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REGIONAL HEALTH PROMOTION: HEALTH CARE DEVELOPMENT AND IMPROVEMENT OF HEALTH CARE SYSTEM
Abstract. The article is devoted to current problems of public health care development and health promotion in the Russian Federation and the main trends of health policy. The role and the responsibility of the state and regional authority in the field of public health care are discussed; consideration is also given to public health priorities. Necessity of acceptance of the public health policy at the regional level to improve the efficiency of health care system, accessibility and quality of public medical care for the population is proved. The article presents a working model of health and discusses contemporary health approaches in health promotion.
Keyword. development policy, health care, modernization, region, model of health, approaches in health promotion, mental health, social health, spiritual health, Health Resources.
I. INTRODUCTION
Currently, health care in the Russian Federation is in crisis and requires modernization. Because the subjects of the Russian Federation were pretty much given free rein in decision making concerning health care development, issues of the development of the regional health care policy are real. Analysis of the current Russian situation in health care area has revealed that during the last 10 years governmental actions were mainly tactical, unsystematically and not strategic (Shilenko, 2012). This is due to the lack of effective scientific public health care policy, taking into account not only the negative impact of the external environment on health care, but also the structure and features of its internal capacity. The development of the regional health care policy is necessary because of the following reasons.
For the past 25 years, the health promotion field has been emphasizing the importance of public policy in effectively addressing the macro-level determinants of health. However, translating this need into action has proven challenging. This article aims to provide health promoters with a range of tools and experiences that will help them make inroads into the field of public policy in Russian Federation. These tools and experiences have not been selected randomly: rather, they are rooted in theories of the policy process. We argue that such theories represent very practical tools for understanding, appraising, and developing health promotion action on the determinants of health at the societal level.
This article pursues two distinct goals. The first is to set the stage for the work presented in this research through a close examination of the nature of public policy and the policy process, and their implications for health promotion. We examine the unique characteristics of public policy and the policy process that explain why the health promotion community has been struggling with the call, from within its own ranks, for the development of policies that will support integrated efforts to achieve human health. We show how public policy processes are complex and iterative, and how they obey a rationality all their own, and hence require specific analyses.
The second goal is to underline their distinctive contributions to this field of knowledge and practice. The work serves to situate public policy within theories from the health promotion literature and to show how such theories are powerful allies in understanding not only whether public policies work, but mostly how they work, thus providing invaluable practical and critical knowledge to health promoters.