Traceability and control as levers to prevent leakage from legal circulation when legalizing medical cannabis.

OBJECTIVE: Aim: To reveal traceability and control as levers to prevent leakage from legal circulation when legalizing medical cannabis. PATIENTS AND METHODS: Materials and Methods: The methodological basis of this research work is based on a systematic approach. Methods of structural and logical analysis, bibliosemantic, abstraction and generalization were used in this article. RESULTS: Results: The analysis of the regulatory framework and regulatory initiatives in the field of circulation of narcotic drugs, in particular, cannabis (in total 56 documents) demonstrated repeated attempts to reform it in Ukraine in order to increase the availability and efficiency of medical and pharmaceutical services. Recently adopted law on the legalization of medical cannabis pays special attention to the traceability of the circulation of medical cannabis and cannabis-based medicines (CbMs) by digitalization and creation of the appropriate electronic information system. CONCLUSION: Conclusions: With the adoption of the law on the legalization of medical cannabis Ukraine became the 57th country in the world to legalize such cannabis. The study and analysis of the regulatory framework of Ukraine, taking into account the best world practices, showed that the legalization of medical cannabis will allow for providing more effective care to many patients including wounded defenders.

Modern educational needs of specialists in the public health system.

OBJECTIVE: Aim: Studying the opinion of public health system workers (emlpoyees) regarding existing educational problems and needs in the context of continuous professional development. PATIENTS AND METHODS: Materials and Methods: Bibliosemantic, medical-statistical, sociological methods are used in the study. The research program provided for conducting sociological surveys of public health specialists in different regions of the country regarding the establishment of priority training topics for public health specialists; preferred methods of learning; barriers to access to education, etc. The scientific base of the research the regional centers for disease control and prevention have become. Statistical processing and mathematical analysis of materials was carried out using methods of statistical analysis. RESULTS: Results: The research has found that the priority topics of training for public health specialists are issues of epidemiology (which were indicated as very important by 67.7±3.7 and as important by 22.0±3.2 per 100 respondents); emergency and disaster management (67.7±3.7 and 31.1±3.6 per 100 respondents), quality and safety (53.0±3.9 and 38.4±3.8), practices based on on evidence (42.1±3.9 and 45.7±3.9) eHealth and digitalization (40.2±3.8 and 38.4±3.8), statistics (38.4±3.8 and 51 ,2±3.9), research methodology (32.9±3.7 and 51.2±3.9) and research ethics (12.8±2.6 and 67.7±3.7, respectively). Webinars (62.2±3.8 per 100 respondents) and online training (60.4±3.8), classroom (42.1±3.9) and hybrid (40.2±3.8) were identified as preferred forms. teaching. The obstacles to the continuous professional development of public health specialists are a lack of time and a lack of finances, a lack of information about desired training programs, their regulations, insufficient support from management, military aggression and the problems caused by it, etc. CONCLUSION: Conclusions: The priority topics of training for public health specialists, preferred methods of training and barriers to access to training determined in the course of the study are the basis for improving the organization of continuous professional development of employees of public health centers.

THE MORBIDITY RATE OF GENITOURINARY DISEASES ACCORDING TO THE DATA ON POPULATION RECEIVING MEDICAL CARE IN A MULTIFUNCTIONAL HEALTH CARE FACILITY.

OBJECTIVE: The aim: Establishing the characteristic features and morbidity rate of genitourinary diseases in order to substantiate the need for health care services. PATIENTS AND METHODS: Materials and methods: The article uses bibliographic, medical, statistical and content analysis, as well as analytical methods. We have analyzed the sex-age characteristics of the morbidity rate of genitourinary diseases, with the morbidity rates among different sex-age groups of the population in 2015-2022 evaluated. RESULTS: Results: Diseases of the genitourinary system constitute a significant share in the overall structure of the morbidity rate (7.3%-10.6%) and disease prevalence (6.1%-7.3%) among adults. In 2015-2022, the dynamics of the morbidity rate of genitourinary diseases and their prevalence were characterized by a constant increase until 2019, with a subsequent decrease until 2022. Such trends in the morbidity rate and prevalence of genitourinary diseases among people may be related to the impact of the COVID-19 pandemic, which led to the restricted access to health care services as a result of taking measures to prevent the spread of infection, excessive load on the network of health care facilities within the pandemic period, etc. The features of prevalence and dynamics of the incidence of genitourinary diseases in adolescents, adults, and persons of older age groups are determined. CONCLUSION: Conclusions: The identified sex-age characteristics of the morbidity rate of genitourinary diseases, prevailing nosologies in certain age and sex groups will become the basis for substantiating measures to improve the quality of medical care, taking into account the principle of patient centricity and integration of care.

ANALYSIS OF MAIN TRENDS OF DEVELOPMENT OF HEALTH CARE IN UKRAINE.

OBJECTIVE: The aim: To substantiate the conceptual approaches of building a cluster model of primary medical care at the level of the hospital district in terms of the development of family medicine, in particular, the consolidation of health care institutions as the main providers of medical services in the provision of primary medical care in the hospital district and improving its efficiency. PATIENTS AND METHODS: Materials and methods: Methods of structural and logical analysis, bibliosemantic, abstraction and generalization were used in this work. RESULTS: Results: The analysis of the legal framework in the field of health care of Ukraine demonstrated multiple attempts to reform it in order to increase the availability and efficiency of medical and pharmaceutical services. The practical implementation of any innovative project becomes much more difficult or even impossible without a carefully developed plan. Today in Ukraine there are 1,469 united territorial communities, 136 districts, so more than one thousand primary health care centers (further written as PHCCs) have been created against, a possible 136. A comparative analysis indicates the economic validity and possibility of such changes - the creation of a single health care facility at the level of a hospital cluster to provide primary medical care. For example, the Bucha district of the Kyiv region consists of twelve territorial communities, and 11 primary health care centers (PHCCs), the latter have separate subdivisions under their control in the form of: general practice-family medicine dispensary (GPFMD), group practice dispensary (GPD), paramedic and midwifery points (PMP), paramedic points (PP). CONCLUSION: Conclusions: The implementation of a cluster model of providing primary medical care in the form of the creation of a single health care facility at the level of a hospital cluster has a number of advantages in the short term. For the patient, it is the availability and timeliness of medical care, at least at the level of the district, not the community; cancellation of paid medical services during the provision of primary medical care regardless of the place of its provision. For the subject of governance (the state) - cost reduction during the provision of medical services.

DEVELOPMENT OF THE PUBLIC HEALTH SYSTEM IN THE CONDITIONS OF CURRENT CHALLENGES AND THREATS.

OBJECTIVE: The aim: Analysis of the development and optimization of the public health system in the face of current challenges and threats. PATIENTS AND METHODS: Materials and methods: Bibliographic, information-analytical, statistical methods and content analysis were used in the study. An analysis of the regulatory framework for the development of the public health system, including WHO strategic documents and national legislation was conducted. A critical assessment of the pre-existing public health system under the Semashko model was provided. The main stages of development of the new public health system of Ukraine, it's structural, financial and economic, organizational and managerial, scientific and educational, information and communication aspects are described. Reporting materials of the Public Health Center of the Ministry of Health of Ukraine and regional health centers, the state institution «Center for Medical Statistics of the Ministry of Health of Ukraine¼ and state institutions «Laboratory Centers of Ukraine¼ were analyzed. RESULTS: Results: The development of the national public health system in Ukraine is carried out in accordance with the main directions of state policy, recommendations of the WHO and other international organizations in health care and aims to ensure health and well-being, prevent and minimize the negative consequences of current challenges and threats to population health. The public health development strategy is defined and enshrined in the legal framework. Structural development includes the creation of a national, 23 regional public health centers, a network of local structures, their staffing, the formation of a network of training institutions and their continuous development. The organizational and managerial strategy provides coordination of activities, intersectoral and intersectoral cooperation, improvement of technological and resource provision of institutions and institutions of the public health system. Financial and economic activities include multi-channel financing of structures and public health activities. Information and analytical activities provide effective monitoring of health and well-being, obtaining organizational and managerial and government structures objective information for making sound management decisions. CONCLUSION: Conclusions: Development of the national public health system in Ukraine and its optimization is carried out in accordance with the main directions of state policy, recommendations of the WHO and other international organizations in health care and aims to ensure health and well-being, prevent and minimize the negative consequences of modern challenges and threats to population health. Optimization of the public health system includes a number of measures of functional-structural, organizational-administrative, regulatory, financial-economic, scientific-educational, information-analytical nature, aimed at ensuring the implementation of the main operational functions of public health.

STUDY OF NEUROTICISM AND EXTRAVERSION AS PREDICTORS OF THE SYNDROME OF EMOTIONAL BURNOUT (EBS) IN STUDENTS.

OBJECTIVE: The aim: To investigate internal factors - neuroticism and extroversion, which can be predictors of emotional burnout syndrome and their prevalence among student youth. PATIENTS AND METHODS: Materials and methods: Used a complex of methods: theoretical - theoretical analysis, synthesis, systematization; sociological method of questioning; empirical: observation, testing-Eysenck's methods for assessing the impact of neuroticism and externality; statistical. The object of the research is the process of influence of personal characteristics (individual factors) on the development and spread of EBS among students. Subject - personal characteristics (individual factors) of students - extraversion and neuroticism. The number of respondents was 610 students. RESULTS: Results: A study of the personal characteristics of neuroticism and extraversion, which can be predictors in the genesis of EBS, was conducted. It has been established that several negative internal factors influence students. The significant prevalence of internal risk factors of EBS indicates the need for a comprehensive approach to its prevention and the need for the development and application of modern adequate methods, forms, and methods of prevention. CONCLUSION: Conclusions: The presence and influence of internal factors on the development of EBS have been theoretically proven. It has been established that there is a significant propagation of personal characteristics that may have signs of negative internal factors. The need for preventive measures for the development of EBS among students has been revealed.

VALUE-MOTIVATIONAL COMPONENT OF A HEALTHY LIFESTYLE OF MODERN UNIVERSITY STUDENTS: THE REAL STATE AND LOGIC OF FORMATION.

OBJECTIVE: The aim: The article presents the theoretical substantiation of the value-motivational component of a healthy lifestyle, the diagnostic procedure, the results of quantitative and qualitative analysis of the real state of its formation in students of modern universities; the pedagogical tools of health-oriented, containing interactive and reflexively oriented forms and methods of educating a healthy lifestyle are presented; specific examples of their implementation are given. PATIENTS AND METHODS: Materials and methods: A set of general scientific methods (analysis, synthesis, comparison, systematization, generalization) and diagnostic standardized methods (M. Rokich's "Value orientations" method, R. Berezivska's questionnaire "Attitude to health" (value-motivational scale), questionnaire "Motivational component of a healthy lifestyle" (N. Voloshko, V. Rybalka). RESULTS: Results: A healthy lifestyle is a way of life based on the value attitude to maintaining, improving and strengthening health through motivated activities aimed at improving living conditions, which ensures quality self-realization of the individual in all spheres of life. An essential component of the structure of a healthy lifestyle is the value-motivational component as a set of motives, needs, attitudes to maintain one's own health and fostering a sense of responsibility for it. The pedagogical tools of health orientation are a set of interactive and reflexively oriented forms and methods of forming a healthy lifestyle, which are based on the partner subject-subject interaction of teacher and students, their dialogue, polylogy and cooperation. CONCLUSION: Conclusions:Theoretical understanding and the results of diagnostic research made it possible to determine the nature and structure of a healthy lifestyle, to determine the real state of formation of its value-motivational component and to develop pedagogical tools of health orientation.

HEALTH OF THE ELDERLY PEOPLE AS THE BASIS FOR FORMATION OF MEDICAL AND SOCIAL NEEDS.

OBJECTIVE: The aim: The identification and determination of needs that the population of older age groups have in medical and social services on the basis of health data and the results of a survey. PATIENTS AND METHODS: Material and methods: Because of bibliographic, epidemiological, medical-statistical, analytical methods the research has investigated the problems of healthy aging, tendencies in population health of the population of Ukraine of senior age groups during 2000-2017, features and tendencies of health of a sample contingent of urban population of elderly age according to appeals in health care facilities during 2009-2019. The use of the sociological method, the self-evaluation of elderly people of their own health, characteristics of lifestyle and medical activity are determined, the needs of older people in medical and social services were assessed. RESULTS: Results: Negative tendencies to increase during 2000-2017 the prevalence of pathology among the population older than working age by 22.8%, including blood diseases in 2 times, endocrine system - in 1.8 times, urogenital system - by 1.5 times, digestive organs - by 1.4 times, tumors and nervous system - by 1.3 times. Among the urban elderly population, the prevalence of sensory diseases, including ear and eye diseases, endocrine disorders, injuries and poisonings, has increased, and mental health indicators have deteriorated. The sociological survey found a low level of self-esteem (31.5±3.5 per 100 had health problems, 10.1±2.3 are significant). Self-medication was practiced by 76.4±3.2 per 100 respondents, 74.2±3.3 were not followed or they violated the doctor's recommendations. 56.2 ±3.7 per 100 respondents had physical examinations in the non-right time 29.7±3.4 had not it.There was a significant prevalence of risk factors, including hypodynamics (21.9±3.1 per 100), tobacco use (29.8±3.4), malnutrition (37.1±3.6), overweight (obesity) (32, 6±3.5), arterial hypertension (37.6±3.6), hypercholesterolemia (28.7±3.4), glucosemia 16.3±2.8). The research has discovered the needs of older people in health care and social services, inter alia in preventive counseling (65.2±3.6 per 100), the introduction of electronic technologies in health care (68.5±3.5), information educational services on health issues (67.4±3.5), provision of services in hospitals at home (66.3±3.5), in increasing the availability of rehabilitation (43.8±3.7), specialized counseling (34.3±3.6) and emergency medical care (16.2±2.8), improvement of socio-economic determinants (78.0±3.1), introduction of activities (48.3±3.7), joint training programs for older people (42.1±3.7), the development of certain skills, the use of technical means, assistive devices (67.4±3.5), the formation of a conducive to better health environment (58, 4±3.7). CONCLUSION: Conclusions: The low level of the elderly people's health, the tendency to increase the burden of disease, the prevalence of risk factors for disease and low medical activity lead tosignificant needs for medical and social services of preventive, treatment-diagnostic, rehabilitation, improving socio-economic determinants, measures to reduce social isolation.

SELF-ASSESSMENT OF THE CONTENT OF THE PUBLIC HEALTH MASTER'S EDUCATIONAL PROGRAM FOR COMPLIANCE WITH THE EUROPEAN PUBLIC HEALTH CORE COMPETENCES PROGRAMME.

OBJECTIVE: The aim: Determining the compliance of the developed Public Health Educational Program with the principles and basic provisions of the WHO-ASPHER Competency Framework for Public Health Workforce in the European Region. PATIENTS AND METHODS: Materials and methods: The study used bibliographic and information-analytical methods and content analysis. A comparative analysis compliance of the content of the Public Health Master's Educational Program, developed in Bogomolets National Medical University, with the provisions of the WHO-ASPHER Competency Framework for Public Health Workforce in the European Region in terms of providing academic disciplines in the ECTS credits (European credit transfer and accumulation system), has been carried out. RESULTS: Results: Comparative analysis of the components of the University Public Health Master's Educational Program and regulations of the WHO-ASPHER Competency Framework for Public Health Workforce in the European Region has identified a high level of their compliance in all areas of competence formation, including science and practice, health promotion, legislation, policy, ethics, common health and safety in health, leadership and operational mind-set, cooperation and partnership, communication, culture and advocacy, strategic and resource management, professional development, organizational training and adaptability. The competence-based educational program provides future professionals with theoretical knowledge and practical skills for a clear understanding of public health problems, a reasonable choice of methods for solving them, taking into account modern practices; forming partnerships, effective communication and cooperation on a cross-sectoral basis, developing leadership skills, organizing and providing people-centred public health services. CONCLUSION: Conclusions: Self-assessment of the content of Public Health Master's Educational Program for compliance with European educational standards for the formation of the necessary competencies is an important tool for its quality formation and improvement. A comparative analysis of the university's Public Health Master's Educational Program, with the European Competency Framework for Public Health Workforce, has identified a high level of compliance.

RESEARCH ON THE EFFECTIVENESS OF TEACHING BIOSTATISTICS OF FUTURE PHYSICIANS.

OBJECTIVE: The aim: To evaluate the effectiveness of teaching biostatistics of future physicians in the context of the introduction of a new curriculum on the subject «Social Medicine, Public Health¼ in the «Biostatistics¼ module. PATIENTS AND METHODS: Materials and methods: During the study 2 groups of students that had different curriculum were formed - experimental group (EG) (n = 257) and control group (CG) (n = 272). Their level of knowledge, skills and abilities was determined with the help of a sociological survey. The level of acquired competencies of students was assessed according to the developed motivational, cognitive, activity and reflective criteria. Bibliosemantic, analytical, sociological, medical-statistical and experimental methods were used to analyze the results. RESULTS: Results: The study analyzed and identified differences in a number of indicators related to the combination of work and study (EG - 28.4±2.8, CG - 43.3±3.0 per 100 students), preferences for the study of biostatistics (EG) - 47.2±3.1, CG - 30.5±2.8 per 100), acquaintances with statistical sizes and methods before the beginning of training of biostatistics (EG - 32.9±3.0, CG - 41.1±3.0 per 100), the presence of difficulties in mastering the subject (EG - 50.2±3.1, CG - 53.2±3.0 per 100). The reasons for dissatisfaction with the educational process, the optimal forms and methods of teaching biostatistics were identified. The proposals of students to improve the quality of teaching the subject are studied. The plans of the participants of the experiment for further study of biostatistics and its use in future professional activities have been clarified. CONCLUSION: Conclusions: The data obtained indicate that the implementation of the new curriculum «Social Medicine, Public Health¼ in the module «Biostatistics¼ has had a positive impact on improving the professional competence of students in biostatistics, which proves its effectiveness.

Reducing health inequalities as a component of the health training programs.

OBJECTIVE: The aim: identifying the characteristics and trends of inequalities in the health of the population to substantiate the educational content of the curriculum for the training of Master in Public Health. PATIENTS AND METHODS: Materials and methods: Bibliographic, sociological, medical-statistical and information-analytical methods were used in the study. Ukraine's healthcare institutions were the scientific base of the study. The data on the average life expectancy, morbidity, mortality, satisfaction of medical needs of different groups of the population for revealing the social gradient are analyzed. Documents on strategies to reduce health inequalities have been examined. RESULTS: Results: Health inequalities between WHO countries have been identified, including a difference in the average life expectancy at birth of 17.1 years in premature mortality due to differences in the levels of economic development of countries. The inequality in the prevalence of diseases and the difference in the satisfaction of specific medical needs among the first and tenth decile population of Ukraine were determined. The prevalence of diseases of the genitourinary system in the population older than 60 years with low rates by 27.3% was higher than the figure among financially insured persons. The incidence of ocular pathology among adults with different income levels varied 1.8 times. The provisions of the WHO strategic documents on reducing health inequalities and its protection and on developing the public health system are analyzed. We justify the necessity of expanding the coverage of the problems of reducing disparities in health and health care in the course of training of the Master in Public Health. A modern curriculum "Social Medicine, Public Health" has been developed with the inclusion of inequalities in public health and appropriate educational and methodological support. CONCLUSION: Conclusion: The strategic goal of reducing inequalities in public health and its care requires integrating these issues into a modern master's in public health program. The curriculum developed covers various aspects of health inequalities and health care, including the identification and assessment of disparities, the clarification of causes, the identification of counter-measures. Created educational and methodological support allows acquiring theoretical knowledge and practical skills that form the necessary competencies of professionals in the context of overcoming inequalities in health.

ACTUAL PROBLEMS OF DERMATOVENEROLOGICAL SERVICE DEVELOPMENT: OPINION OF SERVICE PROVIDERS.

OBJECTIVE: The aim: To determine the features and trends of dermatovenerological health of population; to identify conditions and problems of providing dermatovenerological care. PATIENTS AND METHODS: Materials and methods: Bibliographic, epidemiological, medico-statistical, sociological methods were used. Scientific literature, data from the Center of Medical Statistics of the Ministry of Health of Ukraine concerning population health and dermatovenerological establishments activity on 2000-2019, data of authors` own sociological researches on opinion of dermatovenerological profile experts about available problems and ways of their decision were analyzed. RESULTS: Results: A long-term tendency towards a decrease in the incidence of skin and subcutaneous tissue diseases by 8,6% during 2000-2017 and the incidence of venereal diseases during 2000-2019 was revealed (for syphilis - by 15,5 times, gonorrhea - by 6,8 times). At the same time, during 2014-2019 there was an increase in the incidence of atopic dermatitis by 3,6%, of contact dermatitis - by 5,2%, of trichophytia and microsporia by 22,6%, as well as increase in the prevalence of psoriasis - by 6,0%. The incidence of sexually transmitted diseases remains significant. Trends in recent years indicate a deterioration in dermatological health and an increasing need for medical services. During healthcare reforming over the course of nineteen years there was a reduction in the amount of dermatovenerologists and their number per population by 31,5%, the amount of dermatological institutions - by 2,6 times and beds - by 3,9 times. According to 18,6±3,1 per 100 surveyed respondents, the availability of dermatovenerological care to the population is low, and its deterioration in the COVID-19 pandemic was confirmed by 80,1±4,0. Some factors that negatively affect the quality of medical services have been identified: insufficient amount and quality of medical equipment (57,1±4,0 per 100 respondents), insufficient opportunity for continuous professional development (34,0±3,8); lack of computers (30,8±3,7); lack of motivation to improve the quality of work (28,8±3,6). The priority measures that need to be taken to improve dermatovenerological medical services have been identified. CONCLUSION: Conclusions: The study of dermatovenerological profile experts` opinion regarding the current state of the dermatovenerological service, human resources, the availability and quality of the services made it possible to identify a number of organizational and administrative problems as well as to prioritize activities on providing dermatovenerological care to the population in the context of healthcare reform and COVID-19 pandemic.

Prevalence of bad habits among students of the institutions of higher medical education and ways of counteraction.

OBJECTIVE: Introduction: The relevance of scientific research is determined by the significant importance of lifestyle in preserving and strengthening the health of the population especially young people what determines the future of any society. Among the numerous youth lifestyle characteristics, particular attention is paid to behavioral factors, including the presence of bad habits. Data of scientific publications indicate a significant prevalence in student environment of tobacco-smoking, consumption of alcohol and other manifestations of unhealthy behavior, which are powerful factors of the risk of developing non-communicable diseases, injuries and other health disorders. One of the most important tasks is the formation and establishment of a healthy lifestyle among medical students, because in the future they will not only treat patients, but also carry out professional activities for the prevention of diseases and risk factors for their development, correcting and overcoming already existing risk factors. Doctors must be conscious supporter of healthy lifestyle and serve as a role model for their patients. The aim: To identify the features of prevalence of tobacco use, alcohol and energy drinks among medical students and justify ways of counteraction based on the results of own sociological research, scientific literature, WHO program and strategic documents. PATIENTS AND METHODS: Materials and methods: An anonymous questioning was covered 948 students of institutions of higher medical education including 34.5% of men and 65.5% women. It had been used bibliosemantic, sociological and medical-statistical methods. The information base of the study included program and strategic documents of WHO, sources of scientific literature, data of own research. Statistical processing of the obtained results was carried out using generally accepted medical statistics methods using licensed programs (SPSS, STATA, Statistica 10.0 and MS Excel XP). RESULTS: Results: The results of the study indicate a sufficient significant prevalence in the student environment of tobacco, alcohol and energy drinks. Third part of students consumes tobacco, of which 15.2 per 100 respondents are regular smokers with experience, 9.3 per 100 respondents smoked 10 or more cigarettes a day. A new negative trend is the use of hookah by almost half of the interviewed students and consumption of electronic cigarettes (8.5 per 100 respondents), what must be taken into account when substantiating counteraction ways. Three quarters of the respondents consume alcohol. Despite the prevailing consumption of low-alcohol beverages and wine by respondents, every seventh of the respondents consumes strong drinks. The reason for the worrying is the fact that 13.6 ± 4.7 in 100 respondents combine the consuming of energy drinks with alcohol. By 4.9 per 100 students interviewed, energy drink increases the desire to drink alcohol. CONCLUSION: Conclusions: The revealed connection between tobacco, alcohol and energy drinks consumption among medical students proves the need for an integrated approach to reduce the prevalence of risk factors in the context of a healthy lifestyle.

Modern model of genetic monitoring as a promising tool for reducing incidence of genetic pathologies in Ukraine.

OBJECTIVE: Introduction: The medical and social substantiation of an optimized system of genetic monitoring in Ukraine for providing of quality medical care with economic substantiation should be developed for quality medical care and justification of budget expenditures and the economic evaluation of the effectiveness of treatment and prevention measures. The aim is to develop a modern model for the genetic monitoring and provide substantiation of the measures for the prevention of hereditary transmission of genetic defects and birth of children with congenital defects. PATIENTS AND METHODS: Materials and methods: The following research methods have been employed: systematic approach and analysis technique; bibliographic and semantic method; method of conceptual modeling. CONCLUSION: Conclusions: The model of genetic monitoring with the modern concepts of healthcare reform in Ukraine has been developed taking into account the priorities of the state health policy, modern internationally recognized and recommended by WHO.

Modern demographic trends in Ukraine as a ground for realization of prevention strategies

Introduction: The data of the world statistics show that the process of demographic ageing becomes significant in modern conditions, and the number of elderly people annually increases by 3%. Owing to the global tendencies for ageing, the health care and social security systems are facing important challenges to ensure healthy lives and promote the well-being for this segment of population, provide affordable and quality medical care according to needs. The aim: Establishing modern peculiarities and trends of medical and demographic situation in Ukraine in the context of ageing population in order to substantiate medical and preventive measures. Material and methods: According to the data of the State Service of Statistics of Ukraine of the Ministry of Public Health for 1990-2017 the tendencies of medical and demographic characteristics of the population of Ukraine have been identified. The national medical and demographic indicators have been compared with the indicators of the countries of WHO European Region according to the data of the European Database "Health for everybody". Using the least squares method, a forecast of the Ukrainian population and its age structure for the period up to 2030 has been made. Review: A tendency for Ukrainian population decline by 18,1% over the course of 1990-2017, which is caused by, along with other reasons, decrease in population birth rate by 25,4% and increase in mortality by 19,8%, has been identified. A steady tendency for a decline in the proportion of children's population up to the age 14 years inclusive for the twenty-seven-year period from 21,5% till 15,5%, and for an increase in the proportion of population aged more than 60 years from 18,3 till 22,9% has been detected. The share of people over 65 in the age structure of population has increased from 12,0% till 16,5%. The analysis of regional indicators confirms that there are unfavorable demographic tendencies in the southeastern, northeastern and central provinces, and more favorable tendencies in the provinces of the West Region of the country. The proportion of children's population up to the age 14 years inclusive was in Ukraine close to the indicator in the countries of European Union and less than the average in WHO European Region (17,8%), the proportion of people over 65 - close to European regional indicator (15,5%) and less than the indicator in the countries of European Union (19,0%). A forecast of the population and its age structure up to 2030 has been made, according to which less than 40 million will live in Ukraine, and the proportion of persons over 65 years will reach 19,1%. Conclusions: The tendencies for Ukrainian population decline and changes in its age structure towards ageing make it necessary to take measures to prevent negative medical and demographic trends and provide conditions for healthy ageing, to increase the affordability and quality of medical care, including for persons of senior age groups, and improve the work of health care facilities on prophylaxis of diseases.

health and lifestyle of students' youth: status, problems and ways of solution.

OBJECTIVE: Introduction: The current negative trends in the health of students' youth, which according to many researchers is a social group with an increased risk of diseases, indicate the need to address the problem of preserving and strengthening the health of students through the introduction of effective approaches to the prevention of diseases, risk factors for their development and the formation of the principles of a healthy lifestyle. The aim: Substantiation of measures aimed at prevention of non-communicable diseases and risk factors for their development in students by studying their health and lifestyle, evaluation of international experience in this field. PATIENTS AND METHODS: Materials and methods: We have analyzed the sources of domestic and foreign research literature and conducted sociological research among 332 students of higher education institutions: linguistic, medical and technical universities. It had been used bibliosemantic, sociological and medical-statistical methods. CONCLUSION: Conclusions: Under conditions of the current intensification of the educational process in higher education universities, which is accompanied by a tense education regime, increase of educational load and negative impact on the health of students, the importance of solving the problem of preserving and strengthening the health of student youth is increased. Therefore priority attention is needed the complex realization of measures to the effective prevention of diseases and risk factors for their development among students, creation of pre-conditions for forming in students the principles of healthy way of life and health-protecting behavior, improvement of medical care and implementation of monitoring the health status of students.

Study of motivational factors in doctors in respect of healthcare quality improvement.

INTRODUCTION: The article presents the results of a survey among doctors with different certification categories and experience who work at inpatient and outpatient departments of Sumy healthcare institutions, in respect of the main factors that motivate them to provide quality healthcare. The aim of the study is to identify the factors that may be used as motivators to improve healthcare quality in terms of medical staff in order to ensure system construction of motivational component of healthcare quality management ("incentive picture"). MATERIALS AND METHODS: We conducted a survey among physicians working at inpatient and outpatient departments. A total of 167 respondents were interviewed. The obtained results were processed using OCA-program. CONCLUSIONS: We have found an association between the salary level and certification category of a physician. Despite heavy workload, most doctors were willing to work harder and better for some additional payment. Even though financial satisfaction was low, most doctors did not agree to change their profession for a more payable one. The study revealed that, in doctors' opinion, the introduction of incentive system in healthcare institutions was necessary to provide quality healthcare. Regardless of length of service and workplace, two of the main motivational factors for doctors were moral satisfaction from work and respect of people.