Reducing child mortality in the perinatal period: the relevance of the problem and territorial specifics of the situation in Russia

Decline in child mortality in the perinatal period depends directly on the following set of conditions: health of parents, conditions and way of their life and the quality of medical care. Regional specific features of mortality in the perinatal period are considered in the works of I.N. Noskova, V.G. Lopushansky, I.G. Nezhdanov, S.A. Ulyanovskaya. The goal of the present study is to find ways to minimize the losses due to child mortality in the perinatal period. The information base of the work consists of the data of international organizations, the state statistics service, its territorial unit in the Vologda Oblast, the data of the Department of Healthcare of the Vologda Oblast, as well as the works of domestic and foreign researchers. Using comparative analysis of perinatal mortality in Russia and developed European countries, we substantiate the urgency of improving the system of medical support of pregnancy and childbirth in the Russian Federation. It is established that rural areas are characterized by the worst parameters of survival of children. Based on the analysis of statistical data, we revealed the growing trend of stillbirths in rural areas since 2014 against the background of a decrease in the values of this indicator in urban areas. It is noted that the values of the rates of stillbirths in both urban and rural areas are significantly higher than the values of the early neonatal mortality rates. This suggests that stillbirth rates compared to the early neonatal mortality are more difficult to regulate, making its reduction a crucial task in reducing population losses from mortality of newborns. It is shown that the system of statistical accounting of perinatal mortality in the regional and municipal context needs to be improved. In the final part of the article the necessity of improving the quality and accessibility of medical care for pregnant women and women in childbirth is substantiated, and the relevant recommendations are formulated. The results of the study may be of interest to specialists in the field of social management.