National projects in Tatarstan: how the republic going to improve demography for 8.4bn

The plans include new measures to support families with children, the construction of kindergartens and the care for the elderly

National projects in Tatarstan: how the republic going to improve demography for 8.4bn Photo: rkbrt.ru

Realnoe Vremya continues to publish about how national projects are being implemented in Tatarstan. This part of the study is devoted to Demography. It is one of the most expensive national projects and to some extent is the core for the rest: any positive changes in the life of Tatarstan citizens are aimed at improving the demographic situation. The multi-billion budget of the project will be spent on various payments for the birth of children, new kindergartens, care for the elderly, as well as on combating infertility. Besides, this national project includes the development of sports infrastructure, as well as the promotion of a healthy lifestyle (which, at the same time, remained without federal funding). Read more in the material of Realnoe Vremya.

The focus is on families with newborn children

The national project Demography consists of five regional projects, the total budget of which for the next three years exceeds 7 billion rubles. Moreover, it has recently become known about the increase in financing of this national project: in 2019, an additional 1,4 billion rubles will be spent. The regional project “Financial support for families with children” has been pumped with money the most. As reported by the ministry of economy of Tatarstan (the department coordinates the implementation of the national projects in the republic), he got an additional 1,3 billion rubles in 2019, the total budget now is 3,1 billion rubles.

The regional project aims to increase the total birth rate in the republic, that is, the number of children per woman: from the base value of 1,652 in 2017 to 1,662 in 2019 and to 1,771 in 2024. At the same time, by the end of 2018, according to the registry office of Tatarstan, the birth rate in the republic fell by 3,7% compared to 2017. The national project will reverse this situation.

The basis of the national project is connected with payments, primarily with the monthly payments that appeared in 2018 in connection with the birth of the first child to families with an average per capita income not exceeding the 1,5-fold subsistence minimum. The amount of payments is equal to the subsistence minimum in the region (in Tatarstan — 9,450 rubles). As of the beginning of the summer, 9,629 persons were receiving these payments, with the plan of 8,896.

The regional project aims to increase the total birth rate in the republic, that is, the number of children per woman: from the base value of 1,652 in 2017 to 1,662 in 2019 and to 1,771 in 2024. Photo: tatar-inform.ru

Besides, the maternal capital payments, the amount of which is now 453,026 rubles, also fall under the aegis of the national project Demography. It is expected that by the end of 2019, 20,000 families in the region with two or more children will receive a state certificate for maternity capital, and by the end of 2021 there will be 57,000 such families.

Another type of payment has been approved particularly in Tatarstan: one-time payments for women permanently living in rural areas, urban-type settlements, at the birth of the first or third child. If the mother of the first child has not reached the age of 25, the payment is 50,000 rubles. If a woman under the age of 29 gives birth to her third child, the amount of payment is 100,000 rubles. In 2018, the payment of 50,000 rubles was received by 1,689 mothers, the payment of 100,000 rubles — by 933 women.

It should be noted that in a broad sense the ministry of economy considers more than 40 existing programmes for the creation of social infrastructure and preferential mortgage lending also as part of the national project Demography — it is logical that it is much more effective to increase the birth rate when there are all conditions for family life. Thus, the national project Demography in some sense is the core for a number of projects and programmes.

Support for childless

At the same time, the regional project for the financial support of families with children has a direction for those who cannot have children. At the expense of the CHI (Compulsory Health Insurance) within the project, in 2019 alone it is planned not less than 1809 cycles of in vitro fertilization (IVF) for infertile patients. As of June 1, at least 1,510 IVF cycles have already been used in the republic.

At the same time, IVF is very expensive. The need to finance the activities for IVF procedures for women of the Republic of Tatarstan for the period of 2019-2024 is 1,4 billion rubles. The cost of one cycle is more than 120,000 rubles. In 2019, in vitro fertilization on the terms of placement of the state order for this type of service is organized in seven institutions of private ownership.

At the same time, at the beginning of the year, the ministry of health of the Republic of Tatarstan recognized that the region lacks quotas for IVF. The ministry called the national project Healthcare a possible way to solve this problem. “The national project states that demography should grow naturally. We will consider IVF one of these ways,” Deputy Minister of Healthcare of the Republic of Tatarstan Ayrat Garipov said

Elderly will be cured and retrained

Another regional project that has received additional funding is Older Generation. It was allocated another 105,9 million rubles, the final budget for 2019 is 357,8 million rubles. The regional project includes two main areas: the development of gerontological medicine (that is, medicine related to diseases of old age) and professional retraining of citizens approaching pre-retirement age.

The first direction is much more extensive than the second one. First, in the framework of the regional project, the Regional Geriatric Centre will be created on the basis of the autonomous public health care institution Hospital for Veterans of Wars by the end of 2020. Also, the primary specialized assistance in Geriatrics will be rendered in the 40 geriatric clinics (as of the beginning of 2019 there were 10 geriatric consulting rooms, as of 27 June 2019 — 13 consulting rooms, in the period from 1 July until 1 October 2019 the opening of another 31 physician- geriatrician consulting rooms is provided).

The in-patient care in Geriatrics will be at 170 geriatric beds (in 2019, in hospitals of the republic there will appear 145 geriatric beds; in 2018, 15 geriatric beds in hospitals for war veterans of Kazan and Naberezhnye Chelny functioned; from 1 January 2019 additional 10 beds, 25 in total, were opened in the hospital of Kazan). As a result, at least 1,230 people will receive in-patient medical care according in Geriatrics in 2019.

Also, within the framework of the national project, specialists will be trained under additional professional programmes in geriatrics. By the year 2020, the retraining of 30 physicians in the specialty Geriatrics will be carried out (considering past training programmes in the period 2017-2018, the number of geriatricians will be 50 specialists), 100 nurses will be trained under the programme Nursing in Geriatrics, Medical Social Assistance. From January to May 2019, educational cycles for 34 doctors and 34 nurses have already been conducted.

Primary specialized assistance in Geriatrics will be provided in 40 geriatric consulting rooms. Photo: Maksim Platonov

Besides, the construction of residential building of the Novo-Churilinsky psychoneurological residential care is conducted in the framework of the regional project. This will eventually allow to transfer 97 people living in inpatient psychoneurological institutions in violation of regulations. The cost of the construction is 61,7 million rubles.

As for professional and additional training for citizens of pre-retirement age, 92,4 million rubles will be spent for these purposes. As of 31 May 2019, 211 people have started training, that is, 15,6% of the planned performance indicators of 1,351 people. Both working and looking for a job citizens of pre-retirement age can be trained. The bodies of the employment service will be responsible for this, which will organize the training of such citizens both at the request of employers and in the case of individual application.

In total, the list of possible professions for retraining includes 118 directions. In February, the ministry of labour and social protection reported that the willingness to train 1,727 workers have already expressed by 77 enterprises. The greatest need for training of workers of pre-retirement age is declared by the enterprises such as KAMAZ PJSC, Kazan International Airport and Chemical Plant Karpov.

29 kindergartens to be opened as part of the national project

The regional project Promotion of Women’s Employment — Creation of Conditions of Preschool Education for Children Under the Age of Three Years, as the name implies, has a dual nature. On the one hand, it should increase the availability of pre-school education for children aged 1,5 to 3 years in 2019 to 67,5% (the basic value of 2017 — 43,5%), and by 2024, to completely solve the issue at 100%. On the other hand, it should provide employment for women with pre-school children. The employment rate of such women is expected to reach 78,9% by 2024.

The regional project is to provide employment to women with preschool children. Photo: David Kazansky

It is expected that 900 women will be trained at the expense of the regional budget in 2019. From 2020, the training in this category will be continued within the framework of the above-mentioned regional project, 1,549 women will be trained (8,906 women in 5 years in total).

The regional programme has a fairly sizebable budget of 855,6 million rubles, and we can expect that this will significantly increase the availability of places in preschool institutions. And, as follows from the passport of the project, this issue is to be solved through the construction of new buildings for preschool organizations. Hence the “big construction”: as reported by the regional ministry of education, 29 new kindergartens for 3,090 nursery places will be opened in Tatarstan in 2019. By the end of 2021, it is planned to create 5,000 places for children aged one and a half to three years thanks to the construction of 49 kindergartens in the republic.

Sports demography

The development of sport in the republic is related to the national project Demography, there is no separate “sports” national project. The direction Sport — the Norm of Life is designed to increase the proportion of citizens systematically engaged in physical culture and sports, aged 3 years and older — 46,3% in 2019 (the base value of 2017 — 43,4%, 2024 — 57%).

The amount of funding in 2019 is already known — 149,9 million rubles. This money will be used to build sports infrastructure in 2019. First of all, these are sites for preparation for taking the Ready for Labour and Defence complex — 33 new ones will appear in the republic. Also, equipment for hockey for 30,86 million rubles and for football for 49,38 million rubles will be purchased for sports institutions of Tatarstan. A separate item is the new turf for the football field of the sports school in Apastovo, which will need 10 million rubles. Also, the money of the regional project will be used to build sports grounds in rural areas — this will cost another 2,89 million rubles.

The direction Sport — the Norm of Life is intended to increase the share of citizens who are systematically engaged in physical culture and sports. Photo: Oleg Tikhonov

Sober life does not receive additional financing under the national project

Last on the list in the national project Demography — the regional project Strengthening of Public Health. It sets the following goals: in 2019 to achieve the mortality rate of men aged 16-59 years in 603,8 per 100,000 population (the base value of 2017 — 651,3, in 2024 — 470,1), the mortality of women aged 16-54 years — in 164,2 per 100,000 population (the base value of 2017 — 164,2). The enemy in this regional project they consider to be alcohol: within the framework of the project, they also want to reduce the retail sale of alcoholic beverages per capita (in litres of ethanol) in 2019 to 7,3 liters (the basic value of 2017 is 7,5 litres; in 2024 — 6,8 litres).

However, federal funding is not provided in this project. The whole work is carried out within the framework of existing programmes. It is about providing subsidies from the budget of Tatarstan to socially oriented non-profit organizations implementing projects in the anti-drug sphere, the work of the Regional Resource Centre for volunteers in the framework of the project Common Cause (Obschee Delo), activities on anti-drug propaganda and promotion of healthy lifestyles.

At the same time, Tatarstan is included in the number of 20 subjects of the Russian Federation — participants until 2021 of the pilot project on the introduction of the new model of public health centres, regional and municipal programmes to strengthen public health, as well as corporate programmes to strengthen health in the workplace. To date, only the development of these corporate programmes is underway, but at least one public health centre has already opened in the Republican Clinical Hospital.

The main objectives of the centre are to provide advisory and health assistance to patients discharged from the structural units of the Republican Clinical Hospital, and create a comfortable environment for the formation of a personal trajectory of human health preservation. The medical staff will inform about the harmful for people factors, to foster in patients the responsible attitude for their health and adherence to therapy, to teach hygiene and to motivate the rejection of bad habits.

By Alexander Artemyev
Tatarstan