Ruden V. Prophylactic basis of congenital defects prevention of Ukraine

Thesis is devoted to the problem of congenital defects in population of Ukraine. This pathology is not of particular significance among total morbidity of population, but it has great medical - social importance and impacts other health measures. Besides that, congenital defects being one of the integral parameters of total health of nation form disability of population. The author thoroughly and deeply studied epidemiology of congenital defects' morbidity, researched invalidiza-tion and mortality of population caused by this pathology. It is justified that the problem of congenital defects nowadays must be solved by prophylactic tools, because congenital defects are characterized by wide spectrum of etiological factors. We can get expected beneficial results by influenc-ing on these factors. The author presents materials of research that characterize medical - genetic services activities and demonstrate positive sides of such activity and demerits of prophylactic work of centers of medical genetic consultations. Model - scheme of activities of above mentioned services of patients medical - genetic consultation was developed. The model of secondary and partly of primary prophylaxis is presented on the example of prenatal diagnostics with the help of up - to - date methods of se-lective screening of patients, which is performed in Ukrainian public health. The knowledge level of medical genetics of our physicians - geneticists and general physicians, including family physicians, was studied in detail. The fact of low population's competence concerning congenital defects and their prophylaxis is determined. data were received by the method of sociological researches (survey questionnaire). The author studied activities of 8 interregional, 52 district and 18 regional centers of medical - genetic consultations continuing the research of prophylactic basis of congenital defects prevention. Special attention was paid to the problems of personnel resources, material - technical provision. Main semantic and qualimetric pa-rameters of such centers activities were studied. Results of the research had benefi-cial effects on the improvement of such centers activities. Prognostic tendencies of congenital defects' morbidity and medical - genetic services development to 2010 were determined. Three methods of prognosis were used, namely method of questionnaire assessment, mathematics method and method of extrapolation. Perspectives of this problem's solution as well as barriers that can delay it are presented. It is demonstrated that in future congenital defects' morbidity level would augment, but mortality would be reduced. The main accent would be made on usage of prophylactic technologies. Problem of congenital defects still remains actual nowadays, such conclusion was made, basing on the results of research. This thesis was significantly argued. Population of certain risk insufficiently utilize opportunities of medical - genetic consultations, problem of family planning is solved insufficiently etc. Prophylactic and othermedical technologies that are targeted on the solution of problem of congenital defects of Ukrainian population are suggested. Recom-mendations for the improvement of sanitary - education activities among population of our country were developed. Patients' both social - hygienic and psychological evaluation were performed, special recommendations were developed.