48 research outputs found
Migrant Health Policy in European Union (EU) and a non EU country: Current situation and future challenges for improvement
Aim: The influx of refugees, asylum seekers and migrants in Europe is an ongoing reality and migrant health has become very important public health problem. The aim of this paper is to analyze and compare the health profile, migrant situation and migration integration health policy in Spain as a European Union (EU) country and Republic of North Macedonia as a country in process of European Union accession.
Methods: Migration Integration Policy Index (MIPEX) Health strand questionnaire (2015) was applied to compare health policies for migrant integration in both countries.
Results: There are differences between Spain and Macedonia in health care coverage and access to health services for migrants. Spain has health strand total score of 52 and is in the same group with Austria, Ireland, Belgium, Netherlands, Denmark and Sweden. Macedonia has lower health strand total score 38 and is in the same group with Turkey, Cyprus, Slovakia. Targeted migrant health policies are stronger and services more responsive in Spain compared to Macedonia which offers migrants legal entitlements to healthcare, but health services should be more culturally responsive to migrant health needs.
Conclusion: Health migration policy in both countries is closely tied to the general immigration policy
ΠΠΎΠ΄ΠΎΠ±ΡΡΠ²Π°ΡΠ΅ Π½Π° ΡΠΎΠ²Π΅ΠΊΠΎΠ²ΠΈΡΠ΅ ΠΏΡΠ°Π²Π° Π²ΠΎ Π·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½Π°ΡΠ° Π·Π°ΡΡΠΈΡΠ° Π²ΠΎ Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ°
The rights of patients are based on the general human rights and are an important segment in the process of "Europeanization" of the Republic of Macedonia. The main goal of this study was to analyze the legislative framework of human rights in the health care in the Republic of Macedonia and its implementation in practice. Material and methods: The study was designed as a descriptive-analytical cross sectional study, in which a public health approach, an information-analytical method and evidence synthesis method were applied for the analysis of the relevant legislation. A survey was conducted on a representative stratified sample of patients in the Polog Region in the period from October to November 2017 in the Clinical Hospital Tetovo and the General Hospital Gostivar. Results: The legal system of the Republic of Macedonia was analyzed and compared with 6 transition countries, which had undergone a series of substantial reforms in recent years. The legislative framework in the Republic of Macedonia is a comprehensive frame for protection of patientsβ rights, with which the patient is guaranteed legal rights in the process of treatment, respect and protection of his/her personality and integrity. The implementation of patients' rights in practice in this paper was analyzed by implementation of two rights of patients: the right on information about the recommended medical interventions and the right to accept and reject certain medical intervention. 85.2% of the interviewed patients had information on the right to information about the recommended medical interventions, and 14.8% didnβt have. 72.1% of the interviewed patients had personal experience for this right, and 27.9% didnβt have. Regarding the right to accept and reject certain medical intervention, 77% of the interviewed patients had information on this right, while 23% didnβt have. Personal experience was significantly smaller with this right, i.e. only 32.8% of the interviewed patients had personal experience, and 67.2% didnβt have. These differences were significant for both rights, for information and for personal experience. Conclusions: The human rights in the health care in the Republic of Macedonia are reflected in the national legislation, which is harmonized with the European and international legislation. However, it is necessary to improve the implementation of patients' rights in practice by raising the citizens' awareness about the knowledge of patients' rights and encouraging medical staff to respect the rights of patients and their compulsory application in practice.ΠΡΠ°Π²Π°ΡΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΠΏΡΠΎΠΈΠ·Π»Π΅Π³ΡΠ²Π°Π°Ρ ΠΎΠ΄ ΠΎΠΏΡΡΠΈΡΠ΅ ΡΠΎΠ²Π΅ΠΊΠΎΠ²ΠΈ ΠΏΡΠ°Π²Π° ΠΈ ΡΠ΅ Π²Π°ΠΆΠ΅Π½ ΡΠ΅Π³ΠΌΠ΅Π½Ρ Π²ΠΎ ΠΏΡΠΎΡΠ΅ΡΠΎΡ Π½Π° ,,Π΅Π²ΡΠΎΠΏΠ΅ΠΈΠ·Π°ΡΠΈΡΠ°β Π½Π° Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ°. ΠΠ»Π°Π²Π½Π° ΡΠ΅Π» Π½Π° ΠΎΠ²Π°Π° ΡΡΡΠ΄ΠΈΡΠ° Π±Π΅ΡΠ΅ Π΄Π° ΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ° Π»Π΅Π³ΠΈΡΠ»Π°ΡΠΈΠ²Π½Π°ΡΠ° ΡΠ°ΠΌΠΊΠ° Π½Π° ΡΠΎΠ²Π΅ΠΊΠΎΠ²ΠΈΡΠ΅ ΠΏΡΠ°Π²Π° Π²ΠΎ Π·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½Π°ΡΠ° Π·Π°ΡΡΠΈΡΠ° Π²ΠΎ Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ° ΠΈ ΠΈΠΌΠΏΠ»Π΅ΠΌΠ΅Π½ΡΠ°ΡΠΈΡΠ°ΡΠ° Π²ΠΎ ΠΏΡΠ°ΠΊΡΠ°. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: Π‘ΡΡΠ΄ΠΈΡΠ°ΡΠ° Π΅ Π΄ΠΈΠ·Π°ΡΠ½ΠΈΡΠ°Π½Π° ΠΊΠ°ΠΊΠΎ Π΄Π΅ΡΠΊΡΠΈΠΏΡΠΈΠ²Π½ΠΎβΠ°Π½Π°Π»ΠΈΡΠΈΡΠΊΠ° ΡΡΡΠ΄ΠΈΡΠ° Π½Π° ΠΏΡΠ΅ΡΠ΅ΠΊ, Π²ΠΎ ΠΊΠΎΡΠ° Π±Π΅ΡΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Ρ ΡΠ°Π²Π½ΠΎΠ·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½ ΠΏΡΠΈΡΡΠ°ΠΏ, ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡΠΊΠΎ-Π°Π½Π°Π»ΠΈΡΠΈΡΠ΅Π½ ΠΌΠ΅ΡΠΎΠ΄ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ Π½Π° ΡΠΈΠ½ΡΠ΅Π·Π° Π½Π° Π΅Π²ΠΈΠ΄Π΅Π½ΡΠΈΡΠ° (evidence synthesis) Π·Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΡΠ΅Π»Π΅Π²Π°Π½ΡΠ½Π°ΡΠ° Π»Π΅Π³ΠΈΡΠ»Π°ΡΠΈΠ²Π°. ΠΠ΅ΡΠ΅ ΡΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π°Π½ΠΊΠ΅ΡΠ½ΠΎ ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠ΅ Π½Π° ΡΠ΅ΠΏΡΠ΅Π·Π΅Π½ΡΠ°ΡΠΈΠ²Π΅Π½ ΡΡΡΠ°ΡΠΈΡΠΈΡΠΈΡΠ°Π½ ΠΏΡΠΈΠΌΠ΅ΡΠΎΠΊ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Π²ΠΎ ΠΠΎΠ»ΠΎΡΠΊΠΈΠΎΡ Π Π΅Π³ΠΈΠΎΠ½, Π²ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΎΠ΄ Π΄Π²Π° ΠΌΠ΅ΡΠ΅ΡΠΈ, ΠΎΠΊΡΠΎΠΌΠ²ΡΠΈ-Π½ΠΎΠ΅ΠΌΠ²ΡΠΈ Π²ΠΎ 2017 Π³ΠΎΠ΄ΠΈΠ½Π°, Π²ΠΎ ΠΠ»ΠΈΠ½ΠΈΡΠΊΠ°ΡΠ° Π±ΠΎΠ»Π½ΠΈΡΠ° Π²ΠΎ Π’Π΅ΡΠΎΠ²ΠΎ ΠΈ ΠΠΏΡΡΠ°ΡΠ° Π±ΠΎΠ»Π½ΠΈΡΠ° Π²ΠΎ ΠΠΎΡΡΠΈΠ²Π°Ρ. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΠ΅ΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ°Π½ ΠΏΡΠ°Π²Π½ΠΈΠΎΡ ΡΠΈΡΡΠ΅ΠΌ Π½Π° Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ° ΠΈ Π±Π΅ΡΠ΅ ΡΠΏΠΎΡΠ΅Π΄Π΅Π½ ΡΠΎ 6 Π΄ΡΠΆΠ°Π²ΠΈ Π²ΠΎ ΡΡΠ°Π½Π·ΠΈΡΠΈΡΠ°, ΠΊΠΎΠΈ ΠΏΡΠ΅ΡΡΠΏΠ΅Π° Π½ΠΈΠ·Π° ΡΡΡΡΠΈΠ½ΡΠΊΠΈ ΡΠ΅ΡΠΎΡΠΌΠΈ Π²ΠΎ ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ²Π΅ Π³ΠΎΠ΄ΠΈΠ½ΠΈ. ΠΠ΅Π³ΠΈΡΠ»Π°ΡΠΈΠ²Π½Π°ΡΠ° ΡΠ°ΠΌΠΊΠ° Π²ΠΎ Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ° ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° ΡΠ΅ΠΎΠΏΡΠ°ΡΠ½Π° ΡΠ°ΠΌΠΊΠ° Π·Π° Π·Π°ΡΡΠΈΡΠ° Π½Π° ΠΏΡΠ°Π²Π°ΡΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΡ, ΡΠΎ ΠΊΠΎΡΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΡ ΠΌΡ ΡΠ΅ Π·Π°Π³Π°ΡΠ°Π½ΡΠΈΡΠ°Π½ΠΈ Π·Π°ΠΊΠΎΠ½ΡΠΊΠΈ ΠΏΡΠ°Π²Π° Π²ΠΎ ΠΏΡΠΎΡΠ΅ΡΠΎΡ Π½Π° Π»Π΅ΠΊΡΠ²Π°ΡΠ΅ΡΠΎ, ΠΏΠΎΡΠΈΡΡΠ²Π°ΡΠ΅ΡΠΎ ΠΈ Π·Π°ΡΡΠΈΡΠ°ΡΠ° Π½Π° Π½Π΅Π³ΠΎΠ²Π°ΡΠ° Π»ΠΈΡΠ½ΠΎΡΡ ΠΈ ΠΈΠ½ΡΠ΅Π³ΡΠΈΡΠ΅Ρ. ΠΠΎ ΠΎΠ²ΠΎΡ ΡΡΡΠ΄ ΠΈΠΌΠΏΠ»Π΅ΠΌΠ΅Π½ΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° ΠΏΡΠ°Π²Π°ΡΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π²ΠΎ ΠΏΡΠ°ΠΊΡΠ° Π±Π΅ΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ°Π½Π° ΠΏΡΠ΅ΠΊΡ ΠΈΠΌΠΏΠ»Π΅ΠΌΠ΅Π½ΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° Π΄Π²Π΅ ΠΏΡΠ°Π²Π° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅, ΠΈ ΡΠΎΠ°: ΠΏΡΠ°Π²ΠΎ Π½Π° ΠΈΠ½ΡΠΎΡΠΌΠΈΡΠ°Π½ΠΎΡΡ Π·Π° ΠΏΡΠ΅ΠΏΠΎΡΠ°ΡΠ°Π½ΠΈΡΠ΅ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΠΈ ΠΈ ΠΏΡΠ°Π²ΠΎ Π½Π° ΠΏΡΠΈΡΠ°ΡΠ°ΡΠ΅ ΠΈ ΠΎΠ΄Π±ΠΈΠ²Π°ΡΠ΅ Π½Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ° ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΡΠ°. 85,2% ΠΎΠ΄ Π°Π½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΠΈΠΌΠ°Π»Π΅ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ Π·Π° ΠΏΡΠ°Π²ΠΎΡΠΎ Π½Π° ΠΈΠ½ΡΠΎΡΠΌΠΈΡΠ°Π½ΠΎΡΡ Π·Π° ΠΏΡΠ΅ΠΏΠΎΡΠ°ΡΠ°Π½ΠΈΡΠ΅ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΠΈ, Π° 14,8% Π½Π΅ΠΌΠ°Π»Π΅. 72,1% ΠΎΠ΄ Π°Π½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΠΈΠΌΠ°Π»Π΅ Π»ΠΈΡΠ½ΠΎ ΠΈΡΠΊΡΡΡΠ²ΠΎ Π·Π° ΠΎΠ²Π° ΠΏΡΠ°Π²ΠΎ, Π΄ΠΎΠ΄Π΅ΠΊΠ° 27,9% Π½Π΅ΠΌΠ°Π»Π΅. ΠΠΎ ΠΎΠ΄Π½ΠΎΡ Π½Π° ΠΏΡΠ°Π²ΠΎΡΠΎ Π½Π° ΠΏΡΠΈΡΠ°ΡΠ°ΡΠ΅ ΠΈ ΠΎΠ΄Π±ΠΈΠ²Π°ΡΠ΅ Π½Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ° ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΡΠ°, 77% ΠΎΠ΄ Π°Π½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΠΈΠΌΠ°Π»Π΅ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ Π·Π° ΠΎΠ²Π° ΠΏΡΠ°Π²ΠΎ, Π° 23% Π½Π΅ΠΌΠ°Π»Π΅. ΠΠ½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠΌΠ°Π»ΠΎ Π±Π΅ΡΠ΅ Π»ΠΈΡΠ½ΠΎΡΠΎ ΠΈΡΠΊΡΡΡΠ²ΠΎ Π·Π° ΠΎΠ²Π° ΠΏΡΠ°Π²ΠΎ, ΠΎΠ΄Π½ΠΎΡΠ½ΠΎ ΡΠ°ΠΌΠΎ 32,8% ΠΎΠ΄ Π°Π½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΠΈΠΌΠ°Π»Π΅ Π»ΠΈΡΠ½ΠΎ ΠΈΡΠΊΡΡΡΠ²ΠΎ, Π° 67,2% Π½Π΅ΠΌΠ°Π»Π΅. Π Π°Π·Π»ΠΈΠΊΠΈΡΠ΅ Π±Π΅Π° ΡΠΈΠ³Π½ΠΈΡΠΈΠΊΠ°Π½ΡΠ½ΠΈ Π²ΠΎ ΠΎΠ΄Π³ΠΎΠ²ΠΎΡΠΈΡΠ΅ Π·Π° Π΄Π²Π΅ΡΠ΅ ΠΏΡΠ°Π²Π°, ΠΈ Π·Π° ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡΠ°ΡΠ° ΠΈ Π·Π° Π»ΠΈΡΠ½ΠΎΡΠΎ ΠΈΡΠΊΡΡΡΠ²ΠΎ. ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: Π§ΠΎΠ²Π΅ΠΊΠΎΠ²ΠΈΡΠ΅ ΠΏΡΠ°Π²Π° Π²ΠΎ Π·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½Π°ΡΠ° Π·Π°ΡΡΠΈΡΠ° Π²ΠΎ Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ° ΡΠ΅ ΡΠ΅ΡΠ»Π΅ΠΊΡΠΈΡΠ°Π½ΠΈ Π²ΠΎ Π½Π°ΡΠΈΠΎΠ½Π°Π»Π½Π°ΡΠ° Π»Π΅Π³ΠΈΡΠ»Π°ΡΠΈΠ²Π° ΠΊΠΎΡΠ° Π΅ Ρ
Π°ΡΠΌΠΎΠ½ΠΈΠ·ΠΈΡΠ°Π½Π° ΡΠΎ Π΅Π²ΡΠΎΠΏΡΠΊΠ°ΡΠ° ΠΈ ΠΌΠ΅ΡΡΠ½Π°ΡΠΎΠ΄Π½Π°ΡΠ°. ΠΠ΅ΡΡΡΠΎΠ°, ΠΏΠΎΡΡΠ΅Π±Π½ΠΎ Π΅ ΠΏΠΎΠ΄ΠΎΠ±ΡΡΠ²Π°ΡΠ΅ Π½Π° ΠΈΠΌΠΏΠ»Π΅ΠΌΠ΅Π½ΡΠ°ΡΠΈΡΠ°ΡΠ° Π½Π° ΠΏΡΠ°Π²Π°ΡΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π²ΠΎ ΠΏΡΠ°ΠΊΡΠ°, ΠΏΡΠ΅ΠΊΡ ΠΏΠΎΠ΄ΠΈΠ³Π½ΡΠ²Π°ΡΠ΅ Π½Π° ΡΠ²Π΅ΡΡΠ° Π½Π° Π³ΡΠ°ΡΠ°Π½ΠΈΡΠ΅ Π·Π° ΠΏΠΎΠ·Π½Π°Π²Π°ΡΠ΅ Π½Π° ΠΏΡΠ°Π²Π°ΡΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΠΈ ΠΏΠΎΡΡΠΈΠΊΠ½ΡΠ²Π°ΡΠ΅ Π½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠΎΡ ΠΏΠ΅ΡΡΠΎΠ½Π°Π» Π·Π° ΠΏΠΎΡΠΈΡΡΠ²Π°ΡΠ΅ Π½Π° ΠΏΡΠ°Π²Π°ΡΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡ
Migrant Health Policy in European Union (EU) and a non EU country: Current situation and future challenges for improvement
Aim: The influx of refugees, asylum seekers and migrants in Europe is an ongoing reality and migrant health has become very important public health problem. The aim of this paper is to analyze and compare the health profile, migrant situation and migration integration health policy in Spain as a European Union (EU) country and Republic of North Macedonia as a country in process of European Union accession.
Methods: Migration Integration Policy Index (MIPEX) Health strand questionnaire (2015) was applied to compare health policies for migrant integration in both countries.
Results: There are differences between Spain and Macedonia in health care coverage and access to health services for migrants. Spain has health strand total score of 52 and is in the same group with Austria, Ireland, Belgium, Netherlands, Denmark and Sweden. Macedonia has lower health strand total score 38 and is in the same group with Turkey, Cyprus, Slovakia. Targeted migrant health policies are stronger and services more responsive in Spain compared to Macedonia which offers migrants legal entitlements to healthcare, but health services should be more culturally responsive to migrant health needs.
Conclusion: Health migration policy in both countries is closely tied to the general immigration policy.
Conflicts of interest: None declared
ΠΡΠΎΡΠ΅Π½ΠΊΠ° Π½Π° Π΅ΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΡΠΊΠ°ΡΠ° ΡΠΎΡΡΠΎΡΠ±Π° ΠΈ ΠΎΠΏΡΠΎΠ²Π°ΡΠ΅Π½ΠΎΡΡΠ° ΡΠΎ COVID-19 Π½Π° Π³Π»ΠΎΠ±Π°Π»Π½ΠΎ, ΡΠ΅Π³ΠΈΠΎΠ½Π°Π»Π½ΠΎ ΠΈ Π½Π°ΡΠΈΠΎΠ½Π°Π»Π½ΠΎ Π½ΠΈΠ²ΠΎ
The current pandemic of corona virus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Global COVID-19 burden is characterized by a high variability in death rate across countries. Several possible explanations have been proposed, but it is not clear whether this variability is due to a single predominant factor or instead to multiple causes. The aim of this paper was to present and analyze the epidemiological situation and burden of the COVID-19 pandemic in Kosovo compared to other countries in Europe and the world. Material and methods: Public health approach and desk review were applied to present and analyze the trends over time of selected epidemiological indicators for COVID-19 based on multiple sources of data as well as WHO epidata and literature review. The assessment of the epidemiological situation in EU/EEA member states was done using the surveillance data routinely collected by ECDC. Official medical records from the National Institute of Public Health, other relevant health institutions; State Statistical Office and Ministry of Health in Kosovo were used. Results: According to ECDC as of 11 February 2021, 106,472,660 cases of COVID-19 (in accordance with the applied case definitions and testing strategies in the affected countries) have been reported, including 2,323,103 deaths. COVID-19 cases have been reported from: Africa: 3,673,181 cases, Asia: 20,438,608 cases, Europe: 34,681,426 cases, America: 47,620,931 cases; Oceania: 57,809 cases, Others: 705 cases. Deaths have been reported from: Africa 95,128 deaths, Asia 343,886, America 1,107,066, Europe 775,883, Oceania 1,210 and Other 6 deaths. In Kosovo from 13 March 2020 until 15th February 2021 there have been 64,298 cases of COVID- 19 with 1534 deaths. Absolute values of the indicators remain high in all countries in Europe, including those with stable or decreasing trends in these indicators, suggesting that transmission is still wide spread. The epidemic trajectory over the next months will be determined by the balance of four factors, with many different outcomes possible: the continued scale-up of vaccination, declining seasonality, the spread of new variants and increased behaviors that favor COVID-19 transmission. Conclusion: Findings from this paper can help to develop evidence-based policy interventions in Kosovo for risk assessment of COVID-19 and protection of general population and especially vulnerable groups with higher risk from COVID 19.Π’Π΅ΠΊΠΎΠ²Π½Π°ΡΠ° ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΡΠ° ΡΠΎ ΠΊΠΎΡΠΎΠ½Π° Π²ΠΈΡΡΡ ΠΎΠ΄ 2019Π³.(COVID-19) Π΅ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎ Π·Π°Π±ΠΎΠ»ΡΠ²Π°ΡΠ΅ ΠΏΡΠ΅Π΄ΠΈΠ·Π²ΠΈΠΊΠ°Π½ΠΎ ΠΎΠ΄ Π½ΠΎΠ²ΠΎΠΎΡΠΊΡΠΈΠ΅Π½ΠΈΠΎΡ ΠΊΠΎΡΠΎΠ½Π° Π²ΠΈΡΡΡ 2 ΠΊΠΎΡ ΠΏΡΠ΅Π΄ΠΈΠ·Π²ΠΈΠΊΡΠ²Π° ΡΠ΅ΠΆΠΎΠΊ Π°ΠΊΡΡΠ΅Π½ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ΅Π½ ΡΠΈΠ½Π΄ΡΠΎΠΌ (Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). ΠΠ»ΠΎΠ±Π°Π»Π½ΠΈΠ°ΡΠ° ΠΎΠΏΡΠΎΠ²Π°ΡΠ΅Π½ΠΎΡΡ ΡΠΎ COVID-19 ΡΠ΅ ΠΊΠ°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΈΡΠ° ΡΠΎ Π³ΠΎΠ»Π΅ΠΌΠ° Π²Π°ΡΠΈΡΠ°Π±ΠΈΠ»Π½ΠΎΡΡ Π²ΠΎ ΡΡΠ°ΠΏΠΊΠ°ΡΠ° Π½Π° ΡΠΌΡΡΠ½ΠΎΡΡ Π²ΠΎ Π΄ΡΠΆΠ°Π²ΠΈΡΠ΅. ΠΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½ΠΈ ΡΠ΅ Π½Π΅ΠΊΠΎΠ»ΠΊΡ ΠΌΠΎΠΆΠ½ΠΈ ΠΎΠ±ΡΠ°ΡΠ½ΡΠ²Π°ΡΠ°, Π½ΠΎ Π½Π΅ Π΅ ΡΠ°ΡΠ½ΠΎ Π΄Π°Π»ΠΈ ΠΎΠ²Π°Π° Π²Π°ΡΠΈΡΠ°Π±ΠΈΠ»Π½ΠΎΡΡ ΡΠ΅ Π΄ΠΎΠ»ΠΆΠΈ Π½Π° Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½ Π΄ΠΎΠΌΠΈΠ½Π°Π½ΡΠ΅Π½ ΡΠ°ΠΊΡΠΎΡ ΠΈΠ»ΠΈ Π½Π° ΠΏΠΎΠ²Π΅ΡΠ΅ ΠΏΡΠΈΡΠΈΠ½ΠΈ. Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²ΠΎΡ ΡΡΡΠ΄ Π±Π΅ΡΠ΅ Π΄Π° ΡΠ΅ ΠΏΡΠ΅Π·Π΅Π½ΡΠΈΡΠ° ΠΈ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ° Π΅ΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΡΠΊΠ°ΡΠ° ΡΠΎΡΡΠΎΡΠ±Π° ΠΈ ΠΎΠΏΡΠΎΠ²Π°ΡΠ΅Π½ΠΎΡΡΠ° ΡΠΎ ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΡΠ°ΡΠ° COVID-19 Π²ΠΎ ΠΠΎΡΠΎΠ²ΠΎ ΠΈ Π΄Π° ΡΠ΅ ΡΠΏΠΎΡΠ΅Π΄ΠΈ ΡΠΎ Π΄ΡΡΠ³ΠΈΡΠ΅ Π·Π΅ΠΌΡΠΈ Π²ΠΎ ΠΠ²ΡΠΎΠΏΠ° ΠΈ ΡΠ²Π΅ΡΠΎΡ. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠ°Π²Π½ΠΎΠ·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½ ΠΏΡΠΈΡΡΠ°ΠΏ ΠΈ ΠΏΡΠ΅Π³Π»Π΅Π΄ΠΎΡ Π½Π° Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠΈ ΡΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅ΡΠΈ Π·Π° Π΄Π° ΡΠ΅ ΠΏΡΠ΅Π·Π΅Π½ΡΠΈΡΠ° ΠΈ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ° ΡΡΠ΅Π½Π΄ΠΎΡ Π½Π° ΠΈΠ·Π±ΡΠ°Π½ΠΈΡΠ΅ Π΅ΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΡΠΊΠΈ ΠΈΠ½Π΄ΠΈΠΊΠ°ΡΠΎΡΠΈ Π·Π° COVID-19 Π²ΡΠ· ΠΎΡΠ½ΠΎΠ²Π° Π½Π° ΠΏΠΎΠ΄Π°ΡΠΎΡΠΈ ΠΎΠ΄ ΠΏΠΎΠ²Π΅ΡΠ΅ ΠΈΠ·Π²ΠΎΡΠΈ, ΠΊΠ°ΠΊΠΎ ΠΈ Π΅ΠΏΠΈΠ΄Π°ΡΠ° Π½Π° Π‘ΠΠ ΠΈ ΠΏΡΠ΅Π³Π»Π΅Π΄ Π½Π° Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ°. ΠΡΠΎΡΠ΅Π½ΠΊΠ°ΡΠ° Π½Π° Π΅ΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΡΠΊΠ°ΡΠ° ΡΠΎΡΡΠΎΡΠ±Π° Π²ΠΎ Π·Π΅ΠΌΡΠΈΡΠ΅-ΡΠ»Π΅Π½ΠΊΠΈ Π½Π° ΠΠ£/ΠΠΠ Π±Π΅ΡΠ΅ Π½Π°ΠΏΡΠ°Π²Π΅Π½Π° ΡΠΎ ΠΊΠΎΡΠΈΡΡΠ΅ΡΠ΅ Π½Π° ΠΏΠΎΠ΄Π°ΡΠΎΡΠΈΡΠ΅ Π·Π° ΡΠ»Π΅Π΄Π΅ΡΠ΅, ΡΡΡΠΈΠ½ΡΠΊΠΈ ΡΠΎΠ±ΡΠ°Π½ΠΈ ΠΎΠ΄ ECDC. ΠΠ΅Π° ΠΊΠΎΡΠΈΡΡΠ΅Π½ΠΈ ΠΎΡΠΈΡΠΈΡΠ°Π»Π½ΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΠΈΠ·Π²Π΅ΡΡΠ°ΠΈ ΠΎΠ΄ ΠΠ°ΡΠΈΠΎΠ½Π°Π»Π½ΠΈΠΎΡ ΠΈΠ½ΡΡΠΈΡΡΡ Π·Π° ΡΠ°Π²Π½ΠΎ Π·Π΄ΡΠ°Π²ΡΠ΅, Π΄ΡΡΠ³ΠΈ ΡΠ΅Π»Π΅Π²Π°Π½ΡΠ½ΠΈ Π·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½ΠΈ ΠΈΠ½ΡΡΠΈΡΡΡΠΈΠΈ; ΠΡΠΆΠ°Π²Π½ΠΈΠΎΡ Π·Π°Π²ΠΎΠ΄ Π·Π° ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠ° ΠΈ ΠΠΈΠ½ΠΈΡΡΠ΅ΡΡΡΠ²ΠΎΡΠΎ Π·Π° Π·Π΄ΡΠ°Π²ΡΡΠ²ΠΎ Π½Π° ΠΠΎΡΠΎΠ²ΠΎ. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: Π‘ΠΏΠΎΡΠ΅Π΄ ECDC Π·Π°ΠΊΠ»ΡΡΠ½ΠΎ ΡΠΎ 11 ΡΠ΅Π²ΡΡΠ°ΡΠΈ 2021 Π³ΠΎΠ΄ΠΈΠ½Π°, Π²ΠΎ ΡΠ²Π΅ΡΠΎΡ ΠΏΡΠΈΡΠ°Π²Π΅Π½ΠΈ ΡΠ΅ 106.472.660 ΡΠ»ΡΡΠ°ΠΈ Π½Π° COVID-19 (Π²ΠΎ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎΡΡ ΡΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅ΡΠΈΡΠ΅ Π΄Π΅ΡΠΈΠ½ΠΈΡΠΈΠΈ Π½Π° ΡΠ»ΡΡΠ°ΠΈ ΠΈ ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΈ Π·Π° ΡΠ΅ΡΡΠΈΡΠ°ΡΠ΅ Π²ΠΎ ΠΏΠΎΠ³ΠΎΠ΄Π΅Π½ΠΈΡΠ΅ Π·Π΅ΠΌΡΠΈ), Π²ΠΊΠ»ΡΡΠΈΡΠ΅Π»Π½ΠΎ ΠΈ 2.323.103 ΡΠΌΡΡΠ½ΠΈ ΡΠ»ΡΡΠ°ΠΈ. ΠΡΠΈΡΠ°Π²Π΅Π½ΠΈ ΡΠ΅ ΡΠ»ΡΡΠ°ΠΈ ΡΠΎ COVID-19 ΠΎΠ΄: ΠΡΡΠΈΠΊΠ°: 3.673.181 ΡΠ»ΡΡΠ°ΠΈ, ΠΠ·ΠΈΡΠ°: 20.438.608 ΡΠ»ΡΡΠ°ΠΈ, ΠΠ²ΡΠΎΠΏΠ°: 34.681.426 ΡΠ»ΡΡΠ°ΠΈ, ΠΠΌΠ΅ΡΠΈΠΊΠ°: 47.620.931 ΡΠ»ΡΡΠ°ΠΈ; ΠΠΊΠ΅Π°Π½ΠΈΡΠ°: 57 809 ΡΠ»ΡΡΠ°ΠΈ, Π΄ΡΡΠ³ΠΈ: 705 ΡΠ»ΡΡΠ°ΠΈ. ΠΡΠΈΡΠ°Π²Π΅Π½ΠΈ ΡΠ΅ ΡΠΌΡΡΠ½ΠΈ ΡΠ»ΡΡΠ°ΠΈ ΠΎΠ΄: ΠΡΡΠΈΠΊΠ° 95.128 ΡΠΌΡΡΠ½ΠΈ ΡΠ»ΡΡΠ°ΠΈ, ΠΠ·ΠΈΡΠ° 343.886, ΠΠΌΠ΅ΡΠΈΠΊΠ° 1.107.066, ΠΠ²ΡΠΎΠΏΠ° 775.883, ΠΠΊΠ΅Π°Π½ΠΈΡΠ° 1.210 ΠΈ Π΄ΡΡΠ³ΠΈ 6 ΡΠΌΡΡΠ½ΠΈ ΡΠ»ΡΡΠ°ΠΈ. ΠΠΎ ΠΠΎΡΠΎΠ²ΠΎ ΠΎΠ΄ 13 ΠΌΠ°ΡΡ 2020 Π³ΠΎΠ΄ΠΈΠ½Π° Π΄ΠΎ 15 ΡΠ΅Π²ΡΡΠ°ΡΠΈ 2021 Π³ΠΎΠ΄ΠΈΠ½Π° ΠΏΡΠΈΡΠ°Π²Π΅Π½ΠΈ ΡΠ΅ 64.298 ΡΠ»ΡΡΠ°ΠΈ Π½Π° COVID-19 ΠΈ 1.534 ΡΠΌΡΡΠ½ΠΈ ΡΠ»ΡΡΠ°ΠΈ. ΠΠΏΡΠΎΠ»ΡΡΠ½ΠΈΡΠ΅ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈ Π½Π° ΠΈΠ½Π΄ΠΈΠΊΠ°ΡΠΎΡΠΈΡΠ΅ ΠΎΡΡΠ°Π½ΡΠ²Π°Π°Ρ Π²ΠΈΡΠΎΠΊΠΈ Π²ΠΎ ΡΠΈΡΠ΅ Π·Π΅ΠΌΡΠΈ Π²ΠΎ ΠΠ²ΡΠΎΠΏΠ°, Π²ΠΊΠ»ΡΡΠΈΡΠ΅Π»Π½ΠΎ ΠΈ ΠΎΠ½ΠΈΠ΅ ΡΠΎ ΡΡΠ°Π±ΠΈΠ»Π½ΠΈ ΠΈΠ»ΠΈ ΡΡΠ΅Π½Π΄ΠΎΠ²ΠΈ Π½Π° ΠΎΠΏΠ°ΡΠ°ΡΠ΅, ΡΡΠΎ ΡΠΊΠ°ΠΆΡΠ²Π° Π΄Π΅ΠΊΠ° ΡΡΠ°Π½ΡΠΌΠΈΡΠΈΡΠ°ΡΠ° Π΅ ΡΓ¨ ΡΡΡΠ΅ ΡΠΈΡΠΎΠΊΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅ΡΠ°. Π’Π΅ΠΊΠΎΡ Π½Π° Π΅ΠΏΠΈΠ΄Π΅ΠΌΠΈΡΠ°ΡΠ° Π²ΠΎ ΡΠ»Π΅Π΄Π½ΠΈΡΠ΅ ΠΌΠ΅ΡΠ΅ΡΠΈ ΡΠ΅ Π±ΠΈΠ΄Π΅ ΠΎΠ΄ΡΠ΅Π΄Π΅Π½ ΠΎΠ΄ ΡΠ°ΠΌΠ½ΠΎΡΠ΅ΠΆΠ°ΡΠ° ΠΏΠΎΠΌΠ΅ΡΡ ΡΠ΅ΡΠΈΡΠΈ ΡΠ°ΠΊΡΠΎΡΠΈ, ΡΠΎ ΠΌΠΎΠΆΠ½ΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ ΠΈΡΡ
ΠΎΠ΄ΠΈ: ΠΊΠΎΠ½ΡΠΈΠ½ΡΠΈΡΠ°Π½ΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΡΠ²Π°ΡΠ΅ Π½Π° Π²Π°ΠΊΡΠΈΠ½Π°ΡΠΈΡΠ°ΡΠ°, ΡΠ΅Π·ΠΎΠ½ΡΠΊΠΎ Π½Π°ΠΌΠ°Π»ΡΠ²Π°ΡΠ΅, ΡΠΈΡΠ΅ΡΠ΅ Π½Π° Π½ΠΎΠ²ΠΈΡΠ΅ Π²Π°ΡΠΈΡΠ°Π½ΡΠΈ Π½Π° Π²ΠΈΡΡΡΠΎΡ ΠΈ Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΎ ΠΎΠ΄Π½Π΅ΡΡΠ²Π°ΡΠ΅ ΡΡΠΎ ΠΏΡΠΈΠ΄ΠΎΠ½Π΅ΡΡΠ²Π° Π·Π° ΠΏΡΠ΅Π½ΠΎΡΠΎΡ Π½Π° COVID-19. ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: ΠΠ°ΠΎΠ΄ΠΈΡΠ΅ ΠΎΠ΄ ΠΎΠ²ΠΎΡ ΡΡΡΠ΄ ΠΌΠΎΠΆΠ°Ρ Π΄Π° ΠΏΠΎΠΌΠΎΠ³Π½Π°Ρ Π΄Π° ΡΠ΅ ΡΠ°Π·Π²ΠΈΡΠ°Ρ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈ ΠΈ ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΠΈ Π·Π°ΡΠ½ΠΎΠ²Π°Π½ΠΈ Π½Π° Π΄ΠΎΠΊΠ°Π·ΠΈ Π²ΠΎ ΠΠΎΡΠΎΠ²ΠΎ, Π·Π° ΠΏΡΠΎΡΠ΅Π½ΠΊΠ° Π½Π° ΡΠΈΠ·ΠΈΠΊ Π·Π° COVID-19 ΠΈ Π·Π°ΡΡΠΈΡΠ° Π½Π° ΠΎΠΏΡΡΠ°ΡΠ° ΠΏΠΎΠΏΡΠ»Π°ΡΠΈΡΠ° ΠΈ ΠΎΡΠΎΠ±Π΅Π½ΠΎ Π½Π° ΡΠ°Π½Π»ΠΈΠ²ΠΈΡΠ΅ Π³ΡΡΠΏΠΈ ΡΠΎ ΠΏΠΎΠ³ΠΎΠ»Π΅ΠΌ ΡΠΈΠ·ΠΈΠΊ ΠΎΠ΄ COVID 19
Estimating health impacts and economic costs of air pollution in the Republic of Macedonia
Aim: This paper assesses the magnitude of health impacts and economic costs of fine particulate matter (PM) air pollution in the Republic of Macedonia.
Methods: Ambient PM10 and PM2.5 monitoring data were combined with population characteristics and exposure-response functions to calculate the incidence of several health end-points known to be highly influenced by air pollution. Health impacts were converted to Disability-Adjusted Life Years (DALYs) and then translated into economic terms using three valuation approaches to form lower and higher bounds: the (adjusted) Human Capital Approach (HCA), Value of a Statistical Life (VSL) and the COI (cost of illness).
Results: Fine particulate matter frequently exceeds daily and annual limit values andinfluences a personβs day-to-day health and their ability to work. Converting lost years of life and disabilities into DALYs - these health effects represent an annual economic cost of approximately β¬253 million or 3.2% of GDP (midpoint estimate). Premature death accounts for over 90% of the total health burden since this represents a loss of total life-long income. A reduction of even 1ΞΌg/m3 in ambient PM10 or PM 2.5 would imply 195 fewer deaths and represent an economic savings of β¬34 million per year in reduced health costs.
Conclusion: Interventions that reduce ambient PM10 or PM2.5 have significant economic savings in both the short and long run. Currently, these benefits (costs) are βhiddenβ due to the lack of information linking air quality and health outcomes and translating this into economic terms. Policymakers seeking ways to improve the publicβs health and lessen the burden on the health system could focus on a narrow set of air pollution sources to achieve these goal
Π€Π°ΠΊΡΠΎΡΠΈ ΠΊΠΎΠΈ Π²Π»ΠΈΡΠ°Π°Ρ Π½Π° ΠΏΡΠΈΡΠΎΠ΄Π½ΠΎΡΠΎ Π΄Π²ΠΈΠΆΠ΅ΡΠ΅ Π½Π° Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ΡΠΎ Π²ΠΎ Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° Π‘Π΅Π²Π΅ΡΠ½Π° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ°
The planning of public health programmes is directly related with the demographic characteristics and the population change has longterm impact on the health, health care and community interventions. The objective of this paper is to analyze the factors influencing the trend of population change in the Republic of North Macedonia. Material and methods: Data from the National Statistical Office and World Health Organization have been used. Literature review was conducted applying public health approach and descriptive method. Results: The natural population change in North Macedonia has negative trend in the last 10 years, the birth rate has declined, while the mortality is increasing. The biological factors and fertility rate have significantly influenced the birth rate, while the burden of chronic noncommunicable diseases, road injures, violence and COVID-19 are lead causes of mortality. Numerous factors indirectly affect the negative trend of population change such as the high rate of unemployment, poverty, socioeconomic and political context, migration and availability and quality of health care. Conclusion: Π detailed analysis of the factors affecting the natural population change and an appropriate national response with the aim of reducing the negative trends is needed.ΠΠ»Π°Π½ΠΈΡΠ°ΡΠ΅ΡΠΎ Π½Π° ΡΠ°Π²Π½ΠΎΠ·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½ΠΈΡΠ΅ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΈ Π΅ Π΄ΠΈΡΠ΅ΠΊΡΠ½ΠΎ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΎ ΡΠΎ Π΄Π΅ΠΌΠΎΠ³ΡΠ°ΡΡΠΊΠΈΡΠ΅ ΠΊΠ°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈΠΈ ΠΏΡΠΈΡΠΎΠ΄Π½ΠΎΡΠΎ Π΄Π²ΠΈΠΆΠ΅ΡΠ΅ Π½Π° Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ΡΠΎ ΠΈ ΠΈΠΌΠ° Π΄ΠΎΠ»Π³ΠΎΡΠΎΡΠ½ΠΎ Π²Π»ΠΈΡΠ°Π½ΠΈΠ΅ Π²ΡΠ· Π·Π΄ΡΠ°Π²ΡΠ΅ΡΠΎ,Π·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½Π°ΡΠ° Π·Π°ΡΡΠΈΡΠ° ΠΈ ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΠΈΡΠ΅ Π²ΠΎ Π·Π°Π΅Π΄Π½ΠΈΡΠ°ΡΠ°. Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²ΠΎΡ ΡΡΡΠ΄ Π΅ Π΄Π° ΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ°Π°Ρ ΡΠ°ΠΊΡΠΎΡΠΈΡΠ΅ ΠΊΠΎΠΈ Π²Π»ΠΈΡΠ°Π°Ρ Π½Π° ΡΡΠ΅Π½Π΄ΠΎΡ Π½Π° ΠΏΡΠΈΡΠΎΠ΄Π½ΠΎΡΠΎ Π΄Π²ΠΈΠΆΠ΅ΡΠ΅ Π½Π° Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ΡΠΎ Π²ΠΎ Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° Π‘Π΅Π²Π΅ΡΠ½Π° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ°. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠΎΡΠΈΡΡΠ΅Π½ΠΈ ΡΠ΅ ΠΏΠΎΠ΄Π°ΡΠΎΡΠΈ ΠΎΠ΄ Π΄Π°ΡΠ°Π±Π°Π·Π°ΡΠ° Π½Π° ΠΡΠΆΠ°Π²Π½ΠΈΠΎΡ Π·Π°Π²ΠΎΠ΄ Π·Π° ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠ° ΠΈΠ‘Π²Π΅ΡΡΠΊΠ°ΡΠ° Π·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½Π° ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡΠ°, ΠΊΠΎΠΈ ΡΠ΅ ΡΡΠ°ΡΠΈΡΡΠΈΡΠΊΠΈΠΎΠ±ΡΠ°Π±ΠΎΡΠ΅Π½ΠΈ ΠΈ ΠΏΡΠΈΠΊΠ°ΠΆΠ°Π½ΠΈ ΡΠ°Π±Π΅Π»Π°ΡΠ½ΠΎ ΠΈ Π³ΡΠ°ΡΠΈΡΠΊΠΈ. ΠΠ·Π²ΡΡΠ΅Π½ Π΅ ΠΏΡΠ΅Π³Π»Π΅Π΄ Π½Π° Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ°, Π° ΠΏΡΠΈΠΌΠ΅Π½Π΅Ρ Π΅ ΡΠ°Π²Π½ΠΎΠ·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½ ΠΏΡΠΈΡΡΠ°ΠΏ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ Π½Π° Π΄Π΅ΡΠΊΡΠΈΠΏΡΠΈΠ²Π½Π° Π°Π½Π°Π»ΠΈΠ·Π°. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΡΠΈΡΠΎΠ΄Π½ΠΎΡΠΎ Π΄Π²ΠΈΠΆΠ΅ΡΠ΅ Π½Π° Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ΡΠΎ Π²ΠΎ ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ° ΠΏΠΎΠΊΠ°ΠΆΡΠ²Π° Π½Π΅Π³Π°ΡΠΈΠ²Π΅Π½ ΡΡΠ΅Π½Π΄ Π²ΠΎ ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΡΠ΅ Π΄Π΅ΡΠ΅Ρ Π³ΠΎΠ΄ΠΈΠ½ΠΈ, ΠΎΠ΄Π½ΠΎΡΠ½ΠΎ ΡΠ΅ Π½Π°ΠΌΠ°Π»ΡΠ²Π° Π½Π°ΡΠ°Π»ΠΈΡΠ΅ΡΠΎΡ Π΄ΠΎΠ΄Π΅ΠΊΠ° ΠΌΠΎΡΡΠ°Π»ΠΈΡΠ΅ΡΠΎΡ Π΅ Π²ΠΎ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½Π° Π½Π°ΡΠΎΠΊΠ°, ΡΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ Π±ΡΠΎΡ Π½Π° ΠΏΠΎΡΠΈΠ½Π°ΡΠΈ Π»ΠΈΡΠ°. ΠΠΈΠΎΠ»ΠΎΡΠΊΠΈΡΠ΅ ΡΠ°ΠΊΡΠΎΡΠΈ ΠΈ ΡΡΠ°ΠΏΠΊΠ°ΡΠ° Π½Π° ΡΠ΅ΡΡΠΈΠ»ΠΈΡΠ΅Ρ Π·Π½Π°ΡΠ°ΡΠ½ΠΎ Π²Π»ΠΈΡΠ°Π°Ρ Π½Π° Π½Π°ΠΌΠ°Π»ΡΠ²Π°ΡΠ΅ Π½Π° Π½Π°ΡΠ°Π»ΠΈΡΠ΅ΡΠΎΡ, Π° ΠΎΠ΄ Π΄ΡΡΠ³Π° ΡΡΡΠ°Π½Π° ΠΎΠΏΡΠΎΠ²Π°ΡΠ΅Π½ΠΎΡΡΠ° ΡΠΎ Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΈΡΠ΅ Π½Π΅Π·Π°ΡΠ°Π·Π½ΠΈ Π±ΠΎΠ»Π΅ΡΡΠΈ, ΡΠΎΠΎΠ±ΡΠ°ΡΠ°ΡΠ½ΠΈΡΠ΅ Π½Π΅ΡΡΠ΅ΡΠΈ, Π½Π°ΡΠΈΠ»ΡΡΠ²ΠΎΡΠΎ ΠΈ ΠΠΎΠ²ΠΈΠ΄-19 ΡΠ΅ Π³Π»Π°Π²Π½ΠΈΡΠ΅ ΠΏΡΠΈΡΠΈΠ½ΠΈ Π·Π° Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½Π°ΡΠ° ΡΠΌΡΡΠ½ΠΎΡΡ. ΠΡΠΎΡΠ½ΠΈ ΠΈΠ½Π΄ΠΈΡΠ΅ΠΊΡΠ½ΠΈ ΡΠ°ΠΊΡΠΎΡΠΈ Π²Π»ΠΈΡΠ°Π°Ρ Π½Π° Π½Π΅Π³Π°ΡΠΈΠ²Π½ΠΈΠΎΡ ΡΡΠ΅Π½Π΄ Π½Π° ΠΏΡΠΈΡΠΎΠ΄Π½ΠΎΡΠΎ Π΄Π²ΠΈΠΆΠ΅ΡΠ΅ Π½Π° Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ΡΠΎ, ΠΊΠ°ΠΊΠΎ ΡΡΠΎ ΡΠ΅ Π²ΠΈΡΠΎΠΊΠ°ΡΠ° ΡΡΠ°ΠΏΠΊΠ° Π½Π° ΡΠΈΡΠΎΠΌΠ°ΡΡΠΈΡΠ° ΠΈ Π½Π΅Π²ΡΠ°Π±ΠΎΡΠ΅Π½ΠΎΡΡ, ΡΠΎΡΠΈΠΎΠ΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΠΈΠΎΡ ΠΈ ΠΏΠΎΠ»ΠΈΡΠΈΡΠΊΠΈ ΠΊΠΎΠ½ΡΠ΅ΠΊΡΡ, ΠΌΠΈΠ³ΡΠ°ΡΠΈΠΈΡΠ΅ ΠΈ ΠΏΡΠΈΡΡΠ°ΠΏΠΎΡ ΠΈ ΠΊΠ²Π°Π»ΠΈΡΠ΅ΡΠΎΡ Π½Π° Π·Π΄ΡΠ°Π²ΡΡΠ²Π΅Π½Π° Π·Π°ΡΡΠΈΡΠ°. ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: ΠΠΎΡΡΠ΅Π±Π½Π° Π΅ Π΄Π΅ΡΠ°Π»Π½Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΡΠ°ΠΊΡΠΎΡΠΈΡΠ΅ ΠΊΠΎΠΈ Π²Π»ΠΈΡΠ°Π°Ρ Π½Π° ΠΏΡΠΈΡΠΎΠ΄Π½ΠΎΡΠΎ Π΄Π²ΠΈΠΆΠ΅ΡΠ΅ Π½Π° Π½Π°ΡΠ΅Π»Π΅Π½Π΅ΡΠΎ ΠΈ ΡΠΎΠΎΠ΄Π²Π΅ΡΠ΅Π½ Π½Π°ΡΠΈΠΎΠ½Π°Π»Π΅Π½ ΠΎΠ΄Π³ΠΎΠ²ΠΎΡ ΡΠΎ ΡΠ΅Π» Π½Π°ΠΌΠ°Π»ΡΠ²Π°ΡΠ΅ Π½Π° Π½Π΅Π³Π°ΡΠΈΠ²Π½ΠΈΠΎΡ ΡΡΠ΅Π½Π΄
Stigma Associated with Tuberculosis Disease in Republic of Macedonia Γ’β¬β Results from a Cross-Sectional Study
BACKGROUND: Stigma and discrimination are interrelated and are breaking the fundamental human rights. Both are associated with tuberculosis (TB) disease since ever and have negative influence on activities aimed at TB prevention, treatment and control, both at individual, community and societal level.AIM: To determine the magnitude of TB stigma in Republic of Macedonia, identify root causes and detect main determinants associated with it.MATERIAL AND METHODS: Cross-sectional study was performed on 315 TB patients registered in the period Jul, 2012-Jun, 2013, using selected module from World Health Survey questionnaire. Self-reported data is collected through face to face interview conducted by trained directly observed treatment (DOT) nurses in the patientsΓ’β¬β’ home.RESULTS: 16.7% TB patients have not received any assistance when diagnosed with TB and 8.4% were treated badly by a member of the family or close friends because of the disease, consequences ranging from living the patient completely, refusal to talk or telling other people that the person is infected. An odd for such behavior were higher if the patient is male, married, have no formal education or have completed only primary school, is unemployed and lives in rural area.CONCLUSION: Understanding the origins of TB stigma is integral to reducing its impact on health. Our survey has provided a baseline on the magnitude of existent stigma associated with TB disease and has identified main determinants that trigger stigmatizing behavior
Estimating health impacts and economic costs of air pollution in the Republic of Macedonia
Aim: This paper assesses the magnitude of health impacts and economic costs of fine particulate matter (PM) air pollution in the Republic of Macedonia.Methods: Ambient PM10 and PM2.5 monitoring data were combined with population characteristics and exposure-response functions to calculate the incidence of several health end-points known to be highly influenced by air pollution. Health impacts were converted to Disability-Adjusted Life Years (DALYs) and then translated into economic terms using three valuation approaches to form lower and higher bounds: the (adjusted) Human Capital Approach (HCA), Value of a Statistical Life (VSL) and the COI (cost of illness).Results: Fine particulate matter frequently exceeds daily and annual limit values andinfluences a personβs day-to-day health and their ability to work. Converting lost years of life and disabilities into DALYs - these health effects represent an annual economic cost of approximately β¬253 million or 3.2% of GDP (midpoint estimate). Premature death accounts for over 90% of the total health burden since this represents a loss of total life-long income. A reduction of even 1ΞΌg/m3 in ambient PM10 or PM 2.5 would imply 195 fewer deaths and represent an economic savings of β¬34 million per year in reduced health costs.Conclusion: Interventions that reduce ambient PM10 or PM2.5 have significant economic savings in both the short and long run. Currently, these benefits (costs) are βhiddenβ due to the lack of information linking air quality and health outcomes and translating this into economic terms. Policymakers seeking ways to improve the publicβs health and lessen the burden on the health system could focus on a narrow set of air pollution sources to achieve these goals
Social determinants of equity in access to healthcare for tuberculosis patients in Republic of Macedonia β results from a case-control study
Background:
Health is a complex phenomenon and equity as a basic human right an integral part of constitutions
in almost all countries in the world. In Republic of Macedonia (RM), Tuberculosis (TB) is clustered regionally
and in certain ethnic groups. The main objective of this study was to analyze Social Determinants of Health
(SDH) and equity in access to healthcare services for TB patients in RM, aimed at complex analysis of factors
that cause inequities.
Methods:
Case-control study was conducted in the period MarchβDecember, 2013; βcasesβ are households of
TB patients registered in the period July, 2012βJune, 2013 and controls are households with no TB patients in
their immediate vicinity. World Health Organization (WHO) World Health Survey questionnaire was used to
collect data.
Results:
Analysis of SDH of TB patients shows that patients are mostly males, of lower socio-economic status,
are less educated, unemployed and TB is clustered in certain ethnic groups. Analysis of access has identified these
determinants as important barriers in access to health services.
Conclusion:
The study has documented the basic SDH of TB patients in RM, as well as barriers in access to
healthcare, providing useful baseline information to facilitate determination where to concentrate future efforts
ΠΡΠΈΠΎΡΠΈΡΠΈΠ·Π°ΡΠΈΡΠ° Π½Π° Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈΡΠ΅ Π²ΠΎ Π Π΅ΠΏΡΠ±Π»ΠΈΠΊΠ° Π‘Π΅Π²Π΅ΡΠ½Π° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ° β Π΄Π°Π»ΠΈ Π΅ ΠΏΠΎΡΡΠ΅Π±Π΅Π½ ΠΏΡΠΈΡΡΠ°ΠΏ Π½Π° ΠΠ΄Π½ΠΎ ΠΠ΄ΡΠ°Π²ΡΠ΅
Zoonoses have a different impact on public health, determined by geographical and socio-economic factors, which requires their prioritization for prevention and control purposes to be performed at the national level. Prioritization of zoonoses is a mechanism used in policy-making, primarily in allocating available resources. Aim of the paper is to compare two different methods used for prioritization of zoonoses by Institute of public health (IPH) and Food and Veterinary Agency (FVA). Material and methods: IPH used a method prepared by the U.S. Centers for Disease Control and Prevention (CDC), - One Health Zoonotic Disease Prioritization (OHZDP) tool, adapted to national conditions (2019). FVA used a standardized semi-quantitative method based on the OIE Methodological Manual (List and Categorization of priority diseases in animals including and those transmitted to humans). A total of 21 zoonoses have been selected, based on their importance for the human and veterinary sector. These diseases are ranked according to the stated criteria of the two previously conducted prioritizations and their comparison is performed. Results: With the prioritization conducted by IPH and FVA the first 5 ranked zoonoses are: Hemorrhagic fevers with renal syndrome, Leishmaniasis, Tularemia, Brucellosis and Listeriosis. With the prioritization carried out by the FVA the first 5 ranked zoonoses are: Bovine brucellosis, Bovine tuberculosis, Salmonellosis, Avian influenza and West Nile fever. A Cumulative Annual Incidence is taken as a control parameter. Regarding this, the 5 first ranked zoonoses are Echinococcosis, Brucellosis, Lyme fever, Leishmaniasis and Tularemia. Conclusions: A comparative analysis of the separate lists of priorities for human and veterinary medicine shows that only a certain percentage overlap. Also, the presence of a number of zoonoses with endemic character, but also a more pronounced risk of new emergent diseases, determines the need to provide consensus on the methodology of prioritization of zoonoses, and its formalization and institutionalization, as a crucial step towards identification and prioritization of zoonoses that would be the subject of joint programs and interventions.ΠΠΎΠΎΠ½ΠΎΠ·ΠΈΡΠ΅ ΠΈΠΌΠ°Π°Ρ ΡΠ°Π·Π»ΠΈΡΠ΅Π½ ΠΈΠΌΠΏΠ°ΠΊΡ Π½Π° ΡΠ°Π²Π½ΠΎΡΠΎ Π·Π΄ΡΠ°Π²ΡΡΠ²ΠΎ, Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½ΠΈΡΠ°Π½ΠΎ ΠΎΠ΄ Π³Π΅ΠΎΠ³ΡΠ°ΡΡΠΊΠΈΡΠ΅ ΠΈ ΡΠΎΡΠΈΠΎ-Π΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΠΈΡΠ΅ ΡΠ°ΠΊΡΠΎΡΠΈ, ΡΡΠΎ ΡΡΠ»ΠΎΠ²ΡΠ²Π° Π½ΠΈΠ²Π½Π°ΡΠ° ΠΏΡΠΈΠΎΡΠΈΡΠΈΠ·Π°ΡΠΈΡΠ° Π·Π° ΡΠ΅Π»ΠΈ Π½Π° ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π° ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Π° Π΄Π° Π±ΠΈΠ΄Π΅ ΠΈΠ·Π²Π΅Π΄Π΅Π½Π° Π½Π° Π½Π°ΡΠΈΠΎΠ½Π°Π»Π½ΠΎ Π½ΠΈΠ²ΠΎ. Π¦Π΅Π»ΡΠ° Π½Π° ΡΡΡΠ΄ΠΎΡ Π΅ Π΄Π° ΡΠ΅ ΡΠΏΠΎΡΠ΅Π΄Π°Ρ Π΄Π²Π° ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ ΡΡΠΎ ΡΠ΅ ΠΊΠΎΡΠΈΡΡΠ°Ρ Π·Π° ΠΏΡΠΈΠΎΡΠΈΡΠΈΠ·ΠΈΡΠ°ΡΠ΅ Π½Π° Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈΡΠ΅ ΠΎΠ΄ ΠΠ½ΡΡΠΈΡΡΡΠΎΡ Π·Π° ΡΠ°Π²Π½ΠΎ Π·Π΄ΡΠ°Π²ΡΠ΅ (ΠΠΠ) ΠΈ ΠΠ³Π΅Π½ΡΠΈΡΠ°ΡΠ° Π·Π° Ρ
ΡΠ°Π½Π° ΠΈ Π²Π΅ΡΠ΅ΡΠΈΠ½Π°ΡΡΡΠ²ΠΎ (ΠΠ₯Π). ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠΠ ΠΊΠΎΡΠΈΡΡΠ΅ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ ΠΏΠΎΠ΄Π³ΠΎΡΠ²Π΅Π½ ΠΎΠ΄ U.S. Centers for Disease Control and Prevention (CDC), - One Health Zoonotic Disease Prioritization (OHZDP) tool, ΠΏΡΠΈΠ»Π°Π³ΠΎΠ΄Π΅Π½Π° Π½Π° Π½Π°ΡΠΈΠΎΠ½Π°Π»Π½ΠΈΡΠ΅ ΡΡΠ»ΠΎΠ²ΠΈ (2019). ΠΠ₯Π ΠΊΠΎΡΠΈΡΡΠ΅ΡΠ΅ ΡΡΠ°Π½Π΄Π°ΡΠ΄ΠΈΠ·ΠΈΡΠ°Π½ ΠΏΠΎΠ»Ρ-ΠΊΠ²Π°Π½ΡΠΈΡΠ°ΡΠΈΠ²Π΅Π½ ΠΌΠ΅ΡΠΎΠ΄ Π·Π°ΡΠ½ΠΎΠ²Π°Π½ Π½Π° ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΡΠΊΠΈΠΎΡ ΠΏΡΠΈΡΠ°ΡΠ½ΠΈΠΊ Π½Π° OIE (List and Categorization of priority diseases in animals including and those transmitted to humans). Π‘Π΅Π»Π΅ΠΊΡΠΈΡΠ°Π½ΠΈ ΡΠ΅ Π²ΠΊΡΠΏΠ½ΠΎ 21 Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ, Π²ΡΠ· ΠΎΡΠ½ΠΎΠ²Π° Π½Π° Π½ΠΈΠ²Π½Π°ΡΠ° Π²Π°ΠΆΠ½ΠΎΡΡ Π·Π° Ρ
ΡΠΌaΠ½ΠΈΠΎΡ ΠΈ Π²Π΅ΡΠ΅ΡΠΈΠ½Π°ΡΠ½ΠΈΠΎΡ ΡΠ΅ΠΊΡΠΎΡ. ΠΠ²ΠΈΠ΅ Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ ΡΠ΅ ΡΠ°Π½Π³ΠΈΡΠ°Π½ΠΈ ΡΠΏΠΎΡΠ΅Π΄ Π½Π°Π²Π΅Π΄Π΅Π½ΠΈΡΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌΠΈ Π½Π° Π΄Π²Π΅ΡΠ΅ ΠΏΡΠ΅ΡΡ
ΠΎΠ΄Π½ΠΎ ΡΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈ ΠΏΡΠΈΠΎΡΠΈΡΠΈΠ·Π°ΡΠΈΠΈ ΠΈ Π΅ ΠΈΠ·Π²ΡΡΠ΅Π½Π° Π½ΠΈΠ²Π½Π° ΡΠΏΠΎΡΠ΅Π΄Π±Π°. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ Π‘ΠΎ ΠΏΡΠΈΠΎΡΠΈΡΠΈΠ·Π°ΡΠΈΡΠ° ΡΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΠ΄ ΠΠΠ ΠΈ ΠΠ₯Π (ΡΠ΅ΠΌΠΈ-ΠΊΠ²Π°Π½ΡΠΈΡΠ°ΡΠΈΠ²Π½Π° ΠΌΠ΅ΡΠΎΠ΄Π° Rist CDC), ΠΏΡΠ²ΠΈ 5 ΡΠ°Π½Π³ΠΈΡΠ°Π½ΠΈ Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ ΡΠ΅: Π₯Π΅ΠΌΠΎΡΠ°Π³ΠΈΡΠ½ΠΈ ΡΡΠ΅ΡΠΊΠΈ ΡΠΎ Π±ΡΠ±ΡΠ΅ΠΆΠ΅Π½ ΡΠΈΠ½Π΄ΡΠΎΠΌ, ΠΠ°ΡΡΠΌΠ°Π½ΠΈΡΠ°Π·Π°, Π’ΡΠ»Π°ΡΠ΅ΠΌΠΈΡΠ°, ΠΡΡΡΠ΅Π»ΠΎΠ·Π° ΠΈ ΠΠΈΡΡΠ΅ΡΠΈΠΎΠ·Π°. Π‘ΠΎ ΠΏΡΠΈΠΎΡΠΈΡΠΈΠ·Π°ΡΠΈΡΠ° ΡΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΠ΄ ΠΠ₯Π (ΠΌΠΎΠ΄ΠΈΡΠΈΠΊΠ°ΡΠΈΡΠ° Π½Π° ΠΊΠ²Π°Π½ΡΠΈΡΠ°ΡΠΈΠ²Π½ΠΈΠΎΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΡ Π½Π° OIE), ΠΏΡΠ²ΠΈ 5 ΡΠ°Π½Π³ΠΈΡΠ°Π½ΠΈ Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ ΡΠ΅: Π±ΡΡΡΠ΅Π»ΠΎΠ·Π° ΠΊΠ°Ρ Π³ΠΎΠ²Π΅Π΄Π°, ΡΡΠ±Π΅ΡΠΊΡΠ»ΠΎΠ·Π° ΠΊΠ°Ρ Π³ΠΎΠ²Π΅Π΄Π°, ΡΠ°Π»ΠΌΠΎΠ½Π΅Π»ΠΎΠ·Π°, Π°Π²ΠΈΡΠ°ΡΠ½Π° ΠΈΠ½ΡΠ»ΡΠ΅Π½Π·Π° ΠΈ Π·Π°ΠΏΠ°Π΄Π½ΠΎΠ½ΠΈΠ»ΡΠΊΠ° ΡΡΠ΅ΡΠΊΠ°. ΠΠ°ΠΊΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅Π½ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΠ°Ρ Π΅ Π·Π΅ΠΌΠ΅Π½ ΠΊΡΠΌΡΠ»Π°ΡΠΈΠ²Π½Π° Π³ΠΎΠ΄ΠΈΡΠ½Π° ΠΈΠ½ΡΠΈΠ΄Π΅Π½ΡΠ° (ΠΠΠ). ΠΡΠ²ΠΈΡΠ΅ 5 ΡΠ°Π½Π³ΠΈΡΠ°Π½ΠΈ Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΠΠ ΡΠ΅: ΠΡ
ΠΈΠ½ΠΎΠΊΠΎΠΊΠΎΠ·Π°, ΠΡΡΡΠ΅Π»ΠΎΠ·Π°, ΠΠ°ΡΠΌΡΠΊΠ° ΡΡΠ΅ΡΠΊΠ°, ΠΠ°ΡΡΠΌΠ°Π½ΠΈΡΠ°Π·Π° ΠΈ Π’ΡΠ»Π°ΡΠ΅ΠΌΠΈΡΠ°. ΠΠ°ΠΊΠ»ΡΡΠΎΡΠΈ: Π‘ΠΏΠΎΡΠ΅Π΄Π±Π΅Π½Π°ΡΠ° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΠΎΠ΄Π΄Π΅Π»Π½ΠΈΡΠ΅ Π»ΠΈΡΡΠΈ Π½Π° ΠΏΡΠΈΠΎΡΠΈΡΠ΅ΡΠ½ΠΈ Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ Π·Π° Ρ
ΡΠΌΠ°Π½Π° ΠΈ Π²Π΅ΡΠ΅ΡΠΈΠ½Π°ΡΠ½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Π° ΠΏΠΎΠΊΠ°ΠΆΡΠ²Π° Π΄Π΅ΠΊΠ° ΡΠ°ΠΌΠΎ ΠΎΠ΄ΡΠ΅Π΄Π΅Π½ΠΈ Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ ΡΠ΅ ΠΏΡΠ΅ΠΊΠ»ΠΎΠΏΡΠ²Π°Π°Ρ. ΠΡΡΠΎ ΡΠ°ΠΊΠ°, ΠΏΡΠΈΡΡΡΡΠ²ΠΎΡΠΎ Π½Π° Π³ΠΎΠ»Π΅ΠΌ Π±ΡΠΎΡ Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ ΡΠΎ Π΅Π½Π΄Π΅ΠΌΠΈΡΠ΅Π½ ΠΊΠ°ΡΠ°ΠΊΡΠ΅Ρ, Π½ΠΎ ΠΈ ΠΏΠΎΠΈΠ·ΡΠ°Π·Π΅Π½ ΡΠΈΠ·ΠΈΠΊ ΠΎΠ΄ ΠΏΠΎΡΠ°Π²Π° Π½Π° Π½ΠΎΠ²ΠΈ Π·Π°Π±ΠΎΠ»ΡΠ²Π°ΡΠ°, ΡΠ° ΠΎΠ΄ΡΠ΅Π΄ΡΠ²Π° ΠΏΠΎΡΡΠ΅Π±Π°ΡΠ° Π΄Π° ΡΠ΅ ΠΎΠ±Π΅Π·Π±Π΅Π΄ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½Π·ΡΡ Π·Π° ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΡΠ°ΡΠ° Π½Π° ΠΏΡΠΈΠΎΡΠΈΡΠΈΠ·Π°ΡΠΈΡΠ° Π½Π° Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ, ΠΊΠ°ΠΊΠΎ ΠΈ Π½Π΅ΡΠ·ΠΈΠ½Π° ΡΠΎΡΠΌΠ°Π»ΠΈΠ·ΠΈΡΠ°ΡΠ΅ ΠΈ ΠΈΠ½ΡΡΠΈΡΡΡΠΈΠΎΠ½Π°Π»ΠΈΠ·Π°ΡΠΈΡΠ°, ΠΊΠ°ΠΊΠΎ ΠΊΠ»ΡΡΠ΅Π½ ΡΠ΅ΠΊΠΎΡ ΠΊΠΎΠ½ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΠΊΡΠ²Π°ΡΠ΅ ΠΈ ΠΏΡΠΈΠΎΡΠΈΡΠΈΠ·ΠΈΡΠ°ΡΠ΅ Π½Π° Π·ΠΎΠΎΠ½ΠΎΠ·ΠΈ ΠΊΠΎΠΈ Π±ΠΈ Π±ΠΈΠ»Π΅ ΠΏΡΠ΅Π΄ΠΌΠ΅Ρ Π½Π° Π·Π°Π΅Π΄Π½ΠΈΡΠΊΠΈ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΈ ΠΈ ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΠΈ