PERINATAL CARE INDICATORS IN ALMATY, KAZAKHSTAN FOR 2013-2017: A CROSS-SECTIONAL STUDY.

Protection of maternity and child health is of great medical and social importance. Provision of medical care to women and children in Kazakhstan is the major task for state policy. Still, the data on epidemiological indicators of perinatal care in Kazakhstan are rather limited. This study was aimed at assessment of perinatal care indicators in Almaty, Kazakhstan Republic, over the period from 2013 to 2017. The data on demographic characteristics of study population were obtained from online platform of the Republican Center for Health Development. The analysis of perinatal indicators was carried-out on the basis of statistical reporting form No. 32. We relied on the standard statistical formulas to calculate epidemiological indicators. All statistical tests were performed in SPSS software, Version 17.0 for Windows. The crude birth rate over five years remained stable and was within the range of 25,975-26,289 per 1,000 population. The abortion rate constituted 2.018-2.272 per 1,000 population. The abortion ratio was growing until 2016 and composed 26.387 per 1,000 population. The adolescent fertility rate has dropped significantly over the past period from 4,357 per 1,000 teenage population in 2013 to 3,366 per 1,000 teenage population in 2017. The maternal mortality rate did not exceed 0.02 per 1,000 population. Maternal mortality ratio was within the range of 0.208-0.194 per 1,000 population. Incidence rate of extragenital pathology was very high and peaked in 2016 (1,010.800 per 1,000 population). Only 17.4% of women in labor were recognized as healthy based on the labor results. Effective perinatal technologies that were introduced in the Republic of Kazakhstan have demonstrated their high performance in achieving and maintaining a reasonable level of maternity and child health. This was particularly true for stable rate of general fertility and crude birth rate, and decreasing adolescent fertility rate. However, high rates of extragenital pathology indicate the need to implement national preventive programs aimed at ensuring proper monitoring over maternity health indicators.

The utility of focus group interviews to capture dietary consumption data in the distant past: dairy consumption in Kazakhstan villages 50 years ago.

From 1949 to 1962, residents of several villages in Kazakhstan received substantial doses of radiation to the thyroid gland resulting from nuclear tests conducted at the Semipalatinsk Nuclear Test Site. The primary source of radiation was internal from an intake of radioactive iodine by consumption of contaminated dairy products. A previous research study of childhood exposure and thyroid disease in this region gathered limited data on study participants' dairy intake at the time of the fallout for the purpose of estimating past radiation doses. As many participants were too young at the time of the nuclear tests to recall dietary consumption and existing sources of archival data are limited, it was necessary to interview parents and other village residents who cared for children during this time - older adults ranging in age from 75 to 90 years. Results from 11 focus group interviews conducted in 2007 with 82 women from 4 villages in Kazakhstan yielded group-level estimates of age-, gender-, ethnicity- and village-specific dairy consumption patterns in rural Kazakhstan during the 1950s. Children typically consumed cow's milk with limited consumption of mare, goat and sheep milk; and consumed dairy products such as sour milk (airan), soft cottage cheese (tvorog) and fermented mare milk (koumiss) with the greatest amounts of koumiss reported at ages 15-21 years. The consumption patterns differed by age, and between Kazakh and Russian children, which should lead to different estimates of radiation exposure to the thyroid. This study showed the utility of focus groups to obtain quantitative estimates for dietary intake in the distant past.