Политика в области репродуктивного здоровья в регионах и странах мира
The article deals with such reproductive health problems as maternal mortality, teenage pregnancies, unsafe abortions and unmet need for family planning
Fertility transition in Russia had been completed up to the 1960s, but since then pregnancy termination remained playing a large role in birth control. Official statistics show the positive dynamics of main characteristics of reproductive health in the post-Soviet period. This development is often questioned. Based on the analysis of data from Rosstat, Russian Ministry of Health, and materials from sample surveys, mostly from 21 waves of "Russian Longitudinal Monitoring Survey - Higher School of Economics "(RLMS-HSE) we conclude that the official statistics of abortion are adequate. The article refutes the assumption of significant underreporting of abortions in Russia. Over the past few decades Russia has experienced contraceptive revolution, which led to a more humane way of birth control.
coBverage of specific reproductive health care services as well as assessment of observed versus expected maternal mortality as a function of Socio-Demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility.
Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographic disparities widened and, in 2015, there were still 24 countries with MMR greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated etiologic profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and miscarriage. Historical patterns suggest achievement of SDG 3.1 will require 91% coverage of one antenatal care (ANC) visit, 78% of four ANC visits, 81% of in-facility delivery (IFD), and 87% of skilled birth attendance (SBA).
Several challenges to improving reproductive health lie ahead in the SDG era. Countries should: a) establish or renew systems for collection and timely dissemination of health data; b) expand coverage and improve quality of family planning services, including access to contraception and safe abortion to address high adolescent fertility; c) invest in improving health system capacity, including coverage of routine reproductive health care and of more advanced obstetric care—including emergency obstetric care (EmOC); d) Adapt health systems and data collection systems to monitor and reverse the increase in indirect, other direct, and late maternal deaths, especially in high SDI locations; e) Examine their own performance with respect to their SDI level, using that information to formulate strategies for improving performance and ensuring optimum reproductive health of their population.
Several approaches to the concept of fatherhood present in Western sociological tradition are analyzed and compared: biological determinism, social constructivism and biosocial theory. The problematics of fatherhood and men’s parental practices is marginalized in modern Russian social research devoted to family and this fact makes the traditional inequality in family relations, when the father’s role is considered secondary compared to that of mother, even stronger. However, in Western critical men’s studies several stages can be outlined: the development of “sex roles” paradigm (biological determinism), the emergence of the hegemonic masculinity concept, inter-disciplinary stage (biosocial theory). According to the approach of biological determinism, the role of a father is that of the patriarch, he continues the family line and serves as a model for his ascendants. Social constructivism looks into man’s functions in the family from the point of view of masculine pressure and establishing hegemony over a woman and children. Biosocial theory aims to unite the biological determinacy of fatherhood with social, cultural and personal context. It is shown that these approaches are directly connected with the level of the society development, marriage and family perceptions, the level of egality of gender order.