Trends in the disease prevalence and incidence in the population of the city Bishkek and the Kyrgyz Republic

Анотація

Changes in the political and economic situation in the Kyrgyz Republic in the 90s of the XX century, to a certain degree, had an impact on the health of the population as related to the availability and quality of medical care, especially at the primary level. Naturally, the indicator of the disease prevalence and incidence of the population is one of the most important parameters of the effectiveness of health resource provision, planning of medical care and preventive measures for specific age and social groups. The purpose of the study was to assess the level of the disease prevalence and incidence of the urban population of the Bishkek megacity in comparison with the national level. Data on the disease prevalence and incidence of the population of the Bishkek city population were from the Electronic Health Center of the Ministry of Health of the Kyrgyz Republic for the period 1989-2019 and were compared with the national level. Analytical, statistical and comparative analysis methods were used and data processed with the MS Excel 2021 and SPSS-16 software packages. There is definitely a multidirectional dynamics of the disease prevalence and incidence of the population of the entire country and the city Bishkek during the observation period 1989-2019. However, the disease prevalence in absolute figures shows an increasing growth rate tendency 6.2% (1999) to 5.7% (2009) and 7.0% (2019) and a decline in the relative indicator -5,4%, -5,0% and -10.8% respectively. Bishkek’s absolute numbers fell sharply in 1999 (-30,6%), and 2009 saw an increase of up to 637 252 cases (+56%) and 2019 (926845 or +45,4%) and was similar by the relative number per 100,000 population: +42,5%,+41,8%, +17,3% respectively, which indicates the general increased load on the urban health care system. The disease incidence revealed fluctuations in absolute values and per 100,000 population both in the entire country and Bishkek, with decreasing tendencies by 1999 and an increase in subsequent decades, especially in the group of children and adolescents. In the gender aspect, there is a decrease in the disease morbidity in men and growth in women against the background of variations observed in disease incidence indicators by age groups. The results obtained indicate the uneven dynamics of morbidity in different age and social groups of the urban population compared with the national values. The observed increase in population morbidity in the Bishkek megacity largely correlates with the increasing population size and the state of the city's primary health care network, as well as staffing. At the same time, differences are seen in the gender aspect for the entire country: among men, the incidence was decreasing, while among women there were growing tendencies, and on the contrary, in Bishkek there was a general trend of increasing morbidity among all categories of the population. The presented results indicate the problems of organizing primary health care in the whole country and in Bishkek, especially for the male population, related to healthcare access and shortcomings in the organization of preventive work. Thus, the dynamics of the disease prevalence and incidence in the population of the entire country and the metropolitan area demonstrates multidirectional tendencies, showing shortcomings in the planning and implementation of national programs aimed at strengthening and improving the primary health care system. Overall, this indicates the need to review strategies and approaches to ensure more effective healthcare management.