Norwegian-Russian cooperation in public health education in the Euro-Arctic Barents region

A Norwegian-Russian cooperation in public health education in the Euro-Arctic Barents region started in the 1980s. In the 1990s it has been mostly limited to research- and student exchanges.

In September 2006 seven universities including Northern State Medical University, Arkhangelsk (Russia), University of Tromsø (Norway), Nordic School of Public Health (Sweden), Umeå University (Sweden), Mid-Sweden University (Sundsvall, Sweden), Tampere University (Finland) and the National Institute of Public Health (Oslo, Norway), came together to found the International school of public health in Arkhangelsk, Russia (ISPHA). The mission of the ISPHA was to increase the level of knowledge in methods of research and practice in the field of public health, and to promote the implementation of this knowledge in Northwest Russia. Since 2007, ISPHA is providing public health education based on a 2-year MPH training. In 2007, ISPHA became the first full member of ASPHER. Forty-eight specialists got MPH degrees at ISPHA as a part of the program.

In 2013 a PhD programme between NSMU and the University of Tromsø was established. In 2013-19, 6 PhD theses were defended, and totally 28 full-text papers were published in peer-reviewed journals. In 2017 two new PhD programs in public health between Norway and Russia were initiated. The programme in environmental health and registry epidemiology in Arctic and Sub-Arctic Russia is run in collaboration between two Russian and two Norwegian universities while the second programme on cardiovascular epidemiology is run by NSMU and the University of Tromsø. Both programmes have already recruited PhD students and teachers from both countries. Achievements, challenges, sustainability and future perspectives will be discussed.

In spite of political perturbations, cooperation in public health education and research between Norway and Russia is contributing to better understanding of each other and strengthening public health workforce in Arctic Russia.

Key messages

Norwegian Russian cooperation evolved from exchanges to PhD programs. Most of the graduates strengthen public health capacity in their regions.

Periconceptional folic acid intake in Northwest Russia: a birth registry study

Introduction

Periconceptional use of folic acid supplementation is an evidence-based measure of birth defects prevention. The study was aimed to assess effect of periconceptual use of folic acid on birth defect prevalence in Arkhangelsk county and to investigate socio-demographic factors, which are associated with adherence to this preventive measure.

Methods

A registry-based study was conducted with data from the Arkhangelsk County Birth Registry for 2012-2015. The study population included 57084 pregnancies to calculate the proportion of women taking folic acid and 53340 pregnancy outcomes without missing data to analyze related socio-demographic characteristics.

Results

The proportion of women followed a folic acid supplementation before pregnancy was 1.3% (95% CI: 1.2-1.4), during pregnancy - 55.8% (95%CI: 54.6-56.4). Such women had less risk to deliver a newborn with any birth defects (OR = 0,84, 95%CI: 0,75 - 0,95). Considering birth defects prevalence of 38,6 per 1000 newborns in Arkhangelsk county, number needed to prevent one case of birth defect was 142,9. Based on multivariate analysis, nulliparous married women with higher education, aged 30 or more, had a higher chance to use folic acid before and during pregnancy. The history of spontaneous abortion in the mother's medical history and the first pregnancy were negatively associated with the probability of folic acid intake both before and during pregnancy.

Conclusions

The compliance to periconceptional intake of folic acid among women in the region was low. A level of compliance was associated with such socio-demographic factors as age, education, marital status, gravidity and parity. The findings have direct applications in improving prenatal care in Arkhangelsk county and establishing targets for prenatal counseling.

Key messages

A level of compliance to primary prevention of birth defects is associated with such socio-demographic factors as age, education, marital status, gravidity and parity. Prenatal counseling in terms of birth defects prevention should be based on socio-demographic characteristics of pregnant women.

Social variations in pregnancy outcomes in Murmansk county-one of the Northernmost European provinces

Background

Pregnancy outcomes are widely used indicators of population wellbeing varying both between and within countries. The aim of this study was to assess social variations in preterm births and term small-for-gestation-age (SGA) infants in the Northernmost provinces of Europe - the Murmansk region - using the data from the first Russian population-based birth registry.

Methods

A registry-based study of 52 806 births in the Murmansk region for a 5-year period was performed. We studied the prevalence and social determinants of moderate-to-late preterm births (MLPTB, 224-258 days of gestation), very preterm births (VPTB, 196-223 days) and extremely preterm births (EPTB, 154-195 days) and term SGA for both weight and length births (SGAWL). Associations between social factors and pregnancy outcomes were studied by multivariable logistic regression.

Results

The prevalence of PTB was 6.9 with EPTB, VPTB and MLPTB constituting 0.3%, 0.6% and 6.0%, respectively. A total of 4.1% of infants were SGAWL. Women with primary, secondary and vocational education were 1.59 (95%CI:1.22-1.85), 1.33 (95%CI:1.20-1.48), 1.19 (95%CI:1.22-1.85) times more likely to have MLPTB than women with higher education. Corresponding values for VPTB were 1.65 (95%CI:0.88-3.08), 1.41 (95%CI:1.02-1.95) and 1.27 (95%CI:0.92-1.75), respectively. Single and cohabiting women had significantly elevated risk for MLPTB (ORs=1.47 (95%CI:1.30-1.66) and 1.39 (95%CI:1.26-1.44)) and VLPTB (ORs=2.00, 95% CI: 1.42-2.81 and 1.32, 95% CI: 0.97-1.79) compared to married women. Unmarried mothers were more likely to have SGAWL boys (OR = 1.60, 95% CI: 1.38-1.86) and SGAWL girls (OR = 1.51, 95%CI:1.31-1.76) compared to married women.

Conclusions

We observed significant social variations in pregnancy outcomes by maternal education and marital status in the Murmansk region. Registry data can be used as an effective tool for monitoring inequalities in pregnancy outcomes as indicators of social inequalities.

Key messages

We found significant social variations in pregnancy outcomes in the Northernmost province of Europe - the Murmansk county (Russia). Birth registry data can be used for monitoring of health inequalities in Russia.

[The Effect of Medical Social Characteristics and Style of Life of Mothers on Premature Delivery Risks in the Arctic Region of the Russian Federation]

The article presents the analysis of distribution of medical social characteristics and determinants of style of life of mothers in the groups with premature and urgent/delayed deliveries registered in the Register of deliveries of the Arkhangelsk oblast from 01.01.12 to 31.12.14 (n = 43 327). As compared with the group of urgent/delayed deliveries in the group of premature deliveries (n = 2458 or 5.8% of total number of deliveries), the analysis revealed a large percentage mothers characterizing by non-working, single or without marriage registration, smoking, alcohol abusing, lately registered with their pregnancy, lower education level, aged 35 and older, surplus body mass/obesity. The regression analysis generating odds ratio adjusted to all analyzed characteristics, established statistically reliable increasing of risk of premature delivery in primipara and secundipara females older than 35 years and also having the mentioned risk factors except absence of employment of mother. The established risk factors of premature delivery are to be considered in planning activities on their prevention at the individual level.