Health Care in Rural Areas

Abstract

This article reviews the condition and challenges of health care in rural areas. A particular emphasis is made on assessing the process of reforming health care and its impact on the health of residents of Russian villages by analyzing infrastructure, staffing, and the relationship between the population and medical and preventive care facilities. The article concludes that negative processes predominate: There are trends toward a total reduction in hospitals and ambulatory clinics, which exacerbates the already difficult social situation of residents of rural areas. Statistical data characterizing the state of their health and the demographic situation in rural areas provide evidence of widespread socially significant illnesses and an increase in disability and the mortality rate.

Keywords:

• health
• life world
• rural health care
• rural population

Notes

1. Rural Health Posts.

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3. “Bol’nichnye uchrezhdeniia,” Zdravookhranenie v Rossii–2001. Official website of the Federal State Statistics Service, http://www.gks.ru/bgd/regl/B01_ 34/IssWWW. exe/Stg/d010/i011730r.htm (access date July 1, 2016); “Bol’nichnye organizatsii,” Zdravookhranenie v Rossii–2015. Official website of the Federal State Statistics Service, http://www.gks.ru/bgd/regl/b15_ 34/Main.htm (access date July 1, 2016).

4. “Ambulatorno-poliklinicheskie uchrezhdeniia,” Zdravookhranenie v Rossii–2001. Official website of the Federal State Statistics Service, http://www. gks.ru/bgd/ regl/B01_34/IssWWW.exe/Stg/ d010/ i011810r.htm (access date July 1, 2016); “Ambulatorno-poliklinicheskie organizatsii,” Zdravookhranenie v Rossii–2015. Official website of the Federal State Statistics Service, http://www. gks.ru/ bgd/ regl/b15_ 34/IssWWW.exe/ Stg/03-07.doc (access date July 1, 2016).

5. “Check of the Implementation of the Agreement Between the Ministry of Health of the Russian Federation and Top Executive Agencies of Constituent Entities of the Russian Federation on Achieving Targeted Indicators (Norms) for Optimizing the Network of Medical Organizations of State And Municipal Healthcare Systems.” Official website of the Audit Chamber of the Russian Federation, http:// komitet-bn. km.duma.gov.ru/file.xp?idb=2611678&fn=%C8%ED%F4%EE%F0%EC%E0%F6%E8%FF%20%EE%E1%20 %EE%F1%ED%EE%E2%ED%FB%F5%20%E8%F2%EE%E3%E0%F5%20%CA%CC. pdf&size= 5726689 (access date September 29, 2016).

6. “Schetnaia palata proverila optimizatsiiu v sfere zdravookhraneniia, kul’tury, obrazovaniia, i sotsial’nogo obsluzhivaniia.” Official website of the Audit Chamber of the Russian Federation, http://www.ach.gov.ru/press_ center news/21297 (access date July 1, 2016).

7. Federal targeted program “Sustainable Development of Rural Territories for 2014–2017 and Until 2020,” http:// government. ru/media/files/41d47baf642258e68c1b.pdf (access date July 1, 2016).

8. “Schetnaia palata proverila optimizatsiiu v sfere zdravookhraneniia, kul’tury, obrazovaniia, i sotsial’nogo obsluzhivaniia.” Official website of the Audit Chamber of the Russian Federation, http://www.ach.gov.ru/press_ center news/21297 (access date July 1, 2016).

9. Federal targeted program “Sustainable Development of Rural Territories for 2014–2017 and Until 2020,” http:// government. ru/media/files/41d47baf642258e68c1b.pdf (access date July 1, 2016).

10. “Prichiny neobrashchennia litsami v vozraste 15 let i bolee za meditsinskoi pomoshch’iu pri nalichii potrebnosti v meditsinskoi pomoshchi v 2014” in Zdravookhranenie v Rossii–2015: Stat. cb. (Moscow: Rosstat, 2015), p. 103. Available on the official website of the Federal State Statistics Service, http://www.gks.ru/free_doc/doc_2015/zdrav15pdf (access date August 30, 2016).

11. “Check of the Implementation of the Agreement Between the Ministry of Health of the Russian Federation and Top Executive Agencies of Constituent Entities of the Russian Federation on Achieving Targeted Indicators (Norms) for Optimizing the Network of Medical Organizations of State And Municipal Healthcare Systems.” Official website of the Audit Chamber of the Russian Federation, http://komitet-bn. km.duma.gov.ru/file.xp?idb=2611678&fn=%C8%ED%F4%EE%F0%EC%E0%F6%E8%FF%20%EE%E1%20 %EE%F1%ED%EE%E2%ED%FB%F5%20%E8%F2%EE%E3%E0%F5%20%CA%CC.pdf&size= 5726689 (access date September 29, 2016).

12. “Rasshirenie programmy ‘Zemskii doctor’ sposobstvuet pritoku vrachei v sel’skuiu mestnost.’” Website of the Union of Healthcare Workers of the Russian Federation, http://www. przrf.ru/info/full/selskoe_zdravoohranenie/Rasshirenie-programmy-Zemskij-doktor-sposobstvuet-pritoku (access date October 27, 2016).

13. State Report on the Realization of State Healthcare Policy for 2015. Official website of the Ministry of Health of the Russian Federation, https://www.rosminzdrav.ru/ministry/programms/gosudarstvennоy-doklad-o-realizatsii-gosudarstvennoy-politiki-v-sfere-ohrany-zdorovya-za-2014-god (access date September 4, 2016).

14. “’Protivostoianie logik”: vrach, patsient, i vlast’ v usloviiakh reformirovaniia sistemy zdravookhraneniia,” http://www.levada.ru/cp/wp-content/ uploads/2016/05/299_1-15_Svodnyj-analiticheskij-otchet.pdf (access date September 5, 2016).

15. Ibid.

16. “‘Protivostoianie logik’: vrach, patsient, i vlast’ v usloviiakh reformirovaniia sistemy zdravookhraneniia,” http://www.levada.ru/cp/wp-content/ uploads/2016/05/299_1-15_Svodnyj-analiticheskij-otchet.pdf (access date September 5, 2016).

17. “Prichiny neobrashchennia litsami v vozraste 15 let i bolee za meditsinskoi pomoshch’iu pri nalichii potrebnosti v meditsinskoi pomoshchi v 2014” in Zdravookhranenie v Rossii–2015: Stat. cb. (Moscow: Rosstat, 2015), p. 103. Available on the official website of the Federal State Statistics Service, http://www.gks.ru/free_doc/doc_2015/zdrav15pdf (access date August 30, 2016).

18. “Zabolevaemost’ gorodskikh i sel’skikh zhitelei aktivnym tuberkulezom. Sostoianie zdorov’ia gorodskogo i sel’skogo naselenie VGD,” Zdravookhranenie v Rossii–2015. Official website of the State Federal Statistics Service, http://www.gks.ru/bgd/regl/b15_34/ Main.htm (access date July 1, 2016).

19. “State Report on the Realization of State Healthcare Policy for 2015.” Official website of the Ministry of Health of the Russian Federation, https://www.rosminzdrav.ru/ministry/programms/gosudarstvennоy-doklad-o-realizatsii-gosudarstvennoy-politiki-v-sfere-ohrany-zdorovya-za-2014-god (access date September 4, 2016).

20. “Zabolevaemost’ gorodskikh i sel’skogo naseleniia VGD,” Zdravookhranenie v Rossii–2015. Official website of the State Federal Statistics Service, http://www.gks.ru/bgd/regl/b15_34/ Main.htm (access date July 1, 2016).