Volume 04 Issue 09-2024
43
American Journal Of Social Sciences And Humanity Research
(ISSN
–
2771-2141)
VOLUME
04
ISSUE
09
P
AGES
:
43-52
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
This article is dedicated to the comparative study of maternal and child health protection policy, it briefly covers the
practices of our country and the world, and it defines the main directions for the future. An attempt was made to
reveal the role and role of civil society institutions in maternal and child health protection through real numbers and
their analysis.
KEYWORDS
Civil society, child health protection, study of maternal and child health protection policy.
INTRODUCTION
Civil society institutions play a very important role in
ensuring maternal and child health protection in
Uzbekistan. The activity and effectiveness of these
institutions can be seen as an integral part of the state
policy carried out by the leadership of our country. At
this point, we would like to dwell on a number of
important aspects of the activities of civil society
institutions:
In particular, civil society institutions work together
and provide health care not only for citizens, but also
for mothers and children, health monitoring, medical
services, education and other areas. Civil society
institutions are staffed by medical professionals,
Research Article
ANALYSIS OF THE EXPERIENCE OF CIVIL SOCIETY INSTITUTIONS IN
MOTHER AND CHILD HEALTH PROTECTION
Submission Date:
Aug 30, 2024,
Accepted Date:
Sep 04, 2024,
Published Date:
Sep 09, 2024
Crossref doi:
https://doi.org/10.37547/ajsshr/Volume04Issue09-07
Kutlimurotova Nigora
Independent researcher, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ajsshr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 09-2024
44
American Journal Of Social Sciences And Humanity Research
(ISSN
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2771-2141)
VOLUME
04
ISSUE
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43-52
OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
service workers, and other similar personnel with
modern, advanced knowledge and skills.
In general, civil society institutions are of great
importance for the health and protection of
Uzbekistan.
The main part
. In recent years, extensive actions have
been implemented in our country to protect the health
of mothers and children and further strengthen the
reproductive health of the population. In particular, in
2017-2022, the maternal mortality rate decreased by 1.5
times, and the infant mortality rate decreased by 1.3
times.
The provision of free medicine, medical supplies and
special food products to children suffering from rare
and other genetic diseases was introduced, and the
scope of medical and social assistance to them was
expanded.
Children's anesthesiology-reanimation departments
and pediatric posts providing round-the-clock
emergency medical care were established in district
(city) medical associations, as well as children's
departments in polyclinics.
Additional pediatric nurses and midwives were
allocated to all "medical brigades". Free provision of
necessary vitamin complexes, iodine preparation, iron
and folic acid was introduced for children, pregnant
women and women of childbearing age.
Foreign civil society institutions in Uzbekistan have
good experience in the field of mother and child health
protection.
Studies show that at all stages of Uzbekistan's
development, special attention is paid to the issues of
inter-sectoral
integration
and
its
practical
implementation, in particular, it is reflected in the
coverage of the historical aspect of the formation and
activity of the maternity institute.
At the moment, this approach has prevailed in the
protection of public health since WHO was founded in
1948, which unites 195 independent countries.
Nowadays, issues of interagency relations are an
integral part of almost all official documents of
international bodies, including UNICEF, WHO, etc.
Human health is central to the UN's 17 Sustainable
Development Goals for 2015-2030, which call for
"promoting healthy lives and promoting well-being for
all at all ages." But most of the other goals agreed to
by the 195 UN member states cover issues that span a
wide range of WHO activities and, most importantly,
require
intersectoral
collaboration
in
health,
education, social support, etc.
The importance of following this approach, which is a
specific population of women, children and
adolescents, was emphasized in the global strategy to
protect their health, which was announced at the same
time and envisaged for a decade and a half. According
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VOLUME
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Publisher:
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to this strategy, about 50 percent of the observed
improvements in women's, children's and adolescents'
health are attributable to investments outside the
health sector. It is worth noting that the document
recommends not only multidisciplinary, but also
improving
management
and
action
capacity,
monitoring the impact of these activities and
cooperation on health and sustainable development.
According to the WHO, children are from 0 to 17 years
old, and adolescents are from 10 to 19 years old
(according to a number of classifications - from 10 to 24
years old). However, the terms "adolescent" and
"youth" are often used as synonyms. A characteristic
feature of the wide age group from 0 to 24 years is a
high degree of exposure to significant physical and
mental changes, as well as significant changes in the
stages of socialization that manifest themselves as
they grow older. These changes, which can be
observed both in children and adolescents themselves
and in their families, are the subject of an
interdisciplinary approach.
In the organization of appropriate measures, especially
primary health care, it is necessary to take into account
the emphasis of the WHO Global Strategy for 2016-
2030. and other documents in the field of maternal and
child health, the growth of a whole complex of adverse
events that first appear or clearly worsen during
adolescence.
The abovementioned statements require the
development and implementation of interagency in
the activities of the participating states in the relevant
direction. This applies, for example, to the WHO
European network of healthy cities, which has been
built for 30 years - in this movement, health issues take
priority in the socio-economic and political activities of
local authorities.
It is reported that more than 300 young people die
every day in the European region mainly from
preventable reasons. Deaths of children and
adolescents occur as a result of accidents, traffic
accidents and acts of violence. The number of
adolescents who use alcohol, drugs, tobacco, poor
nutrition, and lack of physical activity is increasing. One
in ten 18-year-olds in the region suffer from violence
and depression, so suicide and attempts to suicide are
on the rise, especially among young men in Eastern
Europe.
Risks to health and life are increasing due to factors
such as early sexual activity, early pregnancy and
childbirth (globally it is one of the leading causes of
death for girls aged 15-19), unprotected sex and
diseases caused by HIV infection. Adolescents' own
cruelty, cyberbullying (bullying using electronic devices
- smartphones, computers, etc.), interpersonal
violence, delinquency, etc., are of great concern. Most
of the WHO documents indicate a clear lack of
preventive measures in this regard.
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Thus, the WHO has identified the ineffectiveness of the
measures taken in a number of countries, including the
Eastern European region, especially in the last decade,
and emphasizes the importance of their adjustments
and extensions taking into account the specific
characteristics of countries.
Solving the problem in Uzbekistan. Data analysis
shows that the recommendations of international
organizations are taken into account in the formation
and implementation of the country's state policy in the
field of protecting the health and rights of the young
generation and strengthening the family institution.
It is noteworthy that the inter-agency approach is
present in almost all official documents at the country
level as an integral part of solving the multifaceted
problems of public health, including children's health.
This is, first of all, the Constitution, Presidential
Decrees, legal acts, decisions of the Government of the
country, etc., i.e. documents with an emphasis on
preventive measures, which, as a rule, are mainly
carried out in primary medical and sanitary institutions
(BMS),
taking
into
account
the
relevant
recommendations of international organizations and
the specific characteristics of local health care.
It can be seen that all the mentioned problems of the
children's population in the countries of the European
region, their medical and social needs are also related
to the situation in Uzbekistan. The earlier model
discussed in detail the specific aspects of the risk-based
approach to the health care of the younger generation.
At the same time, special attention was paid to
mandatory consideration of risks not only to the
health, but also to the life of young people.
In accordance with the international standards that
protect children's rights to safety from information
that harms them mentally, physically and spiritually,
legislation on protecting children from information
that harms their health and development has been
adopted in Uzbekistan. The law, in fact, for the first
time introduced the term "children's information
security", which deserves special attention in the
modern conditions of the impact of environmental risk
factors on the growing, not yet formed organism.
Information security means a state of security in which
there is no risk associated with information that harms
human health and (or) physical, mental, spiritual, moral
development. Local age classification of information
products introduced by law (IP, National Age Rating
System, RARS) is a set of rules that regulate the use of
information that harms the health and development of
children. The classification of information products
assumes that it is reserved for children up to 6 years old
(0+), as well as 6 years old (6+), 12 years old (12+), and
16 years old (16). +), also prohibited among older
children (18+).
Compliance with this law requires strong cross-sectoral
integration of actors, which can be easily identified in
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the areas of implementation of the act. They include:
protection of children from propaganda of violence
and cruelty and information harmful to their moral
development; measures to prevent delinquency and
crimes among minors; prevention of extremist
manifestations in the educational environment,
putting an end to the methods of protection against
illegal and other socially dangerous attacks on the
Internet, mass media and other information and
telecommunication networks, and bringing them to
justice.
Thus, the official state documents, which are
constantly adding new ones in the field under
consideration, as a rule, take into account WHO
recommendations on issues that require interaction
between relevant agencies. This includes presidential
decrees, laws, which are logically continued by
subordinate legal documents in the form of
Government decisions, which in turn approve
strategies, concepts, complex programs, plans for
their implementation, etc. The relevance of their
review and additions should be taken into account in
connection with the initiatives announced in the
annual Addresses of the President, as well as the
decisions made on various aspects at the regularly held
meetings of the specialized coordinating councils
under the President.
Emergencies and other events that occur from time to
time with children stimulate changes in the current
official documents, start preparing a number of new
documents.
According to research, efforts in this regard are
often disrupted, primarily at the country level, often
due to fragmentation and lack of effective
coordination in the implementation of well-planned
actions that stimulate the flow of official documents at
the country level. It is recognized by the participants of
the processes that require an interdisciplinary
approach. In addition, unfortunately, such measures
are often implemented after the incident, but the
incident should be foreseen.
Today, even for a specialist, it is difficult to get accurate
information on the issues that reflect the dynamics of
the loss of life of children and adolescents. According
to the Investigative Committee (TK), 492 children died
during unorganized recreation in recent years (343
drowned, 41 died due to fire, etc.).
In this regard, first of all, it seems necessary to further
improve the educational process by expanding the
programs of children's educational institutions from
the point of view of ensuring life safety. Undoubtedly,
it is important and necessary to strengthen the role of
the family in this regard. There is a need to review
health and health care curricula at the university level
and post-secondary education, with a special focus on
the interdisciplinary department of organizational
technology.
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It seems that a systematic analysis of the dynamics of
regular, often annual reports of ministries and agencies
whose activity is directly related to the health
problems of the young generation should help to
assess the situation related to intersectoral
integration. At the same time, their abundance,
content and diversity of materials not collected
according to a single methodology, although
dedicated to work in one field - children's and
adolescents' health, make it difficult for different
experts to interpret and analyze them.
It is obvious that it is necessary to optimize the
coordinated activities of relevant departments.
The level of integration of specific actions of various
departments on strengthening the health of the young
generation growing up in the regions is clearly visible
in the implementation of health measures at the level
of medical organizations, first of all, children's
polyclinics. This is clearly shown in the scientific
analysis of the leading departments of this activity,
such
as
reproductive
health
and
behavior,
psychological component, medical assistance for
military service, nutrition of children and adolescents,
medical assistance for vocational counseling and
career guidance for adolescents, physical education.
Issues of health protection at the inter-agency level are
also being successfully resolved regionally - with the
help of scientifically based models of the most active
regions in this regard, for example, Khorezm,
Kashkadarya, Andijan and others. First of all, the
effectiveness of the measures taken within the
framework of the implementation of relevant
comprehensive programs at the level of medical
organizations of the pediatric service providing
primary medical and sanitary care.
Studies have shown that there are significant reserves
in this regard due to the constant attention of the
leadership of our country, the efforts of state social
institutions to protect children, and the efforts of the
state, which have become among the priorities in the
field of national security.
Today, the young generation also does not need
constant supervision and appropriate correction. For
example, the situation with the above-mentioned basic
law "On basic guarantees of children's rights in
Uzbekistan" is interesting. Thus, in the first version of
the document, among the guarantees of children's
rights, the state policy implemented in the interests of
children is considered as a priority activity of state
bodies based on the principles of setting state
minimum standards and observing them.
As noted, the ever-increasing impact of environmental
factors and negative social events on the growing
organism contributes to the increase in mental
illnesses and behavioral disorders, the decrease in self-
preservation behavior, in particular, the presence of
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suicide. Here we can add the public resistance to the
tragic events that happened in transport, during
children's recreation, playgrounds, physical education
classes, etc. Therefore, the importance of forming a
conscious need for not only a healthy, but also a safe
lifestyle from childhood and adolescence is increasing.
Another important aspect, in our opinion, is that WHO
recommends targeting 10-year-olds as a component of
a cross-sectoral approach to health, protection of the
rights of children aged 0-17 years, and the provision of
medical care to them. - 17 years. The State Statistics
Service has so far included this group only in the
demographics section, taking into account only
population and child mortality, including infants and 0-
4 year olds. The Ministry of Health, which also takes
into account these age groups in the analysis of death,
provides statistical indicators of morbidity in people
aged 0-14 years, which does not reflect the
characteristics of differentiated child mortality - early (
0-2 years), before school (3-6 age), schoolchildren 7-9,
10-14 and 15-17 years old.
According to the analysis of the materials of a special
complex scientific study of the legal, organizational
and methodological aspects of the protection of the
health of children and adolescents in our country, we
have shown real reserves, the use of which is aimed at
revising and improving legal norms. to increase the
effectiveness of inter-agency cooperation, which
contributes to the strengthening of state security, to
create a framework for the problem.
Once again, we draw attention to the large number of
different, insufficiently effective legislation and other
documents. In this regard, it seems appropriate to
return to the history of the domestic state approach to
the formation of specialized programs, albeit in
another country and under different conditions - in the
USSR.
We regret to say that due to serious financial and other
difficulties during the political and socio-economic
crises that occurred in our country in the late 1980s and
early 1990s, it became impossible to implement the
above-mentioned historical document. But such an
approach with a single program is still interesting,
because at the current stage, the country's top
authorities, relevant authorities and organizations can
easily get confused in the plans with a large amount of
funding for the main activities in each department. In
addition, these plans often include overlapping
activities.
Please note that this article is about legal documents.
At the same time, according to the research, for
example, the absence of a modern regional regulatory
legal framework was noted among the similar
problems that determine the insufficient quality of
medical services for children, identified in schools
studied across the republic.
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As the WHO has highlighted the increasing problems
related to the health and medical-social needs of young
people in many countries of the European region,
especially in the last two decades, the original
recommendations
seem
timely
and
require
consideration in practice and research. Participating
countries of the European region, including
Uzbekistan. They provide a systematic 5S approach to
support countries in improving government and sector
responses to adolescent health.
A unique methodology (toolkit) is offered that
provides:
• support and implement policies based on human
rights principles;
• obtaining strategic information necessary for
planning and monitoring;
• developing youth
-friendly service models that
include school-based health services and primary care;
• availability of sustainable resources for capacity
building and planning;
• a cross
-sectoral approach to policy/strategy and
interventions for adolescent health.
During the studies, significant reserves were identified
in Uzbekistan in terms of rational, coordinated
integration of the activities of the main interested units
in health care, protection of their rights, organization
of medical and social assistance to children,
adolescents and families.
The efforts of the relevant agencies, public and other
organizations at the state level and in localities, which
are often scattered, do not serve to further develop
the system of protecting and strengthening the health
of the young generation, taking into account the
requirements of the time.
We emphasize once again that the cooperation of
relevant structures is an important factor (technology)
in the implementation of the recommendations of
international organizations in this direction, adapted to
the conditions of the country. Taking it into account at
the state and regional level should ensure the effective
implementation of the basic principles of public health
protection, including children's health. Intersectoral
integration on the model of pediatric practice in the
conditions of a specific medical organization allows to
transform this broad concept into the term "medical
and social care". It turns out to be medical and non-
medical professionals (with the participation of a
psychologist, legal adviser, teacher, social worker,
etc.). Such assistance should be equally provided in the
entire system of medical care for the children's
population and in its interconnected links "policlinic -
hospital - sanatorium - polyclinic".
It should be noted that in our study, primary care refers
to the first level of contact between the patient and
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the medical organization in his place of residence,
where the children's polyclinic, which operates on a
local basis, also supervises the provision of medical
care. As indicated above, in educational institutions
located in the service area of this outpatient clinic
(preschool educational institutions, schools, lyceums,
colleges).
At the same time, the country's leading pediatricians
confirmed the importance of continuity in the
implementation of maternal and child health care
programs in the "policlinic-hospital" using the model of
the quality of inpatient medical care for children in the
regions. That is, on the one hand, there is a universal
understanding of the importance of such an approach
at all levels, which is reflected in almost all strategies
and plans of local activities, but on the other hand,
there are serious difficulties in implementing this
approach. Such measures are related to the large
number of interdepartmental commissions and
insufficiently coordinated programs of their actions, as
well as to the lack of attention to the accumulated
experience of departments and regions.
CONCLUSION
WHO estimates that the increasing burden of chronic
diseases, especially among adolescents, will place
great pressure on health systems in the coming
decades. It can be seen that, taking into account the
current situation in our country, our country's science
faces the important tasks of mandatory and
coordinated interagency coordination, which are
carried out in accordance with the recommendations
of international organizations, in order to solve the
problems raised by the health protection of children
and adolescents. Integration, as well as their
justification, taking into account the analysis of
accumulated experience - effective organizational
technologies, both at the state level and in the regions.
It is no coincidence that the strategy for the
development of medical science in our country until
2025 envisages the development of innovations in the
field of health care, increasing the effectiveness of
fundamental and applied scientific research.
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