4. Program of independent preparation.

№ п/п	Educational tasks	Specification of tasks
1	Introduction to basic health facilities, health care providers urban areas, their structure, mission and organization of work. Familiarity with basic accounting records.	Collect basic documents for outpatient administration. Fill the statistical pass the diagnosis and medical certificate of death. Calculate the performance of the clinic.

5. Algorithm for the practical work of students.

1	Questions initial level of knowledge. The tests.
2	Interview, discussion
3	Working with the methodological material
4	Working with case studies, tests.
5	The final control of knowledge

6. Content of theme

PRINCIPLES OF ORGANIZATION OF MEDICAL HELP TO RURAL POPULATION.

Unity of medical and preventive aid;

Guarantee of free primary medical-sanitary help;

Successiveness of out-patient and in-patient medical help;

Stages of specialized medical provision;

District-territorial approach method;

Specialization and integration of medical help;

Referencing service of separate social group of population.

PECULIARITIES OF ORGANIZATION OF MEDIAL HELP TO RURAL POPULATION:

Stages

High specific gravity of before doctor medical help

Special medical establishments in the country

Specific organization and methods of work

MODERN TASKS OF RURAL PUBLIC HEALTH IN UKRAINE:

Rendering of qualitative out-patient help;

Preventive orientation;

Approaching of specialized help;

Organization of first- aid;

Sufficient staff of physicians in hospitals and out-patient clinics.

SOCIAL-ECONOMIC AND MEDICAL-DEMOGRAPHIC FACTORS INFLUENCING ON ORGANIZATION OF MEDICAL AID TO RURAL POPULATION:

Population density

Specificity of agricultural work

(Low mechanization, manual skills, poisonings, seasonal prevalence)

Road condition within the rural area, bus service, etc.

STAGES OF MEDICAL HELP TO RURAL POPULATION

I stage - rural medical division

II stage- district medical establishments

III stage - regional establishments

IV stage - interregional specialized establishments

ORGANIZATION OF MEDICAL-SANITARY HELP TO RURAL POPULATION I STAGE – RURAL MEDICAL DIVISION

Rendering of qualified primary medical-sanitary help (PMSH):

Doctor`s assistant and obstetric points

Rural out-patient clinics

Divisional hospitals

ORGANIZATION OF MEDICAL-SANITARY HELP TO RURAL POPULATION II STAGE –DISTRICT MEDIC ESTABLISHMENTS

Rendering of secondary (specialized) aid

Central district hospital CDH)

District hospitals

District sanitary-epidemiological station

Pharmacy

ORGANIZATION OF MEDICAL-SANITARYHELP TO RURAL POPULATION III STAGE - REGIONAL MEDICAL ESTABLISHMENTS

Rendering of narrow specialized medical help:

Regional hospitals

Regional dispensaries

Regional diagnostic center

Regional sanitary-epidemiological station

Bureau of forensic medicine examination

Hemotransfusion station

Regional pharmacy

ORGANIZATION OF MEDICAL-SANITARY HELP TO RURAL POPULATION IV STAGE:

Medical establishments

Interregional and state specialized centers:

Kiev : cardio surgery, mother and childhood protection centre;

Kharkov : genetic centre;

Odessa : ophthalmologic;

Doneck : oncologic centre.

RURAL MEDICAL DIVISION (RMD) -PRIMARY MEDICAL SECTION AMONG THE ESTABLISHMENTS RENDERING MEDICAL AID TO RURAL POPULATION

To organize a RMD it`s necessary to take into account:

Number of population

Peculiarities of its settling

Size of district territory

Distance between villages

Condition of means communications

I STAGE. DOCTOR`S ASSISTANT AND OBSTETRICS POINT(DAOP)

MAIN TASKS:

Rendering of before doctor medical help:

- out-patient reception;

- medical help at home

Home nursing of children and pregnant women:

- help to women before and after labor;

- dispensary observation after children

Execution of doctor`s prescriptions

Realization of sanitary-hygienic and ant epidemical arrangements

SANITARY- ANTIEPIDEMICAL ARRANGEMENTS

Detection of infectious diseases

Current disinfection

Observation after infectious patients

Preventive vaccination

Dehelmintization arrangements

Current sanitary inspectors

Sanitary-educative work

Prevention of traumatism and pest-

killer poisonings

 

I STAGE. RURAL OUT-PATIENT CLINIC.

Staff:

Therapeutics

Pediatrician or family doctor

Stomatologist (0,5 rate)

Obstetrician-gynecologist ( 0,5 rate)

RURAL OUT-PATIENT CLINIC TASKS

Treatment of patients in clinic and at home;

Organization of first-aid;

Timely hospitalization of patients;

Dynamic observation after women`s an children`s health status;

Temporal disability examination;

Dispensary observation of population;

Sanitary and ant epidemical measures;

Referral for consultations to specialists in district establishments

STRUCTURE OF INDEPENDENT RURAL OUT-PATIENT CLINIC

Rooms of doctors (therapeutics, pediatrician, stomatologist, obstetrician-gynecologist)

Physiotherapy room

Clinical laboratory

X - room

Registry

Functional diagnostics room

I STAGE. DIVISIONAL HOSPITAL. Categories:

I - 75 – 100 beds

II - 50 – 75 beds

III - 35 - 50 beds

IV - 25 – 35 beds

TASKS OF DIVISIONAL HOSPITALS

Urgent surgical and traumatologic aid

Mother and child protection:

- medical help during the labors;

- medical-preventive help to children

Out-patient and in-patient help to population

Realization of antiepidemical measures

Prevention of morbidity and traumatism

Hygienic education of population

II STAGE. CENTRAL DISTRICT HOSPITAL (CDH). Structure:

In-patient department

Out-patient department (+ day in-patient department)

First –aid department

Administrative-economical section

Pathologic-anatomical department

Information-analytic room (department)

OUT-PATIENT DEPARTMENT OF CDH

Therapeutic department (30-40 beds)

Surgical department ( 40-60 beds)

Gynecological department ( 40)

Maternity hospital

Pediatric department ( 30)

TASKS OF CDH:

Rendering of specialized out-patient and in- patient help to district population;

Providing of first-aid to district population;

Organizational-methodical work;

Organization of consultative aid;

Introduction of modern diagnostic, treatment and prevention methods in practice;

Organization of material-technical provision of district public health establishments.

CATEGORIES OF CDH: I - more 350 beds; II - 300 – 350; III - 250 – 300;

IV - 200 – 250; V - 150 – 200; VI - 100 – 150.