POPULATION HEALTH AND HEALTH CARE SYSTEM IN THE
REPUBLIC OF BELARUS
(Public Health of the Republic of Belarus,
an official statistics collection, 2011)
Health and demographic situation
Within recent years the negative dynamics on main demographic indicators has
reached a critical level posing a serious threat to the national security. In order to
reverse the negative demographic trends and create preconditions for population
growth, the President of Belarus passed Decree No. 357 on August 11, 2011 to adopt
the National Programme of Demographic Security of the Republic of Belarus for
2011-2015.
Since 1994 the population of the country has reduced by 799 100 people and as of the
beginning of 2012 it numbered 9.465.1 million.
The positive tendency to an increase in the birth rate has remained since the year
2003. In 2011 it made up 11.5 births per 1000 population (11.4- in 2010). In 2011,
109 147 babies were born in the country (108 050 - in 2010).
The death rate decreased from 14.4 per 1000 population in 2005 to 14.3 per 1000
population in 2011.
In spite of the fact that the death rate of the population of the republic has decreased
by 1.4% as compared with 2005, its rate remains high in Vitebsk (16.2 per 1000
population) and Minsk (16.0 per 1000 population) regions.
An aggregate indicator of public health is life expectancy at birth. Belarus is at the
very bottom of the top 100 countries in terms of life expectancy at birth. By this
indicator Belarus yields to almost 100 countries and as compared with developed
countries the figure is lower by 12-14 years in men and 5-6 years in women. The
highest life expectancy was registered in 1964-1969 – 72.9 years. It declined in the
1990s. In 2003 the indicator made up 68.5 years. The life expectancy at birth has
fallen from 77.2 years (1984-1985) to 76.7 years (2011) in women and from 68.9
years (1964-1965) to 64.7 years (2011) in men. It should be noted that in 2011, the
life expectancy of men and women increased slightly as compared with 2010 and
made up 70.6 years (64.7 years in men and 76.7 years in women). In 2010, the
general life expectancy was 70.4 years (64.6 years in men and 76.5 years in women).
Mother and child protection remains a major priority of the healthcare system in the
Republic of Belarus. Since 1995, the infant mortality decline has been observed.
Since 2000, it has been under 10.0 per 1000 live births (which meets Target No. 3 of
“Health for all in the 21st century” of the World Health Organization). In 2011, the
figure made up 3.9 per 1000 live births, which is among the lowest in the CIS. In
2006, newborns weighing 500-999g were also included in the infant and child
mortality statistics. The highest infant and perinatal mortality was registered in
Gomel region (4.7 per 1000 live births) and Grodno region (4.0 per 1000 live births).
In 2011 the maternal mortality remained the same as compared with 2010: 0.9 per
100 000 live births. In 1990-2011 the maternal mortality rate decreased from 21.8
(1998) to 0.9 per 100 000 live births (2010).
Since 1999, the number of abortions declined from 67 200 to 32 000 in 2011, and fell
below the number of births. However, the abortion rate still remains very high. In
2011, the number of births per 1000 women aged 15-49 was 44.8 (43.6 in 2010);
while the number of abortions per 1000 women of the fertile age was 13.2 (13.5 - in
2010).
Population health
In 2011, an increase in the birth rate, stabilization of total mortality, reduction in
infant and maternal mortality, as well as other positive health trends were registered.
In 1994-2011, in Belarus the incidence rate increased by 24.6% and made up 84255.6
per 100 000 population in 2011 (67,644.0 per 100 000 - in 1994).
The prevalence rate increased by 40.7% and accounted for 155929.0 per 100 000 in
2011 (110798.1 per 100 000 - in 1994). The ratio between the prevalence rate and the
incidence rate increased from 1.64 in 1994 to 1.85 in 2011 that pointed to
accumulation of chronic pathology.
The incidence rate growth in 2011 (in comparison with 2005) was registered in:
congenital malformations, deformations and chromosomal abnormalities – by
33.5%
-
neolpasms – by 20.1%
-
diseases of the respiratory system – by16.4%
-
diseases of the circulatory system – by 10.5%;
With this, the incidence rate reduced in 2011 (in comparison with 2005) in:
-
symptoms, signs and abnormal findings - by 11.8%
-
certain infectious and parasitic diseases – by 10.4%;
-
diseases of the digestive system – by 8.3%;
-
diseases of the musculoskeletal system and connective tissue – by 4.0%
-
diseases of the skin and subcutaneous tissue – by 3.9%.
Diseases of the respiratory system traditionally rank first in the structure of the
incidence rate - 45879.6 per 100 000 population, or 54.4% (39,418.1 or 50.8% - in
2005). The second place goes to injury, poisoning and certain other consequences of
external causes – 8066.0 per 100 000 population, or 9.6% (7,878.4 - in 2005, or
10.1%). Diseases of the skin and subcutaneous tissue rank third - 4061.3 per 100 000
population, or 4.8% (4224.1 or 5.4%) - in 2005).
In the structure of the disease causes the leading place belongs to diseases of the
circulatory system - 51.9% (in 2010 – 53.9%). The incidence rate as regards diseases
of the circulatory system decreased by 1.5% and made up 2674.0 per 100 000
population (in 2010 – 2714.5).
The second leading cause of death is neolpasms (13.4% - in 2011 and 13.4% - in
2010). The incidence rate in neolpasms increased by 20.1% (from 927.0 per 100 000
population - in 2005 to 1113.6 per 100 000 population in 2011).
Traumatism remains a serious social problem. It is the second largest contributor to
the incidence rate (9.6%) and the fourth one in mortality cause (10.0%).
Alcohol and drug abuse continue to cause both material and moral damage to the
society. Within the period 2000-2011 the number of people with chronic alcoholism
and alcoholic psychosis rose by 44.6% (from 1426.9 to 2062.7 per 100 000
population).
Alongside with the growth of alcohol consumption, the increase in drug addiction
was registered.
In 2011 a total of 10872 drug addicts were registered at the
dispensaries (114.9 per 100 000 population). In 1995 there were 1524 per 100 000
population or 14.8, in 2000 – 4545, or 45.5 per 100 000. Since 2000 the number of
drug addicts, registered at the dispensaries, has increased more than twice (in 2000 –
4545 persons, in 2011 – 10872 persons).
Drug addiction is inseparably linked to HIV and AIDS. Prior to 1995, Belarus was in
the group of countries with a low HIV rate. In 2011, there were 1196 new cases of
infection (1 069- in 2010). As of 1 January 2012, there were 12955 officially
registered HIV-infected patients in the Republic of Belarus.
The incidence as regards many infectious diseases still remains high in most
countries of the world. Special attention should be paid to socially-related diseases,
primarily tuberculosis. Since 2004 tuberculosis morbidity has been reducing. In
2011, it was 42.8 per 100 000 population (55.4 - in 2004).
For many years the situation with extremely dangerous infections has remained stable
in the Republic of Belarus. There have been no cases of cholera, brucellosis. Since
2001 no acute poliomyelitis cases have been registered.
At the end of the 1980s a rise of diphtheria incidence rate due to the decrease of the
population immunization was observed. In 1995, the highest number of the diseases
was registered (322 cases – 3.1 per 100 000 population). In 2011, no cases of
diphtheria were registered (in 2010 – 1 case).
The situation with infectious diseases is now under control and is characterized by
stability and even by decline as regards certain forms. The incidence of viral hepatitis
in 1990 was 405.9 per 100 000; in 2002 it was 750.0, and 2011 it decreased to 3.0 per
100 000 population.
Disability.
In 2011, 50 394 persons were newly diagnosed as disabled, which was by 7.3% more
than in 2010. Of them 47 417 were adults (18 years and older), (by 7.8% over than in
2010). The number of newly diagnosed disabled persons among working population
made up 21 011 persons (by 1.7% more than in 2010). The number of newly
diagnosed disabled children increased by 0.3% and amounted to 2 977 persons.
As in the past, mainly, diseases of the circulatory system year were reasons for
disability (24.66 per 10 000 population, or 40.3%); neolpasms (14.89 per 10 000
population, or 24.3%); diseases of the musculoskeletal system and connective tissue
(4.49 per 10 000 population, or 7.3%); as a result of injuries, poisoning and certain
other consequences of external causes (3.77 per 10 000 population, or 6.2%).