Object of study: the existing system of perinatal care. Methods: a systematic approach and analysis bibliosemantychnyy, statistical, sociological, epidemiological, logical and conceptual modeling, model experiment, expert evaluations. Theoretical and practical results: found inadequate organization of perinatal care at the regional level, the discrepancy between the WHO and its strategic direction health care reform Ukraine and spatial characteristics of the demographic situation and the level of health that necessitated the scientific basis and development of an optimized system of perinatal care. We found insufficient logistics, personnel and financial resources perinatal institutions, such as extremely low supply of medical instruments and equipment, and the discrepancy of Health of Ukraine approved the table of equipment. Conceptual approaches to multi-channel financing obstetric facilities and proven high economic efficiency fundraising charity "Zhitomir regional sickness fund." Developed and scientifically-based 3-tier model of perinatal care at the regional level, especially where it is a clear distinction between the levels (regionalization), creation of inter-tribal centers and Perinatal Center, closed in a single system by providing information and common methods of management. The results of medical, social, and economic efficiency of new elements optimized model of perinatal care at the regional level can recommend it for implementation in the areas of similar administrative structure, size and age-sex structure of the population, the number of births, the network of obstetric aid. Scientific novelty: the first in Ukraine: the complex from the standpoint of systematic approach to the study of reproductive health at the regional level, which directly affects the course and outcome of pregnancy is justified in the sense of establishing inter-tribal center in order to reduce maternal and perinatal loss, proven cost-effectiveness to attract extra-budgetary funding sources to provide prenatal care, science-based model of perinatal care at the regional level, proven medical, social, and economic efficiency of the creation of regional perinatal center. Degree of implementation: case studies in the form of a newsletter. Scope: Health Organisation medicine.
