IMPACT OF THE WAR AND THE COVID-19 PANDEMIC ON THE MORTALITY RATE OF CHILDREN UNDER THE AGE OF 1 YEAR IN UKRAINE IN UKRAINE

Background. The war and the consequences of the COVID-19 pandemic have an extremely negative impact on the morbidity and mortality of the child population. The aim of the study is to analyse the impact of the war and the consequences of the COVID-19 pandemic on the dynamics of infant mortality and its components in Ukraine from 2020 to 2023.Study materials and methods. Retrospective analysis and assessment of infant mortality and its components in Ukraine for theperiod from 2020 to 2023 was carried out on the basis of the data of the sectoral statistics of the state institution «Public Health Centre of the Ministry of Health of Ukraine». The methods of systematic approach, statistical data processing and epidemiological analysis of graphical representation were used.Results and discussion. In 2023, after three years of the COVID-19 pandemic and against the background of the ongoing Russian invasion of Ukraine, the infant mortality rate increased to 7.45 ‰ or 11.69 % compared to 2020. This increase was mainly due to a relatively higher increase in postneonatal mortality and late neonatal mortality in the current environment compared to early neonatal mortality. Certain conditions occurring in the perinatal period, congenital anomalies (malformations), malformations and chromosomal disorders, respiratory diseases, especially acute respiratory diseases of the upper airways, pneumonia, infl uenza, some infectious and parasitic diseases and diseases of the nervous system are the main causes of mortality in children in the fi rst year of life in 2023. In the structure of infant mortality, the proportion of deaths of children under 1 year of age due to infectious and parasitic diseases, respiratory diseases and external causes (injuries, poisoning, accidents), diseases of the nervous system and diseases of the circulatory system has increased signifi cantly in the last 4 years, which may also be a result of the direct and indirect synergistic eff ects of the war and the COVID-19 pandemic. The highest infant mortality rates were observed in Kherson (28.27 per cent), Zakarpattia (11.5 per cent), Dnipropetrovsk (9.29 per cent), Kirovograd (9.19 per cent), Donetsk (9.12 per cent), Zhytomyr (8.93 per cent) and Chernihiv (8.71 per cent) regions, which may indicate inadequate staffi ng and resources for paediatric services, particularly as a result of the war. Of particular concern is the 11.5 per cent increase in out-of-hospital mortality in the fi rst year of life compared with 2020, which may be due to the deterioration in the availability of medical care for children as a result of the hostilities in the east and south of the country.Conclusion. After three years of the COVID-19 pandemic and against the background of the ongoing Russian invasion, Ukraine has experienced an increase in infant mortality, with an increase in the incidence of children under one year of age and a greater increase in postneonatal and late neonatal mortality compared with a relatively small increase in early neonatal mortality.