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E. STIKOVA, LJ. PANEVA, F. TOZIJA

PROVISION OF HEALTH CARE FOR THE POPULATION OF CHILDREN
WITH SPECIAL REVIEW OF THE INDICATORS OF HEALTH CONDITION
IN THE PRENATAL AND EARLY NATAL PERIOD

            The aim of this paper is to present the organizational settings of health care on all levels (primary, secondary and tertiary), the personnel with university, college and high school education which gives health care for the children. Children's diseases will be presented, especially those which leave traces in the psychophysical status of the child and pose social and medical problem for the family and the whole community. Death rate of children will also be presented according to the causes of death, in the period of 1987-95.

            Health care of children aged 0-6 years in the primary health care is organized through well-child clinics for infants and preschool children in 18 health facilities and 16 medical centers in the Republic of Macedonia, as well as through rural medical units, with a total of 157 locations.

            The number of physicians in 1995 has increased 9% compared with 1987 and the number of specialists is 66% higher compared with 1987.

            Secondary health care is provided through specialist consulting offices as well as through medical wards in general hospitals and rehabilitation centers.

            Tertiary health care is provided by the clinics of the Faculty of Medicine in Skopje (well-child, otolaryngology, ophthalmology, orthopedics).

            The death rate ascertained by the health care services for infants and preschool children in the period between 1987 and 1995 shows obvious decrease, which is especially the case with perinatal diseases (19% or one fifth) and congenital anomalies (46%). These diseases are confirmed in the period of early childhood, which certainly gives evidence of better health care and early detection of these diseases.

            The death rate of infants is constantly decreasing from 44,0‰  to 22,7‰ of the newborns in 1995.

            Perinatal death rate has decreased from 21,6‰ in 1987 to 19,6‰ in 1995, and the early neonatal death rate (0-6 days old) has also decreased from 12,7‰ to 10,7‰ in 1995. The most frequent cause of death with infants in the early neonatal period are complications in the perinatal period (283 deaths or 82,3%) and congenital anomalies (29 deaths or 8,4% of the deaths in the neonatal period) in 1995.