Providing medical care by family doctors in family planning services and prevention of unwanted pregnancies
Keywords:family planning, prevention of unwanted pregnancy, family doctors, primary medical care
Purpose of the study: to identify the types of medical services for family planning and prevention of unwanted pregnancies that should be provided by family doctors, and competencies they should have to provide, as well as to identify benefits and possible risks for family planning services at the primary level.
Materials and methods. 50 obstetricians and gynecologists and 50 family doctors were interviewed as experts with the help of a specially designed questionnaire. Research results were analyzed using the method of structural-logical analysis.
Results. The list of medical services for family planning and prevention of unwanted pregnancies to be provided by family doctors includes: formation of safe sexual behavior in adolescents and young people, formation of responsible attitude to reproductive health in adolescent girls, explanation to married couples about use of barrier contraception and emergency contraception immediately after sexual intercourse, information activities aimed at promoting a healthy lifestyle, formation of responsible parenthood, strengthening family and marital relations.
The advantages of providing these services at the primary level are increased physical availability of medical care for family planning, possible reduction of unwanted pregnancies, early onset of sexual relations culture and higher opportunities for adolescents to develop a responsible attitude to reproductive health. Among the risks of providing family planning services at the primary level experts noted the low level of professionalism of family doctors and nurses, lack of motivation to provide this area of medical services, low level of interaction between primary and obstetric care services, low public confidence in family doctors.
Conclusion. Applying of expertly defined list of services for family planning and prevention of unwanted pregnancies at the primary level of medical care when family doctors acquire the necessary competencies will increase the availability and effectiveness of this type medical care.
Strategic advisory group on health care reform in Ukraine. National strategy for health care reform in Ukraine for the period 2015–2020. Kyiv (2015): 41 p. Available from: [http://healthsag.org.ua/strategiya/].
Slabkyi, H.O., Lazoryshynets, V.V., Saliutin, R.V. Health care reform: Vinnytsia, Donetsk, Dnipropetrovsk, Odesa, Poltava regions, Kyiv. Results, problems, solutions. Monograph. Kyiv (2014): 207 p.
Slabkyi, H.O. “The development of a network of health care facilities of the general medical practice - family medicine.” In: The development of primary health care on the basis of family medicine. Kyiv (2018): 104–8.
Matiukha, L.F., Nadutyi, K.O., Kondratiuk, N.Y. “The state of modernization of primary health care system in Ukraine.” Ukraine. The health of the nation 2.26 (2013): 76–83.
Shafranskyi, V.V., ed. “An annual report on the state of the population health, the sanitary and epidemiological situation and the results of the health care system of Ukraine. 2015.” Ministry of Health of Ukraine, State Institution “Ukrainian Institute of strategic research of the MoH of Ukraine”. Kyiv (2016): 452 p.
Ministry of Health of Ukraine. Order No. 503 dated 19.03.2018 “On approval of the Procedure for choice of a doctor who provides primary care and the form of declaration on the choice of doctor who provides primary care.” Available from: [https://zakon.rada.gov.ua/laws/show/z0347-18#Text].
Mytnyk, Z.M., Slabkyi, H.O., Kryzyna, N.P., et al. The primary health care / family medicine. Kyiv (2010): 404 p.
Matiukha, L.F., Lekhan, V.M., Hoida, N.H., et al. The order of the organization of providing the medical care and maintenance of the patient’s routes by the general practitioner – the family doctor at various clinical conditions and diseases. Кyiv. Ministry of Health of Ukraine; P.L. Shupyk NMAPE, Ukrainian Institute of Strategic Researches, Dnipropetrovsk State City Administration, SI “Zaporizhzhya MAPE of the MoH of Ukraine”, Chernivtsi Department of Health (2011): 43 p.
Slabkyi, H.O., Zozulia, I.S., Zozulia, A.I. “The priority development of primary health care on the basis of family medicine.” Family medicine 3.53 (2014): 25–7.
Ministry of Health of Ukraine. Order No. 504 dated March 19, 2018 “On approval of the Procedure for providing primary care.” Available from: [https://moz.gov.ua/article/ministry-mandates/nakaz-moz-ukraini-vid-19032018--504-pro-zatverdzhennja-porjadku-nadannja-pervinnoi-medichnoi-dopomogi].
Shcherbynska, O.S., Slabkyi, H.O. “The providing of general practitioners – family doctors the obstetric and gynecological care and characteristics of the relationship of primary care with obstetric and gynecological services.” Family medicine 3 (2019): 63–7.
Verkhovna Rada of Ukraine. Law of Ukraine No. 2168-VIII dated October 19, 2017 “About the State Financial Guarantees of Medical Care of the Population.” Available from: [http://search. ligazakon.ua/l_doc2.nsf/link1/T172168.html].
The Cabinet of Ministers of Ukraine. Resolution No. 407 dated April 25, 2018 “On approval of the Procedure for implementation of state guarantees of medical care for the population under the program of medical guarantees for primary health care for 2018.” Available from: [https://www.apteka.ua/article/458646].
The Cabinet of Ministers of Ukraine. Resolution No. 1124 dated November 27, 2019 “On approval of the Procedure for implementation of state guarantees of medical care for the population under the program of medical guarantees for primary health care for 2020.” Available from: [https://zakon.rada.gov.ua/laws/show/1124-2019-%D0%BF].
Ministry of Health of Ukraine. Order No. 1709 dated July 26, 2019 ”On approval of the Procedure for developing a program of state guarantees of medical care.” Available from: [http://search.ligazakon.ua/l_doc2.nsf/link1/RE33932.html].
The Cabinet of Ministers of Ukraine. Resolution No. 1101 dated 27 December 2017 “About the establishment of the National Health Service of Ukraine.” Available from: https://www.kmu.gov.ua/ua/npas/pro-utvorennya-nacionalnoyi-sluzhbi-zdorovya-ukrayini].
National Health Service of Ukraine. Medical service packages. Content and approach to contracting health care facilities. Kyiv (2020): 59 p.
Center for Medical Statistics of the MoH of Ukraine. The state of health of the female population in Ukraine in 2017. Kyiv (2018). Available from: [http://medstat.gov.ua/ukr/MMXVII.html].
Center for Medical Statistics of the MoH of Ukraine. The state of health of the female population in Ukraine in 2018. Kyiv (2019). Available from: [http://medstat.gov.ua/ukr/MMXVII.html].
Avramenko, N.V., Barkovskyi, D.E. “Aspects of reproductive health of the population in Ukraine.” Zaporizhzhya medical journal 12.3 (2010): 71–3.
Slabkyi, H.O., Shcherbynska, O.S. “Characteristics of abortions in women of Ukraine.” Economics and law of health care of Ukraine 1 (2019): 70–4.
Musii, O.S., ed. An annual report on the state of health of the population, the sanitary and epidemiological situation and the results of the health care system of Ukraine 2013. Kyiv (2014): 437 p.
Levchuk, N.M., Perelli-Harris, B. “Abortions and birth rates in Ukraine: is "competition" continues?” Demography and social economy 2.14 (2010): 64–74. DOI: 10.15407/dse.2010.02.064
Vovk, I.B., Tymchenko, O.I., Revenko, O.O. “Abortion is a predictor of a woman's reproductive health disorders.” Health of Ukraine. March Thematic issue (2014): 33–47.
State Statistics Service of Ukraine. Ukraine. Multi-indicator cluster survey of households, 2012. Кyiv. Publisher “К.І.С.” (2013): 216–27.
Steshenko, V.S. “Studies of childbirth and fertility in real generations of women in Ukraine: conclusions for today.” Demography and social economy 1 (2010): 3–14.
Balakireva, O.M., Bondar, T.V., et al. The state and factors of health of Ukrainian adolescents. Monograph. UNICEF, Oleksandr Yaremenko Ukrainian Institute for Social Research. Кyiv. Publisher “К.І.С.” (2011): 172 p.
Kon, I.S. Adolescent Sexuality on the eve of the 21st Century: A Socio-Pedagogical Analysis. Institute of Ethnology and Anthropology of the Russian Academy of Sciences. Dubna. Publisher “Feniks+” (2001): 208 p.
Copyright (c) 2020 O. S. Shcherbinska, H. O. Slabkyi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.