Assessment of population satisfaction with medical care in conflict conditions.

In the context of health care reform, the primary task is to ensure the delivery of high-quality medical services and good end results in the performance of individual physicians, structural units, and general medical services. The healthcare sector is one of the most socially significant spheres of functioning in every country. The problem of conflicts presents special social importance in this field, as a result of the rather close relationship between doctor and patient. The main objective of this study was to determine patients' satisfaction with the quality of healthcare at the primary level. The survey was conducted using an electronic questionnaire. The sample consisted of 1,146 residents of Chernivtsi and the Chernivtsi region, aged 18-56 and older. Almost half of the respondents (42.5%) offered a neutral overall rating of the quality of medical services at the primary care level. Only 25.5% gave a positive valuation of the quality of health care services they received, while 32% gave a negative evaluation. Patients' actions, opinions, and ideas shape and complement industry policies and the way they are implemented. In this context, if a dialogue is established among the main actors in the healthcare system, improvements in the system can be achieved, which will lead to better health and quality of life for people in the future.

Perinatal mortality after Chornobyl in contaminated regions of Ukraine.

BACKGROUND: Belarus and Ukraine were the countries most affected by the consequences of the Chornobyl nuclear power plant in 1986. A study of perinatal mortality in Belarus found a highly statistically significant increase in the 1990s in the most contaminated oblast Gomel but no increase during this period in the rest of Belarus. As a possible mechanism to interpret this increase as a late Chornobyl effect, it has been suggested that strontium-90 contained in Chornobyl fallout, incorporated during menarche, impairs the immune system of pregnant women which in turn increases perinatal mortality. In the present study, this hypothesis is tested using data from Ukraine. METHODS: Annual data on perinatal mortality, in the period 1981-2006 were provided by the Ministry of Public Health of Ukraine. Trends in perinatal mortality rates in the most contaminated regions of Ukraine (Kyiv and Zhytomyr oblasts and the city of Kyiv; study region) were compared with rates in the rest of Ukraine (control region). To identify any differences in perinatal mortality trends between the study and control regions, the ratios of perinatal mortality rates in the study region to the rates in the control region were analyzed using the calculated strontium concentration as a predictor. RESULTS: A trend analysis of perinatal mortality rates in Ukraine revealed two bell-shaped deviations from a long-term exponential trend with maxima at the beginning and end of the 1990s. The same pattern was found in the data from the study and control regions, but the deviations were almost three times higher in the study region than in the control region. An analysis of the ratios of perinatal mortality rates in the study region to the rates in the control region (odds ratios) showed an increase and decrease during the 1990s which was approximated by a lognormal density distribution. The calculated strontium concentration, when used as a predictor, also fitted the data well. Thus, the data from Ukraine confirms the results from Belarus. The analysis of the odds ratios revealed about 1000 excess perinatal deaths in the study region in the period 1990-2004. The corresponding figure for Ukraine as a whole was estimated at 3500 perinatal deaths. CONCLUSION: It is hypothesized that the observed increase in perinatal mortality in the 1990s may be a late effect of incorporated strontium-90 on the immune system of pregnant women. The analysis is based on a theoretical model, as no data on strontium concentrations were available; the results should therefore be interpreted with caution. An updated study for Belarus would be desirable to corroborate the results.

State Regulation of Ensuring the Quality Medical Care During Martial Law in Ukraine: Lessons for the International Community.

Background: Nowadays, the quality of medical care and health care measures is considered the main target function of the health care system and at the same time the determining criterion for its activities. Objective: The article examines state regulation of medical care quality post- COVID and during martial law, identifying improvement areas. It emphasizes state roles in healthcare standardization, continuous feedback monitoring, and studying patient satisfaction. Interrelationships among Ukraine's state regulation mechanisms are determined, highlighting the need to enhance tools such as criteria and quality indicators for medical care assurance. Methods: The authors of this article utilize various scientific methods, including analysis, synthesis, induction, and deduction, as well as historical and legal, formal legal, and comparative legal methods to examine the state regulation of ensuring the quality of medical care during martial law in Ukraine. Results: The article considered the interrelationships of mechanisms and instruments of state regulation of quality assurance of medical care in Ukraine. Conclusions: The state should enhance medical care quality regulation, drawing on international experiences from the EU and the USA and adapting best practices to national circumstances. The resilience of the healthcare system depends on effective quality assurance, ensuring preparedness, stability, and ongoing improvement prospects.

International Standards and Features of Financing in the Field of Health Care and Provision of Medical Services.

The relevance of this article is due to the fact that international standards in the field of health care and medical services are central to the field of world principles of functioning and development of medical law. The aim of the article is to conduct research on the peculiarities of international standards in the field of health care and medical services, as well as to study the prospects of their implementation in Ukraine. Leading research methods are general and special research methods, including methods of logic, analysis, comparison. The results of this study are to outline recommendations for the use of international standards in the field of health care and medical services in Ukraine and to summarize the legal framework on this issue. The significance of the results is reflected in the fact that this study can serve as a basis for outlining future changes in current legislation of Ukraine on the functioning of the health care system and implementation of world practices in health care. Within the framework of this study, systematized the main international and European documents that reflect the main international standards in the field of health care and medical services and ratified in Ukraine and have a direct impact on the legal framework for this area.

Active European warzone impacts raptor migration.

Human conflicts can have impacts on wildlife, from direct mortality and environmental damage to the displacement of people, changing institutional dynamics and altering economies.1,2,3 Extreme anthropogenic disturbances related to conflict may act as a barrier to migrating birds and increase the energetic costs of migration.4 On February 24th, 2022, the Russian Federation invaded Ukraine, with targeted attacks on Kyiv and the eastern regions.5 By March 3rd, when the first of 19 tagged Greater Spotted Eagles entered Ukraine on migration, the conflict had spread to most major cities, including parts of western Ukraine.6 We quantified how conflict impacted the migratory behavior of this species using GPS tracks and conflict data from the Armed Conflict Location and Event Data (ACLED) project7,8 in a quasi-experimental before-after control-impact design, accounting for meteorological conditions. Migrating eagles were exposed to conflict events along their migration through Ukraine and exhibited different behavior compared with previous years, using fewer stopover sites and making large route deviations. This delayed their arrival to the breeding grounds and likely increased the energetic cost of migration, with sublethal fitness effects. Our findings provide a rare window into how human conflicts affect animal behavior and highlight the potential impacts of exposure to conflict events or other extreme anthropogenic disturbances on wildlife.

Tribulus terrestris and Sport Performance: A Quantitative and Qualitative Evaluation of Its Advertisement and Availability via Online Shopping in Six Different Countries.

Dietary supplements are commonly used among athletes, and the Internet may be an easy source of these products. Tribulus terrestris is an herbal supplement with multiple properties. Of interest to athletes are reports that its consumption can lead to muscle mass gain and a faster recovery process. The objective of this cross-sectional study was to determine the availability of Tribulus terrestris via the Internet in six countries (Canada, Puerto Rico, Russia, Spain, Ukraine, and the United States of America) via a specifically designed computer program. The characteristics of the websites selling this substance, the country from which it can be purchased, the route of administration, and recommendations for its use were analyzed. The results of the study show that this supplement is marketed mainly in Russia, Ukraine, and Spain on many websites that are mostly dedicated to sports products. Just over half of the webpages (59.14%) identified only distribute this supplement within the same country. The main claims for its consumption refer to sports performance benefits, but there are also claims that it may improve male hormone levels and sexual function. Athletes should be encouraged to seek professional advice prior to ingesting this supplement to ensure that it is suitable for their specific training and sports objectives.

Assessing internal displacement patterns in Ukraine during the beginning of the Russian invasion in 2022.

Given the worldwide increase of forcibly displaced populations, particularly internally displaced persons (IDPs), it's crucial to have an up-to-date and precise tracking framework for population movements. Here, we study how the spatial and temporal pattern of a large-scale internal population movement can be monitored using human mobility datasets by exploring the case of IDPs in Ukraine at the beginning of the Russian invasion of 2022. Specifically, this study examines the sizes and travel distances of internal displacements based on GPS human mobility data, using the combinations of mobility pattern estimation methods such as truncated power law fitting and visualizing the results for humanitarian operations. Our analysis reveals that, although the city of Kyiv started to lose its population around 5 weeks before the invasion, a significant drop happened in the second week of the invasion (4.3 times larger than the size of the population lost in 5 weeks before the invasion), and the population coming to the city increased again from the third week of the invasion, indicating that displaced people started to back to their homes. Meanwhile, adjacent southern areas of Kyiv and the areas close to the western borders experienced many migrants from the first week of the invasion and from the second to third weeks of the invasion, respectively. In addition, people from relatively higher-wealth areas tended to relocate their home locations far away from their original locations compared to those from other areas. For example, 19 % of people who originally lived in higher wealth areas in the North region, including the city of Kyiv, moved their home location more than 500 km, while only 9 % of those who originally lived in lower wealth areas in the North region moved their home location more than 500 km..

A Comparison of Ukrainian Hospital Services and Functions Before and During the Russia-Ukraine War.

Importance: Since the full-scale Russian invasion, hospitals in Ukraine have been compelled to close or operate at reduced capacity due to inadequate supplies, damage, or destruction caused by war. Objective: To analyze hospital services in Ukraine during the period before and after the Russian invasion. Design, Setting, and Participants: Of the 450 hospitals currently functioning in Ukraine, a cross-sectional survey was carried out with the participation of 74 hospitals from 12 oblasts. Hospital administrators responded to an online survey with questions on the use of hospital services. Data were abstracted from hospital databases for the prewar period (before February 23, 2022) and during the war (February 23, 2022, to May 30, 2023). Main Outcomes and Measures: Hospital services (including emergency services, preventive services, screenings, laboratory tests, obstetrics, telehealth, pharmacy, and rehabilitation services) were compared during the prewar and war periods. Results: Of 450 Ukrainian hospitals in operation, 74 hospitals (16.0%) across 12 oblasts provided data for the current analyses. During the war, daily emergency admissions increased to 2830, compared with 2773 before the war. At the same time, hospitals reported reduced laboratory testing (72 [97%] vs 63 [85%]), tobacco education (52 [70%] vs 36 [49%]), cancer screening (49 [66%] vs 37 [50%]), gynecological services (43 [58%] vs 32 [43%]), rehabilitation services (37 [50%] vs 27 [36%]), pharmacy services (36 [49%] vs 27 [36%]), and telehealth programs (33 [45%] vs 21 [28%]). Hospitals reported additional difficulties during the war, including disruptions in the supply chain for essential equipment and pharmaceuticals, shortages of laboratory test kits, delays in the delivery of crucial medications, and problems around appropriate medication storage due to power outages. Conclusions and Relevance: The ongoing war has inflicted profound devastation on Ukraine's hospitals. The findings of this cross-sectional survey offer valuable insights into the formidable challenges that hospitals confront in war-affected regions and underscore the pressing necessity for bolstering support to sustain and enhance hospital services during wartime.

Compositional-geochemical characterization of lead (Pb) anomalies and Pb-induced human health risk in urban topsoil.

Urban areas are characterized by a constant anthropogenic input, which is manifested in the chemical composition of the surface layer of urban soil. The consequence is the formation of intense anomalies of chemical elements, including lead (Pb), that are atypical for this landscape. Therefore, this study aims to explore the compositional-geochemical characteristics of soil Pb anomalies in the urban areas of Yerevan, Gyumri, and Vanadzor, and to identify the geochemical associations of Pb that emerge under prevalent anthropogenic influences in these urban areas. The results obtained through the combined use of compositional data analysis and geospatial mapping showed that the investigated Pb anomalies in different cities form source-specific geochemical associations influenced by historical and ongoing activities, as well as the natural geochemical behavior of chemical elements occurring in these areas. Specifically, in Yerevan, Pb was closely linked with Cu and Zn, forming a group of persistent anthropogenic tracers of urban areas. In contrast, in Gyumri and Vanadzor, Pb was linked with Ca, suggesting that over decades, complexation of Pb by Ca carbonates occurred. These patterns of compositional-geochemical characteristics of Pb anomalies are directly linked to the socio-economic development of cities and the various emission sources present in their environments during different periods. The human health risk assessment showed that children are under the Pb-induced non-carcinogenic risk by a certainty of 63.59% in Yerevan and 50% both in Gyumri and Vanadzor.

Surgical treatment of intracapsular temporomandibular disorders.

OBJECTIVE: Temporomandibular joint (TMJ) pathologies are prevalent, affecting approximately 40% of the worldwide population, with nearly 80% involving intracapsular disorders. Despite this, standardized treatment protocols are lacking. This study aimed to compare the efficacy of conservative and surgical approaches in managing intracapsular TMJ disorders. METHODS: Eighty-six patients diagnosed with intracapsular TMJ disorders were included in the study, with 40 males and 46 females, averaging 52.4 ± 4.7 years. Patients were recruited from polyclinics in Beijing, China (n = 36), and Kyiv, Ukraine (n = 50). A comprehensive examination protocol was conducted, including assessment of patient complaints, medical history, jaw mobility measurements, TMJ palpation, and magnetic resonance imaging (MRI) screening. RESULTS: The main outcomes of our study revealed significant improvements in patients undergoing surgical intervention for intracapsular TMJ disorders, particularly in cases of disc displacement. Conservative mouth guard/occlusal splint treatment showed limited effectiveness, primarily improving joint effusion and disc displacement. Surgical intervention led to notable enhancements in various TMJ parameters, with significant improvements observed in joint function and pain reduction. Based on these findings, orthodontic rehabilitation was recommended to ensure long-term efficacy, focusing on optimizing occlusion and restoring TMJ function. These results highlight the importance of tailored treatment approaches for managing intracapsular TMJ disorders, emphasizing the role of surgical intervention coupled with comprehensive rehabilitation strategies. CONCLUSIONS: Future research should consider demographic factors and explore innovative examination methods, such as optical systems, to enhance understanding and management of intracapsular TMJ disorders.

The burden of infectious diseases throughout and after the COVID-19 pandemic (2020-2023) and Russo-Ukrainian war migration.

Understanding how the infectious disease burden was affected throughout the COVID-19 pandemic is pivotal to identifying potential hot spots and guiding future mitigation measures. Therefore, our study aimed to analyze the changes in the rate of new cases of Poland's most frequent infectious diseases during the entire COVID-19 pandemic and after the influx of war refugees from Ukraine. We performed a registry-based population-wide study in Poland to analyze the changes in the rate of 24 infectious disease cases from 2020 to 2023 and compared them to the prepandemic period (2016-2019). Data were collected from publicly archived datasets of the Epimeld database published by national epidemiological authority institutions. The rate of most of the studied diseases (66.6%) revealed significantly negative correlations with the rate of SARS-CoV-2 infections. For the majority of infectious diseases, it substantially decreased in 2020 (in case of 83%) and 2021 (63%), following which it mostly rebounded to the prepandemic levels and, in some cases, exceeded them in 2023 when the exceptionally high annual rates of new cases of scarlet fever, Streptococcus pneumoniae infections, HIV infections, syphilis, gonococcal infections, and tick-borne encephalitis were noted. The rate of Clostridioides difficile enterocolitis was two-fold higher than before the pandemic from 2021 onward. The rate of Legionnaires' disease in 2023 also exceeded the prepandemic threshold, although this was due to a local outbreak unrelated to lifted COVID-19 pandemic restrictions or migration of war refugees. The influx of war migrants from Ukraine could impact the epidemiology of sexually transmitted diseases. The present analysis indicates that continued efforts are needed to prevent COVID-19 from overwhelming healthcare systems again and decreasing the control over the burden of other infectious diseases. It also identifies the potential tipping points that require additional mitigation measures, which are also discussed in the paper, to avoid escalation in the future.

Factors of pre-war educational migration: an investigation of polish medical and dental students in Ukraine.

BACKGROUND: Low admission rates at Polish medical universities led many students to study abroad. Ukraine provided an appealing option for years. The purpose of the study is to investigate the most important factors that motived Polish students enrolled at I. Horbachevsky Ternopil National Medical University in Ukraine to pursue medical and dentistry studies in lower middle-income countries, just before the outbreak of the war. It has become incredibly important to determine crucial economic and non-economic factors. METHODS: The paper draws on a quantitative survey (N = 94) conducted among medical and dental students from Poland who had studied at I. Horbachevsky Ternopil National Medical University in Ukraine using a semi-structured questionnaire. To test whether there was a relationship between the importance of the motives, Pearson's chi-square independence test was employed. RESULTS: The study found the key economic and non-economic factors for pursuing Ukrainian studies were rejection from Polish tuition-free programs, lower Ukrainian tuition and living costs compared to Poland and to other European Union countries. Determining reasons for choosing Ternopil University were recruiter and friend recommendations and its prestige among Ukrainian medical schools. Gender influenced the ranking of motives. CONCLUSION: The article examines the unique pre-war educational migration from Poland to Ukraine - occurring counter to typical flows from lower to higher a lower income country. The study showed that universities should strengthen recruiting efforts and highlight competitive tuition and living costs to attract international students, especially from relatively more developed nations.

Identifying gaps in healthcare: a qualitative study of Ukrainian refugee experiences in the German system, uncovering differences, information and support needs.

BACKGROUND: The 5.8 million Ukrainian refugees arriving in European countries must navigate varying healthcare systems and different and often unknown languages in their respective host countries. To date, there has been little exploration of the experiences, perceived differences, information and support needs of these refugees regarding the use of healthcare in Germany. METHODS: We conducted ten qualitative interviews with Ukrainian refugees living in Germany from February to May 2023, using Ukrainian, English and German language. The transcribed interviews were analysed using the qualitative content analysis method according to Kuckartz and Rädiker with the MAXQDA software. RESULTS: In general, participants consistently had a positive experience of the German healthcare system, particularly regarding the quality of treatments and insurance. Differences have been reported in the structure of the healthcare systems. The Ukrainian healthcare system is divided into private and state sectors, with no mandatory insurance and frequent out-of-pocket payments. Pathways differ and tend to focus more on clinics and private doctors. General practitioners, often working in less well-equipped offices, have only recently gained prominence due to healthcare system reforms. Initiating contact with doctors is often easier, with much shorter waiting times compared to Germany. Interviewees often found the prescription requirements for many medications in Germany to be unusual. However, the mentioned differences in healthcare result in unmet information needs among the refugees, especially related to communication, navigating the healthcare system, health insurance, waiting times and medication access. These needs were often addressed through personal internet research and informal (social media) networks because of lacking official information provided during or after their arrival. CONCLUSIONS: Despite the positive experiences of Ukrainian refugees in the German healthcare system, differences in the systems and language barriers led to barriers using healthcare and information needs among refugees. The dissemination of information regarding characteristics of the German health care system is crucial for successful integration but is currently lacking. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00030942, date of registration: 29.12.2022.

A multilingual analysis of pro Russian misinformation on Twitter during the Russian invasion of Ukraine.

The Russian government has long since engaged in an information campaign of propaganda and disinformation as a major part of foreign policy. This has been taken to new heights since the invasion of Ukraine in February 2022. In this study, we investigate pro-Russian misinformation within the opening weeks of the invasion in 6 languages: English, Japanese, Spanish, French, German, and Korean. Using Twitter data, we apply a combination of network and language embedding models to identify popular topics of misinformation amongst users in each language. Despite English users forming the most dominant language base on Twitter, we find that the popularity of misinformation in Japanese regularly outstrips English for certain topics. Misinformation shared by Spanish users is also over-represented in proportion to its much smaller user base. Our results provide insight into the current state of misinformation in each language. While we discuss some of the possible drivers behind the factors such as language over-representation, our study also highlights the need for further cross-lingual misinformation research in order to better understand this phenomena in a truly global context.

Professional self-determination of future dentists in the modern realities of Ukraine.

OBJECTIVE: Aim: To research how the future dentists' professional self-determination (reflects the cognitive-reflexive component of higher medical education applicants' readiness to use digital technologies in their professional activities) develops within the formation of information technology competence in the modern realities of Ukraine. PATIENTS AND METHODS: Materials and Methods: The author's questionnaire consisted of 15 questions. The questionnaire surveys covered 98 future dentists who studied 'Medical Informatics' and 'Information Technology in Dentistry' at the Ivano-Frankivsk National Medical University in the September-December 2017-2018 and September- December 2022-2023 academic years. The research results were assessed according to the algorithm described. The research used such methods as analysis, synthesis, comparison, concretisation, systematisation, and generalisation, as well as methods of mathematical statistics for evaluating data, namely correlation analysis, Kolmogorov-Smirnov test, Cronbach's alpha, Fisher's test (F-test of equality of variances), Student's t-test and ranking. RESULTS: Results: The research found positive dynamics of the professional self-determination levels (in 2022 compared to 2017, the low level decreased by 20.5%, the satisfactory level - by 19.0%, the average level increased by 20.6%, the high level - by 18.9%) and their quality, which within the research increased by 39.5%. CONCLUSION: Conclusions: By forming information technology competence, future dentists changing the priorities of professional self-determination in the modern realities of Ukraine and acquiring readiness (within the cognitive-reflexive component) to use digital technologies in professional activities.

Results of the study of the attitude of women of reproductive age to the integrated gynecological care provision by family physicians.

OBJECTIVE: Aim: To study and analyze the attitude of women of reproductive age to the integrated gynecological care provision by family physicians, their readiness to receive some gynecological services from family physicians, as well as to analyze the level of women's support and readiness for the integrated provision of gynecological care depending on age and level of education. PATIENTS AND METHODS: Materials and Methods: For the survey, anonymous questionnaires containing questions on the attitude of women of reproductive age to the integrated provision of certain types of gynecological care by family physicians were developed. 181 women from the Kyiv region took part in the survey. RESULTS: Results: Support of more than 80% of respondents regarding the integrated gynecological care provision by family physicians received the following questions: counseling on the prevention of sexually transmitted infections and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (92,3%); counseling on family planning and prevention of unwanted pregnancy (83,4%); counseling on the use of various methods of contraception (82,3%); examination and palpation of mammary glands (80,1%); referral of women to a higher level of obstetric and gynecological care (if necessary (86,2%). CONCLUSION: Conclusions: The majority of respondents (67,4%) are ready or better ready than not ready to receive certain types of gynecological care services from family physicians. Almost the same percentage ratio (more than 60%) of women of each age group and all levels of education are ready or better ready than not ready to receive gynecological care services, which they supported, from family physicians.

Legal conflicts in forensic dentistry: practice and methods of resolving them.

OBJECTIVE: Aim: To investigate and analyze legal conflicts in forensic dentistry of Ukraine. PATIENTS AND METHODS: Materials and Methods: A comparative research method for determining the common and distinctive features of the legal regulation of forensic dental expertise as a subcluster in the legislation of Ukraine. The descriptive (monographic) method reveals the problematic aspects of forensic dental examination through the lens of local normative and general normative connotations. The structural-functional research method made it possible to systematize the peculiarities of forensic medical and forensic dental expert activity. CONCLUSION: Conclusions: The analysis of legal conflicts made it possible to come to the following conclusions, that in Ukraine today there is no specific legal act that would regulate the aspects of performing dental activities. Forensic dental examination in Ukraine, in accordance with the legislation, is an examination of the actions and inactions of the dentist. The adoption of normative legal acts in the field of dental activity and forensic dental examination in Ukraine would make it possible to determine the specifics of establishing facts and circumstances that indicate a violation of the patient's rights.

Postpartum infections and antimicrobial resistance of responsible pathogens in Ukraine: results a multicenter study (2020-2022).

OBJECTIVE: Aim: To determine the current prevalence of postpartum infections and antimicrobial resistance and antimicrobial resistance of responsible pathogens in Ukraine. PATIENTS AND METHODS: Materials and Methods: Multicenter prospective cohort study was conducted from January 2020 to December 2022 in fifteen hospitals from twelve regions of Ukraine. Definitions of healthcare- associated postpartum infection were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST. RESULTS: Results: Among 21,968 women, 6,175 (28.1%) postpartum infections were observed. Of all postpartum infection cases, 83.1% were detected after hospital discharge. The postpartum infection rates were 17.3% after cesarean section and 10.8% after vaginal delivery. The most common postpartum infection types were endometritis (17.3%), followed by urinary tract Infection (3.5%), mastitis (3.4%), surgical site infection (excluding endometritis) (2.4%), and episiotomy site infection (1.5%). The predominant postpartum infection pathogens in Ukraine were: Escherichia coli (10.4%), Enterococcus spp. (9.6%), Staphylococcus aureus (6.7%), Pseudomonas aeruginosa (5.8%), Enterobacter spp. (5.8%). In our study pathogens of postpartum infection had differently levels of resistance to antibiotics. CONCLUSION: Conclusions: Our results indicate that postpartum infections requiring medical attention are common in Ukraine and that most postpartum infections occur after hospital discharge, so that use of routine inpatient surveillance methods alone will lead to underestimation of postpartum infection rates. Optimizing the antibiotic prophylaxis may reduce the burden of postpartum infection, but prevention is the key element.