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Legal regulation on preventing and provision of medical care of patients with general and occupational tuberculosis in Ukraine

ISSN 2223-6775 Ukrainian journal of occupational health Vol.16, No 1, 2020

Legal regulation on preventing and provision of medical care of patients with general and occupational tuberculosis in Ukraine

Nahorna A.M., Kononova I.G., Sokolova M.P.

https://doi.org/10.33573/ujoh2020.01.003

SI “Kundiiev Institute of Occupational Health of the NAMS of Ukraine, Kyiv”

Full article (PDF), UKR

Introduction. According to the WHO findings, high rates of tuberculosis (TB) incidence in Ukraine are in clear correlation with economic development of the country. Measures aimed at decreasing morbidity at the national level and assessing their effectiveness depend on the decline / growth rate of GDP per capita, which is evidence that overcoming the TB epidemic will become possible only if there occur qualitative and positive systemic changes not only in the TB service and the health care system, but in the entire economy of the country.

Workers with TB often lose significant amounts of their work time. Effective timely treatment can return a worker to productive employment. Where there is an occupational risk of TB morbidity, employers have special responsibility for implementation of specific measures in preventing TB disease at workplace.

In Ukraine and in the world, preventive measures are regulated by special regulatory legal acts. Regulatory documents in Ukraine largely take into account the EU requirements and the WHO recommendations. At the same time, the existing changes in the healthcare system and in the social security do not give confidence in implementation and provision of preventive measures for occupational tuberculosis.

Purpose of the study is to conduct a comparative analysis of the national legislation of Ukraine regarding protection of workers from tuberculosis at workplace in accordance with international recommendations and standards.

Materials and methods of the study. The legal acts governing the prevention and treatment of general and occupational TV in Ukraine from 1991 to 2019 were analyzed.

Results. In Ukraine, the basic law on prevention and treatment of tuberculosis is the Law of Ukraine "Fundamentals of the Ukrainian legislation on health care" No. 2801-XII with amendments (1992). The Law of Ukraine No. 1645-III “On Protection of the Population from Infectious Diseases" (2000), which covers the basic principles of the state and legal regulation of activities in the field of protecting the population from infectious diseases, including tuberculosis, is also strategic.

There is a Decree of the Cabinet of Ministers of Ukraine No. 559 (2001) “On approval of the list of professions, industries and organizations whose employees are subject to mandatory preventive medical examinations, the procedure for conducting these examinations and issuing personal medical records”. The Cabinet of Ministers of Ukraine issued the Decree No. 337 dated April 17, 2019 “On Approval of the procedure for investigating and recording incidents, occupational diseases and accidents at work”. At present, the current legal acts, taking into account departmental documents, contain insufficient regulatory actions on preventing tuberculosis of occupational origin.

According to preliminary findings of the WHO expert mission, over the past 5 years in Ukraine there has been a tendency to a decrease in rates of morbidity and mortality from TB; the laboratory network for TB diagnostics has been optimized, and modern quick methods for TB diagnostics have been introduced. It is necessary to implement reforming approaches to providing TB care to the population, including workers, through development of an outpatient care system for TB patients in accordance with modern principles of the infection control, ensuring social support for patients, taking into account the domestic experience and that of the best international practices, and responsibility of the state and society.

Conclusion. 1. The legislative and regulatory framework for prevention and treatment of tuberculosis in Ukraine is based on the documents of various levels and is focused on the new global strategies and guidelines of the World Health Organization and international standards.

2. The problem of tuberculosis is beyond the scope of a purely medical branch and has received the status of a problem of a nationwide scale, as it is a socially dangerous infectious disease, the main factors of which are political, social, economic aspects, and the consequences pose a threat to the economy and national security of the state.

Peculiarities of the regulatory acts on prevention of tuberculosis largely depend on working conditions at workplaces in various sectors where there is a risk of a biological hazard: mining, processing industry, mechanical engineering, agriculture, healthcare facilities, and so on.

3. In view of the above, there is a need to review and change approaches to organizing, planning and financing the program to combat tuberculosis in accordance with new global strategies and guidelines of the World Health Organization, a new WHO global strategy “The End TB Strategy”, in particular, and targets of the Comprehensive Action Plan of antituberculosis actions in the European Region for 2016-2020, which form the basis of the new program.

Key words: tuberculosis, occupational diseases, regulatory legal acts, national legislation

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