Taking into account the increase in the proportion of women in the post-reproductive age in society and the increase in the retirement age, it becomes necessary to preserve their professional and social activity. As of 2016, in the structure of the female population of Ukraine, women over 50 years are 46.7%, respectively, the number of women over 45 years is more than half. However, today the problems of women of post-reproductive age are paid insufficient attention both by society, and by the media and social organizations.The issue of maintaining the life quality and social activity of women in the post-reproductive period was discussed on April 5, 2017 in Kiev at an expert council meeting in which leading experts in obstetrics and gynecology, cardiology, family medicine and oncology participated. As noted at the meeting, the relevance of this topic is primarily due to the deterioration of the life quality due to the cessation of ovarian function and the appearance of symptoms of menopause, along with an increase in the incidence of cardiovascular diseases, oncological pathology, and type II diabetes at post-reproductive age.In this regard, at the meeting of the expert council it was proposed to implement the social and information project “Femininity of the future”, within the framework of which in the next 3 years (2017–2019) in 18 regions of Ukraine a number of measures aimed at preserving the life quality and social activity of women in the post-reproductive period. In particular, among them is the development of methods that reduce the risk of developing diseases, increase the level of knowledge of patients and doctors of different directions on modern approaches to the prevention, diagnosis and treatment of menopausal disorders in women, a large-scale educational program on the preservation of life quality, social activity of women in the post-reproductive period and with respect to methods for reducing the risk of cardiovascular pathology, oncological diseases.
Objective of the study: to assess the main indicators of the reproductive potential of women in Ukraine in dynamics over the period 2000-2018.Materials and methods. Analysis was performed using the data of the State Statistics Service of Ukraine and the State Institution “Center for Medical Statistics of the Ministry of Health of Ukraine” for the period 2000–2018. The methods of a systematic approach, structural-logical, epidemiological analysis were used.Results. Reproductive process dynamic in Ukraine in the XXI century had nonlinear character – increase in the general fertility rate from 7.7 per 1000 population in 2000 to 11.4 in 2012 and the total fertility rate from 1.11 to 1.6, respectively with further deterioration trend – 8.7 and 1.3 in 2018, respectively. Low rates of population reproduction in Ukraine in the XXI century were kept on the background of insufficient resources to ensure the reproduction of the country's population – decrease of the number of women of childbearing age from 12,582.7 thousand in 2000 to 9,998.6 thousand in 2018 with adverse changes in the age profile towards older age groups, high level incidence of reproductive system in women.In 2000–2018 years there is a high level with a negative trend in the prevalence of menstrual disorders (increase by 38.5%), cervical inflammatory diseases (increase by 82.5%), malignant neoplasms of uterine body (increase by 39,9%), mammary glands (increase by 11.99%), cervix (increase by 5.06%), high frequency, with a negative trend, in the incidence of diabetes in pregnant (increase by 662.5%), thyroid disease (increase by 17.3%), circulatory system diseases (increase by 34.4%), urogenital system (increase by 8.7%). In the same time it was achieved a reduction of reproductive losses due to forced abortions by 1.75 times, decrease of mortality during first year of life by 1.7 times and feto-infantile losses of 1.4 times. Conclusion. In recent decades, in Ukraine kept unfavorable demographic situation - decrease in population due to extremely high mortality with low birth rates and low life expectancy.
The primary objective of the reproductive health services system and its individual institutions are, namely: to implement the strategy of women management starting from their fetal life to the old age and ensure quality of life in adolescence, reproductive and postmenopausal periods. Maternal and child death rates are above respectives rates in European countries, and utilization rate of modern contraceptive methods in Ukraine remains low. This can be explained by both, poor awareness of women and insufficient training of medical personnel. In this context, the top priority still is awareness-raising and further implementation of the strategy on reliable contraception means and methods along with effective preconception care as a potent component of family planning.Taking into account modern global trends, the principal goal of Family Planning Service in Ukraine is to improve women’s quality of life and time of active ageing, which achievement can be facilitated by the implementation of 3 priority tasks:• continued realization of the strategy on reliable contraception use and implementation of effective preconception care to abortions prevention and maternal and newborns mortality rates reduction;• reduction cardiovascular and oncological diseases incidence rate in women through development and implementation of respective screening programs, informational and preventive measures;• implementation of best international practices with respect to Family Planning Service efficacy, review and update of family planning clinical protocol with further implementation of such practices at the national and regional levels.Considering this, the Resolution of Advisory Board outlines the main tasks for the implementation of modern international experience and its further implementation at the national level, and amendments to clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care (approved by the order of MOH of Ukraine No. 59 dated January 21, 2014) “Family Planning”. The main additions and comments touched upon the issues of micronutrient status and reproductive health of women, contraceptive methods for women in perimenopause, counseling and selection of contraceptive methods for HIV-positive women. Particular attention was paid to counseling and selection of contraceptive methods for women military personnel.
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