnancy (from 74,2 to 94,6 per 100 subjects);

4) with 32,2% of respondents believe their health is quite suitable for the implementation of child-bearing, and 13,2-27,7% rated their health as poor reproductive and noted the presence of chronic disease, preventing procreation;

5) 45,4% of the respondents did not know what to prenatal they should be served;

6) The largest part of the studied pregnant women appealed to the obstetrician-gynecologist about gynecological diseases (40,7%), 2 times less often - about the pregnancy (19,2%), and contraception (18,1%), even less about the preventive medical examinations (10,2-11,8%);

7) staff working antenatal satisfied with just 29.7% in gynecological departments – 24% and in the maternity hospital obstetric units - 39%;

8) to improve obstetrical institutions necessary measures to comply with the rules of ethics and improve the culture of communication (28,4%) and streamlining of the organization of the health facilities (27,6%), including - Fine-tune the registry, reduce waiting times and ensure the right to choose a doctor, to improve the quality of treatment and diagnosis, the organization of the examinations.

Thus, set the trend increase in the prevalence of somatic and gynecological pathology, especially in young pregnant women aged 20-24 years. About half of the respondents (45.4%) of respondents did not know what to prenatal they should be served. One reason for the lack of medical behavior of women is poor organization of health-care organizations.