Russia - Health



As of the mid-1990s, the overall organization of the health care system has largely been carried over from the Soviet era. Primary care has been delivered through basic units called uchastoks . In rural areas, these districts are served by health posts staffed by midwives or physicians' assistants, while health centers and urban polyclinics are available in larger population centers. The secondary-care network has also been retained from the Soviet era and consisted of uchastok hospitals and health centers, district hospitals and polyclinics, and regional hospitals and polyclinics. Medical facilities throughout the country are generally inadequate, with equipment that is both outdated and in poor condition. A survey conducted in the mid-1990s found a high level of dissatisfaction with the health care system on the part of both the general public and health care personnel, as well as widespread support for privatization. As of 1999, there were an estimated 4.2 physicians and 12.1 hospital beds per 1,000 people. As of 1999, total health care expenditure was estimated at 4.6% of GDP.

As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 9.7 and 13.9 per 1,000 people. There were 1.42 million births in 1999. Infant mortality was 16 per 1,000 live births in 2000 and average life expectancy was 65 years. The total fertility rate in 2000 was 1.3 children per woman during her childbearing years. Children up to one year of age were immunized in 1997 against tuberculosis, 97%; diphtheria, pertussis, and tetanus, 87%; polio, 97%; and measles, 95%.

In 1994, 1.23 million deaths were related to cardiovascular disease. The heart disease mortality rates for Russian men and women were higher than the average for countries of high human development. The likelihood of dying after age 65 of heart disease per 1,000 people was 365 for men and 359 for women in the years 1990–1993. As of 1999, the number of people living with HIV/AIDS was estimated at 130,000 and deaths from AIDS that year were estimated at 850. HIV prevalence was 0.18 per 100 adults.

After the breakup of the Soviet Union diphtheria spread from Russia to its former republics in epidemic numbers. In the Russian Federation, reported diphtheria cases increased from 603 in 1989 to 15,229 in 1993, then to 39,703 in 1994. The mortality rate from diphtheria was 2.8%. The incidence of tuberculosis in 1999 was 123 per 100,000 people. The Russian Federation and countries of Central and Eastern Europe lag behind the West in injury prevention. The accidental death rate for children 5–14 in 1991–93 was 39.6 per 1000,000 for boys and 16.4 per 100,000 for girls. Deaths by suicide are also very high in the Russian Federation at 41.7 per 100,000 people for men and 7.9 per 100,000 for women (aged 15–24).

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