Problems of Social Hygiene,
Public Health and History of Medicine

The article analyzes the impact of the pandemic COVID-19 in 2020 on the state of competition in the medical services market and the competitiveness of primary care organizations, and identifies prospects for the development of the medical services market.The SWOT-analysis and analysis of complaints and statements of citizens on the quality of medical services made it possible to comprehensively assess the strengths and weaknesses of organizations, external opportunities and threats, specify the positions of medical organizations in the medical services market and determine strategic directions for the development and ensuring the competitiveness of primary medical organizations.The results of the study allowed the authors to propose strategic directions for ensuring the competitiveness of the primary medical organization, namely, the creation of mechanisms for material and intangible incentives for medical personnel; improving the quality of health services; modernization of the medical diagnostic base of the primary medical organization.

According to the results of a sociological survey of 10,237 parents of schoolchildren during the period of emergency transfer of students to distance learning in the initial period of the spread of coronavirus infection, a low provision of children with technical teaching aids was revealed: only 18% of children had a stationary computer at home, 42% of children had a basic gadget available. available for training, there was a smartphone. At the same time, it was determined that children also use gadgets for a considerable time for personal purposes (entertainment, games): according to 17% of parents, 3-4 hours, and 8% of parents answered - more than 5 hours a day. However, most parents are not aware of the amount of time a child spends with a gadget due to their busy schedule. A significant number of parents-respondents (16.5%) pointed to difficulties that arose during distance learning in the relationship between the child and the teacher. Only 60% of the parents surveyed indicated that the child sits at the table while working with the gadget, 24% - the child is more likely to sit in an armchair or on the sofa, 16% - more often the child is in the «reclining» position on the sofa or bed. All this determines the health risks of students and indicates the need to develop skills and ways to level them.Taking into account the fact that all participants in the educational process have to face the problems that have arisen during distance learning: students, their parents and teachers, recommendations for the implementation of the general education system of medical, socio-psychological support of students and their families, operational collection data to ensure a quick response, which is possible only by means of technologically modern information systems for medical, social and psychological purposes.

The COVID-19 pandemic poses new challenges for the health sector, related to the organization of medical rehabilitation of patients with COVID-19. Special attention is required for patients after artificial ventilation, who have a high risk of developing physical, mental and cognitive disorders. There are acute post-ovoid syndrome lasting more than 3 weeks and chronic-lasting more than 12 weeks after discharge from the hospital. The most common symptoms are: shortness of breath, fatigue, anosmia, ageusia, myalgia, feeling of fever, tightness in the chest, tachycardia, headaches, anxiety, memory loss, sleep disorders, difficulty concentrating. The article presents the stages of rehabilitation of patients with COVID-19. Dynamic monitoring, measures for the prevention of complications, organization and methods of rehabilitation, including physiotherapy procedures and physical therapy, are considered.

Information on the main indicators of the Pandemic COVID-19 is published daily for each subject of the Russian Federation. Of interest is the comparative ranking of regions in terms of new cases, active cases that have recovered from COVID-19, the allocation of homogeneous groups of regions in terms of the distribution of COVID-19. Since several indicators, respectively, the ranking of regions can be several options: the same regions with a high level of morbidity can be characterized by lower mortality from COVID-19 and vice versa, which will shift their position in the overall rating assessment. Such a state complicates the perception of the situation with the COVID-19 pandemic in the spatial-territorial context. In this regard, it makes sense to develop a certain latent integral indicator for assessing the COVID-19 pandemic process, which will allow comparing the subjects of the Russian Federation with each other in order to develop practical recommendations.

It is known that the oral cavity is an epidemiological hazard due to the high level of viral and bacterial contamination. Despite the narrow specialization and distant connection with the problem of viral pneumonia, dentists, nevertheless, are at risk of contracting the new coronavirus infection COVID-19. To reduce the epidemiological activity the provision of routine dental care was suspended in the vast majority of regions of the Russian Federation including the Moscow region, from the end of March 2020 to June 20, 2020. During the entire period of routine medical care suspended, the Moscow region chief dentist’s team was daily monitoring information about applied patients. The suspension of routine medical care has reduced the number of cases of COVID-19 infection contact transmission in medical organizations during the period of the most active increase in the morbidity. In addition, the decrease in the number of patients enabled medical organizations to reduce the number of medical personnel, which contributed to a decrease in the percentage of morbidity among doctors.

The article considers and justifies the need to change the system of motivation and incentives for the work of medical workers in the Russian healthcare system in the context of new socio-economic conditions and the growth of professional risks in the medical field. The COVID-19 pandemic, which has lasted for more than a year, has exposed significant shortcomings in the system of motivation of medical workers, showing serious problems consisting in a shortage of specialists, hospital beds, medicines, and an increase in professional workload. As a result, of the analysis of statistical data and the conducted sociological survey, a system of key socio-psychological factors and motivational indicators of the work of medical workers was developed, and ways to optimize the system of their labor motivation were identified.

The article examines the features of the regional provision of the health care system with personnel on the basis of a comparative assessment, both in terms of quantitative and level indicators of the personnel potential of the industry of the North Caucasian Federal District. In order to identify a real idea of the state of the personnel potential of the region, the indicators of the load on medical workers were studied. Additionally, they were grouped in relation to the average Russian and mid-level levels. The regional asymmetry of the personnel potential and the corresponding disproportions in the development of the regional health care system are revealed. The directions of reducing the differentiation of staffing of health care institutions in the region are indicated.

The article considers the key factors that negatively affect the quality of work of medical workers and the quality of medical care to the population in the context of the COVID-19 pandemic, which in practice leads to additional deaths from a new coronavirus infection. There are two key reasons that can have a negative impact on the quality of work of medical workers and lead to an increase in the death rate of the population: 1) lack of relevant scientific support; 2) lack of qualified psychological support. The first reason does not allow to increase the professional competence of medical workers, the second reason leads to their professional deformation and emotional burnout. To solve the problem, it is proposed to use modern information and communication technologies: 1) creation of a rapidly updated database and an online system for sharing experience in COVID-19 treatment, centrally accessible to all Russian health workers; 2) creation of a remote psychological support service, also centrally accessible to all Russian health workers.

This article presents the results of a study of the activities of volunteer detachments to support medical organizations during the COVID-19 pandemic in the Kursk region. The organizational and managerial mechanisms of the formation of the volunteer movement of the Kursk region are defined. The specifics of the work of the volunteer movement in conditions of high readiness at the regional level are revealed. The assessment of the level of professional training of medical volunteers is given.

The article notes that the number of citizens who apply for paid medical services is growing all over the world. The main reasons for this growth are: an increase in the level of well-being of the population; an increase in the areas of care for their own health; the inability to get the necessary assistance in state (free) structures that provide medical care; the complete absence of a number of medical services in free polyclinics, etc.The paper also presents data on the conduct of the study, which determines that on the basis of surveys and statistical data, as well as when studying reviews, it can be noted that in their significant part, consumers of medical services note that, first of all, the poor quality of public medical services prompted them to turn to paid services, but a number of respondents note that public free services in the field of medicine, especially recently, have significantly increased the level of quality.It is also concluded that from the point of view of consumers, one of the main advantages of purchasing services in commercial medical institutions is the ability to visit a doctor without waiting lists and guaranteed on the day of the appointment. Among the general trends in the paid medical services market, we can mention measures to consolidate the format and expand the areas of multi-specialty in private clinics, as well as to create conditions and factors, especially in the situation of a pandemic crisis, to provide high-quality medical services, including overcoming the consequences of the coronavirus epidemic and preventing its spread in the network of medical institutions.Statistical data and conclusions on the main areas of multidisciplinary research in the current state of paid medical services in the context of the pandemic crisis are presented. The review of new directions of providing medical services on a daily basis under the influence of the current state of the pandemic is made.

The article discusses the possibilities and prospects of using apitherapy in health tourism in Bashkortostan. The features of the development of beekeeping in the republic and the prospects for the use of beekeeping products in the restoration of the immune system, improvement of the psychological state of the consequences of covid in the conditions of tourist and recreational centers of the region are considered. A health-improving tourist product with the use of apitherapy has been developed.The Bashkirsky Med brand is widely known not only in Russia, but also abroad. The list of measures for the development of beekeeping in the republic includes support for scientific developments in the field of apitherapy. The article examines apitourism as a promising type of tourism in Bashkortostan. It can become one of the most popular types of health tourism and attract not only Russian, but also foreign tourists.

Experience in the functioning of medical clusters made it possible to identify factors that contribute to their successful development. Based on the assessment of the domestic practice of creating clusters in the healthcare sector, their typification was carried out with the identification of groups of high-tech clusters of biomedical technologies and innovations, medical clusters of drug provision and specialized equipment, clusters of medical services, internships and transfer of medical innovations. The grouping of clusters in the healthcare sector operating in the Russian Federation according to the proposed types showed that there are practically no clusters of medical services that are able to bring the quality of medical care to the population to a higher level in the country. The article identifies the problems that prevent the formation of clusters of medical services on the territory of the regions. To solve these problems, an approach was proposed to create a medical technology park on the basis of public-private partnership, which will serve as the basis for a cluster of medical services and built its structural and functional model.

The article presents the experience of the city children's polyclinic No. 133 of the Moscow Department of Health in a difficult epidemiological situation associated with a new infection COVID-19. A description of the stages of the organizational work of a polyclinic in a pandemic is given, including such areas as: a) conducting lectures and webinars for doctors and nurses of a medical organization, introducing recommended methods for diagnosing and treating COVID-19, creating and observing conditions for the personal safety of employees; b) the formation of tools and a database for analytical work; creation of registers of patients and employees of the polyclinic in order to monitor and evaluate the effectiveness of work; characteristics of the structures of age-specific morbidity in children who have undergone a new coronavirus infection and community-acquired pneumonia with substantiated confirmation for them of compulsory dispensary observation and rehabilitation measures; description of the development of routing of healthy and sick children, operational identification and continuous analysis of difficulties in the work of the polyclinic during this period; c) the formation of distance technologies in treatment and prophylactic work with patients, organized group and individual exercise therapy classes, including respiratory rehabilitation gymnastics for children who have undergone a new coronavirus infection; development of an organizational algorithm for the formation of medical and nursing teams for visiting patients with COVID-19 at home and individual teams for visiting patients for patronage. The organization of this treatment and prophylactic work was approved and a confirmation was received from the Ministry of Health of the Russian Federation of the right to replicate the experience gained from the work of the polyclinic in the conditions of COVID-19.

The article analyzes the current practice of remuneration in the Russian budget health care. According to the analysis concluded that at the present stage, the main problems in this area are the high level of differentiation of wages in the context of constituent entities of the Russian Federation, and between different categories of health workers; staff shortages, as well as the opacity of approaches to pay. In addition, it was found that the COVID-19 pandemic not only significantly aggravated the above-mentioned «bottlenecks» of the domestic budget health care, but also created new problems, the most significant of which was the procedure for compensation payments to employees involved in working with COVID-19 patients. Recommendations are formulated to change the current situation, including the need to: review the regulatory approaches to regulating compensation payments to medical workers; formation of lists of professional qualification groups and mandatory types of compensation and incentive payments; determination of the mandatory ratio of the remuneration of the heads of health care institutions to the average salary of the main staff.

The social well-being and health of citizens of all countries has been greatly tested during the pandemic of COVID-19. The situation has exacerbated many social problems. Older women found themselves in a particularly difficult situation, who experienced increased psychological burden, deteriorating health conditions, and social isolation. Even the family had not always proved to be a way of improving the status of women. All this has led to the need to examine the real problems, the objective and subjective factors affecting women's social well-being and the ways in which older women are better off.

The authors analyze the self-preservation practices of young people through the prism of their attitude to vaccination against coronavirus. Based on the results of sociological studies, the prevailing motives that prevent a positive attitude to vaccination are identified. The results obtained allowed us to conclude that in youth groups there is a low level of orientation towards vaccination against coronovirus, and, on the contrary, a high level of trust in fake anti-vaccination myths. Among the priority areas, the authors name the discussion of issues with experts and the active dissemination of this content in the Internet space.

The article examines the dynamics of the attitude of young people about the new coronavirus infection. The attitude of young people to the new coronavirus infection is formed in two types of reality: «online» and «offline». The views, assessments and knowledge of young people about the new coronavirus infection were significantly influenced by the flow of information (often fake) from various sources and, above all, the information posted on social networks. The authors conclude that the attitude to coronavirus infection from the first to the second wave has undergone significant changes and generally influenced the practices of self-preservation behavior of young people. With the expansion of knowledge and experience, understanding them from the point of view of the components of the image of health, there was a clarification of the own behavioral attitudes of young people.

The article presents the results of a study aimed at identifying the problems of maintaining a healthy lifestyle in the context of the COVID-19 pandemic. The results of the study showed that not only people of older age groups are infected, but also young people with chronic diseases. Forced isolation, uncertainty of the future and stress have significantly worsened the physical, social and mental health of the population of all age groups. Therefore, people began to strengthen their own physical, social and psychological health, to carry out preventive health measures. The problems of maintaining a healthy lifestyle in the context of the COVID-19 pandemic can be effectively solved by using an integrated approach to public health, jointly provided by state and public organizations.

One of the vulnerable categories of the population during a pandemic of coronavirus infection is the disabled, both from the point of view of the high risk of a severe course of the disease, and from the point of view of the possibility of significantly limiting everyday, professional and social activities.The article discusses the regulatory and organizational measures taken to ensure the rights of people with disabilities in Russia to prevent the spread of coronavirus infection. The epidemiological situation and features of the spread of coronavirus in long-term care facilities have been analyzed. The mortality rate from COVID-19 among residents of inpatient institutions in the EU countries ranged from 24 to 80%, in Russia the average mortality rate was 2.34 per 100 patients, in St. Petersburg from 1.4% to 2.2% of the number of people living in dependence on the type of institution.Using the example of one of the stationary social service institutions in St. Petersburg, it has been shown that the timely introduction of a set of organizational measures makes it possible to successfully manage the spread of coronavirus among residents and staff of long-term care institutions.

Statement of the research problem. In the context of the coronavirus pandemic, small businesses have been exposed to serious risks, since their viability primarily depends on the consumer demand of the population, which in turn has declined sharply in these force majeure circumstances. Small businesses are either waiting for the lifting of restrictive measures, or they are counting on state support, or they are looking for other ways out of the current situation in order to preserve jobs, the level of income of employees, remain on the market and ensure the supply of vital goods and services to the population. Economic and social stability in the region and in the country as a whole largely depends on the ability of small businesses to assume these obligations.Description of the data or materials used. The study was conducted using the method of semi-formal interviews with owners of enterprises with a staff of up to one hundred people (small businesses). The experts surveyed included 17 small business entrepreneurs from seven Russian regions (Moscow, Saint Petersburg, Omsk region (Omsk), Krasnodar territory (Anapa), Volgograd region (Cherepovets), Arkhangelsk region (Arkhangelsk), Kemerovo region (Jurga)) and by population (cities with millions of people, large and medium-sized cities). The surveyed entrepreneurs represented both industrial production and service companies. The interview was conducted using remote means of communication using a specially developed guide.The results of the study showed that the conditions of the pandemic forced small businesses to change the usual format of work, transform traditional business processes, and switch to remote customer service. Despite the current problems, small businesses are looking to the future with a restrained degree of optimism. The crisis outlined the weakest points of their business to the leaders of small firms, allowed them to abandon inefficient business processes. Those enterprises that could not do this are forced to leave the market. In the post-crisis period, small businesses expect the government to change fiscal and regulatory policies aimed at reducing the financial burden on business and reducing control and audit measures. Despite the current problems, small businesses are looking to the future with a restrained degree of optimism. The crisis revealed the weaknesses of the business and showed possible prospects for development.

The rapid spread of the COVID-19 virus challenges governments to act in ways that are usually reserved for war or natural disasters. The pandemic has caused massive global upheaval that could last for months, or longer. Governments are taking extreme measures to limit economic shocks and human costs. The pressure on the state authorities in this situation increases. In a rapidly evolving crisis, with information coming in from all sides, citizens turn to their governments for information and guidance. They expect to be kept safe and provided with medical care in a timely manner. The purpose of this paper is to review foreign public administration practices in response to the challenges of the COVID-19 pandemic.

The article is devoted to the research of problems and tasks of state management under the conditions of threat of spread of coronavirus infection COVID-19 and consideration of approaches to optimization of processes in the system of state management. The social and economic risks of the pandemic are identified and the directions of anti-crisis measures are considered. Public administration is a system consisting of citizens, business structures and government employees. State authorities, while implementing the directions of public policy, must take into account the interests of all participants of the system, building the channels of interaction between them in the most effective way. The pandemic is a serious challenge to the state administration system of any country, the prevention of the consequences of which requires timely and effective measures to be taken. Under the conditions of the pandemic in Russia, as well as all over the world, the role of the state has significantly increased, both in terms of prevention of pandemic spread, and in the form of measures aimed at supporting citizens and businesses, the most affected spheres of the economy. The purpose of this work is to consider new approaches to optimize the processes in the system of public administration, caused by the need to revise the directions of state policy under the threat of the spread of COVID-19.

The relevance of the study included that scarcity of evidence about the burdens of diseases in Ethiopia, in particular to non-communicable diseases along with the impact of COVID-19.Materials and methods. The systematic analysis and content analysis using GBD 2019 database and health metrics datasets of 2020 was used to analyze diseases burdens trends of Ethiopia. The descriptive retrospective analysis has been performed, and reported in text and charts method.Results. The result of the study showed increment of crude death and premature death due to both communicable and non-communicable diseases such as enteric infections, cardiovascular, neoplasm, others.Conclusion. COVID-19 would be the headache of Ethiopia health systems due to double burdens of diseases have steadily been shooting at ground. Hence, the nation should incite local based innovation work proactively and integrate all health services to fight with COVID-19 based on the experience of Russia.

The efficiency of the process of rehabilitation and meeting special needs of disabled individuals in the modern conditions is one of the indicators of national social policy’s performance. This article presents the results of research on social adaptation of disabled, measures and directions of social support, legal and economic conditions of rehabilitation of disabled. A special attention is dedicated to coordination of directions of social rehabilitation, habilitation and provision of social services to disabled on on the basis of state institutions of social services for the population. The stages of social rehabilitation, habilitation are detailed, which are separated into blocks of the algorithm for managing this dynamic process. The results of the study are aimed at the social services system’s development, improvement of the quality of life of disabled people.