2004

Transcrição

2004

i
saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministro
erovnuli moxseneba
saqarTvelos mosaxleobis
janmrTelobis
mdgomareobis Sesaxeb
2004 weli
Tbilisi
2006
ii
saqarTvelos mosaxleobis janmrTelobis mdgomareoba
2004
erovnuli moxseneba momzadda socialuri da janmrTelobis erovnul
institutSi
instituti madlobas uxdis l.sayvareliZis saxelobis daavadebaTa
kontrolisa da samedicino statistikis erovnul centrs da CoReform-s
informaciis mopovebaSi gaweuli daxmarebisaTvis
masalebiT sargeblobisaTvis specialuri nebarTva saWiro ar aris. sasurvelia wyaros miTiTeba.
dokumentTan dakavSirebul sakiTxebze SegiZliaT mogvmarToT Semdeg misamarTze:
Tbilisi, 0102, iv.javaxiSvilis 51,
socialuri da janmrTelobis erovnuli instituti
tel.:
faqsi:
el. fosta:
95 66 80
96 03 00
[email protected]
iii
winaTqma
saqarTvelos prezidentis 2000 wlis 7 maisis brZanebuleba #179-is
`saqarTvelos
socialuri
ganviTarebis
konceftualuri
safuZvlebis
ganxorcielebis gadaudebel RonisZiebaTa Sesaxeb~ Tanaxmad saqarTvelos
Sromis,
janmrTelobisa
da
socialuri
dacvis
saministros
daevala
yovelwliurad `saqarTvelos mosaxleobis janmrTelobis mdgomareobis Sesaxeb
erovnuli moxsenebis~ momzadeba da gamocema.
mosaxleobis janmrTeloba qveynis ganviTarebis erT-erTi umTavresi
maCvenebelia da Seesabameba arsebul ekonomikur situacias. adamianis sicocxlis
jansaRi sawyisi, misi janmrTelobis SenarCunebisa da ganmtkicebis amocanis
gadawyveta gansakuTrebul pirobebSi ayenebs sazogadoebas, gansazRvravs misi
ganviTarebis dones.
2004 wlis `saqarTvelos mosaxleobis janmrTelobis mdgomareobis
Sesaxeb~ erovnul moxsenebaSi ganxilulia janmrTelobis dacvis iseTi
mniSvnelovani aspeqtebi, rogoricaa janmrTelobis ZiriTadi problemebi,
qceviTi da ekologiuri determinantebi, janmrTelobis dacvis sistemis
mdgomareoba, saqarTvelosa da evropis regionis zogierTi qveynis monacemTa
Sedareba maTSi arsebuli tendenciebis gansazRvris mizniT. 2004 weli
garkveulwilad gardamavali weliwadi iyo, amgvarad erovnul moxsenebaSi
moyvanilia mxolod is informacia, romlis mopovebac gaxda SesaZlebeli.
v
sarCevi
I . j anmrTelobis mdgomareoba saqarTveloSi _____________________________________________ 1
1. demografiuli ganviTarebis ZiriTadi tendenciebi __________________________________________________ 1
2. sicocxlis mosalodneli xangrZlivoba da sikvdilianoba ________________________________________ 6
3. avadobis tvirTi_________________________________________________________________________________________ 9
3.1. avadobisa da dainvalidebis Taviseburebebi _________________________________ 9
3.2. infeqciuri daavadebebi ___________________________________________________ 10
3.2.1. infeqciuri daavadebebis gavrceleba ________________________________________ 11
3.2.2. filtvis da filtvgareSe tuberkulozi ______________________________________ 17
3.2.3. sqesobrivi gziT gadamdebi daavadebebi ______________________________________ 20
3.2.4. SeZenili imunodeficitis sindromi (Sidsi) ___________________________________ 23
3.3. aragadamdebi daavadebebi _________________________________________________ 25
3.3.1. simsivneebi _____________________________________________________________ 26
3.3.2. sisxlis da sisxlmbadi organoebis daavadebebi _______________________________ 30
3.3.3 endokrinuli daavadebebi _________________________________________________ 32
3.3.4. nervuli sistemis da grZnobaTa organoebis daavadebebi _______________________ 35
3.3.5. sisxlis mimoqcevis sistemis daavadebebi _____________________________________ 37
3.3.6. sasunTqi organoebis daavadebebi __________________________________________ 40
3.3.7. saWmlis momnelebeli sistemis daavadebebi___________________________________ 43
3.3.8. Sardsasqeso sistemis daavadebebi __________________________________________ 45
3.4. fsiqikuri janmrTeloba ___________________________________________________ 48
3.5. ubeduri SemTxvevebi da travmebi _________________________________________ 51
4. mosaxleobis calkeuli jgufebis janmrTelobis mdgomareoba___________________________________ 54
4.1. bavSvTa janmrTeloba _____________________________________________________ 54
4.2. dedaTa janmrTeloba _____________________________________________________ 57
4.3. iZulebiT gadaadgilebul pirTa janmrTeloba ____________________________ 61
4.4. dabereba da janmrTeloba ________________________________________________ 62
II. janmrTelobis ZiriTadi determinantebi_________________________________ 64
1. socialur-ekonomikuri determinantebi ______________________________________________________________ 64
1.1. siRaribe da janmrTeloba ___________________________________________________________________ 65
1.2. dasaqmeba _________________________________________________________________ 71
1.3. ganaTleba ________________________________________________________________ 73
1.4. genderuli faqtorebi_____________________________________________________ 74
1.5. fsiqo-socialuri faqtorebi ______________________________________________ 76
2. cxovrebis wesi __________________________________________________________________________________________ 77
2.1. kveba _____________________________________________________________________ 77
2.2. Tambaqos moxmareba _______________________________________________________ 79
2.3. narkotikebis moxmareba ___________________________________________________ 79
2.4. alkoholis moxmareba_____________________________________________________ 81
vi
2004
3. garemos gavlena mosaxleobis janmrTelobaze _____________________________________________________ 83
3.1. atmosferuli haeris sanitariuli mdgomareoba ____________________________ 84
3.2. mosaxleobis wyalmomaragebis sanitariuli mdgomareoba___________________ 86
3.3. maionebeli gamosxivebis mdgomareoba ______________________________________ 88
3.4. profesiuli saqmianoba ____________________________________________________ 89
III. janmrTelobis dacvis sistema ____________________________________________ 92
1. saxelmwifos danaxarjebi janmrTelobis dacvaze__________________________________________________ 92
2. momsaxurebis miwodeba _________________________________________________________________________________ 96
2.1. samedicino kadrebi________________________________________________________ 96
2.2. dawesebulebaTa qseli ____________________________________________________ 98
3. medikamentebis mimoqceva saqarTveloSi ___________________________________________________________
103
IV. daskvna_______________________________________________________________ 105
gamoyenebuli informaciis wyaroebi_________________________________ 109
janmrTelobis mdgomareoba saqarTveloSi
1
I. janmrTelobis mdgomareoba
saqarTveloSi
1. demografiuli ganviTarebis ZiriTadi tendenciebi
XIX-XX saukuneebSi momxdarma uprecedento demografiulma cvlilebebma mTel
msoflioze moaxdina zegavlena. eqspertTa SefasebiT (http://demoscope.ru), msoflios
demografiul ganviTarebaSi 4 ZiriTadi etapis gamoyofa aris SesaZlebeli. esenia:
infeqciuri daavadebebiT gamowveuli sikvdilianobis Semcireba XIX saukunis me-2
naxevarSi;
sicocxlis xangrZlivobis swrafi zrda XX saukunis dasawyisidan;
sicocxlis xangrZlivobis zrdis tempis Seneleba XX saukunis 60-ian wlebSi;
mamakacebsa da qalebs Soris arsebuli sxvaobebis Semcireba XX saukunis ukanasknel
aTwleulSi.
sicocxlis xangrZlivobis zrdas da Sobadobas farTomasStabian Semcirebas
mTeli
sazogadoebis
struqturis
kardinaluri
cvlilebebi
mohyva,
yvelaze
mniSvnelovani ki – axalgazrdebisa da xandazmulTa
cxrili 1.
ricxovnobis Sefardebis Secvla iyo. es procesebi
saqarTvelos mosaxleobis
saqarTveloSic sakmaod mkafiod aris gamoxatuli.
raodenoba (aTasebSi)
qveyanaSi mimdinare demografiuli procesis
saSualo
wlis
wlebi
Sefasebisas gaTvaliswinebul unda iqnes misi
wliuri
dasawyisi
sistemuri buneba, romlis elementebs (mosaxleobis
1988
5377.3
5356.3
raodenoba, Sobadoba, sikvdilianoba da a.S.) Soris
1989
5400.8
5400.8
mWidro
urTierTkavSiri
arsebobs
da
erTi
1990
5424.4
5413.5
romelime maTganis cvlileba aisaxeba danarCenebzec.
1991
5453.3
5421.6
saqarTvelos amJamindeli demografiuli mdgomare1992
5467.4
5420.2
obis daxasiaTeba sakmaod rTulia Tundac imis gamo,
1993
5345.8
5404.5
rom mosaxleobis raodenobac ki ar aris zustad
1994
5208.9
5390.9
cnobili, radganac arasrulfasovnad xorcieldeba
1995
5061.7
5375.1
dabadebaTa, gardacvalebaTa da gare migraciis
1996
4933.3
5373.4
aRricxva.
1997
4808.8
5381.0
ukanaskneli aTwleulis ganmavlobaSi ganviTa1998
4749.5
5394.9
rebulma mniSvnelovanma social-ekonomikurma kri1999
4710.6
5402.1
zisma, samoqalaqo omma, devnilTa nakadma, gazrdilma
2000
4672.2
5100.5
umuSevrobam, mosaxleobis didi nawilis cxovrebis
2001
4634.8
4546.6
pirobebis gauaresebam da migraciis intensivobam
2002
4601.5
4371,5
uaryofiTi gavlena moaxdina ara marto mosaxleobis
2003
4571,1
4315,2
2004
4543.0
4289,1
janmrTelobaze, aramed demografiuli ganviTarebis
wyaro: saqarTvelos statistikuri
ZiriTad tendenciebzec (cxrili 1).
saqarTvelos mosaxleobis saerTo ricxvis da weliwdeuli – 2005.
rac gansakuTrebiT sagangaSoa – bunebrivi matebis
mniSvnelovani Semcireba ukanasknel wlebSi metnaklebad gamoxatuli iyo yvela
regionSi. statistikis saxelmwifo departamentis monacemebiT, qveynis masStabiT
bunebrivi matebis maCvenebeli 1985 wels dafiqsirebuli 51,6-dan 1993 wels 0,8-mde, xolo
2000 wels 0-mde Semcirda. 2003-2004 w.w. bunebrivi mateba 0,1 da 0,2 iyo (cxrili 2). 1992
welTan SedarebiT, mudmivi mosaxleobis ricxovnoba 16,9%-iT aris Semcirebuli. es
kleba qalaqis mosaxleobaSi ufro metadaa gamoxatuli (24,9%), vidre soflad (16,5%).
2
2004
saqarTvelos
mosaxleobis
saerTo
ricxvis gamoxatuli kleba ganpirobebulia
mravali mizeziT, romlebmac Tavis mxriv, gavlena
iqonia mosaxleobis rogorc bunebrivi, aseve
meqanikuri (migraciuli)
moZraobis maCveneblebis cvalebadobaze.
mosaxleobis
bunebrivi
moZraobis
dinamikaSi
yvelaze
SemaSfoTebelia
Sobadobis
1990
6,7
1.4
17.1
9.3
7.6
ukiduresi
Semcireba.
1985
welTan
SedarebiT
1995
4.4
0.6
11.9
10.4
1.5
Sobadobis maCvenebeli (18,5) 1,6-jer Semcirda.
1996
4.0
0.5
11.9
10.4
1.5
Tumca, aRsaniSnavia is garemoebac, rom
1997
3.5
0.5
11.9
10.5
1.4
ukanaskneli 5 wlis monacemebis mixedviT
1998
3.1
0.4
11.5
10.5
1.0
gamoikveTa
Sobadobis
klebis
tempis
1999
3.0
0.4
10.9
10.6
0.3
Senelebis tendencia, 2004 wels ki ukve wina
2000
2.8
0.4
11.0
10.7
0.3
wlis doneze maRalic ki iyo.
2001
3.0
0.4
10.8
10.5
0.3
1990-2003 wlebSi, statistikis saxel2002
2.9
0.4
10.7
10.7
0
2003
2.9
0.4
10.7
10.6
0.1
mwifo departamentis monacemebiT, fertilobis
2004
3,5
0,4
11.5
11.3
0.2
koeficienti (cocxladdabadebulTa raodenoba
wyaro: saqarTvelos statistikuri
15-49 wlis asakis 1 qalze) 2,15-dan 1,37-mde
weliwdeuli – 2005.
Semcirda da 2004 w. odnav moimata – 1,44, maSin
rodesac mSobelTa Taobis bavSvebis imave
raodenobiT CanacvlebisaTvis es maCvenebeli 2,15-ze naklebi ar unda iyos, e.i. qveyana
normalur reproduqtiulobis doneze bevrad dabali maCvenebliT xasiaTdeba (cxrili
3). demografiul mdgomareobaze mniSvnelovan gavlenas mcireSvilianoba axdens.
saqarTveloSi sul ufro iklebs im dedaTa ricxvi, romlebsac 3 da meti Svili hyavT. Tu
1960 wels me-3 bavSvis dabadebis wili dabadebulTa 36,5%-s Seadgenda, amJamad es
maCvenebeli 8,5%-mde aris Semcirebuli.
cxrili 3.
Sobadobis asakobrivi da jamobrivi koeficientebis dinamika
(cocxladdabadebulTa raodenoba Sesabamisi asakis yovel 1000 qalze)
bunebrivi
mateba
sikvdilianoba
Sobadoba
ganqorwineba
qorwineba
wlebi
cxrili 2.
bunebrivi moZraobis maCveneblebis
dinamika 1000 sul mosaxleze
dedis asaki wlebSi
-20
20-24
25-29
30-34
35-39
40-44
1980
45,0
184,5
121,0
61,6
21,1
7,0
1985
49,1
183,7
124,9
63,0
26,0
4,8
1990
58,1
167,3
110,5
64,1
24,7
6,2
1995
64,2
113,3
66,4
419
16,6
4,2
1996
59,7
112,8
69,5
44,1
18,2
4,0
1997
55,2
111,3
72,2
44,6
19,4
5,2
1998
51,4
109,1
71,6
42,3
18,9
4,6
1999
46,5
104,0
70,3
42,5
19,0
4,7
2000
39,9
110,2
74,4
43,3
19,2
4,9
2001
32,5
112,2
71,1
45,2
21,0
5,4
2002
32,7
107,8
63,2
50,4
21,2
6,6
2003
33,7
93,8
75,3
47,4
18,9
5,4
2004
36,4
99,0
76,5
48,0
21,5
5,7
wyaro: saqarTvelos statistikuri weliwdeuli – 2005.
weli
45+
0,8
1,1
0,3
0,7
0,8
3,0
3,0
0,9
0,9
1,4
1,4
0,3
0,5
Sobadobis jamobrivi
koeficienti
2,21
2,26
2,16
1,54
1,55
1,56
1,51
1,44
1,46
1,44
1,42
1,37
1,44
2004 wlis 1 ianvrisaTvis, iseve rogorc gasul wels, saqarTvelos mosaxleobis
52,8% Seadgendnen qalebi, xolo 47,2% - mamakacebi. amasTan, ukanasknel wlebSi
axalSobilTa Soris moimata vaJebis raodenobam. Tu 1989 wels 0-4 wlamde asakobriv
jgufSi 51,1%-s vaJebi Seadgendnen, xolo 20-24 wlis asakobriv jgufSi ukve qalTa
raodenoba (50,6%) Warbobda, 2004 wels 0-4 wlamde asakobriv jgufSi vaJTa wilma 51,3%-s
miaRwia, xolo qalebis raodenobam kvlav 20-24 wlis asakidan (50,3%) gadaaWarba kacebis
raodenobas (cxrili 4).
3
cxrili 4.
mudmivi mosaxleobis raodenoba asakobrivi jgufebis mixedviT (aTasi)
1989 wlis dasawyisi
asaki
sul
kaci
2004 wlis dasawyisi
qali
abs.
%
abs.
%
sul
kaci
qali
abs.
%
abs.
%
0-4
460,9
253,7
55,0
207,2
45
240,7
123,5
51,3
117,2
48,7
5-9
438,8
223,4
50,9
215,4
49,1
252,3
129
51,1
123,3
48,9
10-14
434
220,9
50,9
213,1
49,1
310,7
159,2
51,2
151,5
48,8
15-19
421
218,3
51,9
202,7
48,1
349,2
177
50,7
172,2
49,3
20-24
414,2
203,7
49,2
210,5
50,8
367,5
182,8
49,7
184,7
50,3
25-29
465,1
225
48,4
240,1
51,6
339,1
167,8
49,5
171,3
50,5
30-34
415,7
200,7
48,3
215
51,7
292,7
140,9
48,1
151,8
51,9
35-39
364,6
175,4
48,1
189,2
51,9
296,5
141,9
47,9
154,6
52,1
40-44
269,9
128,8
47,7
141,1
52,3
325,9
154,6
47,4
171,3
52,6
45-49
297,1
139,1
46,8
158
53,2
323,4
152,5
41,2
170.9
52,8
50-54
344,7
163,3
47,4
181,4
52,6
282,8
129,4
47,6
153,4
52,4
55-59
300
138,9
46,3
161,1
53,7
158,5
71,1
44,9
87,4
55,1
60-64
298,9
130,8
43,8
168,1
56,2
203,9
89,4
43,8
114,5
56,2
65-69
164,6
59,8
36,3
104,8
63,7
197,4
84,1
42,6
113,3
57,4
70+
321,2
103
32,1
218,2
67,9
374,6
135,8
36,3
238,8
63,7
sul
5412,5
2566,8
47,4
2845,7
52,6
4328,9
2039,0
47,1
2289,9
52,9
0-14
1333,7
680
51,0
653,7
49,0
803,7
411,7
51,2
392
48,8
15-64
3591,2
1724
48,0
1867,2
52,0
2953,2
1407,4
47,7
1545,8
52,3
65+
487,6
162,8
33,4
324,8
66,6
572,0
219,9
38,4
352,1
61,6
wyaro: saqarTvelos statistikuri weliwdeuli - 2005
mosaxleobis asakobrivi struqturis cvlilebebi gasuli saukunis ganmavlobaSi
mocemulia nax. 1-ze. monacemebi eyrdnoba 1897, 1959 da 1989 wlebSi Catarebul
mosaxleobis aRwerebis masalebsa da statistikis saxelmwifo departamentis 2004 wlis
oficialur monacemebs.
XIX saukunis miwuruls saqarTvelos mosaxleobis sqesobriv-asakobrivi struqturis grafiks naTlad gamoxatuli tolferda piramidis forma aqvs, rac sicocxlis
saSualo xangrZlivobis dabali maCvenebliT aixsneba. 1959 wlis grafikze aSkarad
ikveTeba 35-44 da 10-19 wlis asakobrivi jgufebis mosaxleobis raodenobis mkveTri
kleba, rac ganpirobebuli iyo 1915-1925 wlebSi (pirveli msoflio omi da saqarTvelos
ZaldatanebiTi gasabWoeba) da 1940-1945 wlebSi (meore msoflio omi) Sobadobis mkveTri
SemcirebiT. 1989 wlis grafikze zemoaRniSnuli cvlilebebi Sesabamisad gamoixata 65-74
da 40-49 wlis asakobriv jgufebSi. rac Seexeba grafiks 2004 wlisaTvis, masze kvlav
rCeba `Rrmuli~ 0-9 wlis asakobriv jgufSi, rac ukanaskneli 10 wlis ganmavlobaSi
Sobadobis mniSvnelovani klebiTaa ganpirobebuli (nax. 1).
4
2004
naxati 1.
saqarTvelos mosaxleoba asakisa da sqesis mixedviT
1897 28.01*
mamakaci
1959 15.01.*
mamakaci
qali
70+
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
qali
I
I
II
250 200
150
100
50
0
50
100
150
200 250
aTasi
aTasi
II
250 200 150 100 50
I
50 100 150 200 250
aTasi
1989 12.01.*
70+
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
0
aTasi
2004 01.01.
I
II
II
II
II
III
III
250 200 150 100 50 0 50 100 150 200 250
aTasi
aTasi
250 200 150 100 50 0
50 100 150 200 250
aTasi
aTasi
I – pirveli msoflio omi da saqarTvelos ZaldatanebiTi gasabWoeba
II – meore msoflio omi da omisSemdgomi periodi
III – sabWoTa kavSiris daSlis Semdgom ganviTarebuli socialur-ekonomikuri krizisi
* mosaxleobis aRweris masalebis mixedviT
ukanasknel wlebSi saqarTveloSi sul ufro mcirdeba qorwinebaTa ricxvi, rac
mniSvnelovnad aferxebs qveynis mosaxleobis gamravlebas, amasTan mraval mwvave
socialur, fsiqikur da sxva xasiaTis problemas warmoSobs. ganqorwinebaTa ricxvi
SedarebiT dabalia, magram is uaryofiT gavlenas axdens isedac dabali Sobadobis
maCvenebelze. qorwinebisa da Sobadobis maCveneblebis Sedarebisas
monacemTa
gamoxatulia am
TiTqmis paraleluri kleba 1990-98 wlebSi, Tumca ukanaskneli oTxi wlis
ganmavlobaSi es maCveneblebi umniSvnelod matulobs (nax. 2).
5
naxati 2.
qorwinebisa da Sobadobis zogadi maCveneblebi
(daqorwinebulTa da cocxladdabadebulTa ricxvi 1000 sul mosaxleze)
qorwineba
Sobadoba
30
25
17,1
13,4
20
15
10
6,7
4,9
4,9
12
11,8
4,5
11,9 11,9
11,9
4,4
4
3,5
11,5
3,1
10,9
3
5
11
2,8 3
10,8
2,9
10,7 10,7 11,5
2,9
3,5
0
1990 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
statistikur
monacemebze
dayrdnobiT
da
demografiuli
ganviTarebis
gaTvaliswinebiT, g.wulaZe TanaavtorebTan erTad mosaxleobis raodenobis Semcirebis
prognozs akeTebs. am gamokvleviT, 2050 wlamde saqarTvelos mosaxleobis raodenoba
mniSvnelovnad naklebi iqneba 2000-2005 wlebTan SedarebiT. mosaxleobis formirebaSi
gare migracias mniSvnelovani roli eqneba, gansakuTrebiT 2020 wlamde.
amgvarad, qveyanaSi Tanamedrove demografiul situacias sistemuri krizisis
xasiaTi aqvs. am sistemis Semadgeneli nawilebia: Sobadobis krizisul zRvramde
Semcireba, garkveulwilad sikvdilianobis zrda, mosaxleobis progresirebadi
Sekvecili kvlavwarmoeba zogierT raionSi, deformirebuli sqesobriv-asakobrivi
struqtura, mosaxleobis bunebrivi matebis Semcireba, janmrTelobis gauareseba, gare da
Sida migraciis farTo masStabebi, didi raodenobiT gandevnili mosaxleoba da
demografiuli procesebis marTvis dabali done.
6
2004
2. sicocxlis mosalodneli xangrZlivoba da sikvdilianoba
statistikis saxelmwifo departamentis gaTvlebiT, 2004 wels saqarTveloSi
sicocxlis mosalodneli saSualo xangrZlivoba dabadebisas Seadgenda 71,4 wels
(mamakacebSi – 67,8, xolo qalebSi - 74,9 wels).
saqarTveloSi sicocxlis saSualo xangrZlivoba sWarbobs axlad damoukidebeli
qveynebis saSualo analogiur monacemebs, Tumca CamorCeba evropis monacems (nax 3).
aRsaniSnavia is garemoebac, rom sxvaoba mosalodneli sicocxlis saSualo
xangrZlivobaSi mamakacebsa da qalebs Soris (7,1), iseve rogorc samxreT kavkasiis
mezobel qveynebSi, mniSvnelovnad naklebia yofili sabWoTa kavSiris respublikebis
monacemebTan SedarebiT.
g.wulaZisa da sxv. gamokvlevebiT, 2050 wlamde qveyanaSi gaizrdeba sicocxlis
mosalodneli xangrZlivoba, Tumca is ufro naklebi iqneba, vidre dReisaTvis evropis
ganviTarebul qveynebSi.
naxati 3.
sicocxlis mosalodneli saSualo xangrZlivoba
Life expectancy
at birth,
in years
(arsebuli
uaxlesi
monacemebi)
<= 85
<= 81
<= 77
<= 73
Last
European
Region
evropis
regioni
– 74,91
74.91
available
<= 69
No data
Min = 65
wyaro: monacemTa baza `janmrTeloba yvelasaTvis”, www.who.dk/hfadb.
2004 wels registrirebuli iyo gardacvalebis 48793 SemTxveva (2003 wels – 46057).
sikvdilianobis asakobrivi struqtura mocemulia cxril 5-Si.
7
cxrili 5.
sikvdilianobis asakobrivi koeficientebi
(gardacvlilTa ricxovnoba Sesabamisi asakobrivi jgufis 1000 kacze)
1998 1999
10.5 10.6
22.3 22.5
0.6
0.6
0.4
0.3
0.3
0.2
0.6
0.5
0.9
0.8
1.3
1.2
1.8
1.6
2.5
2.5
3.4
3.4
5.0
5.0
7.8
7.8
12.3 11.4
17.8 17.8
29.2 29.1
46.5 46.5
70.8 71.0
115.0 115.0
211.3 213.6
wyaro: saqarTvelos
sul
0-1
1-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
2000 2001
10.7
10.5
23.1
23.7
0.6
0.6
0.3
0.3
0.3
0.3
0.5
0.7
0.8
0.7
1.2
1.4
1.6
1.8
2.4
2.5
3.4
3.5
5.0
4.9
7.6
7.4
11.4
10.0
17.8
16.3
29.0
26.9
46.4
45.7
71.4
71.0
115.0 114.4
216.9 216.2
statistikuri
2002 2003
10.7
10.6
24.4
25.4
0.6
0.7
0.3
0.1
0.3
0.2
0.7
0.3
0.7
0.6
1.4
1.0
1.8
1.4
2.5
1.8
3.5
2.7
4.9
4.0
7.4
7.4
10.0
11.7
16.3
14.7
26.9
26.7
45.7
40.5
71.1
76.4
114.6 113.2
217.6 264.4
weliwdeuli
2004
11.3
25.2
0.7
0.4
0.3
0.4
0.7
0.9
1.7
2.3
3.4
4.6
6.0
12.0
13.6
30.2
40.2
79.8
122.7
287.6
– 2005.
2004 wels, wina welTan SedarebiT, mosaxleobis sikvdilianobis struqtura
ZiriTadad ar Secvlila (cxrili 6).
cxrili 6.
saqarTvelos mosaxleobis sikvdilianobis struqtura daavadebaTa ZiriTadi
klasebis mixedviT (100000 sul mosaxleze)
gardaicvala
sul
daavadebaTa ZiriTadi klasebi X dsk-s mixedviT
s u l:
infeqciuri da parazituli daavadebebi
simsivneebi
endokrinuli sistemis, kvebis moSlilobis da nivTierebaTa
cvlis darRvevis daavadebebi
sisxlisa da sisxlmbad organoTa daavadebebi, imunuri
meqanizmis CaTreviT mimdinare calkeuli darR.
fsiqiuri da qceviTi aSlilobebi
nervuli sistemis daavadebebi
sisxlis mimoqcevis sistemis daavadebebi
sasunTqi organoebis daavadebebi
saWmlis momnelebeli organoebis daavadebebi
Sardsasqeso sistemis daavadebebi
orsuloba, mSobiaroba da loginobis xanis garT.
kanisa da kanqveSa ujredisis daavadebebi
ZvalkunTovani sistemisa da SemaerTebel qsov. daav.
Tandayolili anomaliebi, deformaciebi da qromosomuli dar.
perinatalur periodSi warmoSobili calkeuli mdgomareobebi
simptomebi, niSnebi da normidan gadaxrebi
travmebi, mowamvlebi
sikvdilianobis
maCvenebeli
2003
46055
357
5681
2004
48793
399
5520
2003
1063,7
8,2
131,2
2004
1134.1
9.3
128.3
1630
850
37,7
19.8
29
45
0,7
0.7
1,3
3,6
697,5
39,3
51,4
8,8
0,3
0,2
0.3
1,9
19,3
33,2
28,8
1.1
4.0
707.9
92.8
39.7
9,5
0.5
0.1
0.4
1.5
20.0
53.9
44.5
55
49
157
171
30192
30455
1703
3991
2225
1708
379
407
21
21
8
6
13
18
84
63
836
859
1439
2317
1246
1914
wyaro: janmrTelobis dacva, saqarTvelo, 2004, statistikuri cnobari.
8
2004
sikvdilianobis struqturaSi wamyvani adgili, iseve rogorc wina wlebSi, ekava
sisxlis mimoqcevis sistemis daavadebebs (62,4%; maCvenebeli 100000 sul mosaxleze –
707,9) da simsivneebs (11,3%; maCvenebeli – 128,3), Semdgom modis sunTqvis organoebis
daavadebebi (8,2%; maCvenebeli – 92,8), es maCveneblebi wina welTan SedarebiT gaizarda,
Semcirebulia krinuli sistemis, kvebisa da nivTierebaTa cvlis darRveviT, saWmlis
momnelebeli organoebis daavadebebiT gamowveuli sikvdilianobis maCveneblebi
(cxrili 7).
cxrili 7.
sikvdilianobis struqtura ZiriTadi mizezebis mixedviT (%)
2002
71,6
10,7
2,6
2,8
9,1
wyaro: saqarTvelos statistikuri weliwdeuli - 2005.
simsivneebi
sunTqvis organoebis daavadebebi
sxva daavadebebi
2003
65,6
12,3
3,7
4,8
10,9
2004
62.4
11.3
8.2
3.5
14.6
aRsaniSnavia is garemoeba, rom gul-sisxlZarRvTa daavadebebisa da simsivneebis
profilaqtika da, Sesabamisad, maT mier gamowveuli sikvdilianoba mniSvnelovnad
SeiZleba Semcirdes mosaxleobaSi cxovrebis jansaRi wesis danergvisa da socialurekonomikuri mdgomareobis gaumjobesebis gziT, rac naklebadaa damokidebuli jandacvis
samsaxurebis xarisxian muSaobaze.
9
3. avadobis tvirTi
3.1. avadobisa da dainvalidebis Taviseburebebi
2004 wlis daavadebianobisa da avadobis wina wlis monacemebTan Sedareba
cxadyofs, rom zogadad qveyanaSi daavadebianobac da avadobac momatebulia daavadebaTa
yvela ZiriTad klasSi, umniSvnelod Semcirda mxolod sasunTqi organoebis
daavadebianiobis maCvenebeli (cxrili 8).
cxrili 8.
daavadebianobis da avadobis maCveneblebi samkurnalo-profilaqtikur dawesebulebebSi
daavadebaTa ZiriTadi klasebi
X dsk-s mixedviT
simsivneebi
endokr. sistemis, kvebis, nivTier. cvlis da imun. darR.
sisxlisa da sisxlmbadi organoebis daavadebebi
fsiqikuri aSlilobebi
nervuli sistemis da grZnobaTa organoebis daavadebebi
Sard-sasqeso sistemis daavadebebi
orsulobis, mSobiarobis da mSobiarobis Semd. periodis garT.
Zval-kunTovani sistemis da SemaerTebeli qsovilis daavad.
Tandayolili anomaliebi
perinatalur periodSi warmoqmnili calkeuli mdgomareobebi
simptomebi da arazustad aRniSnuli mdgomareobebi
travmebi da mowamvlebi
sul
daavadebianoba
2003
2004
1586,4
1786,1
874,4
935,6
3429,0
3628,1
339,5
370,0
2335,9
2445,8
2855,0
3289,1
5776,8
6494,8
7027,6
7022,3
2397,9
2591,1
1389,0
1599,3
131,4
631,6
720,2
774,5
602,4
731,5
134,5
147,3
85,2
86,7
112,7
133,0
785,6
845,2
30583,4
33053,4
avadoba
2003
2004
1002,8
1271,3
164,4
190,9
666,7
684,4
170,9
196,8
139,8
174,7
1043,7
1178,5
1481,7
1616,1
5453,8
5387,9
918,5
958,1
623,7
720,2
93,0
521,6
486,4
543,7
234,8
245,5
24,0
27,3
53,0
53,4
56,3
72,3
663,9
743,2
13277,5 14206,2
2004 w. sicocxleSi pirvelad dadgenili diagnoziT aRricxuli daavadebebis
SemTxvevebis raodenoba 8%-iT gaizarda.
zogadi daavadebianoba 2004 wels, wina welTan SedarebiT, gaizarda saqarTvelos
yvela regionSi, garda raWa-leCxumi/qvemo svaneTis, zemo svaneTis, imereTisa da kaxeTis,
xolo avadobis maCveneblebi saqarTvelos umetes regionebSi gaizarda (cxrili 9).
cxrili 9.
zogadi daavadebianobisa da avadobis maCveneblebi regionebis mixedviT
saqarTvelo
Tbilisi
aWara
guria
raWa-leCxumi da qv. svaneTi
samegrelo
zemo svaneTi
mcxeTa-mTianeTi
samcxe-javaxeTi
qvemo qarTli
imereTi
kaxeTi
Sida qarTli
foTi
daavadebianoba
2003
2004
30583,4
33053,4
40014,1
43827,9
19666,4
21391,1
26335,7
55320,2
30950,7
23866,0
54817,6
53510,6
26157,0
23434,3
22483,2
26571,4
14349,5
22018,0
24697,5
16066,8
27378,8
27125,2
24732,1
29206,3
16935,6
29081,4
avadoba
2003
13277,5
22654,1
8106,1
11771,3
14377,5
7874,0
25574,5
9975,8
7319,9
4947,8
8076,8
9173,7
12103,2
6843,3
2004
14206,2
20921,9
9252,3
16631,9
11479,5
9375,9
11777,5
7644,6
5802,3
9968,8
10409,8
15132,8
10
2004
aRniSnuli mdgomareoba unda miuTiTebdes registraciis sistemis gaumjobesebaze.
miRebuli Sedegebis analizidan Cans, rom saqarTvelos mozrdili mosaxleobis
avadobis struqturaSi wamyvani adgili ukavia sunTqvis organoTa, sisxlis mimoqcevis
(gulis iSemiuri daavadeba da arteriuli hipertenzia), endokrinuli (difuzuri Ciyvi,
Saqriani diabeti) sistemis, nervuli sistemisa da grZnobaTa organoebis daavadebebs.
avadobis maCveneblebSi gansakuTrebiT maRalia sunTqvis organoTa daavadebebis
maCvenebeli.
2004 wels SesaZleblobis SezRudviT invalidad pirveladad cnobil pirTa
ricxvma 20198 Seadgina, rac 2003 w. SedarebiT, 2509 adamianiT metia. maTi ganawileba
invalidobis mizezebis mixedviT mocemulia cxril 10-Si. simZimis xarisxis mixedviT
mkveTrad gamoxatuli iyo 3363 SemTxveva, mniSvnelovnad gamoxatuli – 13200.
cxrili 10.
invalidad pirvelad cnobili pirebis ganawileba invalidobis mizezebis mixedviT
1999
sul
11567
maT Soris qalebi
5146
invalidebi SromiTi dasaxiCrebis an
55
prof. daavadebebis gamo
invalidebi saerTo daavadebebiT
10155
invalidebi samxedro mosamsaxureTa
517
ricxvidan
bavSvobidan invalidebi
840
uvadod daudgindaT invalidoba
3513
wyaro: saqarTvelos statistikuri weliwdeuli – 2005
2000
8914
3856
2001
11678
5647
2002
16024
7694
2003
17689
8271
2004
20198
9933
38
95
98
120
88
7701
10180
13868
15796
18566
382
373
1000
1106
872
793
2290
1030
2952
1058
4705
667
4164
672
4256
SezRuduli SesaZleblobebis mqone pirad cnobilTa (pirveladad da ganmeorebiT)
raodenobam 68234 adamiani Seadgina, maT Soris umetesoba (47814) 40 wlidan sapensio
asakamde (qalebSi – 60 wlis zeviT, mamakacebSi – 65 wlis zeviT) adamianebis jgufs
miekuTvneba, 14133 – 39 wlamde asakSi iyo da mxolod 6287 – sapensio asaks zeviT.
2004 wels SromiTi dasaxiCrebiTa da profesiuli daavadebebiT SezRuduli
SesaZleblobis mqone pirad cnobil iqna 88 adamiani (2003 w. - 120). oTxmocdaaTian
wlebamde, aRniSnuli mizezebiT, SesaZleblobis SezRudvis statusi udgindeboda 500-mde
adamians. aseTi donis Semcireba ZiriTadad gamowveulia umetes sawarmoTa
funqcionirebis SewyvetiT.
SezRuduli SesaZleblobis statusis mqone bavSvTa raodenobam 2004 w. 10722
Seadgina (2003 w. - 11015). 2004 wels dasaxiCrebiT da sxva daavadebebiT SesaZleblobis
SezRudviT pensionerTa ricxvi Seadgenda 135,8 aTas kacs, rac 2003 wlis raodenobas 5,4
aTasi adamianiT aRemateba. 2004 wels 34,1 aTasamde gaizarda bavSvobidan invalidTa
raodenoba (2003 w. – 32,2 aTasi), ramac 5,9% Seadgina.
ukanasknel wlebSi gaizarda socialuri pensiis mimReb SezRuduli SesaZleblobis
statusis mqone pirTa raodenoba da 2004 w. man 29,3 aTasi adamiani (2003 w. – 23,3 aTasi)
Seadgina.
3.2. infeqciuri daavadebebi
evropis regionis umravlesobaSi 21-e saukuneSic ki infeqciuri daavadevevi
avadobisa da sikvdilianobis erT-erT umTavres mizezs warmoadgens. gaCnda
axali daavadebebi, magaliTad, mwvave respiratoruli sindromi (SARS),
aRmocenda TiTqosda miviwyebuli daavadebebic (maT Soris, difTeria), amave
dros ukanasknel aTwleulSi ganviTarebulma movlenebma xeli Seuwyo msoflioSi
11
savaWro urTierTobebis mkveTr gaaqtiurebas da mosaxleobis didi nakadebis migracias,
ramac, Tavis mxriv, kargi pirobebi Seqmna infeqciuri daavadebebis gavrcelebisaTvis
rogorc calkeul qveynebSi, ise maT farglebs gareTac. gasaTvaliswinebelia
`globaluri daTbobis~ Sedegad ganviTarebuli movlenebis gamo gadamtanebiT
gadacemadi daavadebebis mateba bevr qveyanaSi.
bolo aTwleulis manZilze saqarTveloSi mimdinare politikurma da socialurekonomikurma procesebma gamoiwvia rogorc mTlianad mosaxleobis ekonomikuri
mdgomareobis gauareseba, aseve jandacvis sistemis bevri rgolis muSaobis dasusteba.
rogorc Sedegi, Seiqmna pirobebi zogierTi socialurad saSiSi infeqciebiT avadobis
matebisaTvis. amitom Zalze did mniSvnelobas iZens epidzedamxedvelobis gaZliereba,
daavadebaTa kontrolis da profilaqtikis mwyobri sistemis Camoyalibeba, vinaidan
infeqciuri sneulebebiT avadobis maCvenebeli qveynis ganviTarebisa da mosaxleobis
keTildReobis realuri donis erT-erTi maCvenebelia.
3.2.1. infeqciuri daavadebebis gavrceleba
14669
saqarTveloSi arsebuli sakmaod daZabuli sanitariul-epidemiologiuri mdgomareoba, ganpirobebuli dasaxlebuli punqtebis sanitariuli keTilsaimedobis
gauaresebiT, xarisxiani sasmeli wyliT momaragebaSi Seqmnili problemebiT,
siRaribesTan dakavSirebuli socialuri pirobebis gauaresebiT da profilaqtikuri
jandacviTi programebis dafinansebis uaRresad dabali doniT, mniSvnelovan
sirTuleebs uqmnis infeqciur daavadebaTa kontrols da profilaqtikas.
2004 w. saqarTvelos yvela regionSi, garda samcxe-javaxeTisa, aRiniSna
infeqciuri daavadebebis gavrcelebis maCvenebelTa zrda rogorc mTlian mosaxleobaSi,
ise bavSvebSi. gansakuTrebiT moimata (1,9-jer) am daavadebebma TbilisSi mcxovreb
bavSvebs Soris. infeqciur daavadebaTa gavrceleba regionebis mixedviT qveynis saSualo
maCvenebelze maRali iyo Tbilissa da mcxeTa-mTianeTSi, bavSvebSi ki – TbilisSi, Sida
qarTlsa da mcxeTa-mTianeTSi (nax. 4).
naxati 4.
infeqciur daavadebaTa gavrceleba mxareebis mixedviT
16000
14000
sul
bavSvebi
12000
1241,3
3557
1203
3881,5
1793,2
934
1967,4
3946,8
2273,5
2007,8
645,4
1753,8
696,5
2817,4
1253,4
1040,9
2000
459,1
4000
3281
993,8
6000
1063,1
8000
2309,9
4840,9
10000
o
i
l
ve
T
r
sa
qa
r
qa
id
S
o
em
qv
a
qa
av
r
ax
T
T
l
l
i
i
eT
i
T
xe
mc
sa
mc
xe
T
a-
-j
mT
ka
ia
xe
ne
T
i
i
eT
r
gr
im
e
el
o
mi
me
aaW
r
sa
l
eC
gu
r
xu
ia
a
ar
aW
T
bi
l
is
i
0
magram unda aRiniSnos, rom ukanasknel aTwleulSi janmrTelobis dacvis sistemaSi saxelmwifo programebis amuSavebisa da registraciis gaumjobesebis pirobebSi,
infeqciuri daavadebebis gavrcelebam kontrolirebadi xasiaTi miiRo.
2004 wels, wina welTan SedarebiT, dafiqsirda salmonelozebis, baqteriuli
dizenteriis, eSerixiozebis, amebiazis, diareuli daavadebebis, jilexis, brucelozis,
wiTelas, wiTuras, leiSmaniozis, mwvave respiratoruli infeqciebis registrirebuli
SemTxvevebis mateba. danarCeni nozologiebis mixedviT dafiqsirda klebis dinamika.
aRsaniSnavia, rom 2004 wels bavSvebSi ar dafiqsirebula malariis, difTriis
baqteriomatareblebis, jilexisa da tetanusis SemTxvevebi (cxrili 11).
12
2004
cxrili 11.
infeqciuri daavadebebis gavrcelebis dinamika
2003
gripi
fexsaxsrianTamieri da
hemoragiuli virusuli
cxelebebi
maCvenebeli
100000 sul
mosaxleze
raodenoba
maCvenebeli
100000 sul
mosaxleze
raodenoba
maCvenebeli
100000 sul
mosaxleze
m.S. bavSvebi
raodenoba
sul
maCvenebeli
100000 sul
mosaxleze
muclis tifi da paratifebi A,
B, C
salmonelozebi
baqteriuli dizenteria
(Sigelozi)
eSerixiozebi
kvebiTi toqsikoinfeqciebi
m.S. botulizmi
amebiazi
daudgeneli etiologiis
diareuli daavadebebi
jilexi
brucelozi
difTeria
difTeriis
baqteriomatareblebi
meningokokuri infeqcia
tetanusi
mwvave dune dambla
wiTela
wiTura
virusuli hepatitebi sulHE
maT Soris: A
B
С
D da sxva
cofi
malaria
malariis parazitmtarebeli
leiSmaniozi
mwvave respiratoruli
infeqciebi
m.S. bavSvebi
raodenoba
sul
2004
1
0,02
1
0,1
1
0.02
1
0.1
188
4,3
107
12,7
276
6.3
102
11.1
189
4,4
104
12,3
617
14.1
273
29.8
307
449
39
33
6020
7,1
10,4
0,9
0,8
139,1
243
107
4
6
4102
28,7
12,7
0,5
0,7
485,2
553
408
41
51
6035
12.7
9.3
0.9
1.2
138.1
412
96
5
29
4299
45.0
10.5
0.5
3.2
469.4
27
106
26
5
0,6
2,4
0,6
0,1
0
3
11
2
0,0
0,4
1,3
0,2
45
151
12
0
1.0
3.5
0.3
0.0
0
14
3
0
0.0
1.5
0.3
0.0
65
8
11
223
843
2999
1872
394
481
252
11
315
1
103
103728
1,5
0,2
0,3
5,2
19,5
69,3
43,2
9,1
11,1
5,8
0,3
7,3
0,0
2,4
2396,2
32
0
11
151
761
1181
1090
28
3
60
2
47
0
86
74038
3,8
0,0
1,3
17,9
90,0
139,7
128,9
3,3
0,4
7,1
0,2
5,6
0,0
10,2
8756,7
46
7
8
6847
4209
2712
1444
435
509
324
12
257
1
125
120594
1.1
0.2
0.2
156.6
96.3
62.0
33.0
10.0
11.6
7.4
0.3
5.9
0.02
2.9
2758.6
34
0
8
4179
3638
845
705
24
8
108
3
56
0
92
81458
3.7
0.0
0.9
456.3
397.2
92.3
77.0
2.6
0.9
11.8
0.3
6.1
0.0
10.0
8893.3
21663
500,4
7740
915,4
11399
260.8
4542
495.9
0
0,0
0
0,0
0
0.0
0
0.0
infeqciuri da parazituli daavadebebis aRricxul SemTxvevaTa raodenobam 2004
wels moimata 7,2%-iT. 90-iani wlebis dasawyisSi aRricxvianobis sruli moSlis Semdgom,
registrirebul SemTxvevaTa raodenoba, gansakuTrebiT bavSvebSi, realurs miuaxlovda,
rac mTlianad ambulatoriul avadmyofTa xarjze moxda (nax. 5).
13
835
737,5
1491,2
661,8
951,7
244,3
1994
1995
1996
1997
1998
1999
2000
2001
3557
2855,5
2002
2003
1271,3
834,7
1993
1002,8
2527,9
733,2
834,7
1992
1010,5
423,3
769,4
1746,7
1896,8
468,5
847,7
1991
626,8
1149,7
1990
bavSvebi
575
815,8
1281,2
2121,8
1989
961
1191,5
2074,1
sul
1623,7
4702,9
naxati 5.
infeqciuri da parazituli daavadebebis maCveneblebi 100000 sul mosaxleze
2004
miuxedavad seriozuli siZneleebisa, qveyanaSi warmatebiT moqmedebs ìmunizaciis~
saxelmwifo programa, romlis ganxorcielebaSi ukanasknel wlebSi miRweulia
SesamCnevi progresi. saerTaSoriso gamocdilebaze dayrdnobiT Seicvala difTeriatetanusi-yivanaxvelas, poliomielitis savaqcinacio vadebi da daemata B hepatitis
sawinaaRmdego vaqcinacia axalSobilebSi.
2004 wels aRiricxa wiTelaTi daavadebis 6847 SemTxveva (2003 wels 233 SemTxveva).
saangariSo wels avadobis maCvenebeli gaizarda 5,2-dan 156,6-mde (bavSvebSi 5,2-dan 456,3mde). xuTjer moimata wiTuras SemTxvevebis raodenobam.
difTeriis epidemia, romelmac saqarTveloSi 1993 wels ifeTqa, ZiriTadad
asacreli masalebis uqonlobis gamo, 1995 wels dawyebuli gegmiuri acrebis gamosworebisa da masobrivi imunizaciis kampaniebis Sedegad mxolod 1998 wlidan gaxda
kontrolirebadi (1998 wels dafiqsirda SemTxvevebis 60%-iT kleba). am periodSi aSS-is
da sxva ganviTarebuli qveynebis mTavrobebisa da, gansakuTrebiT, gaeros bavSvTa fondis
udidesi daxmarebis Sedegad SesaZlebeli gaxda jer gegmiuri acrebis dawyeba, xolo
Semdeg mosaxleobis masiuri vaqcinacia. 2004 wels avadobis maCvenebeli orjer Semcirda,
ar aRicxula arc erTi difTeriis matarebeli (nax. 6).
naxati 6.
difTeria saqarTveloSi
SemTxvevebi
500
400
10
8
348
312
300
5,8
286
7,9
6
6,4
200
100
avadoba
429
5,6
114
4
2,1
28 0,5
60 1,3
28
0,6 22 0,5
28 0,6 26 0,6
2
12
0,3
0
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
0
2004
qveyanaSi 1992 wlidan ar daregistrirebula poliomielitis arcerTi SemTxveva.
da saqarTvelo sertificirebulia, rogorc poliomielitisagan Tavisufali zona, amis
garantiaa acrebiT mocvis maRali done da mwvave dune damblis (mdd) sindromis
3
14
2004
gamovlenis maCvenebeli, romelic epidzedamxedvelobis xarisxs gansazRvravs (2004 w.
gamovlinda 8 SemTxveva, rac wina welTan SedarebiT 3-iT naklebia).
2003 wlis doneze SenarCunda daudgeneli etiologiis diareuli daavadebebis
maCvenebeli, aRiricxa salmonelezebisa da Sigelozis mateba (Sesabamisad, 88-iT da 428iT) (nax. 7).
naxati 7.
diareuli daavadebebis gavrceleba
250
diareuli daavadebebi
200
salmonelozi
Sigelozi
epidzedamxedvelobis
saxelmwifo programis
amuSaveba
150
100
50
0
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
arakeTilsaimedo situacia SenarCunebulia sakvebiT gadacemadi anTroponozuli
da zoonozuri infeqciebis mxriv, rogorc kvebis produqtebis warmoebis, Senaxvis,
transportirebisa da realizaciis saqmeSi arsebuli darRvevebis, aseve mosaxleobis
nawilis dabali sanitariuli kulturis gamo. 2004 wels aRiricxa amebiazis 51 (wina wels
- 33) SemTxveva, moimata botulizmisa da jilexis SemTxvevaTa ricxvma (nax. 8).
naxati 8.
jilexis da botulizmis SemTxvevebis dinamika
45
27
2003
39
15
botulizmi
39
26
2001
jilexi
41
34
29
39
1999
51
11
1997
6
0
83
53
18
20
40
60
80
100
120
140
160
miuxedavad wina wlebSi dafiqsirebuli klebisa, moimata brucelozis SemTxvevaTa
raodenobam rogorc mTel mosaxleobaSi (2003 w. – 106, 2004 w. - 151), ise bavSvebSi (2003 w.
- 3, 2004 w. – 14).
saangariSo periodSi aRiricxa hepatitis 2712 SemTxveva, rac 9,6%-iT naklebia 2003
wels aRricxul SemTxvevebTan SedarebiT. es ZiriTadad gamowveulia A hepatitis
raodenobis 22,9%-iT klebiT. moimata B, C, E, D da gauSifravi tipis hepatitebis
SemTxvevaTa raodenobam (nax. 9).
15
naxati 9.
virusuli hepatitebis avadobis maCveneblebi
50
40
30
20
43,7
41
45,9
Hepatitis B
Hepatitis C
37,1
31,6
26,7
18,6
14,4
10,6 8,9
8,9
11,5
10,2 11,3
13
11,1
11,6
10
0,8
0
1,6
3,9
4,6
6
10,9
10,5
9,1
10
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
ukanasknel wlebSi bavSvTa asakSi B virusuli hepatitis SemTxvevaTa umniSvnelo
wili aRiniSneba (2004 w. aRiricxa 24 SemTxveva, maCvenebeli 2,6). rutinuli imunizaciis
dawyeba saxelmwifo programiT, usafrTxo ineqciebis da samedicino manipulaciebis
praqtikis danergva, usafrTxo sisxlis programa Tavis efeqts momaval wlebSi kidev
ufro gamoavlens; samwuxarod, problemad
rCeba da matulobs infeqciis
gadacemis
naxati 10.
bunebrivi gzebi (sqesobrivi kontaqti) da
gripis gavrcelebis dinamika
arasamedicino
manipulaciebis
Sedegad
2004
260,8
gadacema (intravenuri narkomania).
2003
500,4
gripi msoflioSi erT-erT yvelaze
2002
146,6
gavrcelebul infeqcias warmoadgens. wina
2001
134,5
welTan SedarebiT, 2004 w. TiTqmis 2-jer
2000
298,7
Semcirda SemTxvevebis raodenoba – 11399
1999
136,45
(maT Soris 4542 bavSvi iyo) (nax. 10). 2004
1998
122,25
wels aRricxulia mwvave respiratoruli
1997
148,8
daavadebebis 120594 SemTxveva (maCvenebeli
1996
195,8
8893,3).
1988
90-iani wlebis dasawyisSi politi3164,5
kuri da ekonomikuri arastabilurobis,
0
500
1000
1500
2000
2500
3000
3500
mosaxleobis
masobrivi
migraciis
da
globaluri daTbobis Sedegad evropis wyaro: janmrTelobis dacva, saqarTvelo,
regionSi mkveTrad gauaresda malariis 2004, statistikuri cnobari.
gavrcelebis situacia. avadobis piki 1995
wels daregistrirda. saqarTveloSic kvlav aRiniSneboda malariis SemTxvevebi,
romelic likvidirebul iyo, magram arsebobda yvela bunebrivi piroba Semotanis
SemTxvevaSi
misi
gavrcelebisa da xelaxla CanergvisaTvis. wlebis ganmavlobaSi
sxvadasxva uwyebebis mier kompleqsurad xorcieldeboda malariis likvidaciis
RonisZiebebi - daWaobebuli adgilebis amoSroba, mcire bonifikacia, gadamtanebis
masobrivi mospoba SxamqimikatebiT, malariasaSiS qveynebSi wamsvlel da Camosul pirTa
registracia da samedicino-profilaqtikuri meTvalyureoba, qimioprofilaqtika
antimalariuli saSualebebiT. 90-ian wlebSi malariis profilaqtikaze mimarTuli
RonisZiebebis daufinanseblobam gamoiwvia saerTod koRoebisa da, maT Soris, malariis
gadamtani anofelesis ricxobriobis zrda, rasac Tan daerTo azerbaijansa da somxeTSi
malariis epidemia. saqarTveloSi malariis pirveli SemTxvevebi 1996 wels gamoCnda (4
SemTxveva), 1998 wels dafiqsirda 16 SemTxveva (14 adgilobrivi da 2 Semotanili), xolo
1999 wels maTma ricxvma 51-s miaRwia, maT Soris, 16 iyo Semotanili da 35 adgilobrivi.
16
2004
2000 wels, gaizarda SemTxvevebis ricxvi da 170-s miaRwia, ZiriTadad, aRmosavleT
saqarTveloSi. 2001 wels saqarTveloSi mkveTrad imata malariis SemTxvevebma da
gafarTovda gavrcelebis geografiuli
naxati 11. areali.
es
tendencia
2002
welsac
malariis registrirebul SemTxvevaTa
gagrZelda.
2003-2004w.w.
dafiqsirda
raodenoba
SemTxvevaTa raodenobis kleba: jer 159-iT,
Semdgom
ki
58-iT.
aRricxuli
474
500
SemTxvevebidan
56
bavSvebze
modis
(nax. 11).
437
450
malariasTan
brZolis
Tanamedrove
400
350
moTxovnebis
gaTvaliswinebiT
mTeli
300
yuradReba
gadatanilia
daavadebul
pirTa
257
250
315
170
200
(daavadebis wyaros) adreul gamovlinebaze
150
da mkurnalobaze.
100
51
5 16
kvlav arakeTilsaimedo situaciaa
4
50 1 0 1
0
0
cofis sawinaaRmdego kompleqsur Ronis1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
ZiebaTa gatarebis TvalsazrisiT (gansakuTrebiT raionebSi).
wyaro: janmrTelobis dacva, saqarTvelo,
cofi
cxovelebSi
gamovlenilia
2004, statistikuri cnobari.
saqarTvelos TiTqmis mTel teritoriaze.
upatrono, moxetiale cxovelebis, kerZod,
naxati 12. ZaRlebisa da katebis mniSvnelovani momravcofiT gardacvlilTa raodenoba
lebis gamo mosalodnelia epizootiis kidev
ufro swrafi gavrceleba. 2004 wels
25 21
SemTxvevebis raodenoba erTiT meti – 12
dafiqsirda (maCvenebeli 0,3), aqedan 3
20
bavSvebSi (maCvenebeli – 0,3) (nax. 12).
13
15
12
12
10 10 11
registrirebul
dakbenil
moqalaqeTa
10
7
ricxvma saangariSo wels 36478 Seadgina,
4
5
acra dasWirda 82,6%-s. aqedan vaqcinaciis
sruli
kursi
daeniSna
32,5%,
xolo
0
pirobiTi –54,7%. amgvarad, saswrafod
1996 1997 1998 1999 2000 2001 2002 2003 2004
misaRebia zomebi moxetiale cxovelebis
populaciis
regulirebisaTvis
da
wyaro: janmrTelobis dacva, saqarTvelo, 2004,
statistikuri cnobari
patroniani
cxovelebis
masiurad
asacrelad.
2004 wels aRiniSna leiSmaniozis
naxati 13. SemTxvevebis
mateba
(125
SemTxveva,
leiSmanioziT avadobis maCveneblebi
maCvenebeli
–
2,9).
vinaidan
CvenSi
bavSvebi
gavrcelebuli leiSmaniozis tipi bavSvTa
14
12,4
sul
daavadebaa, am SemTxvevaTa TiTqmis 74%
12
10,3
10,2
10
bavSvebze modis. 1990-94 wlebSi dafiqsirda 89,3
8,9
10
7,8
12 SemTxveva, 1995 wels - 20 SemTxveva, 1996
8
wels - 96, 1997 wels - 80, 1998 wels – 82, 1999
6
2,9
wels – 92 da 2000 wels – 103, 2001 wels – 125
4
2,4
2,5
2,8
2,3
2
1,6
(maCvenebeli 2,8), aqedan 112 bavSvebSi (89,6%),
2
0
2002 w. – 108 (maCvenebeli 2,5), bavSvebSi – 85
1998 1999 2000 2001 2002 2003 2004
(maCvenebeli 9,3). 2003 wels – 103 (maCvenebeli
2,4), aqedan 86 bavSvebSi (84%), 2004 w. – 125
(maCvenebeli 2,9), bavSvebSi – 92 (74%). (nax. 13).
q. Tbilisze modis SemTxvevaTa 50%-ze meti,
maSin roca ZiriTadi kerebi istoriulad
ganTavsebuli iyo qvemo qarTlsa da kaxeTSi. TbilisSi SemTxvevebis mateba aSkarad
dakavSirebulia daavadebis ZiriTadi rezervuaris - ZaRlebis raodenobis matebasTan.
rac Seexeba gadamtanebs - flebotomusebs _ maTi mateba ukanono nagavsayrelebis
momravlebasac unda ukavSirdebodes, Tumca aRsaniSnavia leiSmaniozis mateba bevr sxva
17
qveyanaSic, gansakuTrebiT ki centralur aziasa da amierkavkasiaSi (http://www.ecoprojects.ru), rac globaluri daTbobis problemebs ukavSirdeba.
saqarTveloSi aRiniSneba Savi Wiris ori bunebrivi kera: maRalmTiani - javaxeTis
zeganze da vake, mTis wina - qveynis samxreT aRmosavleTSi, naxevrad udabno zolSi. Savi
Wiris epizootiebi mRrRnelebSi dafiqsirebulia maRalmTian zolSi – 1979–1983, 1992 da
1997 wlebSi, xolo vake mTis wina zolSi 1966 da 1968-71 wlebSi. adamianebSi Savi Wiri
1924 wlis Semdeg ar aRricxula.
tularemiis bunebrivi kerebi ZiriTadad emTxveva Savi Wiris bunebriv kerebs,
Tumca sivrcobrivad maT meti farTi ukavia da moicavs damatebiT kaxeTisa da qarTlis
zonebsac. sporaduli SemTxvevebi dafiqsirda 1994 da 1995, 1998 wlebSi. 1997 wels adgili
hqonda marcvleulis damuSavebasTan dakavSirebul umniSvnelo epidafeTqebas qarelis
raionSi. epidemiologiuri, epizootologiuri da laboratoriuli gamokvlevebis
safuZvelze gakeTda daskvna, rom 2004 wels Savi Wirisa da tularemiis epizootiebs
bunebriv kerebSi adgili ar hqonda.
sazogadoebrivi jandacvis qselis Camoyalibebas saqarTveloSi udidesi mniSvneloba hqonda, rogorc epidzedamxedvelobis mowesrigebisa da daavadebaTa kontrolis
sistemis gaumjobesebis mxriv, romelic raionul doneze faqtiurad moSlili iyo, ise
epidsituaciis
prognozirebisa
da
adeqvaturi
profilaqtikuri
RonisZiebebis
SemuSavebis da gatarebis TvalsazrisiT.
janmrTelobis
msoflio
organizaciis
moTxovniT,
epidzedamxedvelobis
erovnulma sistemebma unda uzrunvelyon infeqciuri daavadebebis gavrcelebis
tendenciebsa da struqturis Sesaxeb monacemTa drouli miReba, Sefaseba da analizi,
raTa SesaZlebeli gaxdes saTanado kontrolis RonisZiebebis drouli ganxorcieleba.
3.2.2. filtvis da filtvgareSe tuberkulozi
miuxedavad imisa, rom tuberkulozi gankurnebadi daavadebebis ricxvs
miekuTvneba, dReisaTvis tuberkuloziT inficirebulTa ricxvi msoflios mosaxleobis
erT mesameds udris da yovelwliurad registrirdeba 8 mln. axali SemTxveva da 2 mln.
sikvdili. swored amitom janmrTelobis msoflio organizaciam gadadga uprecedento
nabiji da tuberkulozi globalur problemad gamoacxada. arc saqarTvelo darCa
msoflioSi mimdinare procesebis miRma, kerZod, 1992-1996 wlebSi saqarTveloSi moxda
tuberkulozuri infeqciis erTgvari afeTqeba. Seqmnili mdgomareoba qveyanaSi e.w.
`cixis~ tuberkulozis gavrcelebasa da patimarTa sakmaod didi raodenobis amnistiiT
gaTavisuflebasTan mWidrod iyo dakavSirebuli. mogvianebiT, mosaxleobis socialurekonomikuri mdgomareobis gauaresebis fonze tuberkulozma SeaRwia qveynis
mosaxleobis im socialur fenebSic, sadac misi gavrceleba wina wlebSi tradiciulad
dabali iyo.
2004 wels registrirebuli iyo tuberkulozis 4145 axali SemTxveva (avadobis
maCvenebeli 100000 sul mosaxleze – 94,8), rac wina welTan SedarebiT 127-iT metia (nax. 14).
18
2004
naxati 14.
tuberkulozis axali SemTxvevebi
160
140
120
100
134,1
119
96,5
86,4
80
60
27,6
40
22,7
20
0
1991
101
99,2
1992
96,5
92,8
67
94,8
57,9
21,9
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
janmrTelobis
msoflio
organizaciis
rekomendebulDDOTS
strategiaze
orientirebuli mravalwliani saxelmwifo programis Seqmnam da danergvam
epidemiologiuri
situacia
erTgvarad
moawesriga,
aRiniSna
tuberkulozis
kontrolirebadobis niSnebi, Tumca mdgomareoba jerjerobiT seriozulia.
yofili sabWoTa kavSiris qveynebSi tuberkulozis axali SemTxvevebis maCvenebeli
sakmaod varirebs 39,8-dan (estoneTi) 185,4-mde (yazaxeTi), Tumca, unda aRiniSnos, rom 2004
wlis saqarTvelos maCvenebeli (94,8) metia dsT-is qveynebis saSualo maCvenebelze (87,1)
(nax. 15).
naxati 15.
tuberkulozis axali SemTxvevebi yofili sabWoTa kavSiris qveynebSi (2004)
yazaxeTi
176,5
moldova
133,4
123,9
yirgizeTi
saqarTvelo
94,8
dsT
87,1
84,4
ruseTi
ukraina
81,2
uzbekeTi
78,4
tajikeTi
70,4
latvia
68,3
TurqmeneTi
66,8
azerbaijani
64,7
litva
59,3
55,4
belorusia
somxeTi
51,7
evropa
41,8
39,8
estoneTi
0
50
100
150
200
wyaro: monacemTa baza `janmrTeloba yvelasaTvis~, www.who.dk/hfadb
2004 wels tuberkulozis registrirebul SemTxvevebSi axladgamovlenilTa wili
(63,4%) TiTqmis orjer aRemateba e.w. Zvel SemTxvevebs (36,6%), rac janmrTelobis
msoflio organizaciis SefasebiT tuberkulozTan brZolis programis efeqturobaze
miuTiTebs.
tuberkuloziT daavadebulTa registrirebul SemTxvevaTa saerTo raodenobam
Seadgina 6543 (daavadebianoba 100000 mosaxleze _ 149,7). qveynis saSualo maCvenebelTan
SedarebiT daavadebianoba maRali iyo samegreloSi _ 170,8; TbilisSi _ 173,0; aWaraSi _
211,4. daavadebianobis SedarebiT dabali maCvenebeli dafiqsirda samcxe-javaxeTSi _ 67,4
(cxrili 12).
19
cxrili 12.
tuberkulozis gavrceleba saqarTvelos mxareebis mixedviT
daavadebianoba
2003
2004
2003
Tbilisi
173.0
171,8
114,8
aWara
186,1
211.4
140,7
guria
122,4
129.0
97,8
raWa - leCxumi
100,8
115.8
69,2
samegrelo
141,3
170.8
93,6
imereTi
107,9
117.8
70,6
kaxeTi
109,2
104.4
73,4
mcxeTa – mTianeTi
110,4
117.2
71,7
samcxe – javaxeTi
92,4
67.4
41,8
qvemo qarTli
100,1
119.0
58,5
Sida qarTli
125,8
125.5
83,9
saqarTvelo
145,2
149,7
96,5
mxare
avadoba
2004
110.3
151.3
97.7
78.5
105.8
77.6
70.4
71.8
37.1
62.5
84.1
94,8
2004 w. registrirebulia filtvis tuberkulozis 5318 SemTxveva
(maCvenebeli 121,7). baqteriogamoyofiT SemTxvevebis procentuli maCvenebeli
qveynis saSualoze dabali mxolod guriaSi (43,3), TbilisSi (40,4), raWa-leCxumSi
(38,7), aWarasa (32,8) da samcxe-javaxeTSi (20,8) iyo. 2002 welTan SedarebiT,
baqteriogamoyofis SemTxvevaTa procentuli maCvenebeli TiTqmis yvela
regionSi aris gazrdili, rac dadebiT tendencias warmoadgens (cxrili 13).
cxrili 13.
filtvis tuberkulozis axali SemTxvevebi
nacxis analizi
mxare
mgb +
mgb -
abs.
%
abs.
%
Tbilisi
360
40.4
478
55
aWara
132
32.8
240
59.6
guria
42
43.3
55
56.7
raWa-leCxumi
12
38.7
18
58.1
samegrelo
184
50.3
173
47.3
imereTi
218
55.6
170
43.4
kaxeTi
88
45.8
103
53.6
mcxeTa-mTianeTi
31
44.3
34
48.6
samcxe-javaxeTi
10
20.8
37
77.1
qvemo qarTli
111
46.6
108
45.8
Sida qarTli
103
52.3
88
44.7
saqarTvelo
1395
46.1
1522
50.2
baqterioskopiis
gareSe
abs.
%
31
4.6
31
20.8
0
0
1
3.2
9
2.4
4
1
1
0.6
7.1
5
1
2.1
19
7.6
6
3
109
3.6
tuberkulozis axali SemTxvevebis struqtura mocemulia cxril 14-Si.
cxrili 14.
tuberkulozis axali SemTxvevebis struqtura
2001
2002
100000 % abs. 100000
mosaxmosaxleze
leze
sul
3801 85.8
100 4220
96,5
filtvis
2756 62.2 72.5 3093
70,8
filtvgareSe
1045 23.6 27.5 1127
25,8
abs.
2003
100000
%
mosaxleze
100 4018
92,8
100
73,3 2929
67,7
72,9
26,7 1089
25,2
27,1
statistikuri cnobari.
%
abs.
abs.
4145
3026
1119
2004
100000
mosaxleze
94.8
69.2
25.6
%
100
73
27
20
2004 w. registrirebuli tuberkulozis 4145 axali SemTxvevidan 1119
(27%)
filtvgareSe
tuberkulozze
modis, maT Soris axali SemTxvevebis
44,8% - tuberkulozur plevritze,
xolo 29,7% ki limfuri kvanZebis
tuberkulozia (nax. 16).
regionebis mixedviT filtvgareSe tuberkuloziT yvelaze maRali
avadoba dafiqsirda aWaraSi (44,1)
(cxrili 15).
2004
naxati 16.
filtvgareSe tuberkulozis ganawileba
formebis mixedviT (%)
meningiti
2%
ZvalsaxsarTa
10,5%
urogenitaluri
6,8%
sxva
organoTa
2,6%
plevriti
44,8%
limfuri
kvanZebis
29,7%
cxrili 15.
filtvgareSe tuberkulozis axali SemTxvevebi saqarTvelos mxareebis mixedviT
avadoba
mxare
% tuberkuloziT daavadebulTa
saerTo raodenobaSi
2003
2004
2003
2004
28,0
Tbilisi
32,2
30,0
22,9
aWara
32,2
44, 1
36,1
guria
27,4
30,0
23,7
raWa - leCxumi
29,6
17,7
29,2
samegrelo
27,3
27,2
27,6
imereTi
16,7
21,6
27,4
kaxeTi
26,5
23,6
28,1
mcxeTa – mTianeTi
16,9
15,9
46,5
samcxe – javaxeTi
19,4
14,0
23,6
qvemo qarTli
16
14,7
42,9
Sida qarTli
23,2
21,3
27,1
saqarTvelo
25,2
35,6
27,2
29,2
30,7
22,5
25,8
27,8
33,3
22,2
37,7
23,5
25,4
27
mniSvnelovania, rom tuberkuloziT daavadebulTa didi nawili warmodgenilia
uRaribesi mosaxleobiT, narkomanebiT, yofili patimrebiT, romelTa samedicino
aqtivoba, rac sakuTari janmrTelobiT dainteresebas, eqimTan droul vizits, saWiro
samkurnalo RonisZiebebis gatarebaSi Tanamonawileobas gulisxmobs, sakmarisad
dabalia. amitom xSiria faqtebi, rodesac avadmyofi da misi garemocva araviTar zomebs
ar Rebulobs piradi da sazogadoebrivi profilaqtikisaTvis.
3.2.3. sqesobrivi gziT gadamdebi daavadebebi
1997-1998 wlebSi saxelmwifo programis amuSavebis Sedegad sqesobrivi gziT gadamdebi daavadebebis aqtiuri gamovlenis gamo SemTxvevebis mniSvnelovani matebis
Semdgom 1999-2000 wlebSi gamoikveTa klebis tendencia, rac kerebis sanaciiT iyo
ganpirobebuli. 2000-2003 w.w. sifilisiTa da gonokokuri infeqciiT avadobis Sefardeba
(1:0,7; 1:0,8; 1:0,9; 1:0,9) mkveTrad gansxvavdeboda saerTaSoriso monacemebisagan (1 : 2,5). es
ki imaze miuTiTebs, rom gonokokuri infeqciis gamovlineba umetes SemTxvevebSi ar
xorcieldeboda. 2004 wels aRiniSna am Sefardebis cvlileba da is 1:1,4 gaxda (nax. 17).
21
naxati 17.
sqesobrivi gziT gadamdebi daavadebebis axlad registrirebuli SemTxvevebi
3251
2596
triqomoniazi
2969
3934
704
584
891
460
qlamidiozi
2004
935
832
gonorea
2003
1259
2002
970
2001
681
912
sifilisi
1366
1257
0
500
1000 1500 2000 2500 3000 3500 4000 4500
2004 wels gamovlenilia sifilisis yvela formis 681 axali SemTxveva (avadobis
maCvenebeli –15,6), maT Soris - 374 mamakacebSi da 307 - qalebSi. daavadebulTa 36,1% - 2029 wlis, xolo 33,8% ki - 30-39 wlis asakis iyo.
gonokokuri infeqciis 935 axali SemTxveva dafiqsirda (avadobis maCvenebeli –
21,4). daavadebulTa umravlesoba 20-29 wlis asakisaa (59,4%). (cxrili 16).
cxrili 16.
sqesobrivi gziT gadamdebi daavadebebis ganawileba asakobrivi jgufebis mixedviT
asakobrivi jgufebi
15 - 19
20 - 29
30 - 39
sul
0 - 14
40 da <
sifilisiT daavadebis yvela forma
681
4
42
246
230
159
gonokokuri infeqcia sul
935
7
156
555
175
42
qlamidiuri infeqcia
704
0
109
404
144
47
triqomoniazi
3251
5
483
1781
753
229
2004 wels 0-14 wlamde asakis bavSvebSi dafiqsirda sifilisis 4 (yvela gogonebSi),
xolo gonoreis 7 SemTxveva biWebSi.
sqesobrivi gziT gadamdebi daavadebebis ganawileba asakobrivi jgufebis mixedviT
xasiaTdeba daavadebulTa saSualo asakis sagrZnobi SemcirebiT, rac SedarebiT axal
problemas warmoadgens. miuxedavad imisa, rom dRes individualuri dacvis saSualebebi
sakmarisad xelmisawvdomia, maT erTnairad iSviaTad xmaroben rogorc mamakacebi, ise
qalebi.
qalebi gacilebiT ufro xSirad arideben Tavs sqesobrivi gziT gadamdebi
daavadebebis srulfasovan mkurnalobas, vinaidan am kontingentSi daavadeba xSirad
mimdinareobs gamoxatuli simptomatikis gareSe. gasagebia, rom isini infeqciis Semdgomi
gavrcelebis wyaros warmoadgenen.
Tu sifilisi moiTxovs SedarebiT xangrZliv mkurnalobasa da sistematur
kontrols, ris gamoc iSviaTad ifareba kerZo praqtikis eqimis mier, gonorea, rogorc
mosaxleobis, ise zogjer
eqimis TvalSi warmoisaxeba gacilebiT ufro iolad
mosavlel daavadebad. amitom pacienti xSirad itarebs TviTmkurnalobas Zliermoqmedi
antibiotikebiT (romelTa SeZena gaiolebulia `veluri~ farmacevtuli bazris arsebobis
pirobebSi), an mimarTavs araspecialists. mniSvnelovania is garemoebac, rom
22
2004
saqarTveloSi (sadac uSvilo ojaxuri wyvilebis xvedriTi wili erT-erTi yvelaze
maRalia evropaSi), cudad namkurnalevi gonoreis garTulebebi uSvilobis wamyvan
mizezs warmoadgens.
2004 wels, qveynis saSualo maCvenebelTan SedarebiT, sifilisiT avadoba maRali
iyo TbilisSi (25,3), imereTsa (24,1) da aWaraSi (16,7) rac Seexeba gonoreas, qveynis
saSualoze maRali maCvenebeli dafiqsirda TbilisSi (39,2), mcxeTa-mTianeTSi (34,2),
kaxeTsa (28,0) da raWa-leCumsa da qvemo svaneTSi (23,51). samwuxarod, sifilisis 3
SemTxveva aRiricxa raWa-leCumsa da qvemo svaneTSi, sadac SarSan arc erTi SemTxveva
ar iyo dafiqsirebuli. 2004 w. guriaSi gonoreis arc erTi SemTxveva ar aRricxula
(cxrili 17).
aRsaniSnavia, rom mosaxleobaSi farTodaa gavrcelebuli sqesobrivi gziT
gadamdebi sxva daavadebebic, maT Soris seriozul problemas warmoadgens qlamidiuri
infeqcia da triqomoniazi. 2004 wels aRiniSna triqomoniazis 3251 SemTxveva (avadoba
74.4), xolo qlamidiuri infeqciis – 704 SemTxveva (avadoba 16,1), rac metia, wina welTan
SedarebiT. am daavadebebis klinika xasiaTdeba latenturi mimdinareobiT da iSviaTad
gamoxatuli simptomatikiT. amasTan sayuradReboa, rom daavadebaTa es jgufi iseve,
rogorc qronikuli gonorea, uSvilobis erT-erT ZiriTad mizezs warmoadgens, rac
daavadebulTa axalgazrda asakis gaTvaliswinebiT uaryofiTad moqmedebs qveyanaSi
arsebul isedac mZime demografiul mdgomareobaze.
cxrili 17.
sqesobrivi gziT gadamdebi daavadebebis axali SemTxvevebi
sul
100000
mosaxleze
sul
100000
mosaxleze
sifilisis da
gonokokuri
infeqciebis
Sefardeba
274
63
14
30
169
54
4
1
22
24
3
681
25.3
16.7
9.8
6.4
24.1
18.2
13.1
0.5
4.4
7.6
5.9
15.6
424
47
0
61
107
114
43
35
63
21
12
935
39.2
12.5
0
13.1
15.2
2.8
34.2
16.8
12.6
6.6
23.5
21.4
1:1,5
1:0,7
1:0,0
1:2
1:0,6
1:2,1
1:10,7
1:35
1:2,9
1:0,9
1:4
1:1,4
sifilisi
mxare
Tbilisi
aWara
guria
samegrelo
imereTi
kaxeTi
mcxeTa – mTianeTi
samcxe – javaxeTi
qvemo qarTli
Sida qarTli
saqarTvelo
gonokokuri infeqciebi
23
3.2.4. SeZenili imunodeficitis sindromi (Sidsi)
2003 welTa SedarebiT, aiv-inficirebisa da Sidsis registrirebuli SemTxvevebis
raodenoba 31,3%-iT gaizarda. 2004 wlis bolos registrirebuli iyo aiv infeqcia/Sidsis
508 SemTxveva (maT Soris aiv-iT inficirebis 458 da Sidsis 20 SemTxveva). mxolod 2004
wels gamovlenili iyo inficirebis 163 axali SemTxveva (nax. 18). aiv infeqcia/Sidsis
diagnoziT saqarTveloSi 2004 w. gardaicvala 55 adamiani.
naxati 18.
aiv/Sidsis axal SemTxvevaTa dinamika
163
180
160
140
120
93
93
94
79
100
80
60
40
20
21
1
3
1
6
0
6
2
25
34
8
0
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
wina welTan SedarebiT avadobis maCvenebeli Seicvala 2,2-dan – 3,7-mde,
daavadebianoba gaizarda 8,9-dan – 11,6-mde. unda aRiniSnos, rom 1996 welTan SedarebiT
SeimCneva am maCvenebelTa mkveTri zrda,
rac aiv/Sidsis swraf gavrcelebas asaxavs
naxati 19.
(nax. 19).
aiv/Sidsis gavrceleba
aiv-iT inficirebul da SidsiT
daavadebianoba
avadoba
daavadebul 508 piridan – 407 (80,1%)
3,7
mamakacia da 101 (19,9%) qali.
2004
11,6
aiv infeqcia/SidsiT daavadebulTa
2,2
2003
8,9
ZiriTad
kontingents
Seadgendnen
2,1
2002
7,2
narkomanebi (344 SemTxveva, e.i. 67,7%) da
2,1
2001
SemTxveviTi sqesobrivi kavSiris mqone
5,2
1,8
pirebi (155 SemTxveva, e.i. 30,5%). (nax. 20).
2000
3,4
2004 w. saqarTveloSi
gamovlinda aiv0,7
1999
1,8
inficirebisa da Sidsis 11 axali SemTxveva
0,5
1998
1,1
ucxoelebSi.
0,4
1997
aiv infeqciis SemTxvevebi maRali
0,7
0,2
riskis
jgufebidan
gavrcelda
1996
0,4
mosaxleobis farTo fenebSic. aRricxulia
aiv/Sidsis meuRlidan meuRleze, sqesobriv
0
5
10
15
partniorebs Soris, Zmebs Soris da
dedidan Svilze gadacemis SemTxvevebi.
statistikuri cnobari
miuxedavad imisa, rom jerjerobiT
Sidsi mniSvnelovan adgils ar ikavebs qveynis mosaxleobis avadobisa da
sikvdilianobis struqturaSi da saqarTvelo miekuTvneba Sidsis dabali prevalentobis
qveynebs, Catarebuli situaciuri analiziT gamovlenili risk-faqtorebis gadacemis
maCveneblebis (intravenuri narkomaniis da aiv infeqcia/Sidsis gadacemis maRali riskis
24
2004
qcevebis
gavrcelebis
done
da
sxv.)
naxati 20.
gaTvaliswinebiT, saqarTveloSi arsebobs
aiv-iT
inficirebul
da
SidsiT
aiv
infeqcia/Sidsis
epidemiis
swrafi
daavadebulTa procentuli ganawileba
gavrcelebis yvela winapiroba. amitom
infeqciis wyaroebis mixedviT
udidesi
mniSvneloba
eniWeba
profilaqtikuri RonisZiebebis gatarebas,
seqs.
kerZod, sisxlisa da misi preparatebis
kontaqtiT;
30,5%
usafrTxoebis garantirebas, mosaxleobis
dedidan
ganaTlebas, narkomaniis profilaqtikas da
bavSvze; 0,6%
sxv. miT umetes, rom janmrTelobis
msoflio
organizaciis
mowodebaa
am
sisxlis
mimarTulebiT
gansakuTrebuli
preparatebis
mniSvneloba mieniWos saqmianobis iseT
recipientebi;
narkomanebi;
0,4%
67,7%
mimarTulebebs,
rogoricaa:
sxvadasxva
samedicino
samsaxurebis
integracia
(profilaqtikuri,
reproduqciuli
janmrTelobis, pirveladi jandacvis, Sids- wyaro: janmrTelobis dacva, saqarTvelo, 2004,
is, patimarTa samedicino momsaxurebis da
sxv.); epidemiologiuri zedamxedvelobis
srulyofa;
aiv-infeqciasTan
dakavSirebuli
qceviTi
risk-faqtorebis
kvleva,
nebayoflobiTi konsultireba da testireba, vertikaluri gadacemis profilaqtika,
sanganaTlebis gaumjobeseba da sxv.
25
3.3. aragadamdebi daavadebebi
ukanaskneli aTwleulebis ganmavlobaSi e.w. aragadamdebi daavadebebi gulsisxlZarRvTa daavadebebi, simsivneebi, diabeti, filtvis qronikuli obstruqciuli
daavadeba, asTma da mentaluri darRvevebi - warmoadgens avadobis globaluri tvirTisa
(DALY) da sikvdilianobis ZiriTad, mzard faqtors msoflioSi da gansakuTrebiT
evropis regionSi. 2002 wels msoflioSi sikvdilianobis 59% da avadobis globaluri
tvirTvis TiTqmis naxevari (47%), xolo evropaSi sikvdilianobis - 86% da avadobis
globaluri tvirTis - 76% aragadamdeb daavadebebze modioda (nax. 21, 22).
janmrTelobis msoflio organizaciis gaangariSebiT, uaxloesi 10 wlis ganmavlobaSi
388 milioni adamiani gardaicvleba am daavadebebiT, 2020 wlisaTvis kidev ufro
gaizrdeba aragadamdebi daavadebebis wili da is msoflioSi - 60%, xolo evropis
regionSi 80%-ze meti iqneba.
nax. 21. sikvdilianoba daavadebaTa
ZiriTadi jgufebis mixedviT, 2002
nax. 22. avadobis globaluri tvirTi
(DALYs), 2002
dazianebebi
dazianebebi
aragadamdebi daavadebebi
aragadamdebi daavadebebi
gadamdebi daavadebebi
gadamdebi daavadebebi
9%
8%
12%
59%
86%
47%
32%
msoflio
76%
41%
6%
evropa
14%
msoflio
10%
evropa
wyaro: World Health Report 2004.
aragadamdebi daavadebebis (xSirad moixsenieba qronikul daavadebebad) rogorc
sazogadoebrivi jandacvis mniSvnelovani problemis ganmsazRvreli ZiriTadi
faqtorebia: maRali avadoba da sikvdilianoba, avadobis maRali tvirTi da mzardi
ekonomikuri Rirebuleba. amave dros, isini dakavSirebulia cxovrebis wesTan da iseT
Tavidan acilebad risk-faqtorebTan, rogoricaa Tambaqos moxmareba, alkoholis
gamoyeneba, arajansaRi kveba da hipodinamia. am risk-faqtorebs gaaCniaT ekonomikuri,
socialuri, genderuli, politikuri, qceviTi da garemo determinantebi.
aragadamdebi daavadebebis gavrcelebis swrafi mateba ganapirobebs samedicino
momsaxurebis deficitis zrdas rogorc qveynis SigniT, aseve qveynebs Sorisac da
safrTxes uqmnis mravali qveynis socialur-ekonomikur ganviTarebas. ganviTarebuli
qveynebisagan gansxvavebiT, sadac es daavadebebi erTmniSvnelovnad wamyvan faqtors
warmoadgens, afrikisa da aziis ganviTarebad qveynebSi ormag tvirTs qmnis, radgan iq
izrdeba aragadamdebi daavadebebis gavrceleba da aseve maRali rCeba gadamdebi
daavadebebis maCveneblebic. evropis Rarib qveynebSi ki, sadac makroekonomikuri
monacemebi ganviTarebadi qveynebis parametrebs uaxlovdeba, daavadebaTa tvirTis
xarisxi evropis ganviTarebuli qveynebis msgavsia, Tumca aseve maRali rCeba gadamdebi
daavadebebis zrdis riskic.
janmrTelobis msoflio organizaciis monacemebiT, saqarTveloSi 2002 wels
avadobis tvirTis mixedviT (saqarTveloSi jer-jerobiT ar xdeba am indikatoris
gamoTvla) aTi wamyvani daavadebidan cxra aragadamdebi daavadeba iyo (mTliani
avadobis tvirTis 53%) (cxrili 18).
26
2004
cxrili 18.
avadobis tvirTi (DALYs) ZiriTadi mizezebis mixedviT, 2002
yvela SemTxveva
1 gulis iSemiuri daavadeba
2 cerebrovaskularuli daavadeba
3 unipolaruli depresia
4 perinataluri mdgomareobebi
5 osteoarTriti
6 wamlis miRebiT gamowveuli darRvevebi
7 RviZlis cirozi
8 smenis dakargva, SeZenili
9 diabeti
10 asakze damokidebuli mxedvelobis darRvevebi
wyaro: World Health Statistics - 2005, WHO
DALYs
891192
163411
122449
61490
37345
24362
21844
21203
19467
17864
17793
%
100
18,3
13,7
6,9
4,2
2,7
2,4
2,4
2,2
2,0
2,0
3.3.1. simsivneebi
janmrTelobis msoflio organizaciis monacemebiT, yovelwliurad simsivnis 11
milioni axali SemTxvevis diagnostireba xdeba msoflioSi, aqedan 6 milioni
mTavrdeba sikvdiliT. 2020 wlisaTvis mosalodnelia axali SemTxvevebis
gaormageba, romelTagan 10 milioni aRmoCndeba fataluri anu simsivnis
diagnoziT gardaicvleba 12,5%.
2004 wels avTvisebiani simsivneebis diagnoziT aRricxvaze imyofeboda 28853
avadmyofi (daavadebianoba – 660,0). gamovlenilia sicocxleSi pirvelad dadgenili
diagnozis 5726 SemTxveva (avadoba 131,0), rac 9%-iT metia wina welTan SedarebiT.
sicocxleSi
pirvelad
dadgenili
avTvisebiani
simsivneebiT
aRricxul
avadmyofebSi 54,2% (3100) qalia, xolo 45,8% mamakaci (nax. 23).
naxati 23.
avTvisebiani simsivneebis avadobis maCveneblebi
kontingenti sul
pirvelad dadgenili diagnozi - kaci
700
600
500
457,7
482,5
54,9 60,4
65,3 67,5
1995
1996
475,1
501,9
538,9
557,4
pirvelad dadgenili diagnozi - qali
660
637,8
603,3
586,8
400
300
200
100
80,6 86,8
88,1 89,4
95,1 96,2
119,7 124
98,3 94,9 111,8 112,7
120,9 121,7
121,7
134,3
0
1997
1998
1999
2000
2001
2002
2003
2004
simsivneebiT avadoba erT-erTi yvelaze metad gavrcelebulia rogorc evropis
maRalganviTarebul, ise yofili sabWoTa kavSiris qveynebSi (nax. 24). simsivneebiTaa
gamowveuli dasavleT evropaSi sikvdilianobis mesamedi, centralur da aRmosavleT
evropaSi - mexuTedi, xolo dsT-is qveynebSi - 10%. simsivnur warmonaqmnebs Soris
avadobis maRali tvirTiT gamoirCeva filtvis kibo da mkerdis kibo qalebSi.
27
naxati 24.
simsivneebis axali SemTxvevebis maCvenebeli (100000 mosaxleze)
yofili sabWoTa kavSiris qveynebSi (2004)
litva
464,1
latvia
419
belorusia
376,8
369,7
329,7
325,4
evropa
ukraina
ruseTi
dsT
267,1
194,2
192,1
190,1
yazaxeTi
somxeTi
moldova
saqarTvelo
131
yirgizeTi
87,4
67,9
67,7
59,5
32,5
azerbaijani
uzbekeTi
TurqmeneTi
tajikeTi
0
100
200
300
400
500
wyaro: monacemTa baza `janmrTeloba yvelasaTvis~, www.who.dk/hfadb.
2004 wels, 7%-iT klebis miuxedavad,
isev maRalia (43%) daavadebis IV stadiaSi
gamovlenil
SemTxvevaTa
raodenoba.
onkologiuri avadmyofebis mxolod 29%-s
daudgindaT daavadebis I da II stadia, rodesac
st a di a
mkurnalobis
efeqturoba
daavadebis
g a mo v
l eni l i
lokalizaciis
mixedviT
50-98%
Seadgens,
ar aris
xolo
III
stadiis
(rac
saTanadod
aqveiTebs
4%
I-II
29 %
mkurnalobis
efeqturobas
daavadebis
lokalizaciis mixedviT 10-60%-mde) mqone
IV
pacientTa xvedriTi wili 24%-s Seadgenda
43 %
(nax. 25).
III
zemoaRniSnulidan gamomdinare, unda
24%
gaumjobesdes
vizualuri
simsivneebis
gamovlena zogadi praqtikis eqimTa doneze,
amasTan erTad, ufro farTod unda iqnes
gamoyenebuli
endoskopiuri
teqnika
(bronqoskopia, gastroskopia, kolonoskopia) Sinagani lokalizaciis simsivneebis
gamosavlenad.
onkologiuri
daavadebebiT
avadobis
maCvenebeli
qveynis
saSualoze
gansakuTrebiT maRali iyo raWa-leCxumsa (188,3) da Sida qarTlSi (150,9). daavadebianoba
maRali iyo aWaraSi (992,5), Sida qarTlsa (950,5) da kaxeTSi (938,2) (cxrili 19). bavSvebSi
rogorc axlad gamovlenil SemTxvevaTa, aseve daavadebianobis maCvenebeli yvelaze
maRali iyo guriaSi. gasul welTan SedarebiT, avadobis maCveneblebis mateba aRiniSneba
yvela regionSi, guriis garda, sadac TiTqmis 50%-iT Semcirda axal SemTxvevaTa
raodenoba. yvela regionSi daavadebianobis zrdis fonze samcxe-javaxeTSi aRiniSneboda
umniSvnelo kleba.
naxati 25.
pirvelad dadgenili avTvisebiani
simsivnis sixSire stadiebis mixedviT
28
2004
cxrili 19.
avTvisebiani simsivneebis gavrceleba saqarTvelos regionebSi
axali SemTxvevebi
maCvene- bavSveb- maCvenebeli
Si
beli
Tbilisi
1419
131.2
3
1.4
aWara
512
136.2
0
0.0
guria
104
72.5
3
10.6
raWa-leCxumi
96
188.3
0
0.0
samegrelo
591
126.8
2
2.1
imereTi
947
135.4
6
4.4
kaxeTi
510
125.3
1
1.2
mcxeTa–mTianeTi
173
137.9
2
7.7
samcxe–javaxeTi
209
100.7
1
2.0
qvemo qarTli
454
91.3
4
3.3
Sida qarTli
474
150.9
4
5.8
afxazeTi
88
1
saqarTvelo
5726
131.0
27
2.9
wyaro: janmrTelobis dacva, saqarTvelo, 2004, statistikuri
sul
sul
6133
3732
1038
297
2113
4755
3820
785
1008
1825
2985
80
28853
cnobari.
kontingenti
maCvene- bavSvebbeli
Si
567.0
6
992.5
33
724.1
11
582.7
0
453.3
5
679.6
13
938.2
7
625.8
3
485.6
6
366.8
7
950.5
23
1
660.0
115
maCvenebeli
2.8
36.5
38.9
0.0
5.4
9.6
8.3
11.6
12.2
5.8
33.6
12.6
lokalizaciis mixedviT avTvisebian simsivneTa axali SemTxvevebis struqturaSi
maRalia: qalebSi - sarZeve jirkvlis (35,6%), sasqeso organoebis (24,6%) da saWmlis
momnelebeli organoebis (16,9%); mamakacebSi - sunTqvis da gulmkerdis organoebis
(31,6%), saWmlis momnelebeli organoebis (25,9%) da sasqeso organoebis (8,9%)
simsivneebi (cxrili 20).
cxrili 20.
gansakuTrebulad xSiri lokalizaciis avTvisebiani simsivneebis gavrceleba
simsivnis lokalizacia
aRricxvaze myofi
1998
1999
2000
2001
sul:
552,6
555,1
559,5
590,5
sul
101,6
98,6
96,9
113,0
pirvelad dadgenili
mamak
102,1
99,2
100,0
114,1
diagnozi
qali
101,3
98,0
94,1
112,1
mamak
1,0
0,9
1,0
1,0
saylapavi
qali
0,5
0,2
0,3
0,4
mamak
6,1
5,6
6,0
6,9
kuWi
qali
3,0
3,9
3,5
4,4
mamak
3,4
4,4
3,9
4,9
swori nawlavi
qali
3,6
3,2
2,9
4,2
mamak
7,4
8,1
7,5
9,0
xorxi
qali
0,3
0,2
0,3
0,2
traqea, bronqebi,
mamak
25,8
27,1
27,5
30,2
filtvebi
qali
3,3
3,6
3,3
4,3
sarZeve jirkvali
qali
34,5
36,3
35,0
40,0
saSvilosnos yeli
qali
10,6
9,8
7,9
10,7
winamdebare jirkvali
mamak
5,1
4,3
5,5
6,3
limfuri da sisxlmbadi
mamak
6,3
5,4
4,9
6,0
organoebi
qali
4,4
3,7
3,0
3,8
2002
603,3
122,0
119,7
124,0
1,6
0,4
11,7
6,5
4,9
4,5
9,5
0,2
28,0
3,5
44,6
11,2
7,3
6,6
4,6
2003
637,8
121,3
120,9
121,7
0,9
0,4
7,5
5,4
6,0
4,0
9,6
0,2
28,0
4,4
43,8
12,5
8,1
5,4
3,8
2004
660,0
131,0
127,4
134,3
1,7
0,6
11,2
6,2
6,6
6,0
9,7
0,6
29,5
5,0
47,8
13,3
7,8
7,1
4,3
yuradRebas ipyrobs simsivnuri daavadebis gavrcelebis Taviseburebebi sqesis
mixedviT. ase, magaliTad, qalebSi avadobis struqtura Semdegnairia: 35,6% - sarZeve
jirkvlis, 24,6% sasqeso organoebis kibo. e.i. qalebSi onkologiuri avadobis 60,2%
modis reproduqciuli organoebis kibos wilad. asakTan erTad avadoba TandaTanobiT
29
matulobs da ZuZus kiboian qalebSi maqsimalur maCvenebels aRwevda 55-59 wlis asakSi
(nax. 26).
naxati 26.
sarZeve jirkvlis avTvisebiani simsivneebiT avadoba qalebSi asakobrivi jgufebis
mixedviT
200
177
150
119,7
120,9
102,9
87,1
85,9
100
90,2
78,8
58,5
37,3
50
22
13,5
6,3
0
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85 +
mamakacebSi lokalizaciis mixedviT sicocxleSi pirvelad dadgenili simsivneebis
struqturaSi
31,6% - sunTqvisa da gulmkerdis organioebis da 25,9% saWmlis
momnelebeli organoebis kiboze modis. e.i. mamakacebSi onkologiuri avadobis naxevarze
meti (57,5%) sasunTqi gzebisa da kuW-nawlavis simsivneebiTaa gamowveuli. asakobrivi
jgufebis mixedviT sasunTqi organoebis simsivneebis sixSire yvelaze metad gamoxatuli
80-84 asakobriv jgufSi iyo (nax. 27).
naxati 27.
sunTqvisa da gulmkerdis organoebis avTvisebiani simsivneebiT avadoba mamakacebSi
asakobrivi jgufebis mixedviT
250
207,6
200
172,8
165,8
187,5
140,7
150
120,6
94,2
100
50
24,7
0,6
0,6
0
2,1
74,2
43,3
5,9
0
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85 +
wina welTan SedarebiT, lokalizaciisa da sqesis mixedviT axali SemTxvevebis
matebis fonze mamakacebSi 23%-iT Semcirda Tvalis, Tavis tvinisa da cns sxva nawilebis
simsivneebi.
aRricxuli avadmyofebidan gardaicvala 4322. avTvisebiani simsivnis diagnozis
dadgenidan pirvel wels gardaicvala avadmyofTa 38,0%. 2004 wels kontingentis saerTo
raodenobis 43,2% xuTi da meti wlis ganmavlobaSi aRricxvaze myofi avadmyofia.
2004 wels simsivneebis diagnoziT stacionarebSi hospitalizirebulia 9191
avadmyofi (maCvenebeli 210,2), letalobis maCvenebeli – 2.2, maT Soris 0-14 wlamde
asakis 650 bavSvia. bavSvebSi simsivneebiT letalobis maCvenebeli Seadgenda 1,5%.
specialur mkurnaloba utardeboda avTvisebiani simsivneebiT daavadebul 3002
avadmyofs II klinikur jgufSi, mkurnaloba daamTavra 2477 avadmyofma. mkurnaloba
qirurgiuli meTodiT Cautarda 833 avadmyofs, sxivuri meTodiT – 252, medikamenturad –
375, xolo kombinirebuli meTodiT – 936 avadmyofs.
30
2004
3.3.2. sisxlis da sisxlmbadi organoebis daavadebebi
2004 wels sisxlisa da sisxlmbadi organoebis daavadebebis diagnoziT
registrirebuli iyo 16175 avadmyofi (2003 wels - 14695), daavadebianobis maCvenebelma
Seadgina 370,0 (2003 wels – 339,5), maT Soris 8233 bavSvi iyo (maCvenebeli 898,8). sicocxleSi
pirvelad dadgenili diagnoziT registrirebul iqna
8605 pacienti (2003 wels – 7400),
avadobis maCvenebeli – 196,8 (2003 wels – 170,9), maT Soris bavSvebi – 4848.
sisxlisa da sisxlmbadi organoebis daavadebebis gavrcelebis dinamikis analizi
cxadyofs, rom 2000 da 2003 wlebSi umniSvnelo klebis miuxedavad qveyanaSi aRiniSneba
am daavadebebis mateba. 2004 wlis daavadebianobis maCvenebeli 1,7-jer aRemateba 1997
wlis analogiur monacemebs. 2004 wels sicocxleSi pirvelad dadgenili diagnoziT
aRricxul avadmyofTa raodenobam 2003 welTan SedarebiT, moimata da mTlianad
registrirebul avadmyofTa 53% Seadgina (nax. 28, 29).
naxati 28.
sisxlisa da sisxlmbadi organoebis
daavadebaTa gavrceleba
naxati 29.
sisxlisa da sisxlmbadi organoebis
daavadebaTa gavrceleba bavSvebSi
daavadebianoba
daavadebianoba
avadoba
1000
avadoba
400
900
350
800
300
700
250
600
200
500
400
150
300
100
200
50
100
0
0
1997
1998
1999
2000
2001
2002
2003
2004
1997
1998
1999
2000
2001
2002
2003
2004
sisxlisa da sisxlmbadi organoebis gavrceleba regionebis mixedviT qveynis
saSualoze maRali iyo guriaSi (810), raWa-leCxumSi (755,4), samcxe-javaxeTsa (465,8) da
samegreloSi (456,1). yvelaze dabali daavadebianobisa da avadobis maCveneblebi aRiniSna
mcxeTa-mTianeTSi. bavSvebSi yvelaze maRali avadobisa da daavadebianobi maCveneblebi
dafiqsirda guriaSi, yvelaze dabali maCveneblebi ki TbilisSi (cxrili 21).
cxrili 21.
sisxlis da sisxlmbadi organoebis daavadebaTa gavrceleba regionebis mixedviT
aWara
Tbilisi
kaxeTi
imereTi
samegrelo
Sida qarTli
qvemo qarTli
guria
samcxe-javaxeTi
mcxeTa-mTianeTi
saqarTvelo
2003
daavadebianoba
avadoba
sul
m.S.
sul
m.S.
bavSvebSi
bavSvebSi
212.2
561.2
98.8
266.9
148.5
249.0
94.9
135.3
351.0
794.2
169.4
465.1
280.4
855.9
135.2
410.9
447.3
679.4
277.7
412.2
342.2
1112.0
202.3
747.9
279.7
935.6
122.2
434.5
671.4
2089.9
339.9
978.4
551.8
1696.5
283.9
912.9
83.8
198.3
39.5
95.0
648.2
1070.7
276.7
555.6
339.5
836.4
170.9
437.6
2004
daavadebianoba
avadoba
sul
m.S.
sul
m.S.
bavSvebSi
bavSvebSi
279.8
781.4
184.8
560.1
190.5
298.3
84.5
99.3
375.5
847.7
188.4
535.2
304.7
1003.4
163.5
558.4
456.1
895.5
267.3
575.5
359.5
972.6
236.6
693.7
292.0
733.2
143.7
431.3
810.6
2243.9
529.4
1557.3
465.8
1023.4
228.3
445.6
110.0
292.9
52.6
185.0
755.4
1387.9
198.2
406.8
370.0
898.9
196.8
529.3
31
sisxlisa da sisxlmbadi organoebis daavadebebis registrirebuli SemTxvevebis
90% anemiebia (nax. 30, 31). 1997 welTan SedarebiT gaormagda anemiebis axladgamovlenili
SemTxvevebis raodenoba. janmos SefasebiT, anemia aris dainvalidebis meore wamyvani
mizezi msoflioSi da amis gamo is aris janmrTelobis globaluri da seriozuli
problema. ganviTarebadi qveynebis mosaxleobis naxevars da ganviTarebuli qveynebis 3040% anu msoflioSi 2 miliardamde adamians aqvs anemia, aqedan 50% aris
rkinadeficituri.
anemia
zrdis
dedaTa
da
bavSvTa
sikvdilianobis
risks,
rkinadeficituri anemia iwvevs bavSvis fizikuri ganviTarebis Seferxebas da
mozrdilebSi Sromisunarianobis daqveiTebas.
naxati 31. anemiebis gavrceleba bavSvebSi
naxati 30. anemiebis gavrceleba
daavadebianoba
avadoba
304,6
400
350
300
250
200
daavadebianoba
avadoba
900
340
340,9
309
333,5
800
700
275,4
619,6
600,1
600
246,7
182,3
500
825,9
691,7
764,6
731
556,5
555,2
400
150
100
93,3
124,8
142,2
143,7
176,7
163,5 170,9
185,6
200
50
267,5297,4
276,5
294,8
378,4
398,3 419,9
504,9
100
0
0
1997
300
1998
1999
2000
2001
2002
2003
2004
1997
1998
1999
2000
2001
2002
2003
2004
wyaro: janmrTelobis dacva, saqarTvelo, 2004, statistikuri cnobari
2004 wels saqarTveloSi sisxlisa da sisxlmbadi organoebis daavadebaTa
diagnoziT stacionarebidan gavida 960 avadmyofi (maCvenebeli – 22,0), letaloba – 1,4.
stacionaridan gasuli 404 bavSvia (maCvenebeli – 44,1), letaloba 0,7. hospitalizebul
avadmyofTa saerTo raodenobis 58% mkurnalobda TbilisSi.
q. Tbilisis monacemebiT, anemiebis struqturaSi 85% ukavia rkinadeficitur
anemiebs, 4,3% kvebasTan dakavSirebul anemiebs, 2,1% vitamin-12 deficitur da fermentuli
darRvevebiT gamowveul anemiebs, 1,3% foliumdeficitur anemiebs (nax. 32).
naxati 32.
anemiebis struqtura
rkinadeficituri
vitamin-12 deficituri
foliumdeficituri
kvebasTan dakavSirebuli sxva
fermentuli darRvevebiT gamowveuli
Talasemia
sxva memkvidruli hemolizuri
SeZenili hemolizuri
sxva aplaziuri
mwvave posthemoragiuli
sxva
32
2004
3.3.3 endokrinuli daavadebebi
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
zogierTi sxva paTologiisagan gansxvavebiT, endokrinuli daavadebebi ara marto
sul ufro did adgils ikavebs saqarTvelos mosaxleobis avadobis struqturaSi, aramed,
rac gansakuTrebiT mniSvnelovania, moiTxovs sabiujeto saxsrebis mzard xarjvas. es
ganpirobebulia imiT, rom pacientTa sakmarisad did ricxvs esaWiroeba specifikuri
medikamentebiT, sakvebi produqtebiT, hormonaluri preparatebiT momarageba, romelTa
umetesi nawilis warmoeba qveyanaSi gaZnelebulia. amasTan, importuli preparatebiT
momaragebis wyvetiloba zogjer avadmyofis mkvlelobis tolfasia. zemoaRniSnulidan
gamomdinare,
am
jgufis
avadmyofTa
naxati 33.
saTanado
uzrunvelyofa
saxelmwifos
endokrinuli
sistemis
daavadebebiT
prerogativad rCeba.
avadobis maCvenebeli
2004
wlis
monacemebiT
saqarTveloSi
endokrinuli
sistemis
1400
daavadebebis, kvebis, nivTierebaTa cvlis
1200
sul
da imunitetis darRvevebis diagnoziT
1000
bavSvi
registrirebuli iyo 129346 avadmyofi
800
(daavadebianoba 2958,8), aqedan sicocxleSi
600
pirvelad dadgenili diagnoziT 29920
400
(avadoba – 684,4), romelTa Soris 6580
200
(22%) iyo bavSvi (avadoba – 718,4). Tu 2003
wels, wina wlebTan SedarebiT, aRiniSna
0
axali
SemTxvevebis
kleba
rogorc
saerTod, ise bavSvebSi, 2004 wels moxda
axali SemTxvevebis umniSvnelo mateba,
bavSvebSi
axali
SemTxvevebis
18%-iani wyaro: janmrTelobis dacva, saqarTvelo,
klebis fonze (nax. 33).
registrirebul SemTxvevaTa struqtura Semdegnairad gamoiyureba: 39% - farisebri jirkvlis gadideba da dauzustebeli
Ciyvi (daavadebianoba – 1149,4); 28% - insulindamoukidebeli Saqriani diabeti
(daavadebianoba – 827,7); 10% insulindamokidebuli Saqriani diabeti (daavadebianoba –
316,3); 8,4% - Tireotoqsikozi CiyviT da Ciyvis gareSe (daavadebianoba – 250,1), 5,4% aratoqsiuri kvanZovani Ciyvi (daavadebianoba – 160,4), 2% - simsuqne (daavadebianoba –
53,6) da sxv. (cxrili 22).
cxrili 22.
endokrinuli daavadebebis struqtura
m.S. sicocxleSi pirvelad
dadgenili diagnoziT
sul
m.S. bavSvebi
registrirebuli avadmyofebi
sul
m.S. bavSvebi
raode- daavade- raode- daavade- raoderaodeavadoba
avadoba
noba
bianoba
noba
bianoba
noba
noba
sul
m.S. Tireotoqsikozi CiyviT an
Ciyvis gareSe
farisebri jirkvlis gadideba da
dauzustebeli Ciyvi
aratoqsiuri kvanZovani Ciyvi
Saqriani diabeti
insulindamokidebuli
Saqriani diabeti
insulindamoukidebeli
simsuqne
129346
2958,8
22227
2426,7
29920
684,4
6580
718,4
10932
250,1
1352
147,6
3274
74,9
374
40,8
50248
1149,4
17563
1917,5
13597
311,0
4276
466,8
7010
160,4
649
70,9
2299
52,6
116
12,7
13826
316,3
202
22,1
2418
55,3
39
4,3
36184
827,7
40
4,4
4813
110,1
16
1,7
2344
53,62
468
51,1
812
18,6
227
24,8
33
8210,9
sagulisxmoa, rom sxvadasxva regionis mosaxleobaSi am jgufis daavadebaTa gavrceleba gamoxatulad gansxvavdeba, rac dakavSirebulia rogorc geografiul, aseve
ekologiur faqtorebTan. am mxriv gansakuTrebiT sagangaSo mdgomareobaa raWaleCxumsa da zemo svaneTSi (nax. 34).
naxati 34.
endokrinuli sistemis daavadebaTa gavrceleba mxareebis mixedviT
daavadebianoba
684,4
726,3
2958,8
3365,5
440,2
646
1402,1
2782,8
4236,2
avadoba
959
1669,4
1512,7
2026,4
493,9
1000
310,4
2000
254
3000
1787,1
4000
2299,6
5000
1151,8
6000
780,5
4292
7000
860,5
8000
5540,3
9000
0
Tbilisi
aWara
guria
raWa-leCxumi
samegrelo
imereTi
kaxeTi
mcxeTamTianeTi
samcxejavaxeTi
qvemo qarTli Sida qarTli
saqarTvelo
diabeti aris mzardi, Cumi epidemia, romelsac SeuZlia `gamanadgurebeli dartyma~
miayenos jandacvis samsaxurebs mTels msoflioSi. ukanasknel wlebSi swrafad izrdeba
diabetiT daavadebulTa ricxvi. Tu 1985
naxati 35.
wels mxolod 30 milion adamians
Saqriani diabetis axali SemTxvevebi evropis
hqonda diabeti, 2002 wels ukve 179
zogierT qveyanaSi, 2004
milioni adamiani iyo daavadebuli da
CexeTi
janmrTelobis msoflio organizaciis
532
Evro gaerTaienba
413,9
monacemebiT 2025 wlisaTvis es ricxvi
slovakeTi
387,1
300 milionamde gaizrdeba, xolo 2030
litva
306,3
wels 366 milions miaRwevs da avad
estoneTi
297,3
iqneba mTliani mosaxleobis 6,8%.
fineTi
274,3
diabetiT daavadebulTa 90%-s aqvs
ukraina
195,6
meore tipis diabeti.
latvia
188,3
amJamad ganviTarebul qveynebSi
belorusia
168
diabetis gavrceleba ufro maRalia
ruseTi
167,1
ganviTarebad qveynebTan SedarebiT.
saqarTvelo
165,4
diabetis saerTaSoriso federaciis
dsT
145,2
monacemebiT,
2025
wlisaTvis
somxeTi
112,7
ganviTarebul qveynebSi gaormagdeba
yazaxeTi
106,3
diabetianTa
raodenoba,
xolo
yirgizeTi
63,1
ganviTarebad qveynebSi maTi ricxvi
TurqmeneTi 5,1
gasammagdeba,
es
niSnavs,
rom
0
100 200 300 400 500 600
diabetianTa
76%
icxovrebs
am
qveynebSi. Saqriani diabetiT avadobis
wyaro: monacemTa baza `janmrTeloba yvelasaTvis~,
maCvenebeli evropis regionis zogiwww.who.dk/hfadb
erTi qveynisaTvis mocemulia nax. 35-Si
iseve, rogorc mTlianad evropis regionSi, sadac Saqriani dibetiT 36,6 milioni
mozrdili aris daavadebuli, saqarTveloSic es daavadeba farTodaa gavrcelebuli da
2004 wlis bolos endokrinuli sistemis daavadebebis, kvebis, nivTierebaTa cvlisa da
imunitetis darRvevebis mqone avadmyofTa 39%-s Seadgenda. meTvalyureobaze myofi 50010
avadmyofidan (daavadebianoba – 1144,0) 242 (daavadebianoba – 26,4) bavSvi iyo. pirvelad
dadgenili diagnoziT aRricxuli iyo 7231 (avadoba – 165,4) avadmyofi, maT Soris 55
(avadoba 6,0) bavSvi. Saqriani diabetis socialuri mniSvneloba miT ufro yuradsaRebia,
rom meTvalyureobaze myof avadmyofTa saerTo raodenobidan 28% (13826 avadmyofi)
insulinis momxmarebelia. amasTan erTad bavSvebSi, sadac daavadeba gansakuTrebiT mZimed
mimdinareobs, aRiricxeba 202 (83,5%) insulindamokidebuli pacienti (cxrili 23).
34
2004
cxrili 23.
Saqriani diabetis gavrceleba
2002
2003
abs.
maCveabs.
maCvemniSvn. nebeli mniSvn. nebeli
sul registrirebuli
51889
1187,0
52504
1212,9
m.S. bavSvi
323
35,3
286
33,8
meTvalyureobaze myofi kontingenti
47164
1078,9
48200
1113,4
m.S. bavSvi
257
28,8
228
27,0
insulindamokidebuli
14114
322,9
14279
329,9
m.S. bavSvi
208
22,7
195
23,1
pirvelad dadgenili diagnoziT
5888
134,7
5983
138,2
m.S. bavSvi
76
8,3
40
4,7
2004
abs.
maCvemniSvn. nebeli
56598
1294,7
235
25,6
50010
1144,0
242
26,4
13836
316,3
202
22,0
7231
165,4
55
6,0
ukanasknel wlebSi aranakleb seriozuli problemebi warmoCinda mosaxleobaSi
farisebri jirkvlis paTologiis farTo gavrcelebasTan dakavSirebiT, romelic gascda
saqarTveloSi tradiciulad arsebul ioddeficitis regionebs. 2004 wels CiyviT da
Ciyvis gareSe Tireotoqsikozis diagnoziT registrirebuli iyo 10932 avadmyofi
(daavadebianoba 250,1), farisebri jirkvlis gadidebiTa da dauzustebeli Ciyvis
diagnoziT – 50248 (daavadebianoba – 1149,4), xolo aratoqsikuri kvanZovani Ciyvis
diagnoziT – 7010 (daavadebianoba – 160,4). sicocxleSi pirvelad Ciyvis da Ciyvis gareSe
Tireotoqsikozis diagnozi daudginda 3274 adamians (avadoba – 74,9), farisebri
jirkvlis gadidebisa da dauzustebeli Ciyvis diagnozi – 13597 (avadoba – 311,0),
aratoqsikuri kvanZovani Ciyvis diagnozi – 2299 avadmyofs (avadoba 52,6) (cxrili 22).
registrirebul
avadmyofTa
struqturaSi
bavSvebi
TireotoqsikoziT
daavadebulebs Soris 12,4%-s Seadgendnen, farisebri jirkvlis gadidebiTa da
dauzustebeli CiyviT – 35%-s, xolo aratoqsikuri kvanZovani CiyviT – 9,3%-s. sicocxleSi
pirvelad dadgenili diagnoziT bavSvebze modioda am daavadebebis 11,4%, 31,4% da 5%.
saqarTveloSi 2004 wels farisebri jirkvlis gamosakvlevad samkurnalo
dawesebulebebs mimarTa 64667 adamianma, maT Soris 29701 bavSvma. aRniSnuli
kontingentidan farisebri jirkvlis gadideba aRmoaCnda 28922 (44,7%) adamians, maT
Soris 12507 (42,1%) bavSvs. farisebri jirkvlis gadidebis SemTxvevaTa struqtura
mocemulia nax. 36-ze. gamokvleul pirTa saerTo raodenobidan mkurnaloba daeniSna
20861 adamians, maT Soris 7354 – bavSvs. iodiT profilaqtika Cautarda 22065 adamians,
maT Soris 10447 bavSvs.
naxati 36.
farisebri jirkvlis gadidebis SemTxvevaTa struqtura stadiebis mixedviT
II
24,1%
III
10,6%
Ib
28,7%
Ia
36,6%
endokrinuli sistemis, kvebis, nivTierebaTa cvlis da imunitetis darRvevebis
diagnoziT stacionarebSi mkurnalobda 3343 avadmyofi (letaloba 2,0) da 298 bavSvi (arc
erTi ar gardacvlila). avadmyofTa 67% (2248 SemTxveva) Saqriani diabetis diagnoziT
iyo hospitalizebuli (letaloba 1,5).
35
3.3.4. nervuli sistemis da grZnobaTa organoebis daavadebebi
dResdReobiT fsiqikuri da nervuli sistemis daavadebebiT 450 milioni adamiania
daavadebuli msoflioSi, am daavadebebze modis sikvdilianobis 1% da avadobis
globaluri tvirTis 11%. gamokvlevebma aCvena, rom sicocxlis saSualo xangrZlivobis
zrdisa da ganviTarebul da ganviTarebad qveynebSi mosaxleobis daberebis fonze,
izrdeba bevri qronikuli daavavadeba da progresirebs fizikuri da gonebrivi
darRvevebi, maT Soris nervuli sistemis daavadebebi. winaswari gaTvlebiT, 2020
wlisaTvis
fsiqonevrologiuri sistemis daavadebebiT gamowveuli avadobis
globaluri tvirTi 14,7%-mde gaizrdeba.
2004 wels saqarTveloSi nervuli sistemisa da grZnobaTa organoebis daavadebebiT daavadebianobis maCvenebeli 3289,1 iyo. daavadebebis aRricxul SemTxvevaTa
mniSvnelovani klebis Semdeg daiwyo maCveneblebis mateba da 2004 wels man eqvsjer da
metad gadaaWarba 1995 wlis monacemebs. avadobis maCvenebelma ki 1178,5 Seadgina (nax. 37).
naxati 37.
nervuli sistemis da grZnobaTa organoebis daavadebebis gavrceleba
5000
2855,0
daavadebianoba
avadoba
4000
3000
2220,9
2151,9
2213,4
2639,6
1798,6
1481,1
930,4
2000
1986,2
737,0
632,8
1122,7
515,9
559,0
549,3
1992
1993
459,9
366,7
1994
1995
1996
1997
1998
973,3
721,3
644,9
363,7
341,8
0
1991
805,4
805,2
1000 708,7
3289,1
1999
2000
2001
2002
1043,7 1178,5
2003
2004
2004 wels, wina welTan SedarebiT, aRiniSna nervuli sistemisa da grZnobaTa
organoebis daavadebebiT avadobisa da daavadebianobis maCveneblebis mateba yvela
nozologiur jgufSi, garda fsiqozisa da Wkuasustobis gareSe mimdinare epilefsiiT
avadobisa. nervuli sistemisa da grZnobaTa organoebis daavadebebis gavrcelebas
bavSvebSi, 2001 wels dafiqsirebuli klebis fonze, mesame welia, rac moimata glaukomiT,
kataraqtiTa da axlomxedvelobiT daavadebianobam. rac Seexeba avadobas, aRiniSna
kataraqtiTa da qronikuli otitiT avadobis umniSvnelo kleba (cxrili 24).
cxrili 24.
nervuli sistemis da grZnobaTa organoebis daavadebebis struqtura
2003
daavaavadebidoba
anoba
sul
2004
daavaavadebidoba
anoba
m. S. bavSvebi
2003
2004
daavadaavaavaavadebidebidoba
doba
anoba
anoba
2855,0
39,2
1043,7
5,8
3289,1
43,1
1178,5
9,3
3527,7
184,9
1602,6
24,5
3698,7
179,4
1711,9
31,8
epilefsia fsiqozisa da
Wkuasustobis gareSe
162,9
29,4
169,4
27,3
220,9
38,8
215,4
39,6
periferiuli nervuli sistemis
daavadebebi
606,2
231,3
684,7
296,6
204,4
75,7
198,8
83,8
glaukoma
114,9
31,6
140,2
38,5
5,6
1,9
6,3
2,2
kataraqta
301,5
106,7
376,0
114,5
16,8
6,5
19,0
4,7
axlomxedveloba
qronikuli otiti
307,6
95,0
384,4
126,2
411,0
120,3
523,2
187,2
219,5
103,4
241,8
116,7
457,2
304,9
429,6
285,5
sul
bavSvTa cerebruli dambla
36
2004
2004 wels nervuli sistemisa da grZnobaTa organoebis daavadebaTa sixSire
qveynis saSualo maCvenebelze maRali iyo Tbilissa (avadoba – 1714,9) da Sida qarTlSi
(1627,8) (cxrili 25).
cxrili 25.
nervuli sistemis da grZnobaTa organoebiT avadobis maCveneblebi
sul
2003
m.S. bavSvebi
sul
2004
m.S. bavSvebi
Tbilisi
1924,4
3511,0
1714,9
3701,0
aWara
429,5
521,3
596,5
484,8
guria
613,7
1931,7
991,2
2622,6
raWa-leCxumi
837,9
767,7
992,8
1364,0
samegrelo
493,8
580,2
612,3
695,8
imereTi
512,7
611,2
776,2
983,6
kaxeTi
615,5
526,0
681,0
630,7
mcxeTa-mTianeTi
650,3
409,1
837,8
605,1
samcxe-javaxeTi
541,1
236,3
448,9
168,9
qvemo qarTli
358,1
534,3
475,5
690,9
Sida qarTli
saqarTvelo
1237,1
3125,2
1627,8
3266,7
1043,7
1602,6
1178,5
1711,9
2004 wels saqarTveloSi nervuli sistemisa da grZnobaTa organoebis
daavadebaTa diagnoziT stacionarebidan gavida 10629 avadmyofi (maCvenebeli – 243,1),
letaloba – 1,3. stacionaridan gasuli 2708 bavSvia (maCvenebeli – 295,7), letaloba 1,14.
bavSvTa cerebruli damblis diagnoziT stacionarebSi mkurnalobda 1 wlamde asakis 27
bavSvi da periferiuli nervuli sistemis daavadebebiT - 179 bavSvi. hospitalizebul
avadmyofTa saerTo raodenobis 61,3% mkurnalobda TbilisSi (cxrili 26).
cxrili 26.
nervuli sistemis da grZnobaTa organoebis daavadebebis diagnoziT
stacionarebidan gasuli avadmyofebi
sul
stacionaridan gavida
letaloba
sul
maCvenebeli
m.S. bavSvebi
stacionaridan gavida
sul
maCvenebeli
letaloba
Tbilisi
6515
602.3
1640
779.0
1.8
1.65
aWara
1374
365.4
223
246.8
0.7
0
guria
95
66.3
63
223.0
0.0
0
raWa-leCxumi
23
45.1
3
35.9
4.4
0
samegrelo
469
100.6
71
76.2
0.2
1.4
imereTi
993
141.9
397
292.1
0.5
0.8
kaxeTi
473
116.2
119
140.3
0.0
0
mcxeTa-mTianeTi
0
0.0
0
0.0
0.0
0
samcxe-javaxeTi
128
61.7
33
67.1
0.8
0
qvemo qarTli
147
29.5
73
60.5
0.7
0
Sida qarTli
149
47.4
86
125.6
2.0
0
sxva uwyeba
saqarTvelo
263
-
0
-
0,4
0
10629
243.1
2708
295.7
1.3
1.14
37
2004 wels nervuli sistemisa da grZnobaTa organoebze Catarda 1932 operacia,
(maCvenebeli 42,2; letaloba 4,7), maT Soris Tavis tvinze gakeTda 871 (maCvenebeli 19,9)
operacia, letaloba 9,3 (nax. 38). Tavis tvinze operaciebis 75% gakeTda TbilisSi; 10,3%
imereTSi, 6,1% - sxva uwyebebSi; 5,6% - aWaraSi. mxedvelobis organoebze gakeTebulia 5077
operacia. kataraqtis gamo operacia gaukeTda 3100 avadmyofs, rac mxedvelobis organoebze
gakeTebuli operaciebis 61%-s Seadgens (nax. 39).
naxati 38.
nervuli sistemisa da grZnobaTa organoebze
Catarebuli qirurgiuli operaciebi
278
periferiul nervul
sistemaze
617
562
871
993
822
Tavis tvinze
2004
2003
kataraqta
2002
enukleacia
sul
1563
500
1000
3100
2943
2216
1500
2000
2004
2003
126
121
173
728
735
544
glaukoma
1932
1932
0
naxati 39.
mxedvelobis organoebze Catarebuli
qirurgiuli operaciebi
2002
5077
sul
4829
4211
0
1000
2000
3000 4000
5000 6000
7000
3.3.5. sisxlis mimoqcevis sistemis daavadebebi
6494,8
5776,8
1616,1
5322,4
1481,7
4838,1
1299,6
1297,3
4257,4
999
3527,1
1029,2
3221,3
1000,6
3124,1
523,7
323,6
4524,7
janmrTelobis msoflio organizaciis monacemebiT, sisxlis mimoqcevis sistemis
daavadebebi pirvel adgilzea avadobis tvirTis Sefasebisas evropis regionSi, rac
marTebulia saqarTvelos SemTxvevaSic. msoflios mosaxleobis avadobis struqturaSi
gulsisxlZarRvTa daavadebebs wamyvani adgili ekava, kerZod, 1,2 miliardi, anu
mosaxleobis 20% aris daavadebuli, aseve maRalia am daavadebebis gavrceleba evropaSi
- mosaxleobis daaxloebiT 25%.
saqarTveloSi 2004 wels sisxlis mimoqcevis sistemis daavadebebis diagnoziT
registrirebuli iyo 283921 avadmyofi (2003 wels - 250072), daavadebianobis maCvenebelma
Seadgina 6494,8 (2003 wels – 5776,8), maT Soris 6473 bavSvi iyo (maCvenebeli 706,9). sicocnaxati 40. xleSi pirvelad dadgenili diagnoziT
registrirebul iqna 70648 pacienti (2003
sisxlis mimoqcevis sistemis daavadebaTa
wels – 64140), avadobis maCvenebeli – 1616,1
gavrceleba
(2003 wels - 1481,7), maT Soris bavSvebi – 1614.
avadoba
daavadebianoba
sisxlis mimoqcevis sistemis daavadebebis gavrcelebis dinamikis analizi
7000
cxadyofs, rom Tu 1996 wlamde aRiniSne6000
boda avadmyofTa raodenobis Semcirebis
5000
tendencia,
1997
wlidan
is
Seicvala
4000
daavadebulTa
raodenobis
matebiT,
rac
3000
registraciis gaumjobesebasa da Sesabamisi
2000
saxelmwifo programebis amoqmedebasTan
1000
unda iyos dakavSirebuli. 2004 wels, wina
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
welTan
SedarebiT,
aRiniSna
rogorc
daavadebianobis,
ise
avadobis
maCveneblebis
mateba (nax. 40).
38
2004
24,9%
25,6%
24,4%
26,8%
23,5%
22,7%
16,3%
10,4%
10,3%
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
11,1%
28,4%
naxati 41.
2004 wels sicocxleSi pirvelad
sisxlis mimoqcevis sistemis avadobis
dadgenili diagnoziT aRricxul avadmyofTa
xvedriTi wili registrirebul
raodenobam wina welTan SedarebiT, moimata
kontingentSi
da mTlianad registrirebul avadmyofTa
40%
24,9% Seadgina, Tumca 1993-1996 wlebSi es
35%
maCvenebeli 9-11%-is farglebSi meryeobda
30%
25%
(nax. 41).
20%
gulsisxlZarRvTa
registrirebuli
15%
daavadebebis struqturaSi 47,8% ukavia
10%
hipertonul, 30,1% - gulis iSemiur, 5,4% 5%
0%
revmatiul da 4,5% Tavis tvinis vaskularul
daavadebebs. TiTqmis aseTivea sicocxleSi
pirvelad
gamovlenil
daavadebaTa
struqturac. amave dros, bavSvebSi umetes wyaro: janmrTelobis dacva, saqarTvelo,
nawils gulis revmatiuli daavadebebi 2004, statistikuri cnobari.
Seadgens (daavadebianoba – 33,5%, avadoba
32,8%).
naxati 42.
90-iani wlebis dasawyisSi qveynis
kardioqirurgiuli
operaciebis
raodenoba
mosaxleoba da, pirvel rigSi bavSvebi,
faqtobrivad kardioqirurgiuli daxmarebis
2004
gareSe darCa. saerTaSoriso organizaciebis
m.S.
Ria
2003
xelSewyobiT
moxerxda
sakiTxis
gulze
2002
nawilobrivi
gadawyveta.
ganviTarda
2001
medicinis
iseTi
maRalteqnologiuri
dargebi,
rogoricaa
bavSvTa
sul
kardioqirurgia, gulis iSemiuri daavadebis
diagnostikisa da mkurnalobis invaziuri
meTodebis gamoyeneba.
0
200
400
600
800
2004
wels
saqarTveloSi
gulze
gakeTda 739 operacia (letaloba 3,1). Ria wyaro: janmrTelobis dacva, saqarTvelo, 2003,
gulze Catarda 142 operacia, maT Soris 131 statistikuri cnobari.
kardiostimulatoris implantacia da 184
endovaskuluri balonuri dilatacia. sisxlZarRvebze Catarda 1359 operacia (letaloba
– 3,2) (nax. 42).
marTalia, qveyanaSi arsebuli maRalkvalificiuri kadrebi da Sesabamisi
simZlavreebi
operaciaTa
ricxvis
gazrdis
saSualebas
iZleva,
programebis
dafinansebasTan dakavSirebuli siZneleebis gamo ver xerxdeba kardio-qirurgiuli
aqtivobis mniSvnelovani gazrda, maSin rodesac sayovelTaod cnobilia, Tu ramdenad
aumjobesebs gulis iSemiuri daavadebis mimdinareobas qirurgiuli mkurnalobis
meTodebi.
gulis iSemiuri daavadebis axlad gamovlenili SemTxvevebis 2,4% gulis mwvave
infarqtia, xolo 8,7% - stenokardia.
stacionarebSi miokardiumis mwvave infarqtis diagnoziT Semosuli 3608
avadmyofidan daavadebis dawyebis pirvel 24 saaTSi, rodesac saeqimo dakvirvebas da
saTanado specializebul mkurnalobas gadamwyveti mniSvneloba aqvs, Semovida mxolod
1626 (45,1%) avadmyofi.
saqarTvelos stacionarebSi sisxlis mimoqcevis sistemis daavadebebis diagnoziT
mkurnalobda 27740 avadmyofi (letaloba 6,0%), aqedan 925 bavSvia (letaloba 5,0%).
sisxlis mimoqcevis sistemis daavadebebis maCveneblebi momatebulia yvela
nozologiis mixedviT, garda avadobis maCveneblisa stenokardiisa da gulis iSemiuri
daavadebebis dros (cxrili 27).
39
cxrili 27.
sisxlis mimoqcevis sistemis daavadebebis gavrceleba
1997
1998
1999
2000
2001
2002
2003
2004
m.S. pirvelad dadgenili diagnoziT
3221,3
523,7
3527,1
1000,6
4524,7
1029,2
4257,4
999,0
4838,1
1297,3
5322,4
1299,6
5776,8
1481,7
6494,8
1616,1
gulis revmatiuli daavadebebi
349,1
57,2
321,5
62,6
335,6
65,8
332,7
70,6
341,2
73,4
356,3
73,6
358,8
68,9
350,6
76,0
hipertenzia – sul
1189,1
180,7
1422,1
380,7
1872,4
429,8
1853,5
412,0
2158,9
535,6
2410,4
569,9
2730,6
686,4
3108,2
801,9
gulis iSemiuri daavadeba - sul
1089,5
167,8
1219,7
385,9
1536,6
300,8
1392,2
289,3
1602,6
432,9
1760,8
400,1
1875,7
441,0
1955,1
449,8
mwvave infarqti
75,9
18,1
54,6
16,7
89,3
22,0
54,8
20,6
55,9
22,4
70,9
35,1
69,8
32,0
75,8
39,6
stenokardia
209,1
48,8
369,4
157,0
473,4
108,1
415,3
95,2
488,0
122,0
519,6
117,8
560,0
125,5
575,9
140,0
155,9
11,4
138,0
16,7
124,0
36,2
215,9
82,2
216,1
87,4
235,6
82,8
244,2
91,3
189,9
107,8
daavadebebis dasaxeleba
Tavis tvinis vaskularuli daavadebebi
ukanasknel
wlebSi
gansakuTrebiT
sagangaSoa
arteriuli
hipertenziis
gavrcelebis maCvenebelis gamudmebiT mateba, rac qveynis mosaxleobisaTvis SedarebiT
axali risk-faqtorebis (siRaribe, kvebiTi reJimis darRvevebi, Tambaqosa da alkoholis
moxmarebis zrda, stresuli mdgomareobebis momravleba da sxv.) wina planze wamoweviT
unda yofiliyo ganpirobebuli (nax. 43).
naxati 43.
arteriuli hipertenziis gavrcelebis dinamika
daavadebianoba
3500
avadoba
2730,6
3000
2410,4
2158,9
2500
1872,4
2000
1500
3108,2
1853,5
1422,1
1214,4 1189,1
1000
500
0 110,1
1996
180,7
380,7
429,8
1997
1998
1999
412
2000
536,6
2001
569,9
2002
686,4
2003
801,9
2004
2004 wels qveynis masStabiT sisxlis mimoqcevis daavadebaTa matebis fonze
daavadebianobis maCvenebelma moiklo aWaraSi. rac Seexeba avadobis maCveneblebs, is
wina welTan SedarebiT yvela regionSi aris momatebuli (cxrili 28).
40
2004
cxrili 28.
sisxlis mimoqcevis sistemis daavadebebi regionebis mixedviT
mxare
2003
daavadebianoba
2004
daavadebianoba
avadoba
9086,7
Tbilisi
7765,8
224,1
2496,4
aWara
2116,6
701,3
5101,9
guria
4769,9
1109,8
22019,3
raWa-leCxumi
20978,3
2626,5
5337,5
samegrelo
4947,6
1123,7
5614,3
imereTi
4603,9
1223,5
6001,0
kaxeTi
5965,5
1184,1
5020,6
mcxeTa-mTianeTi
4654,3
1369,9
4880,1
samcxe-javaxeTi
4581,9
1217,3
2920,6
qvemo qarTli
2416,3
615,0
3790,3
Sida qarTli
2864,9
922,5
6494,8
saqarTvelo
5776,8
1481,7
avadoba
1688,6
1077,9
1477,4
2515,8
1199,3
1902,6
1305,1
1318,5
1582,4
809,0
1297,0
1616,1
3.3.6. sasunTqi organoebis daavadebebi
5387,9
7022,3
5453,8
7027,6
4306,1
5966,1
3532,7
5083,7
4848,1
3382,8
3291,8
4662,7
2526,5
3562,2
2380,1
3607,2
3063,6
4206,3
msoflioSi yoveldRiurad asobiT adamiani itanjeba sasunTqi sistemis
daavadebebiT. dResdReobiT 300 milion adamians aqvs asTma, 80 milioni adamiania avad
filtvis
qronikuli
obstruqciuli
naxati 44.
daavadebis mZime formiT, milioniobiT
sasunTq organoTa daavadebebis gavrceleba
adamians awuxebs qronikuli riniti da
sasunTqi sistemis dauzustebeli qronikuli
avadoba
8000
daavadebebi. janmos monacemebiT 2004 wels 4
daavadebianoba
7000
milionamde
adamiani
gardaicvala
6000
qronikuli respiratoruli daavadebebiT da
5000
uaxloes 10 weliwadSi es ricxvi 30%-iT
4000
gaizrdeba.
3000
2004 wels sasunTqi organoebis daava2000
debebis diagnoziT registrirebuli iyo
1000
0
306984 SemTxveva (2003 wels – 304217),
1996 1997 1998 1999 2000 2001 2002 2003 2004
daavadebianobis maCvenebeli – 7022,3 (2003
wels – 7027,6), maT Soris sicocxleSi
pirvelad dadgenili diagnoziT 235532 (77%) wyaro: janmrTelobis dacva, saqarTvelo, 2004,
(2003 wels – 236091), avadobis maCvenebeli – statistikuri cnobari.
5387,9 (2003 wels – 5453,8) (nax. 44).
15 wlamde asakis bavSvebSi registrirebuli iyo sasunTqi organoebis
daavadebebis 161811 SemTxveva (daavadebianobis maCvenebeli – 17666,0), maT Soris
sicocxleSi pirvelad dadgenili diagnoziT - 139364 (avadobis maCvenebeli – 15215,3).
2004 wels, wina welTan SedarebiT, aRiniSneba sasunTqi organoebis daavadebebiT
gamowveuli daavadebianobisa da avadobis maCveneblebis umniSvnelo kleba, Tumca 2003
welTan SedarebiT, maRalia am daavadebebis registrirebuli SemTxvevebi (cxrili 29).
41
cxrili 29.
sasunTqi organoebis daavadebebis gavrceleba
2003
2004
m.S. bavSvebi
sasunTqi organoebis daavadebebi - sul
sicocxleSi pirvelad dadgenili
diagnoziT
qronikuli faringiti, nazofaringiti,
sinusiti
diagnoziT
nuSisebri jirkvlis da danamatebis
qronikuli daavadeba
diagnoziT
polinozi
diagnoziT
pnevmonia - sul
diagnoziT
qr. da dauzust. bronqiti, emfizema
diagnoziT
bronquli asTma
diagnoziT
filtvis sxva qronik. obstruqciuli
daavadebebi
diagnoziT
danarCeni respir. daavadebebi
diagnoziT
sul
maCvenebeli
sul
maCvenebeli
304217
7027,6
157730
236091
5453,8
17615
m.S. bavSvebi
sul
maCvenebeli
sul
maCvenebeli
18655,2
306984
7022,3
161811
17666,0
137155
16221,8
235532
5387,9
139364
15215,3
406,9
4874
576,5
21553
493,3
7322
799,4
7394
170,8
1998
236,3
10053
229,0
3632
396,5
19908
459,9
10701
1265,6
22781
521,1
12679
1384,3
8032
185,5
4308
509,5
9010
206,1
4993
545,1
7235
167,1
2158
255,2
7983
182,6
2664
290,9
2597
60,0
789
93,3
3837
87,8
1453
158,6
22988
531,0
7732
914,5
21790
498,4
7272
793,9
15094
348,7
5204
615,5
15650
358,0
5227
576,1
17006
392,8
2933
346,9
17422
398,5
2808
306,6
6790
156,9
1394
164,9
6379
145,9
1215
132,7
12875
297,4
1873
221,5
13949
319,9
2180
238,1
2926
67,6
445
51,6
3273
74,8
668
72,9
3650
84,3
400
47,3
3904
89,3
826
90,2
1352
31,2
243
28,7
1440
32,9
474
51,8
46759
1080,2
22174
2622,6
54332
1242,9
28790
3143,2
38338
885,6
19080
2256,7
45669
1044,7
25721
2808,1
2004 wels sasunTqi organoebis daavadebebis struqturaSi wamyvani adgili ekava
tonzilitebs
(7,4%),
pnevmonias
(7,1%),
qronikul faringitebs, nazofaringits da
qr.
sinusits (7%) da qronikul da dauzustebel
faringitebi
pnevmonia
bronqitebsa da emfizemas (5,7%) (nax. 45).
7,0%
7,1%
tonziliti
sicocxleSi
pirvelad
dadgenili
7,4%
bronqiti da
diagnoziT
sasunTqi
organoebis
emfizema
5,7%
daavadebebis struqtura gansxvavdeba sul
registrirebul
daavadebaTa
struqtubronquli
asTma
risagan.
pirvelad
dadgenili
faringitebi,
filtvisa da
sxva sasunTq
alergiuli
4,5%
nazofaringitebi da sinusitebi – 4,3%-s,
sxva
organoTa
surdo
qronikuli
daavadebebi
nuSisebri jirkvlebisa da adenoidebis
2,6%
daavadebebi
64,4%
qronikuli daavadebebi – 3,8%-s, alergiuli
1,3%
surdo – 1,6%-s, pnevmonia – 6,6%-s,
qronikuli da dauzustebeli bronqitebi da
2004, statistikuri cnobari, Tbilisi, 2005.
emfizema – 2,7%-s, bronquli asTma 1,4%-s,
filtvis sxva qronikuli da obstruqciuli
daavadebebi – 0,6%-s da sasunTi organoebis sxva daavadebebi 78,9%-s (sasunTq organoTa
mwvave infeqciebis CaTvliT) Seadgenen.
sasunTqi organoebis daavadebebis diagnoziT saqarTvelos stacionarebSi
mkurnalobda 38395 avadmyofi (maCvenebeli – 878,3, letaloba – 0,7%), aqedan 26552 bavSvi
naxati 45.
sasunTqi organoebis daavadebebis
struqtura
42
2004
(maCvenebeli – 2755,9, letaloba 0,3%), maT Soris, erT wlamde asakis – 7627 (maCvenebeli
– 16748,3, letaloba 0,6%).
regionebis mixedviT sasunTqi organoebis axlad registrirebuli SemTxvevebis
raodenoba qveynis saSualo maCvenebelze (5387,9) maRali iyo TbilisSi (avadoba –
11086,4), guriaSi (avadoba – 7108,8) da Sida qarTlSi (avadoba – 1194,0), xolo dabali qvemo qarTlsa (1433,1) da samcxe-javaxeTSi (1460,0). daavadebianobis maRali maCveneblebi
iyo TbilisSi, xolo dabali qvemo qarTlsa da aWaraSi da a.S. (cxrili 30).
cxrili 30.
sasunTqi organoTebis daavadebebis gavrceleba regionebis mixedviT
2004
2003
daavadebianoba
avadoba
daavadebianoba
avadoba
sul
bavSvebi
sul
bavSvebi
sul
bavSvebi
sul
bavSvebi
Tbilisi
13524,1 43995,7 12927,5 43112,8
11833,9 40153,6 11086,4
38696,9
aWara
3015,8
7275,1
2036,0
5668,5
2665,3
4332,1
1694,9
3064,8
guria
7012,7
17640,3
5477,8
15201,4
8640,7 20025,5 7108,8
17838,2
raWa-leCxumi
6673,9
8313,1
2978,3
5030,3
6058,6
8554,7
2738,9
5037,1
imereTi
3868,4
7702,9
2345,6
5032,5
4213,9
8543,9
2660,3
5787,4
kaxeTi
4610,5
9071,2
3167,0
7212,2
5244,1 10373,6 3734,4
8674,7
samegrelo
3583,0
6404,6
1593,6
3134,9
4216,0
7665,1
2143,1
4397,9
mcxeTa-mTianeTi
4585,0
9789,3
3497,2
8223,1
4362,9
8356,1
3097,0
6772,0
samcxe-javaxeTi
3274,2
4014,9
1286,8
1542,3
3315,1
3426,2
1433,1
1428,3
qvemo qarTli
2406,4
6278,6
1418,2
4286,9
2622,2
5058,6
1460,0
3616,3
Sida qarTli
6051,5
1995,1
5107,8
17945,6
7353,9 22671,5 6337,7
20852,0
saqarTvelo
7027,6
18655,2
5453,8
16221,8
7022,3 17666,0 5387,9
15215,3
pnevmoniis diagnoziT registrirebulia 21790 SemTxveva (daavadebianoba – 498,4),
maT Soris sicocxleSi pirvelad dadgenili diagnoziT aRricxulia 15650 SemTxveva
(avadoba – 358,0). bavSvebSi pnevmoniis diagnoziT registirebulia 7272 SemTxveva
(daavadebianoba – 793,9); pirvelad dadgenili diagnoziT – 5227 (avadoba – 576,1) (nax. 46).
pnevmoniis diagnoziT stacionarSi gatarebul iqna 9757 avadmyofi (maCvenebeli – 223,2),
maT Soris 6508 bavSvi, rac avadmyofTa saerTo raodenobis 66,7% iyo. letalobam,
Sesabamisad, 0,7% da 0,3% Seadgina. stacionarSi gatarebul bavSvTa saerTo
raodenobidan 7627 iyo erT wlamde asakis (letaloba - 0,6).
asTma jandacvis seriozul problemas warmoadgens mTel msoflioSi, mas
nacionaluri epidemiac ki uwodes. igi iSviaTad klavs, magram xangrZlivi droiT
aavadebs uamrav adamians. msoflioSi dReisaTvis asTmiT daavadebulia mTliani
populaciis 5%.
naxati 46.
pnevmoniiT avadobis dinamika
576,1
2004
615,5
348,7
622,6
2002
327,3
518,7
2001
404,5
387,8
342,9
1998
100
200
53,7
62,8
56,1
56,9
400
500
600
700
bavSvi
49,7
46,1
1998
300
62,7
47,1
sul
152,2
0
2002
1999
bavSvi
220,6
67,6
67
64,8
2000
230,4
1999
52,5
2003
2001
282
2000
72,9
74,8
2004
358
2003
naxati 47.
bronquli asTmiT avadobis dinamika
0
10
20
30
40
50
sul
60
70
80
43
2004 wels saqarTveloSi bronquli asTmis diagnoziT registrirebuli iyo 13949
avadmyofi (daavadebianobis maCvenebeli – 319,9). asTmis diagnozi sicocxleSi pirvelad
daudginda 3273 avadmyofs (avadobis maCvenebeli – 74,8). bavSvebSi bronquli asTmis
diagnoziT regitrirebuli iyo 2180 (daavadebianoba – 238,1); maT Soris sicocxleSi
pirvelad dadgenili diagnoziT - 668 (avadoba – 72,9). ukanasknel eqvs weliwadSi
bronquli asTmiT avadobis dinamika mocemulia nax. 47-ze. bronquli asTmis diagnoziT
stacionarSi gatarebuli iyo 1560 avadmyofi (maCvenebeli 35,7, letaloba 0,7%), maT
Soris 373 bavSvi.
bronquli asTmis oficialurad registrirebuli maCveneblebis SedarebiT dabali
sidide, samwuxarod, ar asaxavs qveyanaSi Seqmnil realur mdgomareobas. amas mowmobs
bavSvTa Soris asTmisa da alergiis gavrcelebis Seswavlis saerTaSoriso programis
(ISAAC) I da II fazis farglebSi Catarebuli epidemiologiuri kvlevis Sedegad
miRebuli monacemebi, romlebic 10-15-jer maRalia oficialur statistikur monacemebze.
3.3.7. saWmlis momnelebeli sistemis daavadebebi
2004 wels saWmlis momnelebeli
sistemis daavadebebis diagnoziT registrirebuli iyo 113272 avadmyofi (daavadebianoba 100000 mosaxleze – 2591,1),
882,7
sicocxleSi pirvelad dadgenili diag2004
958,1
noziT aRricxulia 41885 avadmyofi (avadoba
805,8
2003
918,5
- 958,1).
1112,8
2002
registrirebuli SemTxvevebidan – 13398
832,2
785,9
bavSvi
bavSvebSia aRricxuli (daavadebianoba –
2001
902,7
1462,8); aqedan 8085 SemTxveva sicocxleSi
sul
654,6
2000
628,9
pirvelad dadgenili diagnozia (avadoba –
633,7
1999
882,7) (nax. 48).
899,4
1031,7
1988-2004 wlebSi saWmlis momne1998
863,1
lebeli sistemis daavadebebis maCveneblebs
0
200
400
600
800
1000 1200
gadaxris
didi
amplituda
axasiaTebs.
avadobis
maCvenebeli,
rogorc
mTel
mosaxleobaSi, aseve bavSvebSi ori pikiT
(1990 weli da 1994 weli) xasiaTdeba. 1995
wlidan saWmlis momnelebeli sistemis
daavadebaTa sicocxleSi pirvelad dadgenili diagnoziT aRricxuli SemTxvevebi iwyebs
klebas da 2000 wlisaTvis minimalur mniSvnelobas aRwevs, Tumca 2001 wlidan kvlav
daiwyo maCveneblebis mateba.
2003 wels dawyebuli klebis fonze kvlav dafiqsirda saWmlis momnelebeli
sistemis daavadebaTa sicocxleSi pirvelad dadgenili SemTxvevebis raodenobis mateba
bavSvebSi. saWmlis momnelebeli sistemis daavadebebiT daavadebianobis maCvenebeli
nozologiebis mixedviT maRalia naRvlis buStis kenWovani daavadebebiT da
qolecistitiT (daavadebianoba – 882,0) da gastritiT da duodenitiT daavadebulebSi
(daavadebianoba – 679,3), xolo yvelaze dabali maCvenebeli - kuWukana jirkvlis
daavadebebis SemTxvevaSi (daavadebianoba – 30,5) (cxrili 31).
naxati 48.
saWmlis momnelebeli sistemis
avadobis dinamika
44
2004
cxrili 31.
saWmlis momnelebeli sistemis daavadebebis gavrceleba zogierTi nozologiis mixedviT
sul
daavadebianoba
100000 mosaxlezze
m.S bavSvebSi
daavadebianoba
100000 bavSvze
kuWisa da Tormetgoja
nawlavis wyluli
18272
418,0
286
31,2
gastriti, duodeniti
29697
679,3
2688
293,5
38557
882,0
3307
361,1
1332
30,5
25
2,7
113272
2591,1
13398
1462,8
naRvlis buStis kenWovani
daavadebebi qolecistiti,
qolangiti
kuWukana jirkvlis
daavadebebi
sul
saWmlis momnelebeli sistemis daavadebebiT avadobis maCvenebelma 2004 wels, 2003
welTan SedarebiT, moimata yvela regionSi kaxeTis, raWa-leCxumisa da samegrelos
garda (cxrili 32).
cxrili 32.
saWmlis momnelebeli sistemis daavadebebiT avadobis maCveneblebi regionebis mixedviT
2003
sul
m.S. bavSvebSi
sul
sul
avadoba
sul
avadoba
sul
avadoba
Tbilisi
14883
1389,5
2157
1031,1
15534
1436,1
aWara
1679
451,0
270
371,4
1931
513,5
guria
1293
909,9
511
1838,1
1960
1367,2
raWa-leCxumi
473
934,8
85
858,6
295
578,8
samegrelo
4149
1030,6
452
575,1
3832
822,1
imereTi
4185
603,9
933
684,5
5567
795,7
kaxeTi
3145
780,2
606
770,0
2824
693,5
mcxeTa-mTianeTi
670
539,9
103
425,6
789
629,0
samcxe-javaxeTi
1134
551,3
25
62,2
1305
628,6
qvemo qarTli
1440
292,3
162
168,4
1584
318,4
Sida qarTli
1740
559,7
531
874,8
1853
590,1
saqarTvelo
39759
918,5
6813
805,8
41885
958,1
2004
m.S. bavSvebSi
sul
avadoba
3240
1538,9
372
411,7
650
2300,6
74
885,4
516
554,0
836
615,0
682
804,0
122
470,2
31
63,1
208
172,5
543
793,0
8085
882,7
2004 wels saqarTvelos stacionarebSi saWmlis momnelebeli sistemis
daavadebebis diagnoziT mkurnalobda 26269 avadmyofi, maT Soris 3909 bavSvi (15%).
letalobam sul Seadgina 1,6; xolo 0-14 wlamde asakis bavSvebSi – 0,3.
avadmyofTa saerTo raodenobidan umravlesoba (38%) mkurnalobda Tbilisis
stacionarebSi; imereTSi – 14,6%; qvemo qarTlSi – 8%; aWaraSi – 7,5%; Sida qarTlSi –
6%; danarCeni 26% ganawilda saqarTvelos sxva regionebSi.
saWmlis momnelebeli davadebebis 34% naRvlis buStis kenWovani daavadebebiT,
qolecistitiTa da qolangitiT daavadebulebze modis da am nozologiiT daavadebianoba
da avadoba ganuxrelad izrdeba 2000 wlidan. 2004 wels naRvlis buStis kenWovani
daavadebebiT, qolecistitiTa da qolangitiT hospitalizebul iqna 3377 avadmyofi
(maCvenebeli 77,2), aqedan 72 bavSvi (maCvenebeli 7,9) (nax. 49).
45
naxati 49.
naRvlis buStis kenWovani daavadebebis, qolecistitis, qolangitis gavrceleba
daavadebianoba
1000
avadoba
800
737,5
624,7
618,0
600
882,0
842,6
774,9
698,2
513,6
400
200
166,3
184,2
237,8
141,4
207,8
245,6
175,3
1999
2000
2001
2002
2003
2004
73,1
0
1997
1998
3.3.8. Sardsasqeso sistemis daavadebebi
2004 wels ambulatorul-poliklinikur dawesebulebebSi registrirebuli iyo
Sardsasqeso sistemis daavadebebis 69913 SemTxveva (daavadebianoba – 1599,3), maT Soris
6895 bavSvebSi (daavadebianoba – 752,8). sicocxleSi pirvelad dadgenili diagnoziT
aRiricxa 31485 SemTxveva (avadoba – 720,2), maT Soris 4671 bavSvi (avadoba – 510,0).
1989-1996 wlebSi Sardsasqeso sistemis daavadebebis aRricxuli SemTxvevebis ricxvma
2-jer iklo da, Sesabamisad, daavadebianobis maCvenebeli 1768,4-dan – 787,6-mde Semcirda,
rac aRricxvianobis sistemis moSlasTan unda yofiliyo dakavSirebuli. 1999 wels, wina
welTan SedarebiT, dafiqsirda avadmyofTa ricxvis 29,2%-iani mateba, rasac 2000 wels
mohyva rogorc daavadebianobis, ise avadobis maCveneblebis garkveuli kleba. 20012004 wlebSi dafiqsirda rogorc daavadebianobis, ise avadobis maCveneblebis
umniSvnelo mateba (nax. 50). registirebul avadmyofTa saerTo raodenobidan 45%-s
sicocxleSi pirvelad daudginda diagnozi.
naxati 50.
Sardsasqeso sistemis daavadebebis gavrceleba
daavadebianoba
2500
avadoba
1389,0
1200,0
2000
1500
787,6
822,3
1599,3
1245,9
938,3
1348,4
828,8
1158,4
1000
500
304,7
720,2
571,9
476,9
351,2
296,8
623,7
569,2
529,5
286,9
0
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
avadobis maCvenebeli Semcirda Semdeg daavadebebSi:
sindromi, nefrozi, mamakacTa unayofoba (cxrili 33).
nefriti,
nefrozuli
46
2004
cxrili 33.
Sardsasqeso sistemis daavadebaTa struqtura
abs. mniSvneloba
2003
maCvenebeli
2004
sul
27001
31485
nefriti, nefrozuli sindromi, nefrozi
2176
3033
Tirkmlis infeqciebi
3053
4226
Tirkmlebis da SardsawveTis kenWebi
2025
2784
winamdebare jirkvlis daavadebebi
1461
1841
mamakacTa unayofoba
102
227
salfingiti, ooforiti
2078
2505
endometriozi
509
557
saSvilosnos yelis erozia da eqtropioni
2389
2708
menstrualuri ciklis darRveva
2142
2488
qalTa unayofoba
945
1075
2003
2004
623,7
50,3
70,5
46,8
71,4
12,9
91,0
22,3
104,6
183,6
81,0
720,2
69,4
96,7
63,7
89,3
19,6
108,4
24,1
117,2
214,4
92,6
2004 wels Sardsasqeso sistemis daavadebebiT daavadebianoba qveynis saSualo
maCvenebelze maRali iyo raWa-leCxumSi (2646,7) da samegreloSi (1669,8). rac Seexeba
avadobis maCveneblebs, is maRali iyo guriasa (873,3) da samegreloSi (cxrili 34).
cxrili 34.
Sardsasqeso sistemis daavadebebis maCveneblebi regionebis mixedviT
daavadebianoba
2003
2004
avadoba
2003
2004
1033,4
1342.9
565,2
519.3
1220,8
1571.2
513,3
831.1
1089,4
1545.8
446,9
873.3
2642,3
2646.7
670,0
496,4
1511,9
1669.8
589,9
728.8
1173,4
1273.2
525,1
581.4
1031,5
1127.5
393,7
466.9
645,4
868.9
266,7
519,8
1410,8
1459.6
526,0
633.4
968,0
1162.3
434,2
503.7
796,4
1109.1
530,7
690.0
1389,0
1599,3
623,7
720,2
Tbilisi
aWara
guria
samegrelo
imereTi
kaxeTi
mcxeTa-mTianeTi
samcxe-javaxeTi
qvemo qarTli
Sida qarTli
saqarTvelo
Sardsasqeso sistemis daavadebaTa registrirebul struqturaSi yvelaze xSirad
gvxvdeboda: Tirkmlis infeqciebi (13,4%), nefriti, nefrozuli sindromi da nefrozi
(9,6%), saSvilosnos yelis erozia da eqtropioni 8,6%), salpingiti da ooforiti (8%),
Tirkmlisa da SardsawveTis kenWebi (8,8%), menstrualuri ciklis darRveva (7,9%),
winamdebare jirkvlis daavadebebi (5,8%) da a.S. (nax. 51).
47
naxati 51.
Sardsasqeso sistemis daavadebebis struqtura
Tirkmlis
infeqciebi; 13,4%
nefriti,
nefrozi; 9,6%
sxva; 31,9%
saSvilosnos
yelis erozia;
8,6%
mamakacTa
unayofoba; 0,8%
endometriozi;
1,8%
salpingiti,
ooforiti; 8,0%
qalis unayofoba;
3,4%
prostatis
kenWovani
daavadebebi; 5,8% daavadebebi; 8,8%
menstrualuri
ciklis darRveva;
7,9%
2004 wels saqarTveloSi Sardsasqeso sistemis daavadebebis diagnoziT
stacionarebidan gaewera 9207 avadmyofi, gardaicvala 92 (letaloba – 1,0). gaweril
avadmyofTa saerTo raodenobidan 1172 bavSvia.
stacionarebidan nefritis da nefrozis diagnoziT gaewera 859 avadmyofi
(letaloba – 0,5), maT Soris 155 bavSvi; Tirkmlebis infeqciebiT gaewera 721 avadmyofi
(letaloba – 0,7), maT Soris 193 bavSvi; Tirkmlisa da SardsawveTis kenWovani daavadebis
diagnoziT gaewera 638 (letaloba – 0,6), maT Soris 5 bavSvi; winamdebare jirkvlis
daavadebebiT gaewera 1517 (letaloba – 1,2) avadmyofi, maT Soris 53 bavSvi.
stacionarebSi registrirebul avadmyofTa Soris yvelaze xSiri iyo winamdebare
jirkvlis daavadebebis (16%), nefritis da nefrozis (9%), Tirkmlis infeqciebis (8%) da
Tirkmlisa da SardsawveTis kenWebis (7%) diagnozebi.
2004 wels saqarTvelos stacionarebSi Tirkmlebsa da SardsawveTebze Catarda
1964 operacia (letaloba – 0,97), winamdebare jirkvalze Catarda 1179 operacia
(letaloba – 0,42). 2004 wels Catarda Tirkmlis gadanergvis 8 operacia, romelTa
Sedegad arc erTi pacienti ar gardacvlila (nax. 52).
naxati 52.
operaciebi Tirkmlebsa da SardsawveTze
operaciebi Tirkmlebsa da SardsawveTze
operaciebi winamdebare jirkvalze
2296
2485
2246
1964
2500
1463
2000
1500
1000
1256
1341
500
1065
1260
1179
0
2000
2001
2002
2003
2004
48
2004
3.4. fsiqikuri janmrTeloba
adamianis cxovrebis erT-erT umTavres nawils misi fsiqikuri janmrTeloba
warmoadgens, misi mniSvneloba xazgasmulia janmos mier SemoTavazebul janmrTelobis
ganmartebaSi: “janmrTeloba ganisazRvreba, rogorc sruli fizikuri, gonebrivi da
socialuri keTildReoba da ara mxolod daavadebis ararseboba”, ris gamoc fsiqikuri
janmrTelobis dacvis problemebi sul ufro did mniSvnelobas iZens.
dReisaTvis daaxloebiT 450 adamiani itanjeba fsiqikuri darRvevebiT. yovel
meoTxe ojaxSi erTi wevri mainc iyo an aris avad fsiqikuri moSlilobebiT.
SefasebebiT, fsiqikuri da nevrologiuri aSlilobebi avadobisa da dainvalidebis
mizezTa Soris wamyvan adgils ikavebs. neirofsiqiatriul aSlilobebze modis avadobis
globaluri tvirTis 12%. Sromisuunarobis 10 ZiriTad mizezTagan 5 swored fsiqikur
aSlilobebs ukavSirdeba da mosalodnelia, rom 2020 wlisaTvis invalidobis gamo
dakarguli wlebis (DALYs) mixedviT is 15%-mde gaizrdeba, depresiuli mdgomareobebi
ki meore adgils daikavebs (gulis iSemiuri daavadebebis Semdeg) (www.who.int).
fsiqikur aSlilobaTa mizezebi da Sedegebi mraval socialur da ekonomikur
faqtors ukavSirdeba. aRmosavleT evropaSi ukanaskneli aTi wlis ganmavlobaSi
momxdar socialur-ekonomikur cvlilebebs depresiebis gavrceleba mohyva, xolo
TviTmkvlelobebiT gamowveuli sikvdilianobis maCvenebeli zogierT qveyanaSi
aRemateba sagzao-satransporto SemTxvevebiT gamowveul sikvdilianobis maCvenebels.
zemoaRniSnulma ganapiroba is, rom janmrTelobis msoflio organizacia udides
mniSvnelobas aniWebs fsiqikuri aSlilobebis profilaqtikas, mkurnalobas, avadmyofTa
movlis
problemebs,
fsiqikuri
cxrili 35.
janmrTelobis ganmtkicebasa da dacvas.
fsiqikuri aSlilobebis gavrceleba
2004
wels
saqarTvelos
2003
2004
ambulatorul-poliklinikur dawesebulebebSi
fsiqikuri
da
qceviTi
registrirebul avadmyofTa
101118
106921
raodenoba
aSlilobis diagnoziT registrirebuli
daavadebianoba
2335,9
2445,8
iyo 106921 avadmyofi (daavadebianoba –
registrirebul
avadmyofTa
2445,8). sicocxleSi pirvelad dadgenili
4027
4967
raodenoba bavSvbebSi
diagnoziT
aRricxuli
iyo
7537
daavadebianoba
476,3
542,3
avadmyofi (avadoba – 174,7), maT Soris
axal
SemTxvevaTa
1290 bavSvi (avadoba – 140,8) (cxrili 35).
6051
7637
raodenoba
ukanaskneli 10 wlis ganmavloavadoba
139,8
174,7
baSi fsiqikuri aSlilobebis axladreaxal
SemTxvevaTa
gistrirebuli SemTxvevebis dinamikaSi
1021
1290
raodenoba bavSvebSi
mniSvnelovani Zvrebi moxda. kerZod,
avadoba bavSvebSi
120,8
140,8
oTxmocdaaTiani
wlebis
dasawyisSi
wyaro:
janmrTelobis
dacva,
saqarTvelo,
2004,
qveyanaSi ganviTarebuli Rrma krizisis
fonze mniSvnelovnad Semcirda avadobis statistikuri cnobari.
maCvenebeli, rac ganpirobebuli iyo ara
naxati 53.
marto aRricxvianobis sistemis moSliT,
fsiqikuri aSlilobebiT avadobis dinamika
aramed janmrTelobis dacvis sistemis
200
dafinansebaSi
Seqmnili
umZimesi
sul
174,7
180
141,1
139,8
138,1
mdgomareobiTac, ris gamoc sazogadoebis
bavSvebi
160
140,8
140
132,7
135,2
yvelaze daucveli fena praqtikulad
134,4
120
120,8
samedicino daxmarebis gareSe aRmoCnda.
100
82,1
106,2
69,2
67
1995 wlidan saxelmwifom Tavis Tavze aiRo
80 56,8
59,6
60
63,7
fsiqikur avadmyofTa garkveuli nawilis
40
45,6
16,5 18 25,1
samedicino
momsaxurebis
xarjebi.
20
0
samedicino momsaxurebis gaumjobesebisa
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
da aRricxvianobis mowesrigebis fonze
dafiqsirda avadobis maCveneblebis zrda
da 1998-2004 wlebSi oTxmociani wlebis
49
dafiqsirebul donesac ki gadaaWarba
(nax. 53). sakmarisia aRiniSnos, rom 199638,92
litva (2004)
2004 wlebSi saqarTvelos ambulatorul31,74
ruseTi (2004)
poliklinikur dawesebulebebSi regis31,56
belorusia (2004)
trirebul
fsiqikur
avadmyofTa
24,55
kontingentis saerTo raodenoba TiTqmis
dsT (2004)
2-jer gaizarda, xolo 8-jer gaizarda
23,66
estoneTi (2004)
registrirebuli
axali
SemTxvevebis
22,34
latvia (2004)
raodenoba
bavSvebSi.
22,03
ukraina (2004)
qveyanaSi
mkveTrad
moimata
17,62
evro-25 (2004)
fsiqogenurma, e.w. reaqtiulma aSlilo17,03
moldova (2004)
bebma, gansakuTrebiT xandazmul asakSi,
11,43
fsiqosomaturma darRvevebma,
depreyirgizeTi (2004)
siebma,
ukanasknel
aTwleulSi
gaizarda
4,1
saqarTvelo (2004)
TviTmkvlelobaTa ricxvi. miuxedavad
2,13
somxeTi (2003)
amisa, saqarTveloSi TviTmkvlelobiT
0
10
20
30
40
50
ganpirobebuli
sikvdilianobis
maCvenebeli
yvelaze
dabalia
evropis
wyaro: monacemTa baza `janmrTeloba
regionSi
(garda
somxeTisa)
(nax.
54).
yvelasaTvis~, www.who.dk/hfadb.
msoflioSi
yovelwliurad
suicidis 870 000-mde SemTxveva aRiricxeba, 2020 wlisaTvis es ricxvi 1,5 milionamde
gaizrdeba. TviTmkvlelobebiTaa ganpirobebuli avadobis globaluri tvirTis 1,4% (nax.
55).
naxati 54. TviTmkvleloba
naxati 55. suicidebi, maCvenebeli 100000 mosaxleze
wyaro: www.who.int
2004
wels
saqarTveloSi
Tavi
moikla 175-ma adamianma (maCvenebeli – 4,1),
maT Soris 147-ma kacma da 28-ma qalma.
CamoxrCobiT, mogudviT, moxrCobiT da
dauzustebeli
wyalSi daxrCobiT Tavi ganzrax daiziana
20
143-ma;
TviTmkvleloba
cecxlsasroli
TviTmowamvla
3
iaraRiT, sxva basri sagniT ganaxorciela 9m; ganzrax TviTmowamvliT – 3-mma, ganzrax
cecxlsasroli iaraRiT
8
TviTdazianebiT dauzustebeli moqmedebis
CamoxrCobiT
143
meSveobiT 20-ma adamianma (nax. 56).
2004 wels dispanserul aRricxvaze
0
50
100
150
200
myof avadmyofTa fsiqikuri da qceviTi
aSlilobebiT
daavadebianobam
moimata
wyaro: statistikis saxelmwifo departamenti
yvela
regionSi,
garda
samegrelosi.
avadobis maCvenebeli ki mxolod mcxeTa-mTianeTSi Semcirda (nax. 57).
naxati 56.
sikvdilis mizezebi suicidebis dros
50
2004
naxati 57.
fsiqikuri aSlilobebiT dispanserul aRricxvaze myof avadmyofTa
ganawileba mxareebis mixedviT
2500
2068,2
avadoba
1874,3
2000
1578,2
1505
1500
1000
daavadebianoba
2368,8
2297,1
1427,1
1288,1
1258,7
962,4
787,1
500
38,1
97,3
215
97
47,7
55,7
27
52,6
73,2
64,1
73,3
0
Tbilisi
aWara
guria
samegrelo
imereTi
samcxejavaxeTi
Sida qarTli
mcxeTamTianeTi
qvemo qarTli
kaxeTi
saqarTvelo
naxati 58.
dispanserebis monacemebiT, 2004 wels
fsiqikuri aSlilobebis struqtura
fsiqikuri da qceviTi aSlilobebis axali
SemTxvevebis 13%-s (412) 0-14 wlamde bavSvebi
epilefsia
Seadgendnen.
reaqtiuli
fsiqoziT da
fsiqozi
iseve, rogorc wina wels, 2004 welsac
WkuasustobiT
8%
12%
fsiqikuri daavadebebis struqturaSi wamyvani
moxucebulobi
sxva
s
fsiqozi
da
adgili ekava fsiqozebs, romlebic fsiqikuri
12%
Wkuasustoba
aSlilobebiT registrirebuli yvela avadmyofis
11%
41%-s
Seadgenda
(am
ricxvSi
ar
Sedis
alkoholuri
fsiqozebi),
xolo
gonebrivi
Sizofrenia
57%
CamorCenilobebiT (oligofrenia) – 30% da
arafsiqozuri xasiaTis fsiqikuri darRvevebiT 29%. fsiqozebis struqturaSi 57%-s Sizofrenia
Seadgenda.
arafsiqozuri
xasiaTis
fsiqikuri
fsiqozi
darRvevebis klasSi 38% ekava nevrozebs, 12% 41%
fsiqopaTias, 11% - epilefsias arafsiqoturi
darRvevebiT.
arafsiqozuri
oligofrenia
darRvevebi
30%
gonebrivi CamorCenilobis saerTo raode29%
nobidan 42,5%-s debiloba Seadgenda (nax. 58).
ukanaskneli 4 wlis ganmavlobaSi aRiniSna
konsultaciur momsaxurebaze myof fsiqikur
avadmyofTa kontingentisa da axali SemTxvevebis TiTqmis 1,5-jer Semcireba (nax. 59).
naxati 59.
konsultaciur momsaxurebaze myof fsiqikur avadmyofTa kontingenti
21,9
2004
0,8
daavadebianoba
avadoba
18,4
2003
1,1
36,3
2002
0,7
34,9
2001
0,7
3,2
50,9
2000
0
20
40
60
51
3.5. ubeduri SemTxvevebi da travmebi
janmrTelobis msiflio organizaciisa da msoflio bankis mier gamoqveynebuli
monacemebis mixedviT, sagzao-satransporto trvmatizmi jandacvis sistemaTa mzard
problebas warmoadgens. avtokatastrofebSi daRupulTa mTliani raodenobidan (1,2 mln
yovelwliurad) 50%-e meti 15-dan 44 wlamde asakis adamianebze modis, maT Soris
umetesoba – ojaxis marCenalia (www.who.int). dabali da saSualo Semosavlebis mqone
qveynebSi
sagzao-satransporto
travmatizmis
Rirebuleba
mTliani
erovnuli
Semosavlebis 1-2%-s Seadgens. swored amitom janmrTelobis msoflio organizaciam 2004
w. Catarebuli janmrTelobis dRe pirvelad sagzao moZraobis usafrTxoebas miuZRvna.
saqarTveloSi iseve, rogorc evropis regionis mTel teritoriaze, erT-erT
mniSvnelovan problemas ubeduri SemTxvevebi da travmebi warmoadgens, rac sul ufro
met sazrunavs uCens janmrTelobis dacvis sistemebs, radganac izrdeba maTi zegavlena
avadobis globalur tvirTze. evropis regionis mTliani sikvdilianobis daaxleobiT
erTi meaTedi swored ubedur SemTxvevebze, mowamvlebsa da sxva travmebze modis
(saSualod 6% da 12% regionis dasavleT da aRmosavleT nawilebSi). sagangaSoa isic,
rom 0-14 wlamde asakis bavSvTa sikvdilianobis 40% swored sagzao-satransporto da
sxva saxis travmebiTaa ganpirobebuli. amave dros, travmebi bavSvTa dainvalidebis
ZiriTad mizezs warmoadgens.
2004 wels saqarTveloSi registrirebuli travmebis, damwvrobisa da mowamvlebis
raodenobam Seadgina 36948 SemTxveva (daavadebianoba – 845,2), maT Soris 32488 axali
SemTxvevaa (avadoba – 743,2). bavSvebSi registrirebuli iyo 6836 axali SemTxveva
(avadoba - 757,3) (nax. 60).
naxati 60.
travmebis, damwvrobisa da mowamvlebis axali SemTxvevebis raodenoba
sul
bavSvebi
6936
2004
32488
6058
2003
28741
6908
2002
28714
4979
2001
23709
4435
2000
19811
4219
1999
19144
4526
1998
20765
6226
1997
21807
7163
1996
22159
0
5000
10000
15000
20000
25000
30000
35000
sxvadasxva lokalizaciis travmebis, damwvrobebisa da mowamvlebis axal
SemTxvevaTa Soris yvelaze xSiri iyo Wrilobebis, sisxlZarRvTa dazianebebis,
zedapiruli travmebis, daJeJilobebis da daCeCqvilobebis SemTxvevebi (avadoba - 348),
rac am klasis daavadebebis 56,6%-s Seadgenda (nax. 61).
52
2004
naxati 61.
travmebis, damwvrobisa da mowamvlebis struqtura procentebSi
mowamvlebi
4,6%
13,4%
nervebis da zurgis tvinis travmebi
0,6%
3,9%
Wrilobebi, sisxlZarRvTa dazianebebi, zedapiruli travmebi,
daJeJilobebi da daCeCqvilobebi
50,1%
1,7%
Tavis qalis Sida travmebi
3,0%
11,6%
qveda kidurebis motexiloba
7,9%
7,6%
xerxemlis, Tavis qalis da tanis Zvlebis motexiloba
1,5%
0%
10%
20%
30%
40%
50%
60%
travmatizmis gamo samedicino dawesebulebebSi mosaxleobis mimarTvianobis
ZiriTadi mizezebi araproporciulad nawildeboda. travmebis umetesoba WrilobebiT,
amovardnilobebiTa da Zvlebis motexilobebiT iyo warmodgenili, rac sagrZnoblad
zrdida am pacientebis samkurnalo da sareabilitacio xarjebs. analogiuri tendenciebiT
xasiaTdeba bavSvTa travmatizmis struqturac (cxrili 36).
cxrili 36.
registrirebuli travmebis, damwvrobebisa da mowamvlebis raodenoba da struqtura
travmebi, mowamvlebi, damwvrobebi - sul
xerxemlis, Tavis qalisa da tanis Zvlebis motexiloba
zeda kidurebis motexiloba
qveda kidurebis motexiloba
amovardniloba (motexilobis gareSe), daWimuloba,
saxsrebis da mimdebare kunTebis deformireba
Tavis qalis Sida travmebi Tavis qalis motexil. gareSe
gul-mkerdis, muclis da menjis Rruebis Sin. organ. travmebi
Wrilobebi, sisxlZarRvebis dazianebebi, zedapiruli
travmebi, daJeJilobebi da daCeCqvilobebi
nervebis da zurgis tvinis travmebi
sxva travmebi
damwvroba
mowamvlebi
sul
registrirebuli
sul avadoba %
sul
avadoba
%
bavSvebi
32488
490
2055
1859
743,2
11,2
47,0
44,8
100
1,5
6,3
5,7
6936
29
376
244
757,2
3,2
41,0
26,6
100
0,4
5,4
3,5
3003
68,7
9,2
780
85,1
11,2
969
546
22,2
12,5
3,0
1,7
93
55
10,1
6,0
1,3
0,8
16272
372,2
50,1
3300
360,2
47,6
196
4351
1260
1487
4,5
99,5
28,8
34,0
0,6
13,4
3,9
4,6
76
1291
322
370
8,3
140,9
35,1
40,4
1,1
18,6
4,6
5,3
0-14 wlis asakis bavSvebSi travmebis, damwvrobebisa da mowamvlebis struqturaSi
gansakuTrebiT maRalia Wrilobebis, sisxlZarRvTa dazianebebis, zedapiruli travmebis,
daJeJilobebisa da daCeCqvilobebis SemTxvevebi (avadoba – 360,2), rac Seadgens bavSvebSi
travmuli paTologiis 47,6%-s.
maRali daavadebianoba regionebis mixedviT aRiniSneboda guriaSi, Sida qarTlsa
da mcxeTa-mTianeTSi; yvelaze dabali – qvemo qarTlSi. igive suraTs iZleva avadobis
maCvenebeli (cxrili 37).
53
cxrili 37.
travmebisa da mowamvlebis daavadebianobisa da avadobis maCveneblebi
regionebis mixedviT
sul
daavadebianoba
714,6
426,7
899,1
786,5
868,5
1474,7
390,7
1552,8
891,1
1222,9
979,0
845,2
regioni
aWara
Tbilisi
kaxeTi
imereTi
samegrelo
Sida qarTli
qvemo qarTli
guria
samcxe-javaxeTi
mcxeTa-mTianeTi
raWa-leCxumi
saqarTvelo
avadoba
552,1
371,0
795,5
728,8
801,1
1382,0
319,6
1511,6
579,0
1117,6
879,0
743,2
m.S. bavSvebSi
daavadebianoba
avadoba
744,9
547,9
578,0
548,1
1243,8
1180,1
941,6
860,0
744,1
693,6
1251,5
1188,7
311,0
271,2
2304,1
2212,1
655,1
463,9
458,7
400,8
777,7
646,1
842,5
757,3
wyaro: janmrTelobis dacva, saqarTvelo, 2004, statistikuri cnobari, Tbilisi, 2005.
travmebiT, damwvrobebiT, mowamvlebis diagnoziT stacionaridan gasulia 18835
avadmyofi (letaloba – 3,2%), maT Soris - 3130 bavSvi (letaloba 0,9%); aqedan travmebiT
– 5737 (bavSvi – 602); damwvrobebiT – 625 (bavSvi 249); mowamvlebiT – 3060 (bavSvi – 647).
travmebiT, damwvrobebiT da mowamvlevis diagnoziT hospitalizebulTa 50%
mkurnalobda TbilisSi, 11% - imereTSi, 8% - samegreloSi (cxrili 38).
cxrili 38.
travmebiT, damwvrobebiT da mowamvlebiT hospitalizebul avadmyofTa raodenoba da
letaloba regionebis mixedviT
sul
gavida
m.S.
gardaicvala
maT Soris bavSvebi
letaloba
%
gavida
aWara
1186
47
4,0
212
Tbilisi
9487
324
3,4
1957
kaxeTi
821
16
1,9
146
imereTi
2062
57
2,8
380
saamegrelo
1518
49
3,2
100
Sida qarTli
965
27
2,8
74
qvemo qarTli
762
23
3,0
81
guria
246
15
6,1
91
samcxe-javaxeTi
315
9
2,9
50
mcxeTa-mTianeTi
140
3
2,1
8
raWa-leCxumi
162
5
3,1
30
afxazeTi
2
0
0
0
sxva uwyeba
1169
28
0
1
saqarTvelo
18835
603
3,2
3130
m.S.
letaloba
gardaicvala
(%)
2
24
0
1
0
0
2
0
0
0
0
0
0
29
0,9
1,2
0
0,3
0
0
2,5
0
0
0
0
0
0
0,9
54
2004
4. mosaxleobis calkeuli jgufebis janmrTelobis mdgomareoba
4.1. bavSvTa janmrTeloba
qveyanaSi
arsebuli
demografiuli
situaciidan
gamomdinare,
erT-erT
umniSvnelovanes problemas bavSvTa janmrTelobis mdgomareoba warmoadgens. bavSvTa
janmrTelobis mravali Semadgeneli nawili ukavSirdeba iseT parametrebs, rogoricaa
dedis janmrTelobis mdgomareoba, organizmis ganviTareba pre- da perinatalur
periodebSi, socialuri da fizikuri pirobebi sicocxlis pirvel wlebSi. kerZod,
siRaribe da arakeTilsaimedo garemo SeiZleba im socialur faqtorTa rigSi
aRmoCndes, romlebic mTeli cxovrebis ganmavlobaSi gamanadgureblad imoqmedebs
janmrTelobaze.
saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros
monacemebiT, 2004 wels sul cocxali daibada 46373 bavSvi. avadmyofi daibada an avad
gaxda 4948 bavSvi, aqedan aRricxulia perinatalur periodSi warmoqmnili calkeuli
mdgomareobebis 4617 da
Tandayolili anomaliebis 301 SemTxveva. wina welTan
SedarebiT Semcirda Tandayolili anomaliebis,
respiratoruli moSlilobis
sindromisa da izoimunizaciiT gamowveuli hemolizuri daavadebebis raodenoba (cxrili
39).
cxrili 39.
axalSobilTa avadoba
2003
2004
raodenoba 1000 cocxal- raodenoba 1000 cocxalSobilze
Sobilze
347
18
522
607
678
1625
325
sefsisi
respiratoruli moSlilobis sindromi
zrdis Seferxeba
Tavis qalas da sxva samSobiaro travmebi
saSvilosnosSida hipoqsia da asfiqsia
izoimunizaciiT gamow. hemolizuri daavad.
8,1
0,4
12,2
14,1
7,1
37,8
7,6
301
60
505
658
681
1741
252
6,5
1,3
10,9
14,2
14,7
37,5
5,4
1995
1996
1997
1999
1 wlamde bavSvTa sikvdilianoba
adreuli neonataluri
perinataluri
2001
neonataluri
postnataluri
2003
12,1
3,2
4,1
12,3
18
27,7
28,1
28,8
2002
18,5
13,5
20,1
16,3
2,6
5,2
11,1
14,7
26,4
29,6
2000
20
12,2
7,3
21,2
13,8
32,1
23,4
14,4
8,9
4,3
1998
13
8,9
31,6
22,7
10
32,3
4,910,4
25
11,6
11,3
3,7
13,5
8,1
3
13,7
9,9
35
30
25
20
15
10
5
0
27,8
2004 wels 0-6 dRemde asakSi gardaicvala 561 bavSvi (maCvenebeli 12,1 – 1000
cocxalSobilze), rac 3,1%-iT metia wina welTan SedarebiT.
saqarTvelos samedicino dawesebulebebma (stacionari, poliklinika) aRricxes
erT wlamde asakis 834 bavSvis gardacvaleba (sikvdilianobis maCvenebeli 1000
cocxalSobilze 18,0), miuxedavad gardacvlilTa raodenobis matebisa, es maCvenebeli
Semcirda wina welTan SedarebiT (2003w. – 18,5 yovel 1000 dabadebulze). 2004 wels
Semcirda adreuli neonataluri sikvdilianobis maCvenebeli (2004 w.- 12,1; 2003 w. – 12,3),
gviani neonataluri sikvdilianobis maCvenebeli (2004 w. – 3,2; 2003 w., - 4,1) da
perinataluri sikvdilianoba (2002 w. – 28,8; 2003 w. – 28,1) (nax. 62).
naxati 62.
erT wlamde asakis bavSvTa sikvdilianoba (1000 cocxladSobilze)
2004
55
saqarTveloSi erT wlamde asakis bavSvTa sikvdilianobis oficialurad
registrirebuli maCvenebeli garkveulwilad maRalia yofili sabWoTa kavSiris sxva
respublikebTan SedarebiT da mniSvnelovnad sWarbobs evrokavSiris saSualo
maCvenebels (nax. 63).
naxati 63.
erT wlamde asakis bavSvTa sikvdilianoba (arsebuli uaxlesi monacemebi)
28,66
yirgizeTi (2004)
27,9
tajikeTi (2001)
18
saqarTvelo (2004)
15,2
uzbekeTi (2004)
yazaxeTi (2004)
13,98
dsT (2004)
13,88
12,84
azerbaijani (2002)
12,12
moldova (2004)
somxeTi (2003)
11,79
ruseTi (2004)
11,54
ukraina (2004)
9,42
latvia (2004)
9,38
7,89
litva (2004)
6,9
belorusia (2004)
6,49
evro-25 (2004)
5,44
estoneTi (2004)
maCvenebeli 1000 cocxladSobilze
0
5
10
15
20
25
30
35
g.wulaZis, m.maRlaferiZisa da d.vadaWkorias gaTvlebiT, 2050 wlamde
prognozirebulia CvilTa sikvdilianobis Semcireba, Tumca es maCvenebeli mainc ufro
maRalia iqneba, vidre sadReisod aris ganviTarebul qveynebSi.
socialur-ekonomikuri siZneleebis gamo jer kidev maRalia mkvdradSobadobis
maCvenebeli.
2004 wels daibada 722 mkvdari bavSvi
naxati 64.
(mkvdradSobadobis maCvenebeli 15,3), rac wina
mkvdradSobadobis maCvenebeli
wlis maCveneblebTan SedarebiT
dabalia
(nax. 64).
25
samSobiaro
saxlebis
monacemebiT,
22,3
20,2
19,3
46373 cocxalSobilidan 95,7% (44386 bavSvi)
20
17,6
15,415,4 16 15,3
imyofeboda bunebriv kvebaze. maT Soris
12,9
15
pirveli
saaTis
ganmavlobaSi
ZuZuze
10
miyvanili iyo 29705 (64,1%), 1-8 saaTis
6,0
ganmavlobaSi - 7878 (17%), 8-24 saaTis
5
ganmavlobaSi - 4550 (9,8%) axalSobili.
0
bavSvTa poliklinikebis monacemebiT, im
1995
1997
1999
2001
2003
bavSvTa raodenobidan, romelTac 2004 wels
SeusruldaT 1 weli, 3 Tvis asakamde bunebriv
kvebaze imyofeboda 22927 bavSvi.
2000 wlamde qveyanaSi ar moipoveboda
rutinuli statistika 5 wlamde asakis bavSvTa gardacvalebis Sesaxeb. 2000 wlidan ukve
aRiricxeba stacionarebSi 5 wlamde asakis gardacvlil bavSvTa, xolo 2002 wlidan ki
binaze gardacvlil bavSvTa raodenobac. 2004 wels samedicino dawesebulebebSi
(stacionari, poliklinika) aRiricxa 0-14 wlamde asakis 1025 gardacvlili bavSvi. aqedan 0-1
wlamde asakis – 834, 0-5 wlamde asakis – 929 bavSvi. bavSvTa 91,2% stacionarebSi
gardaicvala.
56
2004
seriozuli problemebi wamoiWra imasTan
cxrili 40.
dakavSirebiT,
rom
arsebul
socialurerT
wlamde
asakis
bavSvTa
avadoba
ekonomikur pirobebSi ojaxi xSirad saTanadod
ver uzrunvelyofs bavSvis gamozrdas da,
weli
raodenoba
rogorc Sedegi - progresulad matulobda 1
1998
80396
wlamde asakis bavSvTa avadobis SemTxvevebi.
1999
81331
Tumca 2004 wels es monacemi Semcirda:
2000
83282
aRricxulia 1 wlamde asakis bavSvTa avadobis
2001
84951
61418 SemTxveva (maCvenebeli 134869,0) (cxrili 40).
2002
64296
2004 wels samedicino dawesebulebebSi
2003
62860
2004
61418
registrirebuli iyo 342459 daavadebis SemTxveva
0-14 wlis asakis bavSvebSi (daavadebianobis wyaro: janmrTelobis dacva, saqarTvelo,
maCvenebeli – 37388,6), maT Soris sicocxleSi 2004, statistikuri cnobari.
pirvelad dadgenili diagnoziT aRricxulia
237332 SemTxveva (avadobis maCvenebeli 25911,2).
naxati 65.
bavSvebSi avadobis SemTxvevaTa raodenoba
bavSvTa avadobis struqtura
maRalia
daavadebaTa
Semdeg
klasebSi:
14%
sasunTqi
organoebis
daavadebebi
139364
3%
4%
(avadobis maCvenebeli – 15215,3); infeqciuri da
7%
parazituli daavadebebi – 32580 (avadobis
maCvenebeli – 3557,0); nervuli sistemis da
58%
grZnobaTa organoebis – 15680 (avadobis
14%
maCvenebeli – 1711,9), kanisa
da kanqveSa
ujredisis daavadebebi – 9965 (avadobis
maCvenebeli – 1087,9), travmebi da mowamvlebi
nervuli da grZnobaTa organoebis daavadebebi
– 6936 (avadobis maCvenebeli – 757,3) (nax. 65).
stacionarebSi hospitalizebul iqna 56617
bavSvi, maT Soris 1 wlamde asakis - 18334.
sxva
2004 wels afxazeTis avtonomiuri
respublikis
janmrTelobis
dacvis wyaro: janmrTelobis dacva, saqarTvelo,
saministros samedicino dawesebulebebis mier
registrirebuli iyo 40789 (wina wels – 34039) devnili avadmyofi bavSvis mimarTva
(saerTo mimarTvianobis 17,6%). devnil bavSvTa daavadebebis struqturaSi maRalia
sasunTqi organoebis (45%) da infeqciuri (31,3%) daavadebebis xvedriTi wili.
mosaxleobis optimaluri asakobrivi struqturiT uzrunvelyofa qveynis
socialuri politikis erT-erTi umTavresi problemaa, romelTanac mWidrod aris
dakavSirebuli bavSvTa sxvadasxva asakobriv jgufebze janmrTelobisaTvis mavne
faqtorebis zemoqmedebis Semcireba,AmaTi normaluri swavla-aRzrdisa da dasvenebis,
kvebis, fizikuri da fsiqoemociuri statusis gaumjobesebis sakiTxebi.
57
4.2. dedaTa janmrTeloba
saqarTveloSi
arsebuli
rTuli
demografiuli
situaciis
fonze
umniSvnelovanesia dedaTa janmrTelobis gaumjobeseba da sikvdilianobis Semcireba.
2004 wels saqarTveloSi imSobiara 44396 qalma, rac wina welTan SedarebiT 2338
mSobiarobiT metia. maTgan 45554 qalma (97,5%) imSobiara samSobiaro saxlebSi (ganyofilebebSi) da 1180-ma (2,5%) - binaze.
2004 wels Catarda 7793 sakeisro kveTis operacia, rac mSobiarobaTa saerTo
raodenobis 16,7%-s Seadgenda. sayuradReboa is garemoeba, rom wlidan wlamde
matulobs sakeisro kveTis xvedriTi wili: 1999 – 8,1%, 2000 – 9,2%, 2001 – 10,3%, 2002 –
12,2%, 2003 - 14,1%, 2004 w. – 16,7%.
cxrili 41.
saswrafo
sakeisro
kveTa
mSobiarobis da sakeisro kveTis monacemebi
Catarda
48,3%-Si,
xolo
2003
2004
gegmiuri – 51,2% (2003 wels –
abs.
%
abs.
%
Sesabamisad, 50,5% da 49,5%)
imSobiara sul
44396
46734
(cxrili 41).
amasTan erTad,
m.S. samSobiaroSi
43170
97,2
45554
97,5
Semcirda saswrafo sakeisro
binaze
1226
2,8
1180
2,5
kveTis operaciaTa procentuli
sakeisro kveTa
6259
14,1
7793
16,7
wili da Sesabamisad, moimata
m.S. gegmiuri
3160
50,5
3989
51,2
gegmiur operaciaTa wilma, rac
saswrafo
3099
49,5
3766
48,3
dadebiTi tendenciis maCvene- wyaro: janmrTelobis dacva, saqarTvelo, 2004,
belia.
orsulobis, mSobiarobis
da abortis garTulebebTan dakavSirebuli dedaTa sikvdilianoba warmoadgens
Tavisebur indikators, romelic asaxavs ara marto orsulTa janmrTelobis mdgomareobas, aramed qalTa mosaxleobis avadobas, orsulTa meTvalyureobisa da zogadad
sameano daxmarebis dones, eqimTa kvalifikacias. ukanasknel wlebSi am maCveneblis
sakmarisad swrafi zrdis fonze, 2004 wels, wina welTan SedarebiT, Semcirda dedaTa
sikvdilianobis maCvenebeli da is 45,3 gaxda. sul 2004 w. 21 deda gardaicvala (nax. 66).
naxati 66.
dedaTa sikvdilianobis maCveneblis dinamika (yovel 100000 cocxalSobilze)
100
90
80
70
60
50
34,6
40 32,4
30
20
22
18
10
0
1993
1994
70
55,1
maCvenebeli
raodenoba
68,2
59,9
51,3
58,7
49,2
46,6
52,2
45,3
30
1995
31
1996
37
1997
34
1998
24
23
1999
2000
27
2001
21
2002
21
23
2003
2004
unda aRiniSnos, rom dedaTa sikvdilianobis maCvenebeli saqarTveloSi erT-erTi
yvelaze maRalia ara marto evropis regionSi, aramed yofili sabWoTa kavSiris
respublikebSic (nax. 67)
58
2004
naxati 67.
dedaTa sikvdilianoba (arsebuli uaxlesi monacemebi)
gardacvlilTa ricxvi 100 000 cocxladSobilze
yirgizeTi
saqarTvelo
tajikeTi
somxeTi
yazaxeTi
uzbekeTi
dsT
moldova
ruseTi
azerbaijani
belorusia
TurqmeneTi
litva
estoneti
ukraina
latvia
evro-25
0
10
20
30
40
50
60
wyaro: monacemTa baza `janmrTeloba yvelasaTvis”, www. who.dk/hfadb.
saqarTveloSi 2004 wels qalTa konsultaciebSi aRricxvaze imyofeboda 63632
qali, maT Soris 2004 wels Semosul 46383 orsulTagan 12 kviris orsulobis vadamde
aRricxvaze ayvanil iqna 48,2%. orsuloba bolomde miitana 40445 qalma, romelTagan
konsultacias 4 srul vizitze mimarTa 59,4% (rac 1,2%-iT naklebia 2003 welTan
SedarebiT).
rezus-faqtorze da sifilisze gamoikvlies Sesabamisad 37381 da 32551 orsuli.
sifilisi aRmoaCnda 32 qals, rac TiTqmis 1,3-jer metiia 2003 welTan SedarebiT.
orsulobis, mSobiarobasa da loginobis xanis garTulebebis gamomwvev
daavadebaTa ganxilviT vlindeba, rom 2004 wels pirvel adgilzea anemia (50,5%), Semdeg
farisebri jirkvlis disfunqcia (13,4%), Sard-sasqeso sistemis daavadebebi (11,6%), venuri
darRvevebi orsulobis periodSi (5,2%). aRniSnul daavadebaTa struqturaSi anemiisa da
farisebri jirkvlis disfunqciis maRali xvedriTi wili gansakuTrebul yuradRebasa da
reagirebas saWiroebs, aucilebelia iodis deficitiT pirobadebul daavadebaTa
winaaRmdeg brZolisa da prevenciuli RonisZiebebis gaZliereba (nax. 68).
59
naxati 68.
orsulobis periodSi qalTa konsultaciebSi gamovlenili daavadebebi (%)
sisxldena orsulobis
periodSi
sisxlis mimoqcevis
0,6%
sistemis daavadebebi
2,6%
SeuCerebeli
pirRebineba
orsulobis periodSi
1,4%
Sard-sasqeso sistemis
daavadebebi
11,7%
venuridarRvevebi
orsulobis dros
5,3%
sxva
0,7%
farisebri jirkvlis
paTologia
13,5%
antenataluri
nayofis araswori
mdebareoba
1,1%
skriningis dros
gamovlenili
normidangadaxrebi
1,8%
arasrulyofili kveba
3,0%
anemia
51,1%
preklampsia da
eklampsia
1,5%
Saqriani
diabeti
0,3%
mioma
1,6%
ukanasknel wlebSi gamovlenilia fertiluri asakis qalTa janmrTelobis
gauaresebis tendencia, rasac xels uwyobs ojaxis dagegmvisa da reproduqciuli
janmrTelobis sakiTxebSi qalTa ganaTlebis arasakmarisi done. sxva SemTxvevaSi Zneli
asaxsnelia is garemoeba, rom ojaxis dagegmvis procesSi kvlav wamyvani adgili ukavia
aborts, romlis mxolod aRricxuli SemTxvevebis saerTo raodenobam 2004 wels 17210
Seadgenda, rac yovel 100 cocxalSobilze 37,1-ia, maT Soris 6552 (38,1%) _ “mini abortia”.
2004 wels orsuloba xelovnurad Seiwyvita 15 wlamde asakis 6 gogonam (2003 w. - 2). aseve
stabilurad maRalia abortebis raodenoba 15-19 wlamde asakis gogonaTa Soris (2004 w.
– 1494, 2003 w. – 897, 2002 w. - 789). miuxedavad registrirebuli abortebis ricxvis klebisa,
evropis sxva qveynebTan SedarebiT saqarTveloSi abortebis raodenoba kvlav maRali
rCeba. marTalia, jer kidev dabalia kontraceptivebis momxarebel qalTa raodenoba,
magram 1992-2004 wlebSi mainc ikveTeba spiralisa da hormonaluri kontraceptivebis
momxmSrebelTa jamuri raodenobis zrda registrirebul abortTa ricxvTan SedarebiT
(cxrili 42).
cxrili 42.
abortebi da kontraceptivebis gamoyeneba
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
cocxalSobilTa
ricxvi
abortebi
sul
maT Soris
mini aborti
57311
56341
53300
52851
49588
46827
46765
46006
45033
44093
46373
45858
39538
30003
23403
21018
18306
14951
15008
13908
13834
17210
10295
7522
5867
5541
6806
6549
5414
5330
5143
5183
6552
abortebis
maCvenebeli
1000 cocxalSobilze
857.9
715.2
554.1
447.6
423.8
390.9
319,7
326,2
308,8
313,7
371,1
`spiralis~
gamoyenebis
ricxvi
9127
9538
10817
8171
9148
11539
9120
9032
8252
9084
9047
hormonaluri
kontraceptivebis gamoyenebis
ricxvi
3983
5181
3699
4869
6276
9142
7865
8755
8143
9340
10996
60
2004
samwuxarod, yovelwliurad klebulobs Casaxvisa da Sobadobis maCveneblebi
fertiluri asakis qalebSi – 1990 welTan SedarebiT es maCvenebeli 2-jerze metad
Semcirda, Tumca, 2003 welTan SedarebiT, 2004 w. aRiniSna mcire mateba (nax. 69).
naxati 69.
Casaxvisa da Sobadobis maCveneblebi fertiluri asakis yovel 1000 qalze
120
111,6
Sobadoba
Casaxva
107,1
90,4
100
76,8
80
60
40
74,6
71,2
63
60,6
62,2
57,5
54,1
53,4
51,4
40,3
39,6
38,8
68,2
61,7
51,4
55,1
51,7
42,3
39,4
40,6
39,4
41,2
42,7 40,4
37,8
40
20
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
g.wulaZisa da sxv. avtorTa mier Catarebuli gamokvlevebiT, 2050 wlamde
saprognozo periodSi mniSvnelovnad Semcirdeba fertiluri asakis qalTa rogorc
raodenoba, ise wili.
61
4.3. iZulebiT gadaadgilebul pirTa janmrTeloba
qveynis
mosaxleobis
janmrTelobis
mdgomareobis
amsaxvel
erT-erT
mniSvnelovan jgufs iZulebiT gadaadgilebuli pirebi warmoadgenen.
2004 wels, devnilTa Soris samedicino dawesebulebebSi mimarTvianobam 255120
Seadgina, rac 2003 welTan SedarebiT, 35,1%-iT metia. aseve gaizarda (44,69%-iT)
pirveladi mimarTvianobac (cxrili 43).
cxrili 43.
2004 wels registrirebuli mimarTvianoba
sul
131776
65937
27050
21400
8072
885
s u l
255120
wyaro: afxazeTis avtonomiuri respublikis janmrTelobis dacvis
q.Tbilisi
samegrelo-zemo svaneTi
imereTi
gali
aWara
kodori
mimagrebuli
mosaxleobis
raodenoba
85219
107272
32433
45523
6981
1053
278481
saministros monacemebi.
mozrdilTa mimarTvianobis struqtura ZiriTadi klasebis mixedviT Semdegia:
sasunTqi organeobis daavadebebi – 25,7%, sisxlis mimoqcevis sistemis daavadebebi –
20,1%, nervuli sistemisa da grZnobaTa organoebis daavadebebi – 18,2%, endokrinuli
daavadebebi – 7,7%, saWmlis momnelebeli organoebis daavadebebi – 7,7%. 2003 welTan
SedarebiT mniSvnelovnad Semcirda saWmlis momnelebeli sistemis daavadebebi da
gaizarda nervuli sistemisa da grZnobaTa organoebis daavadebebis maCvenebeli.
bavSvTa momarTvianobis struqturaSi kvlav wamyvani adgili sasunTqi organeobis
daavadebebs ukavia (45,0)%, Semdeg modis infeqciuri daavadebebi – 31,3%, kanisa da
kanqveSa ujredisis daavadebebi – 4,3%, nervuli sistemisa da grZnobaTa organoebis
daavadebebi – 4,0%. 2004 wels bavSvTa mimarTvianobam 40789 Seadgina, rac saerTo
mimarTvianobis 17,6%-ia.
demografiuli
maCveneblebidan
sayuradReboa
Sobadobis
arasaxarbielo
mdgomareoba – Sobadoba 1,5; sikvdilianoba 2,4.
62
2004
4.4. dabereba da janmrTeloba
mosaxleobis dabereba – Tanamedrove epoqis maxasiaTebeli demografiuli
movlenaa. is ganpirobebulia faqtorTa kompleqsiT, romelic moicavs: mosaxleobis
aRwarmoebis Taviseburebebs, mosaxleobis migraciis intensiurobasa da mimarTulebebs,
omebis sanitariul-demografiul Sedegebsa da sxv. ekonomikuri TvalsazrisiT
mosaxleobis dabereba zegavlenas axdens ekonomikur zrdaze, investiciebze, moxmarebaze,
Sromis bazarze, pensiebze, dabegvrasa da materialuri faseulobebis erTi Taobidan
meoreze gadasvlaze.
msoflioSi momxdarma demografiulma cvlilebebma mkveTrad Secvala viTareba
yvela regionSi. mosaxleobis daberebis process kaciobriobis istoriaSi analogebi ar
gaaCnia: xandazmulTa proporciis zrdas axalgazrdebis proporciis kleba sdevs Tan.
gaeros mier momzadebul moxsenebaSi `msoflios mosaxleobis dabereba: 1950-2050 w.w.~
aRniSnulia, rom 2050 wlisaTvis pirvelad msoflio istoriaSi xandazmulTa raodenoba
gadaaWarbebs axalgazrda mosaxleobis raodenobas. es istoriuli cvlileba
ganviTarebul qveynebSi 1998 wels ukve moxda (cxrili 44).
cxrili 44.
65 w. meti asakis mosaxleobis ricxovnoba
mln.
%
1995
2025
1955
2025
afrika
7
63
3
4
azia
62
470
4,1
9,6
laTinuri amerika
7
65
3,6
9,2
evropa
38
105
9,2
19,4
Crd. amerika
16
67
8,7
18,5
wyaro: Martin L.G., Preston S.H. Demography of Aging. Washington, D.C., National Academy Press, 1994,p. 2-3
regioni
saqarTvelo ekonomikuri TvalsazrisiT ganviTarebadi qveyanaa, xolo
demografiulad ganviTarebul qveynebs miekuTvneba. ekonomikurad ganviTarebuli
qveynebis msgavsad, saqarTveloSic mcirdeba Sobadoba, garkveulwilad izrdeba
sikvdilianoba, sul ufro regulirebadi xdeba Sobadoba, ojaxis formireba mTavrdeba
axalgazrda asakis qalebSi, matulobs erT da orSviliani ojaxebis ricxvi. amis Sedegad
mcirdeba axalgazrda Taobis da izrdeba 60 welze uxnesi mosaxleobis wili, e.i.
mosaxleoba demografiulad berdeba. es procesebi gansakuTrebiT gamoikveTa
ukanasknel wlebSi.
1989 da 2002 w.w. aRweris Sedegebis
naxati 70. mixedviT,
saqarTveloSi
Secvlilia
mosaxleobis xvedriTi wili asakobrivi
mosaxleobis
asakobrivi
ganawileba.
jgufebis mixedviT
24,9%-dan 20,8%-mde Semcirda 15 wlamde
asakis bavSvTa procentuli Semadgenloba,
2004
13,2%
xolo 65 wlis asakze meti mosaxleobis
2002
65+
13,2%
raodenoba momatebulia 8,9%-dan 13,2%1989
8,9%
mde (nax. 70). es tendencia 2004 w.
gagrZelda. am maCveneblebis mixedviT
68,2%
saqarTvelo
mosaxleobis
daberebis
15-64
67,3%
4
66,2%
maRali doniT xasiaTdeba.
2004
wlis
monacemebiT
18,6%
saqarTveloSi sapensio asakis mamakacTa
0-14
19,5%
(65 da meti wlis) ricxvma 219,9 aTass,
24,9%
xolo qalTa (60 da meti wlis) – 466,6
aTass miaRwia, rac jamSi 686,5 aTasis
0%
20%
40%
60%
80%
tolia.
aRniSnuli
mdgomareoba
seriozul
problemebs
uqmnis
sazogadoebas, vinaidan am kontingentis
63
janmrTelobasa da socialur dacvaze gaweuli xarjebi mZime tvirTad awveba qveynis
ekonomikas. gaeros monacemebiT (http://www.un.org) mxolod daberebis procesTan
dakavSirebuli samedicino momsaxurebis saSualo jamuri Rirebuleba 2000-2050 w.w.
periodSi 41%-s Seadgens, rac ganviTarebadi qveynebisaTvis 36%, xolo ganviTarebuli
qveynebisaTvis – 48% iqneba.
saqarTvelos
demografiuli
perspeqtivebic
(g.wulaZe,
n.maRlaferiZe,
a.vadaWkoria) sakmaod pesimisturia. avtorTa azriT, 2050 wlisaTvis Semcirdeba 15
wlamde asakis mosaxleobis wili, xolo demografiuli dabereba dRevandelTan
SedarebiT ufro maRali iqneba. qveynis mosaxleobis saSualo asaki 36-37 wlidan 42-47
wlamde gaizrdeba.
mTel msoflioSi, mosaxleobis daberebasTan erTad, eTikuri sakiTxebis
mniSvneloba sul ufro izrdeba. maT Soris aris: resursebis problema, sikvdilis
daCqarebasa an sicocxlis gaxangrZlivebasTan dakavSirebuli samedicino Carevebi,
genetikuri kvlevebi da manipulaciebi, Raribi da Sromisuunaro moxucTa uflebebi da
sxv. eTikurad koreqtuli gadawyvetilebebis miReba, xandazmulTa interesebis da
uflebebis dacva, maTi cxovrebis xarisxis gaumjobeseba – es is qvakuTxedebia,
romlebsac daberebasTan dakavSirebuli nebismieri politika unda emyarebodes.
jandacvis msoflio organizaciis mowodebaa àqtiuri daberebis~ politikis gatareba,
rac adamianTa maqsimalurad xangrZlivi aqtiurobis mxardaWeras isaxavs miznad.
64
2004
II. janmrTelobis ZiriTadi determinantebi
arsebobs adamianis janmrTelobis ganmsazRvreli ori ZiriTadi ganzomileba:
sicocxlis xangrZlivoba da cxovrebis xarisxi. janmrTelobis msoflio organizaciis
SefasebebiT (http://www.who.int), adamianis janmrTelobaze moqmed faqtorTa Soris
yvelaze mniSvnelovan uaryofiT zemoqmedebas Raribi qveynebis mosaxleobaze axdens:
dabali wona, uxarisxo sasmeli wyali, aradamakmayofilebeli sanitarul-higienuri
pirobebi, rkinadeficituri anemia, myari sawvavis gamoyenebiT gamowveuli atmosferos
dabinZureba da siRatake. amave dros, mdidar qveynebSi ZiriTad problemebs miekuTvneba
maRali arteriuli wneva, sisxlSi qolesterinis maRali done, Warbi wona, hipodinamia,
mavne Cvevebi (Tambaqosa da aklkoholis moxmareba), adamianis janmrTelobisaTvis
saSiSi kvebis produqtebis warmoeba.
1. socialur-ekonomikuri determinantebi
adamianis janmrTeloba mWidrod aris dakavSirebuli keTildReobis iseT
faqtorebTan, rogoricaa piradi usafrTxoeba, adeqvaturi Semosavali, sacxovrebeli,
socialuri mxardaWera, sazogadoebriv cxovrebaSi monawileobis ufleba da sxv. am
faqtorebs Soris arsebuli urTierTobebi Zalian rTulia da maT udidesi zegavlenis
moxdena SeuZliaT mosaxleobis janmrTelobaze.
calkeuli pirovnebisa Tu mTlianad mosaxleobis janmrTeloba aris
damokidebuli:
•
biologiur da fsiqologiur faqtorebze (memkvidreoba, sxeulis agebulebis tipi,
temperamenti da sxv.);
•
fizikur garemoze (adgilmdebareoba, flora, fauna da sxv.);
•
socialur-ekonomikur da politikur faqtorebze, romlebic Sromisa da yofacxovrebis pirobebis cvalebadobas ganapirobeben;
•
sazogadoebis wevrTa cxovrebis wesze.
aRniSnuli faqtorebi ganapirobebs rogorc individualur, aseve mTlianad
sazogadoebis janmrTelobas (naxati 71).
naxati 71.
pirovnebaze moqmedi faqtorebis gavlena daavadebis aRmocenebaze
daavadeba
fizikuri garemo
ojaxi
sazogadoeba
samuSao
janmrTelobis ZiriTadi determinantebi
65
janmrTeli ar SeiZleba iyos adamiani, romelic ar avadmyofobs, magram
imavdroulad iZulebulia iSimSilos, ganicdides xarisxiani wylis naklebobas, ar aqvs
saxl-kari da a.S. dResdReobiT msoflioSi mcxovrebi 6 miliardze meti adamianidan 1
miliardi siRaribis zRvars miRma cxovrobs, 3 miliardi moixmars dReSi 1 aSS dolarze
naklebs, 3 miliardisaTvis xelmisawvdomi ar aris sufTa sasmeli wyali, 2 miliardi
saerTod ver moixmars eleqtroenergias. ar SeiZleba janmrTelad CaiTvalos is
sazogadoeba da mTlianad mosaxleoba, sadac farTodaa gavrcelebuli narkomania,
alkoholizmi, mosaxleobisaTvis miuwvdomelia saTanado ganaTleba, Tanamedrove
sakomunikacio saSualebebi, samedicino daxmareba. yvela zemoCamoTvlili da sxva
mravali faqtori xels uwyobs rogorc calkeuli pirovnebis dasnebovnebas, ise
mosaxleobaSi daavadebaTa gavrcelebas, rac kidev ufro amZimebs saerTo situacias.
mosaxleobis janmrTeloba sazogadoebis ganviTarebis ZiriTadi pirobaa da amave dros
_ misi moqmedebis saboloo Sedegi (nax. 72).
naxati 72.
adamianis janmrTelobaze moqmedi faqtorebi
socialur-ekonomikuri faqtorebi (sacxovrebeli, Sromis pirobebi, Semosavali da sxv.)
daavadeba
biologiuri faqtorebi (asaki, sqesi, sxeu-lis
wona, genetikuri faqtorebi da sxv.)
fizikuri garemo
(klimati, haeri, wyali, niadagi da sxv.)
samedicinobiologiuri faqtorebi
daavadeba
qceviTi faqtorebi
daavadeba
jandacvis sistemis saqmianobasTan
dakavSirebuli faqtorebi
1.1. siRaribe da janmrTeloba
dReisaTvis 1,1 miliardi adamiani, anu msoflios mosaxleobis meeqvsedi, ganicdis
ukidures siRaribes, isini arian Ratakebi RaribTa Soris da cxovroben ganviTarebad
qveynebSi. ukiduresad Raribebi (1,1 miliardi adamiani) da Raribebi (1,5 miliardi
adamiani) Seadgenen msoflios mosaxleobis 40%-s. yovelwliurad 8 milionze meti
adamiani kvdeba im mizeziT, rom arian Zalian Raribebi da ara aqvT elementaruli
samedicino daxmarebisadmi ekonomikuri xelmisawvdomoba.
siRaribe ukve aRar Tavsdeba nacionalur sazRvrebSi, is ukve gaxda globaluri,
gadakveTs sazRvrebs pasportis gareSe narkotikebis, avadmyofobebis, garemos
dabinZurebis, migraciis, terorizmis da politikuri arastabilurobis saxiT. "siRaribis
globalizaciis” gamo 2000 welis seqtemberSi gaeros 189 wevri qveynis mier miRebul
iqna deklaracia aTaswleulis ganviTarebis miznebis Sesaxeb (MDGs), romelSic pirvel
mizans siRaribis Semcireba warmoadgens (cxrili 45).
66
2004
cxrili 45.
siRaribis dayofa regionebis mixedviT
Semosavali 2$ naklebi dReSi
milioni adamiani
aRm. azia da wynari okeania
CineTi
evropa da cent. azia
mosaxleobis %
1990
2002
2015
1990
2002
2015
1116
748
260
69,9
40,7
12,7
825
533
181
72,6
41,6
13,1
23
76
39
4,9
16,1
8,2
2,2
1.1
52,1
25,9
saqarTvelo
laT. amerika da karibia
125
119
106
28,4
22,6
17,2
Sua aRm. da Crd. afrika
51
61
40
21,4
19,8
10,4
samxreT azia
958
1091
955
85,5
77,8
56,7
sub-saharuli afrika
282
516
592
75,0
74,9
67,1
2654
2611
1933
wyaro: Millenium Development Goals. WB. www.worldbank.org
60,8
49,9
32,8
sul
ukanasknel aTwleulSi msoflioSi mimdinare globaluri procesebis fonze
saqarTveloSi, iseve rogorc evropisa da centraluri aziis regionis gardamavali
ekonomikis qveynebSi, aRiniSna siRaribis donis mniSvnelovani zrda. mTliani Sida
produqtis axlandeli moculoba mniSvnelovnad CamorCeba gardamaval periodamde
arsebuls, rac ZiriTadad politikur, ekonomikur da sazogadoebriv cxovrebaSi
momxdarma cvlilebebma ganapiroba (nax. 73).
naxati 73.
zomier siRaribeSi (Semosavali 2$ naklebi dReSi) mcxovrebi mosaxleoba yofili
socialisturi banakis qveynebSi
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
yirgizeTi
somxeTi
saqarTvelo
ruseTi
rumineTi
l i tv a
1998
1999
2000
2001
2002
2003
wyaro: Millenium Development Goals. Progress and Prospects in Europe and Central Asia. WB, 2005
67
1994-1997 wlebSi ekonomikuri reformisa da stabilizaciis programis ganxorcielebis Sedegad miRweul iqna ekonomikis zrda da inflaciis mkveTri kleba, ramac
Seamcira siRaribis done qveynis garkveul nawilebSi, ZiriTadad qalaqebsa da maT
SemogarenSi. 1996-1997 wlebSi mTliani Sida produqtis saSualo wliuri zrdis tempma
10%-s gadaaWarba, xolo inflacia 13,8%-dan (1996 w.) 7,3%-mde (1997 w.) Semcirda. 1998
wlidan
saqarTvelos
ekonomikaSi
ganviTarebulma
krizisulma
movlenebma
mniSvnelovnad Seaferxa ekonomikuri zrda, ris gamoc momdevno wlebSi SesamCnevi gaxda
siRaribis gaRrmaveba mTeli qveynis masStabiT. mTliani Sida produqtis saSualo
wliuri zrda 1998-1999 wlebSi 3%-mde Semcirda. amave wlebSi inflaciis maCvenebeli
10,7%-10,9% iyo. 2000 w. aRiniSna mTliani Sida produqtis saSualo wliuri zrdis kidev
ufro dabali maCvenebeli – 1,8%, Tumca, inflaciis done TiTqmis 2,5-jer Semcirda da
4,6% Seadgina.
ekonomikuri zrdis TvalsazrisiT 2001 wels gamoikveTa dadebiTi tendencia, rac
mTliani Sida produqtis 4,8%-ian zrdaSi gamoixata. Semdeg wlebSi es tendencia
SenarCunda da 2003 wels 1996 wlis dones gautolda kidec, Tumca 2004 wels kvlav
daiklo mSp-is zrdis tempma da gaizarda inflacia. (nax. 74, 75).
naxati 75. inflacia
naxati 74. mSp-is zrdis tempi
12%
11,2%10,7%
11,1%
10%
8%
6%
4%
2%
4,8%
5,5%
6,2%
2,9% 3,0%
1,8%
0%
1996 1997 1998 1999 2000 2001 2002 2003 2004
16%
14%
12%
10%
8%
6%
4%
2%
0%
13,8%
10,7% 10,9%
7,0% 7,5%
7,3%
4,6%
5,3%
3,5%
1996 1997 1998 1999 2000 2001 2002 2003 2004
wyaro: saqarTvelos finansTa saministro, www.mof.ge
siRaribe janmrTelobis ganmsazRvreli erT-erTi umTavresi maCvenebelia.
siRaribe aramarto aradamakmayofilebeli janmrTelobis ZiriTadi determinantia, is
misi potenciuri Sedegic aris. miuxedavad misi warmomqmneli mizezebisa (Semosavlis
moculoba, socialur-ekonomikuri mdgomareoba, cxovrebis pirobebi, ganaTlebis done) –
siRaribe avadmyofobis erTaderTi umTavresi determinantia. siRatake asocirdeba
mosalodneli sicocxlis xangrZlivobis ufro dabal donesTan, axalSobilTa
sikvdilianobis
maRal
maCvenebelTan,
reproduqciuli
janmrTelobis
aradamakmayofilebel mdgomareobasTan, infeqciuri daavadebebiT dasnebovnebis
(upirveles yovlisa, tuberkuloziTa da aiv/Sids-iT) maRal riskTan, Tambaqos,
alkoholisa da narkotikebis moxmarebis maRal maCvenebelTan, arainfeqciuri
daavadebebiT avadobis, depresiebis, suicidebis, Zaladobis ufro maRal donesTan da
garemos mavne faqtorebis ufro gamoxatul xangrZliv moqmedebasTan.
janmos monacemebiT, 5 wlamde asakis bavSvTa Soris sikvdilianobis 10,5 milioni
SemTxvevidan 97% ganviTarebad qveynebze modis da umetesoba gamowveuli iyo
pnevmoniiTa da diareiT; 2 mln bavSvis sikvdilis Tavidan acileba SesaZlebeli
iqneboda vaqcinaciis farTod danergviT; yovelwliurad 585 000 axalgazrda qali
iRupeba orsulobis an mSobiarobis dros. evropaSi iRupeba 1400-dan erTi, aziaSi 65-dan
erTi, xolo afrikaSi 16-dan erTi.
cudi
janmrTeloba
da
siRaribe
mizez-Sedegobrivadaa
erTmaneTTan
dakavSirebuli. es niSnavs, rom avadmyofi adamianisTvis arsebobs gaRaribebis ufro
meti SesaZlebloba, xolo Raribebi ganekuTvnebian avadmyofobisa da invalidobis
mimarT ufro mowyvlad jgufs. cudi janmrTeloba da janmrTelobaze gaRebuli xarjebi
68
2004
mniSvnelovan tvirTad awveba Rarib mosaxleobas da gardamavali siRaribisken ubiZgebs
“SeZlebulTa” mniSvnelovan nawilsac.
Sinameurneobebis nominaluri Semosavlebis moculoba bolo wlebSi zrdis
tendenciiT xasiaTdeba da 2001 wels, 1996 welTan SedarebiT, 25%-iT gaizarda. Tumca es
zrda jer kidev ar aris
cxrili 46. sakmarisi siRaribis arsebiTi
erTi Sinameurneobis saSualoTviuri Semosavlebi (lari) SemcirebisTvis.
statistikis
saxelmwifo
departamentis
2001
2002
2003
2004
monacemebiT, 2004 wels, wina
sul qveyanaSi
173,7
226,9
242,3
260,0
welTan
SedarebiT,
qalaqad
170,5
202,5
233,8
247,0
Sinameurneobis
saSualoTviuri Semosavlebi gaizarda
soflad
177,2
253,4
250,6
273,0
rogorc qalaqad, ise soflad
(cxrili 46).
2004 wels Sinameurneobebis mTliani xarjebi TveSi erT Sinameurneobaze 361,6
lari iyo (2003 w. – 339,8 lari), samomxmareblo xarjebi ki 315,7 lari (2003 w. – 290,2
lari). Sinameurneobebis resursebis ZiriTadi nawili sursaTze ixarjeba (131,6 lari).
fuladi da arafuladi sasursaTo xarjebis wili mTliani xarjebis daaxloebiT 56%-ia.
Sinameurneobebis xarjebSi didia e.w arafuladi xarjebis (sakuTari warmoebis an
ufasod miRebuli sursaTi) wili _ mTliani xarjebis daaxloebiT 20%. amis gamo
Sinameurneobebis socialur-ekonomikuri mdgomareoba mniSvnelovnad damokidebulia
sakuTari miwidan miRebul mosavalze.
2004 wels pirvelad ekonomikaSi dasaqmebulTa saSualoTviuri nominaluri
xelfasma gadaaWarba saarsebo minimums (nax. 76).
naxati 76.
ekonomikaSi dasaqmebulTa saSualo Tviuri nominaluri xelfasi
saSualoTviuri nominaluri xelfasi
200
137,1
saarsebo minimumi
150
125,9
2000
2001
2002
2003
156,6
113,5
116,6
94,6
50
114,6
72,3
100
130,7
125,4
0
140
135
130
125
120
115
110
105
100
2004
bolo wlebis ganmavlobaSi mkveTrad imata mosaxleobaSi socialur-ekonomikurma uTanabrobam. Semosavlebis faqtiuri ganawilebis mixedviT uTanabrobis maCvenebeli (`jinis~ indeqsi) 1997-2000 ww. 0,52-0,53 farglebSi iyo, Tumca unda aRiniSnos, rom
uTanabrobas ufro kargad asaxavs `jinis~ indeqsi mTliani moxmarebis mixedviT, romlis
mniSvneloba amave periodSi 0,39-is toli iyo. `jinis~ indeqsi 2004 wlis mdgomareobiT
0,46 iyo. uTanabroba SedarebiT
cxrili 47.
dabalia moxmarebis SemTxvesocialur-ekonomikuri uTanabroba
vaSi, romlis mixedviT `jinis~
indeqsi 0,39-is tolia, rac
`jinis~ indeqsi
ufro Tanabari ganawilebis
2000
2001
2002
2003
2004
maCvenebelia
(cxrili
47).
mTliani Semosavlebis
0,50
0,50
0,47
0,49
0,46
moyvanili monacemebi cxadmixedviT
yofs, rom `jinis~ indeqsi
mTliani moxmarebis
0,40
0,38
0,37
0,38
0,39
bolo
wlebis
manZilze
mixedviT
ramdenadme stabiluri xasiwyaro: saqarTvelos statistikuri weliwdeuli - 2005.
aTisaa.
69
oficialuri saarsebo minimumis (137,1 lari) mimarT siRaribis done 2004 wlis
monacemebiT daaxloebiT 52,7%-s Seadgenda. 1994 wels siRaribis done 80% iyo, 1995 wels
- 60%. bolo aTwleulSi siRaribis yvelaze dabali done 1997 wels dafiqsirda _
daaxloebiT 46,2%, 2003 wlamde siRaribis done mcired gamoxatuli zrdis tendenciiT
xasiaTdeba (2003 w. – 54,5%), 2004 wels ki kvlav aRiniSna klebis tendencia.
ukiduresi siRaribis zRvris mimarT siRaribis dones 2000 wlidan zrdis
tendencia axasiaTebs da TiTqmis 1,7-jer aRemateba 1997 wlis dones (nax. 77).
naxati 77.
siRaribis done
siRaribis done oficialuri saarsebo minimumis mimarT (%)
60
52,1
50
46,2
51,8
51,8
50,2
51,1
52,1
54,5
52,7
40
30
siRaribis done ukiduresi siRaribis zRvris mimarT (%)
20
14
9,9
13,8
15,2
14,3
13,8
15,1
16,6
16,9
1998
1999
2000
2001
2002
2003
2004
10
0
1996
1997
wyaro: ekonomikuri ganviTarebis saministro - statistikis deparatmenti. www. statistics.ge
siRaribis donis erT-erTi yvelaze mniSvnelovani ganmsazRvreli faqtori
umuSevrobaa. rac ufro metia SinameurneobaSi umuSevari wevrebi, miT ufro metia aseTi
Sinameurneobebis siRaribis zRvars miRma moxvedris riski. siRaribis zRvars miRma
myofi Sinameurneobebis TiTqmis 40%-Si arcerTi wevri ar aris dasaqmebuli. Raribi
Sinameurneobebis TiTqmis 45%-Si erT momuSaves saSualod 2 an meti suli hyavs sarCeni
Tavis CaTvliT. SinameurneobebSi, romelTa yvela wevri umuSevaria, siRaribis done
saSualoze TiTqmis 3-jer maRalia. 1998-2001 ww. ganmavlobaSi oficialurad
registrirebuli umuSevrebis ricxvi qveyanaSi 10,9%-iT gaizarda (xelaxali
registraciis Sedegad 2002-2004 w.w. es monacemebi Semcirebulia) (nax. 78).
naxati 78.
umuSevroba saqarTveloSi
2041,0
2050,4
2104,2
2051,6
16%
14%
12%
10%
8%
257,6
47,9
235,9
48,7
6%
265
39,3
2009,5
276,9
103,8
500
2025,8
1000
294,7
101,9
1500
2113,3
13,8%
2000
235,6
114,5
14,5%
212,2
122,2
2500
ekonomikurad aqtiuri mosaxleoba (aTasi)
umuSevrebi (aTasi)
oficialurad registrirebuli umuSevrebi (aTasi)
umuSevrobis done
12,6%
12,6%
11,5%
11,1%
10,3%
4%
2%
0%
0
1998
1999
2000
2001
2002
2003
2004
70
2004
nax. 79.
umuSevrobis done, anu umuSevarTa
umuSevrobis done yofil sabWoTa
raodenobis
Sefardeba
ekonomikurad
respublikebSi (2004)
aqtiuri
mosaxleobis
raodenobasTan,
saqarTvelo
12,6
mocemulia naxat 78-ze. mniSvnelovania,
yirgizeTi (2002)
12,5
rom dasaqmebis samaxurSi registrirebuli
estoneTi
9,7
umuSevrebis 34%-s umaRlesi ganaTlebis,
somxeTi
8,7
xolo 65%-s sruli saSulo ganaTlebis
ukraina
8,6
mqone
pirebi
Seadgenen.
asakobrivi
latvia
8,5
struqturis mixedviT 74% aris 25-49
yazaxeTi
8,4
wlamde asakis mosaxleoba.
ruseTi
7,8
saqarTveloSi umuSevrobis done
dsT
6,91
SedarebiT maRalia yofili sabWoTa
litva
6
kavSiris
qveynebis
monacemebTan
taJikeTi (2002)
2,3
SedarebiT (nax. 79).
belorusia
1,9
siRaribe
qalaqad
da soflad
moldova
1,8
mniSvnelovnad gansxvavebul movlenas
azerbaijani
1,4
warmoadgens. siRaribe qalaqad ZiriTadad
uzbekeTi (2002)
0,4
dakavSirebulia
arasrulfasovan
0
5
10
15
kvebasTan, rac saerTo jamSi ufro mwvave
da Rrma siRaribis maCvenebelia. soflad
wyaro: monacemTa baza `janmrTeloba
ki siRaribe kvebasTan iSviaT SemTxvevaSia yvelasaTvis”, www. who.dk/hfadb.
dakavSirebuli, Tumca es mxolod im
faqtiTaa ganpirobebuli, rom soflad kvebis produqtebis moxmarebas ZiriTadad
sakuTari warmoebis sursaTi gansazRvravs. soflad mosaxleobis umTavres problemas
fuladi resursebis deficiti da infrastruqturis arasakmarisi ganviTareba
ganapirobebs, rac Sesabamisad amcirebs xelmisawvdomobas momsaxurebis ZiriTad
saxeebze.
fertiluri asakis qalebi da bavSvebi, romlebic qveynis mosaxleobis TiTqmis
45%-s Seadgenen, maRali riskis fenas miekuTvnebian. siRaribe, arasrulfasovani, dabalkaloriuli kveba gansakuTrebiT moqmedebs qalTa reproduqciul unarze da bavSvTa
zrda-ganviTarebaze.
saqarTvelos
siRaribis
siRrmis
endemuri
maCveneblebi
pirdapirkorelaciur kavSirSia mkvdradSobadobasTan da perinatalur sikvdilianobasTan.
71
1.2. dasaqmeba
janmrTelobis msoflio organizaciis monacemebiT (http://www.who.int), dasaqmebuli
mosaxleobis janmrTelobis mdgomareobis Sefasebisas gamoxatulia pirdapiri
korelacia, erTi mxriv, dakavebuli Tanamdebobis stabilurobasa da, meore mxriv,
avadobasa da sikvdilianobas Soris. rogorc umuSevroba, ise samuSaos dakargvis SiSi
uaryofiTad moqmedebs adamianis janmrTelobaze, zrdis fsiqologiuri da fizikuri
darRvevebisa da suicidebis risks, rac marTebulia nebismieri adamianisaTvis,
miuxedavad misi ganaTlebis donisa da sacxovreblis sakuTrebisa. amave dros,
franqfurtis goeTes saxelobis universitetis mecnierTa gamokvlevebiT dadasturda,
rom samuSao, romelic adamianisagan mudmiv gonebriv daZabulobasa da mniSvnelovani
gadawyvetilebebis miRebas moiTxovs, dadebiTad moqmedebs Tavis tvinis mdgomareobaze
da
anelebs
misi
ujredebis
negatiuri
asakobrivi
cvlilebebis
procesebs
(http://medportal.ru/mednovosti/news/2006).
saqarTvelos socialur-ekonomikuri politikis umTavres prioritets SromiTi
resursebis sruli dasaqmebis miRweva da mosaxleobis socialuri dacvis moqnili
saxelmwifo sistemis formireba warmoadgens.
21-e saukunis damdegs kvlav gagrZelda gasuli aTwleulisaTvis damaxasiaTebeli
ZiriTadi tendencia – dasaqmebulTa raodenobaSi TviTdasaqmebulTa xvedriTi wonis
zrda, romelTa 80%-ze meti sofelSia TviTdasaqmebuli. evrokavSiris qveynebSi es
maCvenebeli 16%-s ar aRemateba. soflad TviTdasaqmebis aseTi maRali monacemi,
romelic dabali ganviTarebis qveynebisTvisaa damaxasiaTebeli, garda mZime
ekonomikuri pirobebisa, imiTac aixsneba, rom TviTdasaqmebulad aRiricxebian ojaxur
sawarmoSi usasyidlod momuSave pirebic (aseTni ki soflad miwis privatizaciis Sedegad
yvela ojaxSi moiZebnebian). amis Sedegia is, rom arabunebrivad maRalia dasaqmebis done
soflebSi, sadac 15 wlis da ufrosi asakis mosaxleobis 75%-ia dasaqmebulia, maSin
rodesac igive cifri evrokavSiris qveynebSi 50%-s ar aRemateba. amiT aixsneba is
mdgomareobac, rom qalaqad fiqsirdeba umuSevrobis bevrad maRali done, vidre
soflad, TumcaRa, realurad dReisaTvis qalaqSi dasaqmebis ufro meti SesaZleblobebia
sofelTan SedarebiT.
socialurma da ekonomikurma cvlilebebma, romlebic saqarTvelos sazogadoebam
bolo aTwleulis ganmavlobaSi ganicada, sruliad Secvala dasaqmebis struqtura.
saqarTveloSi gasuli saukunis bolo aTwleulSi ganviTarebuli socialurekonomikuri da politikuri movlenebis Sedegad mniSvnelovnad gauaresda ekonomikis
funqcionirebis ZiriTadi maCveneblebi. ekonomikis ngreva ki uaryofiT zegavlenas
axdenda qveynis mosaxleobis dasaqmebaze.
saqarTvelos Sromis bazrisaTvis damaxasiaTebel mniSvnelovan tendencias
dasaqmebulTa struqturaSi soflis meurneobis, vaWrobis, momsaxurebis dargebSi
dasaqmebulTa raodenobisa da xvedriTi wonis zrda warmoadgens. imavdroulad
sagrZnobladaa Semcirebuli mrewvelobis, mSeneblobis, mecnierebis, jandacvisa da sxva
sferoebis wili.
dasaqmebulTa
raodenobis
zrdis
tempi
mniSvnelovnad
CamorCeba
TviTdasaqmebulTa analogiur maCvenebels, daqiravebiT dasaqmebulTa raodenoba
sagrZnoblad mcirdeba, rac ZiriTadad saxelmwifo sakuTrebis sawarmoSi dasaqmebulTa
ricxovnobis mkveTri SemcirebiT aris gamowveuli. statistikis saxelmwifo
departamentis monacemebiT, 2004 w. saqarTveloSi ekonomikurad aqtiuri mosaxleoba
2041 aTass adamians Seadgenda, maT Soris dasaqmebuli iyo 1783,3 aTasi adamiani anu
ekonomikurad aqtiuri mosaxleobis 87,3% (daqiravebuli 699,5 aTasi - 29,4%,
TviTdaqiravebuli 1181,7 aTasi – 57,9%), umuSevari – 257,6 aTasi (cxrili 48).
dasaqmebulTa Soris 407 aTasi adamiani (22,8%) muSaobda saxelmwifo seqtorSi.
72
2004
cxrili 48.
15 wlis da ufrosi asakis mosaxleobis ganawileba
ekonomikuri statusis mixedviT
sul 15 welsze ufrosi asakis mosaxleoba
sul aqtiuri mosaxleoba (samuSao Zala)*
sul aqtiuri mosaxleoba (samuSao Zala)**
momuSave
daqiravebuli
TviTdasaqmebuli
gaurkveveli
umuSevari*
umuSevari**
erT welze naklebi
erTidan sam wlamde
sam welze meti
arasdros ar umuSavia
mosaxleoba samuSao Zalis gareT*
mosaxleoba samuSao Zalis gareT **
umuSevrobis done (procentebSi)*
umuSevrobis done (procentebSi)**
aqtiuribis done* (procentebSi)
aqtiuribis done** (procentebSi)
dasaqmebis done (procentebSi)
I
3142,6
2006,7
2088,8
1746,4
619,8
1125,4
1,2
260,2
342,4
96,3
72,7
109,3
110,5
1129,5
1047,4
13,0
16,4
63,9
66,5
55,6
II
3121,7
2053,9
2106,5
1809,0
608,1
1200,6
0,2
244,9
297,5
65,4
65,6
100,2
98,6
1065,2
1012,5
11,9
14,1
65,8
67,5
57,9
III
3180,9
2093,1
2146,3
1819,2
577,5
1239,3
2,4
273,8
327,0
88,5
74,3
101,3
95,9
1085,6
1032,4
13,1
15,2
65,8
67,5
57,2
IV
3159,3
2010,2
2073,8
1758,6
598,1
1158,1
2,4
251,6
315,2
88,5
71,7
93,2
102,5
1143,4
1079,8
12,5
15,2
63,6
65,6
55,7
sul 15 welsze ufrosi asakis mosaxleoba
sul aqtiuri mosaxleoba (samuSao Zala)*
sul aqtiuri mosaxleoba (samuSao Zala)**
momuSave
daqiravebuli
TviTdasaqmebuli
gaurkveveli
umuSevari*
umuSevari**
erT welze naklebi
erTidan sam wlamde
sam welze meti
arasdros ar umuSavia
mosaxleoba samuSao Zalis gareT*
mosaxleoba samuSao Zalis gareT **
umuSevrobis done (procentebSi)*
umuSevrobis done (procentebSi)**
aqtiuribis done* (procentebSi)
aqtiuribis done** (procentebSi)
dasaqmebis done (procentebSi)
1000
638,5
664,7
555,7
197,2
358,1
0,4
82,8
108,9
30,7
23,1
34,8
35,2
359,4
333,3
13,0
16,4
20,3
21,2
17,7
1000
657,9
674,8
579,5
194,8
384,6
0,1
78,5
95,3
20,9
21,0
32,1
31,6
341,2
324,4
11,9
14,1
21,1
21,6
18,6
1000
658,0
674,7
571,9
181,6
389,6
0,8
86,1
102,8
27,8
23,4
31,9
30,2
341,3
324,6
13,1
15,2
20,7
21,2
18,0
1000
636,3
656,4
556,7
189,3
366,6
0,8
79,6
99,8
28,0
22,7
29,5
32,5
361,9
341,8
12,5
15,2
20,1
20,8
17,6
aTasi kaci
sul
3151,1
2041,0
2103,9
1783,3
600,9
1180,8
1,6
257,6
320,5
84,7
71,1
101,0
101,9
1105,9
1043,0
12,6
15,2
64,8
66,8
56,6
yovel 1000 mcxovrebze
1000
647,7
667,7
565,9
190,7
374,7
0,5
81,8
101,7
26,9
22,6
32,1
32,3
351,0
331,0
12,6
15,2
20,6
21,2
18,0
* Sromis saerTaSoriso organizaciis (Sso) kriteriumiT
** Sromis saerTaSoriso organizaciis (Sso) Serbilebuli kriteriumiT
wyaro: http://www.molhsa.ge
umuSevarTa Soris registrirebuli samuSaos maZiebeli 47,9 aTas adamians
Seadgenda, xolo registrirebuli umuSevari – 46,9 aTass (maT Soris 49% - qalebia).
umuSevarTa Soris umaRlesi ganaTlebis mqone adamianebi ricxvi 34,3%-s aRwevs.
amgvarad, dasaqmebis problema, romelic erT-erT umniSvnelovanes socialurekonomikur determinants warmoadgens, arsebuli mZime ekonomikuri pirobebis gamo
saqarTveloSi ufro met xvedriT wonas iZens.
73
1.3. ganaTleba
janmrTelobis erT-erT mniSvnelovan determinants ganaTleba warmoadgens.
ganaTleba iseve, rogorc Semosavlis done, uzrunvelyofs ganviTarebis mdgradobas da
gansazRvravs sikvdilianobisa da avadobis formirebas. ganaTleba dakavSirebulia
qcevis kulturasa da cxovrebis wesTan da Sromis usafrTxo pirobebis arCevis
saSualebasac iZleva. materialuri mdgomareoba da kulturuli potenciali
mniSvnelovnad ganapirobebs bavSvis ganaTlebis dones, rac, Tavis mxriv, aisaxeba mis
janmrTelobis mdgomareobaze.
saqarTvelo tradiciulad xasiaTdeba ganaTlebis farTo gavrcelebiT. bavSvebis
TiTqmis 98% dadis skolaSi, Tumca yuradsaRebia is garemoebac, rom bavSvebis 2% ar
iRebs sabazo ganaTlebas. mosaxleobis ara umetes 5%-s aqvs mxolod dawyebiTi an
naklebi ganaTleba, xolo 15 welze ufrosi asakis mosaxleobis 40%-s saSualo
ganaTleba aqvs, 20%-s saSualo-specialuri, xolo 24%-s umaRlesi (cxrili 49).
cxrili 49.
mosaxleobis ganaTlebis done
10 wlisa da meti asakis mosaxleobis 1000 sulze aqvs
arasruli an sruli umaRlesi da saSualo ganaTleba - sul
m.S. umaRlesi
daumTavrebeli umaRlesi
saSualo profesiuli
zogadi saSualo
arasruli saSualo
sabazo
1979
1989
2000
2001
2002
698
798
849
944
997
103
19
100
292
184
184
137
22
169
328
142
142
196
39
170
322
122
122
247
57
189
331
120
120
243
36
170
32
390
126
2004-2005 saswavlo wels saqarTveloSi funqcionirebda 1247 skolamdeli
dawesebuleba, 3175 saxelmwifo zogadsaganmanaTleblo skola, 176 arasaxelmwifo
zogadsaganmanaTleblo skola, 80 dawyebiTi profesiuli saswavlebeli, 87 saxelmwifo
saSualo profesiuli saswavlebeli, 66 arasaxelmwifo saSualo profesiuli
saswavlebeli. skolamdel dawesebulebebSi swavlobda 75,4 aTasi bavSvi, saxelmwifo
zogadsaganmanaTleblo
skolebSi
–
625,4
aTasi
bavSvi,
arasaxelmwifo
zogadsaganmanaTleblo skolebSi 21
aTasi bavSvi. 2004 wels arsebuli
zogadsaganmanaTleblo dawesebulebidan aratipiur SenobaSi ganTavsebuli iyo 665,
xolo avariul mdgomareobaSi imyofeboda 218 Senoba (183 ZiriTadi Senoba da 35
damxmare nageboba). 2063 zogadsaganmanaTleblo dawesebulebaSi funqcionirebda
stadionebi an sportuli moednebi, xolo 1565 skolas hqonda daxuruli sportuli
darbazi.
raodenobriv maxasiaTeblebs sakmaod CamorCeba ganaTlebis xarisxi da
dRevandelobis moTxovnebisadmi Sesabamisoba. gaizarda SesaZleblobebis uTanasworoba
da Raribi axalgazrdoba sul ufro moklebulia xarisxian umaRles saswavleblebSi
swavlis saSualebas. mSoblebis ganaTlebis maRali done, Tavis mxriv, moqmedebs bavSvis
janmrTelobaze.
amis garda, cxadia, rom bavSvis zrdasTan erTad sul ufro meti mniSvneloba
eniWeba mSobelTa codnas iseT sferoebSi, rogoricaa kveba, higiena, garemosTan
dakavSirebuli riskebi, ramac SeiZleba didi roli iTamaSos janmrTeli axali Taobis
aRzrdaSi. cnobili faqtia, rom kveba da adamianTa wonis indeqsi, maT mier alkoholis
moxmareba korelaciaSi aris ganaTlebis donesTan.
mSoblebis ganaTleba da socialuri mdgomareoba garkveulwilad ganapirobebs
bavSvis mier profesiis arCevasa da Semdgom Semosavlis miRebas. bavSvebs, romlebsac
ganaTlebisa an profesiuli momzadebis ufro maRali done aqvT, meti SesaZlebloba
eZlevaT profesiuli saqmianobisaTvis da, Sesabamisad, Semosavlis misaRebad, rac
saboloo jamSi, janmrTelobis ufro ukeTesi donis albaTobasac zrdis.
74
2004
1.4. genderuli faqtorebi
janmrTelobis erT-erT determinants genderuli kuTvnileba warmoadgens da
genderuli faqtorebiT gamowveuli uTanasworoba garkveul zegavlenas axdens
adamianis janmrTelobasTan dakavSirebuli riskebis warmoqmnaze.
genderulma kuTvnilebam SeiZleba ganapirobos sxvaoba qalTa da mamakacTa
daavadebianobis
struqturasa
da
socialur
statusSi,
qcevis
stereotipebis
Taviseburebebi samedicino daxmarebisaTvis mimarTvis dros, sxvadasxvagvari reagireba
samedicino momsaxurebis mimwodebelTa mxridan. janmrTelobis TviTSefasebisas,
rogorc wesi, mamakacebis ufro maRal Sefasebas aZleven sakuTar janmrTelobas, vidre
qalebi.
rac Seexeba TviT janmrTelobas, arsebobs naTlad gamoxatuli genderuli
sxvaobebi, romlebic gamowveulia biologiuri maxasiaTeblebiT, da am yvelafers Tan
erTvis socialur-ekonomikuri faqtorebi. qalebis sicocxlis xangrZlivoba aRemateba
mamakacebisas, magram is ormagi datvirTva, romelic gaaCniaT qalebs (samsaxuri da
ojaxi) maT daavadebianobaze mkveTr negatiur zegavlenas axdens, magaliTad, qalebSi
ufro xSiria depresiebi da fsiqo-socialuri frustraciebi. amave dros, rusi
mecnierebis gamokvlevebiT dadasturda, rom yvelaze did negatiur gavlenas yofili
socialisturi qveynebis mamakacTa janmrTelobaze axdens siRaribe.
statistikis saxelmwifo departamentis monacemebiT, 2004 wels saqarTvelos
mosaxleobis 52,9%-s qalebi Seadgendnen. dasaqmebulTa Soris ganawileba TiTqmis
Tanabari iyo: 47,1%-s qalebi Seadgendnen, xolo - 51,9%-s mamakacebi. qalebis sicocxlis
xangrZlivoba ufro maRalia, vidre mamakacebisa. magram am tendenciis Sedegi isic aris,
rom qalebSi siRaribis zRvars miRma aRmoCenis albaToba ufro maRalia da maT
xandazmulobasTan dakavSirebuli dainvalidebis ufro meti Sansi aqvT.
amave dros mamakacebSi ufro xSiria ubeduri SemTxvevebi. janmrTelobis
msoflio organizaciis monacemebiT, ukanasknel wlebSi yofil socialistur qveynebSi
aRiniSneba Sromisunariani asakis mamakacTa janmrTelobis mdgomareobis gauareseba.
magaliTad, tuberkuloziT avadoba mamakacebSi jgufSi ufro maRalia, vidre
qalebSi (nax. 80).
naxati 80.
filtvis tuberkuloziT avadobis maCvenebeli sqesis mixedviT
60
sul
50
qali
kaci
40
30
20
10
52,3
24
36,7
22,7
14,2
21,3
22,3
1998
24
13,7
13
0
38,2
31,9
20,4
16,5
9,8
34,6
6,4
6,5
9,5
1999
2000
2001
9,6
11,3
2002
2003
2004
aiv infeqcia/Sidsis registrirebul SemTxvevaTa Soris mamakacebze modis 82%.
avTvisebiani simsivneebiT avadobis maCvenebeli 100000 sul mosaxleze Seadgenda
131,0, is SedarebiT metia qalebSi (134,3) - maTze SemTxvevebis 54,1% modis, vidre
mamakacebSi (127,4). magram yuradRebas ipyrobs simsivnuri daavadebis gavrcelebis
75
Taviseburebebi sqesis mixedviT. ase, magaliTad, qalebSi avadobis struqtura Semdegnairia: 35,6% ZuZus, 24,6% qalis sasqeso organoebis, 16,9% - saWmlis momnelebeli
organoebis kibo. e.i. qalebSi onkologiuri avadobis 60,2% modis reproduqciuli
organoebis kibos wilad. asakTan erTad avadoba TandaTanobiT matulobs. ZuZus kiboian
qalebSi is maqsimalur maCvenebels 55-59 wlis asakSi aRwevs. mamakacebSi lokalizaciis
mixedviT sicocxleSi pirvelad dadgenili simsivneebis struqturaSi 31,6% - sunTqvisa
da gulmkerdis organoebis da 25,9% saWmlis momnelebeli organoebis kiboze modis. e.i.
mamakacebSi onkologiuri avadobis naxevarze meti (57,5%) sasunTqi gzebisa da kuWnawlavis simsivneebiTaa gamowveuli. asakobrivi jgufebis mixedviT sunTqvisa da
gulmkerdis organoebis simsivneebis sixSire yvelaze metad gamoxatuli 80-84 asakobriv
jgufSi iyo.
fsiqikuri da qceviTi aSlilobebiT dispanserul da konsultaciur dakvirvebaze
myof avadmyofTa 57,9%-s mamakacebi Seadgendnen da maTze axali SemTxvevebis 53,4%
modioda. fsiqikuri da qceviTi aSlilobebis klasis rigi daavadebebi umetesad
aRricxulia qalebSi (nevrozebis 51,5%). rac Seexeba iseT daavadebebs, rogoricaa
fsiqozi da Wkuasustoba, epilefsia WkuasustobiT, fsiqopaTia, fsiqomaturi mdgomareoba,
debiloba da reaqtiuli mdgomareoba, maTi 60-69% mamakacebSia registrirebuli.
fsiqoaqtiur nivTierebaTa moxmarebiT gamowveuli fsiqikuri da qceviTi
aSlilobebis mxolod 2% (axali SemTxvevebis 9,1%) qalebze modis, maT Soris
alkoholizmiT aRricxulTa mxolod 2,8%-s qalebi Seadgenen. 2004 w. qalebi Seadgendnen
aRricxvaze ayvanil pirTa mTliani raodenobis 1%-s, Tumca saeqsperto SefasebiT es
raodenoba ufro metia.
2004 w. registrirebul TviTmkvlelobaTa saerTo raodenobidan (175) mxolod
16% (28 SemTxveva) modioda qalebze.
devnil mamakacebSi registrirebuli sikvdilianobis maCvenebeli 1,3-1,35-jer
aRemateba qalebisas. aRniSnulis mTavari mizezebia mamakacTa mier samedicino
dawesebulebebSi ufro iSviaTi mimarTva, maTSi aramanifestirebuli steresuli
mdgomareobis gacilebiT maRali done.
swored amitom, janmrTelobis msoflio organizaciis mier genderul faqtorebze
orientacia gamocxadebulia erT-erT ZiriTad strategiul mimarTulebad, raTa ufro
mizanmimarTulad da efeqturad ganxorcieldes janmrTelobis SenarCunebasa da dacvaze
orientirebuli saqmianoba.
76
2004
1.5. fsiqo-socialuri faqtorebi
janmrTelobis msoflio organizaciis monacemebiT, fsiqo-socialuri stresi
miCneulia erT-erT mniSvnelovan faqtorad, romelic xels uwyobs mTeli rigi
mdgomareobebis ganviTarebas, maT Sorisaa: gulis daavadebebi, hipertenzia, wylulovani
daavadebebi,
RviZlis
cirozi,
alkoholuri
fsiqozi,
nevrozi,
mkvlelobebi,
TviTmkvlelobebi, ubeduri SemTxvevebi, da sxv. aRniSnuli daavadebebi xasiaTdeba zrdis
tendenciiT im qveynebSi, sadac mwvave socialur-ekonomikuri gardaqmnebi adeqvaturi
socialuri politikis ararsebobis fonze mimdinareobs. am qveynebSi janmrTelobis
gauaresebas xeli Seuwyo iseTi fsiqo-socialuri stresuli mdgomareobebis
ganviTarebam, romlebic ganpirobebuli iyo umuSevrobis mosalodneli matebiT,
dasaqmebis arastabilurobiT, ojaxis institutis SesustebiT, gaRatakebis masStabebis
zrdiT, mosaxleobis migraciiT da sxv.
emocionaluri janmrTeloba sakmaod faqizi indikatoria da misi gauareseba,
rogorc wesi, fizikuri janmrTelobis gauaresebis maniSnebelia. ukanasknel wlebSi
Catarebuli gamokvlevebiT dadginda, rom fsiqo-socialur faqtorebze zemoqmedebiT
SesaZlebelia infarqtisa da koronaruli daavadebebiT gamowveuli sikvdilianobis
50%-iT Semcireba (http://www.cardiosite.ru).
saqarTveloSi XX saukunis 90-iani wlebidan yvela am faqtorebma Zalian didi
roli Seasrula mosaxleobis janmrTelobis mdgomareobis gauaresebaSi.
imata garkveuli daavadebebisa da maTdami mgrZnobiare risk-jgufebis ricxvma.
uwinares yovlisa, es aris posttravmuli stresuli darRvevebi, socialur-stresuli
aSlilobebi, depresia, sxva nervuli gamovlinebebi. sagulisxmoa, rom es daavadebebi
sxvadasxva asakis adamianebs moicavs. damafiqrebelia is, rom maT Soris bevria
axalgazrda. es bunebrivicaa, radgan yvelaze mgrZnobiared isini ganicdian
cxovrebiseul siZneleebs.
gansakuTrebiT sagangaSoa devnili mosaxleobis fsiqo-socialuri mdgomareoba.
rogorc mozrdil mosaxleobaSi, ise bavSvebSi aRiniSneba posttravmuli darRvevebi,
socioapatiis elementebi, agreTve parasomniebi da e.w. Ramis koSmarebi, panikuri
mdgomareobebi.
Seqmnil viTarebas kidev ufro arTulebs is, rom ar aris Seswavlili
zemoaRniSnuli daavadebebiT ganpirobebuli mosaloneli Sedegebi, daudgenelia is
fiziologiuri, paTofiziologiuri da neirofsiqologiuri meqanizmebi, romlebic
udides gavlenas axdens pirovnebis Camoyalibebaze.
rogorc calkeuli adamianisaTvis, ise mTlianad sazogadoebisaTvis metad mwvave
socialuri da fsiqikuri problemaa dauqorwinebloba. 2002 wels saqarTveloSi
Catarebuli mosaxleobis aRweris monacemebiT irkveva, rom maRal asakobriv jgufebSi
aTiaTasobiT mamakaci da qali arasodes yofila daqorwinebuli. kidev ufro
damafiqrebelia is, rom am kategoriis mosaxleobaSi
metismetad maRalia
sikvdilianobis
done.
qarTveli
demografebis
kvlevebiT
dadgenilia,
rom
daqorwinebul mamakacebTan SedarebiT, dauqorwinebel mamakacebSi orjer ufro
maRalia sikvdilianoba. aseve maRalia qvrivi mosaxleobis sikvdilianobis donec.
radganac medicinis muSakebs saqme aqvT mxolod fsiqo-socialuri steresis SedegebTan,
maT ar ZaluZT am faqtoris profilaqtika. fsiqo-scialuri stresis donis daqveiTeba
mxolod politikuri da ekonomikuri mdgomareobis gaumjobesebiT aris SesaZlebeli.
77
2. cxovrebis wesi
jandacvis msoflio organizaciis eqspertebis SefasebiT (http://www.who.int), gulsisxlZarRvTa daavadebebis, insultebisa da diabetis 80%-is acileba SesaZlebelia im
SemTxvevaSi, Tuki aRikveTeba daavadebis gamomwvevi ZiriTadi mizezebi – araswori kveba,
hipodinamia da Tambaqos moxmareba.
2.1. kveba
kveba garemos erT-erTi yvelaze mZlavri faqtoria, romelic gavlenas axdens,
rogorc janmrTel, aseve avadmyof adamianze, igi akavSirebs garemosa da organizms,
uzrunvelyofs organizmSi sakvebi produqtebidan rTuli organuli nivTierebebis
(cila, cximi, naxSirwylebi, vitaminebi) da sxva qimiuri elementebis, mineraluri
nivTierebebisa da wylis miwodebas. TiToeuli ingredientis xangrZlivi deficiti an
siWarbe SeiZleba qronikuli arainfeqciuri daavadebebis erT-erTi gamomwvevi mizezi
gaxdes. magaliTad, 90-ian wlebSi poloneTSi 10%-iT Semcirda axalgazrdebis
sikvdilinoba mas Semdeg, rac bazari gajerebul iqna xiliTa da bostneuliT da moxda
fasebis subsidireba rZis produqtebsa da karaqze (http://www.who.int). miCiganis Statis
universitetis samedicino skolis mecnierTa mier Tagvebze Catarebuli kvlevebiT ki
dadasturda, rom mxolod Warbi kaloriebis moxmarebis 8%-iT SemcirebiT SesaZlebelia
sicocxlis gaxangrZliveba 20-40%-iT (http://medportal.ru/mednovosti/news/2006).
dReisaTvis kvebis faqtorebiT gamowveul daavadebebs (alimentarul daavadebebs)
jer kidev didi wili aqvs mosaxleobis avadobisa da sikvdilianobis struqturaSi. Tu
ganviTarebuli saxelmwifoebisaTvis problemis simwvave gamoixateba, ZiriTadad,
racionis Warbi kaloriulobisa da zogierTi sakvebi ingredientis farTo moxmarebis
Sedegad gamowveuli iseTi arainfeqciuri qronikuli daavadebebis ganviTarebiT,
rogoricaa
simsuqne,
gul-sisxlZarRvTa
daavadebebi
da
sxv.,
ganviTarebadi
qveynebisTvis, m.S. saqarTvelosTvisac, am mxriv aqtualuria SimSilis problema, mTeli
rigi kvebiTi faqtorebis (cilebi, cximebi, mikroelementebi da sxv.) deficiti, rac Tavis
mxriv mosaxleobaSi iwvevs avitaminozs, anemiebs, bavSvebSi zrdisa da ganviTarebis
daqveiTebasa da sxv.
saqarTvelos statistikis saxelmwifo departamentis monacemebiT, 2004 wels, 2003
welTan SedarebiT, erT sul mosaxleze purisa da purproduqtebis 4,4%-iT (135,2 kg-dan
141,2 kg-mde), makaronisa da analogiuri nawarmis 1,5%-iT (6,5 kg-dan 6,6 kg-mde), xorcisa
da xorcis produqtis 5,1%-iT (17,6 kg-dan 18,5 kg-mde), zeTisa da cximebis 3,3%-iT (12,3 kgdan 12,7 kg-mde), Saqrisa da sakonditro nawarmis 1,7%-iT (23,5 kg-dan 23,9 kg-mde),
moxmarebis raodenobrivi maCveneblebis zrdis fonze, adgili hqonda bostneulisa da
kartofilis 0,07%-iT (134,8 kg-dan 134,7kg-mde) rZisa da rZis produqtis 1,2%-iT (83,3 kgdan 82,3 kg-mde), Tevzeulis 2,6%-iT (3,9 kg-dan 3,8 kg-mde), kvercxis 4,4%-iT (113 calidan 108
calamde), yurZnisa da xilis 14,3%-iT (46,2 kg-dan 39,6 kg-mde) moxmarebis raodenobrivi
maCveneblebis Semcirebas (cxrili 50).
78
2004
cxrili 50.
saqarTveloSi erT sul mosaxleze zogierTi sakvebi produqtis moxmarebis maCveneblebi (kg)
#
produqtis dasaxeleba
1
2
puri da purproduqtebi
marcvleuli da burRuleuli
3
makaroni da analogiuri nawarmi
4
5
6
7
8
9
10
11
12
13
14
2003
2004
135,2
141,2
6,3
6,3
mateba da/an kleba %-Si
2003 welTan SedarebiT
+4,4
0
6,5
6,6
xorci da xorcis produqtebi
17,6
18,5
rZe da rZis produqtebi
83,3
82,3
Tevzi da Tevzis produqtebi
3,9
3,8
zeTi da cximebi
12,3
12,7
kvercxi (cali)
113
108
Saqari da sakonditro nawarmi
23,5
23,9
bostneuli
134,8
134,7
yurZeni, xili
46,2
39,6
min. wyali, ualkoholo sasmeli, wvenebi
2,6
2,6
yava, Cai, kakao
0,7
0,7
kvebis sxva produqtebi
9,0
9,4
+1,5
+5,1
-1,2
-2,6
+3,3
-4,4
+1,7
-0,07
-14,3
0
0
+4,4
aRsaniSnavia, rom 2004 wels mosaxleobis kvebis racionSi 31,9% ekava makaronis
nawarms, pursa da burRuleuls, bostneuls – 27,9%, rZesa da rZis produqtebs – 17,2%,
xorcis wilma ki mxolod 3,8% Seadgina (nax. 81).
naxati 81.
mosaxleobis kvebis racioni
sxva produqtebi
14,3%
xorci
3,8%
4,9%
Saqari
rZe da rZis produqtebi
17,2%
bostneuli
27,9%
31,9%
makaroni, puri, burRuleuli
0%
5%
10%
15%
20%
25%
30%
35%
79
2.2. Tambaqos moxmareba
Tambaqos moxmarebasTan dakavSirebiT sazogadoebis danakargebi wlidan wlamde
izrdeba. dadgenilia, rom sigaretis SeZenaze daxarjuli Tanxebi mwevelTa
diagnostikis, mkurnalobisa da reabilitaciis safasuris tolia. amas emateba
arapirdapiri xarjebic, romlebic mwevelTa Sromisuunarobisa da naadrevi
sikvdilianobis maRali doniT aris ganpirobebuli. Tambaqos mwevelebSi Sromisuunaro
dReTa ricxvi 25-50%-iT ufro maRalia, vidre aramwevelebSi.
gul-sisxlZarRvTa da onkologiur daavadebaTa ganviTarebis erT-erTi yvelaze
kargad Seswavlili risk-faqtoria nikotinis zemoqmedeba adamianis organizmze.
gardacvlil onkologiur avadmyofTa 30% Tambaqos moixmarda, filtvis kibos dros ki
mwevelTa xvedriTi wili 80%-s aRwevs.
aSS-is pediatriis akademiisa da fondi `memkvidreoba~-s mier Catarebuli
gamokvlevebiT, Tambaqos moxmarebiT gamowveuli avadobis tvirTi ZiriTadad bavSvebze
modis (http://contact.tobinfo.org). e.w. meoradi mowveva seriozul safrTxes uqmnis bavSvTa
janmrTelobas. aq igulismeba mcire wona dabadebisas, uecari sikvdilis sindromi, asTma
da Suayuris anTebebi bavSvebSi, rasac emateba Tambaqos mwevelTa garemoSi gazrdili
bavSvebis mier SemdgomSi Tambaqos moxmarebis maRali procenti.
Tambaqos moxmareba saqarTveloSi sazogadoebrivi jandacvis erT-erT umTavres
problemas warmoadgens. sxvadasxva kvlevebis monacemebiT (saqarTvelos Sromis,
janmrTelobisa da socialuri dacvis saministros sazogadoebrivi jandacvis
departamentis informacia), sadReisod Tambaqos moixmars qveynis mozrdili
mosaxleobis daaxloebiT 40%. mamakacebs Soris mwevelia 50-65%, xolo qalebs Soris
mwevelobis progresi katastrofulia – igi bolo 16 wlis ganmavlobaSi TiTqmis 6-jer
gaizarda (m.S. Tambaqos moxmarebis gavrceleba gazrdilia orsulebSi) da 22%-s miaRwia.
sagangaSo mdgomareobaa bavSvebsa da axalgazrdebSi, kerZod, 14-16 wlamde bavSvebSi
Catarebuli erovnuli donis kvlevis mixedviT, skolis moswavleTa 42%-s gasinjuli
aqvT Tambaqo (maTgan 52,2%-ma Tambaqo 10 wlamde asakSi gasinja); 23,3% regularulad
eweoda gamokvlevis periodSi; skolis moswavleTa 93,3% imyofeba mwevelTa garemoSi,
xolo 74%-s mravaljer aqvs nanaxi Tambaqos reklama.
sxvadasxva kvlevebiT dadasturda, rom saqarTvelos mosaxleobis umetesi nawili
imyofeba Tambaqos permanentuli da intensiuri zemoqmedebis qveS. Tambaqos moxmarebis
sixSire rogorc mamakacebSi, aseve qalebSi yvelaze maRalia 26-59 wlis asakobriv
jgufSi, isini ewevian mTeli moxmarebuli sigaretis 60,5%-s. maTze modis sigaretis
SeZenaze daxarjuli mTeli Tanxis ori mesamedi.
qveyanaSi
Sromis,
janmrTelobisa
da
socialuri
dacvis
saministros
sazogadoebrivi jandacvis departamenti 1996 wlidan axorcielebs cxovrebis jansaRi
wesis damkvidrebaze mimarTul saqmianobas, romlis mTavari komponentia Tambaqos
winaaRmdeg brZola. warmoebs miznobivi jgufebis (prioriteti bavSvebi da
axalgazrdoba) informaciuli, saganmanaTleblo, kvleviTi da meTodologiuri muSaoba.
2.3. narkotikebis moxmareba
msoflios TiTqmis yvela qveyanaSi aRiniSneba wamalTdamokidebulebisa da
gansakuTrebiT, narkomaniis zrdis tendencia. amasTan dakavSirebiT gaerTianebuli
erebis organizacia da yvela qveynis mTavroba ganagrZobda wamalTdamokidebulebasTan
brZolis RonisZiebebis intensifikacias, radganac narkotikebze damokidebuleba
aramarto qronikuli daavadeba, aramed socialuri problemac aris.
samwuxarod, saqarTveloSi aRiniSna narkosituaciis gauareseba. es ganpirobebuli
iyo rigi garemoebebiT, romelTagan, garda saerTo mZime socialur-ekonomikuri
mdgomareobisa, gadamwyveti mniSvneloba iqonia orma faqtorma. kerZod, saqarTvelos
azia-evropis satranzito qveynad gadaqcevam da, amdenad, misma moxvedram narkomafiis
interesebis sferoSi, da qveyanaSi didi raodenobiT heroinis SemoRwevam, rasac 1998
wlamde faqtiurad adgili ar hqonia.
80
2004
2004 wels saqarTveloSi aRricxul iqna narkomaniis 6532 SemTxveva (daavadebianoba – 149,4), maT Soris, pirvelad dadgenili diagnoziT 495 (avadoba – 11,4).
narkomania aRiarebulia Sidsis da C-hepatitis gavrcelebis erT-erT ZiriTad
faqtorad. Cvens qveyanaSi aRricxul aiv-inficirebulTa da SidsiT daavadebulTa 70%mde intravenuri narkomania, xolo C-hepatiti, romelic organizmze damangreveli
zemoqmedebiTa da gavrcelebis gzebiT ar Camouvardeba Sidss – narkomanebs Soris ukve
epidemiis xasiaTs iRebs.
narkologiis institutis monacemTa bazaSi oficialurad registrirebulia
narkotikuli saSualebebis 24 000 momxmarebeli da damokidebuli piri. eqspertuli
SefasebiT, narkotikul nivTierebaTa momxmarebelTa raodenoba gacilebiT aRemateba
oficialurad aRricxuls da is 200000-240000 farglebSia. yvelaze metad gavrcelebuli
narkotikuli nivTiereba aris marixuana, ukanasknel wlebSi adgili hqonda misi
moxmarebis mkveTr zrdas, gansakuTrebuli mateba aRiniSna 2002 wels, rodesac
registrirebuli marixuanas momxmarebelTa raodenoba erTi wlis manZilze TiTqmis
samjer gaizarda. xolo narkotiki, romlisadmi damokidebuleba yvelaze xSirad
gvxvdeba _ opiumis jgufis nivTierebebi. aRricxul pirTa Soris 59% opiumis jgufis
narkotikebis (opiumi, heroini da sxv.) gamomyenebelia, eqspertTa SefasebiT maTi
raodenoba qveyanaSi SesaZloa 80 000 aRwevdes (nax. 82).
naxati 82.
aRricxvaze myof narkotikebis momxmarebelTa danawileba
moxmarebuli nivTierebis mixedviT (%)
70
60
50
40
30
20
10
0
opiumi
marixuana
sxva
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
wyaro: narkoviTareba saqarTveloSi - 2004, wliuri angariSi.
2003 wlidan saqarTveloSi Semovida yayaCos Tesli, romelic opiumis maRali
SemcvelobiT
xasiaTdeba.
aRniSnuli
yayaCos
Teslis
moxmarebam
advilad
xelmisawvdomobisa da siiafis gamo swrafad miaRwia saxifaTo masStabebs,
gansakuTrebiT, axalgazrdebsa da narkotikebis araregularul momxmareblebSi.
specializebul
narkologiur
dispanserebSi
fsiqoaqtiuri
nivTierebebis
gamoyenebiT gamowveuli fsiqiuri da qceviTi aSlilobebiT 2004 wels dakvirvebaze
imyofeboda 31417 avadmyofi (2003 wels - 28361). maT Soris, sicocxleSi pirvelad dadgenili
diagnoziT 3025 (2003 wels – 2599). am kontingentis ganawileba calkeuli nozologiuri
jgufebis mixedviT mocemulia cxril 51-Si.
unda aRiniSnos is sakmaod mZime garemoebac, rom narkotikebis moxmareba yvelaze
xSiria 21-dan 35 wlamde asakobriv jgufze, anu is sazogadoebis yvelaze Sromisunarian
nawilze modis. opioidebis momxmareblebisaTvis yvelaze damaxasiaTebeli asakia 26-30
weli, xolo opioidebze damokidebulTaTvis – 31-35. marixuanas momxmamrebelTa asaki
meryeobs 13-14 wlidan 50 welsa da zemoT, moxmareba yvelaze maRalia 21-25 wlis
asakobriv jgufSi.
2004 wels registrirebul pirTa Soris 24%-s gaaCnia umaRlesi ganaTleba, 48%-s
ki saSualo.
81
cxrili 51.
fsiqoaqtiuri nivTierebebis gamoyenebiT gamowveuli fsiqiuri da qceviTi aSlilobebi
28361 655,2
7960 183,9
6741 155,7
35
0,8
13256 306,2
345
8,0
alkoholizmi
narkomania
toqsikomania
narkotikul nivTierebaTa borotad gamoyeneba
aranarkotikul nivTierebaTa borotad gamoyeneba
2599 60,0
174
4,0
495 11,4
1
0,02
1903 44,0
15
0,3
cnobari.
31417
8033
6532
45
16350
327
avadoba
axali
SemTxvevebi
daavadebianoba
registrirebuli
SemTxvevebi
avadoba
2004
axali
SemTxvevebi
daavadebianoba
registrirebuli
SemTxvevebi
2003
718,7 3025 69,2
183,8 189 4,5
149,4 447 10,2
1,03
15
0,3
374,0 2085 47,7
7,5
174 4,0
narkomaniis
winaaRmdeg
brZola
gaerTianebuli
erebis
organizaciis
prioritetuli moTxovnaa da igi or ZiriTad mimarTulebas moicavs. pirveli –
mosaxleobisaTvis narkotikuli nivTierebebis xelmisawvdomobis aRkveTa (rac
praqtikulad SeuZlebelia) an mniSvnelovani Semcireba, rac ZiriTadad Zalovani
struqturebis movaleobaa, meore – narkotikuli nivTierebebis moxmarebaze
mosaxleobis moTxovnilebis mospoba (rac praqtikulad SeuZlebelia) an mniSvnelovnad
Semcireba.
mosaxleobaSi narkotikul nivTierebebze moTxovnilebis Semcireba Tavis mxriv
or ZiriTad faqtorzea damyarebuli. pirveladi prevencia, anu mosaxleobaSi
narkotikebis moxmarebisadmi negatiuri damokidebulebis gamomuSaveba, da narkotikuli
nivTierebebis moxmarebiT gamowveuli daavadebebis mkurnaloba. am saqmeSi Sromis,
janmrTrelobisa da socialuri dacvis saministrosTan erTad mniSvnelovani wvlilis
Setana SeuZliaT ganaTlebis, kulturis, sportis, turizmisa da sxva uwyebebs.
wamalTdamokidebuleba unda ganixilebodes farTo konteqstSi, rac gulisxmobs
narkotikebis problemis gadawyvetas populaciis doneze. swored amitom, evropis
regionSi gacxadebuli janmrTelobis msoflio organizaciis nacionaluri politikis
ZiriTad mimarTulebas informaciis gavrceleba, swavleba, mkurnaloba da reabilitacia
warmoadgens.
2.4. alkoholis moxmareba
janmrTelobis msoflio organizaciis SefasebiT, evropis regionSi avadobis
tvirTis daaxloebiT 9% modis spirtiani sasmelebis moxmarebaze, rac sxva riskis
faqtorebTan erTad, ganapirobebs iseTi daavadebebis ganviTarebas, rogoricaa: RviZlis
cirozi, hipertenzia, insulti, gulis iSemiuri daavadebebi, pankreatiti, kuWis, RviZlis,
swori nawlavis, xorxis simsivneebi da sxv., iwvevs fsiqomotoruli da kognitiuri
funqciebis
seriozul
darRvevebs.
alkoholur
Trobas
mohyveba
emociuri
TviTkontrolis Sesusteba, rac SeiZleba Zaladobis gamovlinebis biZgi gaxdes.
Rvinisa da sxva spirtiani sasmelebis zomieri moxmarebis didma istoriulma
tradiciebma xeli Seuwyo saqarTveloSi alkoholizmis dabali donis SenarCunebas 90ian wlebamde. amasTan erTad saqarTvelosaTvis gacilebiT damaxasiaTebelia spirtiani
sasmelebis, gansakuTrebiT Rvinis, e.w. sayofacxovrebo moxmareba, rac sakmarisad did
zians ayenebs mosaxleobis janmrTelobis mdgomareobas.
momdevno wlebSi mdgomareobis gamwvavebas xeli Seuwyo qveyanaSi politikuri da
gansakuTrebiT ekonomikuri situaciis gamZafrebam, magari
spirtiani sasmelebis
dempingur fasebSi gasaRebam, rasac Tan sdevda Sida bazarze maRalxarisxiani Rvinis
nawarmis arasakmarisi gamoSveba. erT-erT seriozul problemas warmoadgens
sazogadoebriobis lmobieri damokidebulebac axalgazrdebis mier spirtiani sasmelebis
82
2004
gadaWarbebuli moxmarebis mimarT. zemoaRniSnulma mniSvnelovnad Seuwyo xeli magari
spirtiani sasmelebis moxmarebis zrdas mosaxleobaSi da gansakuTrebiT axalgazrdebSi,
maT Soris qalebSic. amave dros, janmrTelobis msoflio organizaciis monacemebiT,
evropis regionSi yovelwliurad 55 aTasze meti axalgazrda iRupeba alkoholis
moxmarebis Sedegad.
2004 wlis bolos narkologiuri profilis dispanserebSi fsiqoaqtiuri
nivTierebebis gamoyenebiT (alkoholizmi, narkomania, toqsikomania) gamowveuli
fsiqiuri da qceviTi aSlilobebiT dakvirvebaze imyofeboda 31417 avadmyofi,
(daavadebianoba – 718,7), maT Soris sicocxleSi pirvelad dadgenili diagnoziT - 3025
(avadobis maCvenebeli – 69,2). 2003 welTan
SedarebiT maCveneblebi gazrdilia.
cxrili 52.
2004 wels saqarTveloSi aRricxul iqna
alkoholizmis gavrceleba
alkoholizmis 8033 SemTxveva, maT Soris
2002
2003
2004
sicocxleSi pirvelad dadgenili diagnoziT
daavadebianoba
188,8
183,9
183,8
iyo 198, avadobis maCvenebeli ki – 4,5. saxezea
avadoba
4,7
4,0
4,5
2003 wels dafiqsirebuli raodenobis mateba: wyaro: janmrTelobis dacva, saqarTvelo,
wina wels aRricxulTa raodenobam Seadgina 2004, statistikuri cnobari.
7960, axali SemTxvevebi 174 iyo (cxrili 52).
alkoholis moxmarebiT gamowveuli
fsiqikuri da qceviTi aSlilobebis SemTxvevebidan (8033) 44,9% Tbilisze modis.
83
3. garemos gavlena mosaxleobis janmrTelobaze
jansaRi garemo ganapirobebs janmrTel mosaxleobas (nax. 83, 84). janmrTelobis
dacva saWiroebs garemos SenarCunebas da mis aRdgenas im SemTxvevaSi, roca garemo
ganicdis adamianis saqmianobiT an bunebrivi katastrofebiT gamowveul damRupvel
gavlenas.
naxati 83.
garemo faqtorebiT gamowveuli sikvdilianoba
1800
1600
1400
1200
1000
800
600
400
200
0
1700
1600
1200
800
150
wylis
dabinZureba
myari sawvavis
moxmareba
daxurul
sivrceSi
haeris
dabinZureba
qalaqad
sagzao
SemTxvevebi
klimatis
cvlileba
wyaro: World Health Report – 2002. WHO
naxati 84.
garemo faqtorebiT gamowveuli avadobis tvirTi
garemo faqtorebiT
gamowveuli avadobis
tvirTis wili avadobis
globalur tvirTSi
wyaro: janmrTelobis msoflio organizacia - www.who.int
2004 wels qveynis mosaxleobis sanitariul-higienuri situacia daZabuli rCeboda
da SeimCneoda misi arastabiluri mdgomareoba. socialuri da garemo faqtorebis
adamianis janmrTelobaze negatiuri zegavlena atarebda gamoxatul xasiaTs da
garkveulwilad
ganapirobebda
mosaxleobis
janmrTelobis
mdgomareobis
maxasiaTeblebisa da mediko-demografiuli maCveneblebis gauaresebas.
84
2004
ekonomikuri krizisis fonze da mosaxleobis udidesi nawilis sicocxlis donis
Semcirebis pirobebSi sul ufro Zneldeba adamianis janmrTelobaze qimiuri, fizikuri,
biologiuri da socialuri faqtorebis gavlenis Tavidan acileba, rac TavisTavad
aRrmavebs adamianis organizmis fsiqo-emociuri datvirTvisa da gadaZabvis procesebs,
agreTve organizmis adaptaciur-SemgueblobiTi meqanizmebis Sesustebas.
dasaxlebuli adgilebis garemo faqtorebis (atmosferuli haeri, wyali, niadagi)
sanitariul-higienuri mdgomareoba xasiaTdeboda dabinZurebis garkveuli doniT, didi
qalaqebisa da dasaxlebuli punqtebis aradamakmayofilebeli sanitariul-higienuri da
komunaluri mdgomareobiT, naklovanebebiT mosaxleobis xarisxiani sasmeli wyliTa da
sakvebi produqtebiT uzrunvelyofaSi, bavSvTa mosaxleobis aRzrdisa da swavlebis
pirobebis higienuri moTxovnebis darRvevaSi, mosaxleobaSi dabali sanitariuli
ganaTlebiTa da kulturiT, ramac Tavisi gamoxatuleba hpova mosaxleobis
janmrTelobis mdgomareobis maxasiaTeblebis gauaresebaSi.
qalaqebis, raionebisa da sxva dasaxlebuli adgilebis centralizebuli
wyalmomaragebis sistemebis, maTi nagebobebisa da qselebis sanitariul-teqnikuri
mdgomareobis Semdgomi gauareseba, wyalmomaragebis wyaroebis sanitariuli dacvis
moTxovnebis ugulebelyofa xels uwyobda qveynis mosaxleobis mier higienur
normebTan Seusabamo da arastandartuli sasmeli wylis gamoyenebas.
sanitariul-epidemiologiuri
keTildReobis
problemebi
damokidebulia
sazogadoebis
socialur-ekonomikur
mdgomareobaze
da
warmoadgens
rogorc
sauwyebaTSoriso, aseve interseqtoraluri regulirebis sferos. Sesabamisad, qveynis
mosaxleobis sanitariul-epidemiologiuri keTildReobis stabilizaciis amocanebi da
problemebi
unda
wydebodes
aRmasrulebeli
xelisuflebis,
adgilobrivi
TviTmmarTvelobisa
da
mmarTvelobis
organoebis,
sameurneo
subieqtebis
uflebamosilebisa da kompetenciis farglebSi.
3.1. atmosferuli haeris sanitariuli mdgomareoba
atmosferul haeris sanitariuli mdgomareobis Sefaseba saqarTveloSi
gansakuTrebul yuradRebas iTxovs, radgan qveynis geografiuli mdebareoba da
satranzito funqcia, reliefis gamo paraleluri avtomagistralebis ar
arseboba,
ukanasknel wlebSi mrewvelobis seqtoris xvedriTi wilis Semcirebis fonze
avtosatransporto
saSualebebis raodenobis zrda da maTi mWidro nakadebi
ganapirobebs mavne nivTierebebiT atmosferuli haeris dabinZurebis maRal dones, rac
ar gamoricxavs didi qalaqebisa da sxva mWidrod dasaxlebuli teritoriebis
mosaxleobis janmrTelobaze zegavlenas.
saqarTvelos statistikis saxelmwifo departamentis monacemebiT, 2004 wels, 2003
welTan SedarebiT, qveynis masStabiT atmosferul haerSi gafrqveuli iyo 1,4-jer
naklebi mavne nivTierebebi, ramac 307,5 aTasi tona Seadgina. 2004 welsac yvelaze maRali
iyo avtotransportidan gafrqveuli mavne nivTierebebiT atmosferuli haeris
dabinZurebis maCvenebeli – 199,1 aTasi tona, Tumca es raodenoba 1,9-jer naklebia, vidre
2003 wels. 2004 wels samrewvelo seqtoris mier atmosferuli haeris gaWuWyianebis
xvedriTi wili Seadgenda 35,3%, xolo avtotransportis – 64,7% (cxrili 53).
cxrili 53.
atmosferul haerSi mavne nivTierebaTa saerTo gafrqvevebSi samrewvelo obieqtebis
(gafrqvevis stacionarul wyaroTa) da avtotransportis xvedriTi wilis maCveneblebi
gafrqvevis saxeobebi
stacionaruli wyaroebi
avtosatransporto saSualebebi
sul
raodenoba
aTasi tona
(%)
aTasi tona
(%)
aTasi tona
wlebi
2003
55,0
12,5
386
87,5
441
2004
108,4
35,3
199,1
64,7
307,5
85
2004 wels, 2003 welTan SedarebiT, atmosferul haerSi
mavne
nivTierebebis
gamomfrqvevi stacionaruli wyaroebis saerTo raodenoba Semcirda 39,5%-T (933-dan 564mde), xolo mavne nivTierebebis gamomfrqvevi stacionaruli organizebuli wyaroebis
raodenoba 49,9%-iT (823-dan 411-mde).
2004 wels stacionaruli wyaroebidan atmosferul haerSi gafrqveuli iyo 108,4
aT.t. mavne nivTierebebi, maT Soris 6,4 aTasi tona myari da 102,1AaTasi tona airadi da
Txevadi, xolo gafrqveuli airadi da Txevadi nivTierebebis saerTo raodenobidan
gogirdovani anhidridi Seadgenda 8,7 aTas tonas, azotis Jangeulebi - 1,9 aTas tonas,
arameTanuri aqroladi organuli nivTierebebi (aaonebi) - 89,9 aTas tonas, danarCeni 0,6 aTas tonas (cxrili 54).
cxrili 54.
stacionaruli wyaroebidan (samrewvelo procesebidan)
atmosferul haerSi gafrqveuli mavne nivTierebebis raodenoba
gafrqvevebis raodenobebi,
aTasi tona
2003
gafrqveuli mavne nivTierebebi, sul
m a T S o r i s:
myari
airadi da Txevadi
m a T S o r i s:
gogirdovani anhidridi
naxSirJangi_CO
azotis Jangeulebi (NO2-ze gadaangariSebiT)
arameTanuri aqroladi organuli naerTebi-aaon
(naxSirwyalbadebi)
danarCeni
204
sul
%
sul
%
55,1
100,0
108,4
100
6,6
48,5
12,0
88,0
6,4
102,1
5,9
91,2
0,7
4,2
1,2
42,2
1,2
7,6
2,1
76,7
1,0
8,7
1,9
89,9
0,92
8,02
1,75
89,9
0,2
0,4
0,6
0,5
zemoaRniSnuli monacemebis mixedviT, 2004 wels, iseve rogorc 2003 wels, qveynis
masStabiT stacionaruli wyaroebidan atmosferuli haeris dabinZurebaSi wamyvani
adgili ekava arameTanur aqrolad organul naerTebs, romelTa xvedriTi wili
gafrqvevebis saerTo raodenobaSi 89,9% Seadgenda.
2004 wels, 2003 welTan SedarebiT, aRiniSna stacionaruli wyaroebidan
atmosferul haerSi gamofrqveuli mavne nivTierebebis gauvnebelyofis maCveneblebis
zrda, ramac Sesabamisad, Seadgina 106,0 da 49,4 aTasi tona.
garemos dacvisa da bunebrivi resursebis dacvis saministros monacemebiT,
saqarTvelos qalaqebis atmosferuli haeris mavne nivTierebebiT dabinZureb saSualo
wliuri koncentraciebi mocemulia cxrilSi 55.
cxrili 55.
#
qalaqis
dasaxeleba
mtveri
saS.
1
2
3
4
5
6
Tbilisi
rusTavi
quTaisi
baTumi
zestafoni
axalcixe
0.3
0.2
0.4
0.9
maq.
1.1
0.5
1.7
1.7
gogirdis
dioqsidi
saS.
0.10
0.12
maq.
damabinZurebeli ingredientebi mg/m3
naxSir
xsnadi
azotis
azotis
mJava
sulfatebi
oqsidi
dioqsidi
saS.
maq.
2
3
2
11
5
5
0.15
0.17
saS.
maq
0.02
0.04
saS.
0.03
1
manganumis
dioqsidi
maq.
saS.
maq.
saS.
maq.
0.03
0.05
0.04
0.08
0.06
0.006
0.06
3
zemoaRniSnulis gaTvaliwinebiT cxadi xdeba, rom qveynis dasaxlebuli adgilebis
atmosferuli haeris sanitariuli dacvisa da mosaxleobis janmrTelobisaTvis
usafrTxo garemos uzrunvelsayofad misi xarisxobrivi mdgomareobis monitoringis
sakiTxi kvlav aqtualuria.
86
2004
3.2. mosaxleobis wyalmomaragebis sanitariuli mdgomareoba
msoflioSi dRiTidRe matulobs sasmeli wylis miwodebis saSualebebi, Tumca
gaeros monacemebiT, 2015 wlisaTvis jer kidev ar iqneba gadawyvetili sufTa wylis
miwodebis probleba da dabinZurebuli wyaroebis wyals 800 milioni adamiani moixmars
(http://un.by/ru).
saqarTvelos wyliT uzrunvelyofa saSualo maCvenebelzea da usafrTxo wylis
momaragebis uzrunvelyofa erT-erTi mniSvnelovani amocanaa saqarTvelos mosaxleobis
janmrTelobisa da ekologiuri usafrTxoebis uzrunvelyofis saqmeSi.
mTlianad, bevri wyalsadenis saTave nagebobebisa da umetesi wyalsadenebis
qselis sanitarul-teqnikuri mdgomareoba aradamakmayofilebelia, rac dadasturda
sasmeli wylisagan gamowveuli masobrivi daavadebebis xSiri gamovlinebebiT.
dReisaTvis wyalsaRebi nagebobebis umetesobaze ar arsebobs specialurad SemoRobili
daculi sanitaruli zonebi, wyalsadenebis 60%-s, sakanalizacio qselebis 50%-sa da
koleqtorebis umravlesobas gasuli aqvs eqsploataciis vada.
wyalkanalebis umetesobaze didi xnis ganmavlobaSi ar Catarebula saremontoaRdgeniTi samuSaoebi. Sedegad, avariebi wyalmomaragebisa da sakanalizacio sistemebSi
sakmaod gaxSirda, ramac Tavis mxriv gamoiwvia sasmeli wylis danakargebi, wylis
mimRebi nagebobebisa da gruntis wylebis dabinZureba.
saqarTvelos
dasaxlebuli
punqtebis
umravlesoba
sasmel
wyals
araregularulad iRebs; ar arsebobs zusti aRricxva warmoebuli da moxmarebuli
wylis odenobisa. mdgomareoba mZimdeba imiT, rom wylis xarsixze laboratoriuli
kontroli ar tardeba sruli moculobiT, Sedegad wyali, romelic miewodeba
momxmarebels, xSirad ar Seesabameba saxelmwifo standarts da sanitarulepidemiologiur moTxovnebs.
saqarTveloSi
wyalsadenisa
da
sakanalizacio
momsaxurebis
ZiriTadi
momxmareblebia: mosaxleoba, sabiujeto organizaciebi, sawarmoo dawesebulebebi,
komunaluri dawesebulebebi da kerZo seqtori. saqarTveloSi wyalmomaragebis
Taviseburebebia is, rom didi nawili miwodebuli wylisa modis miwisqveSa wyaroebze,
risTvisac damaxasiaTebelia wylis stabiluri miwodeba da maRali xarsisxi, romelic
wylis
aRebis
adgilas
organoleptikuri,
qimiuri,
toqsikologiuri
da
mikrobiologiuri maxasiaTeblebiT ZiriTadad Seesabameba rogorc erovnuli, aseve
jandacvis msoflio organizaciis rekomendebul normativebs (cxrili 56).
cxrili 56.
3
sufTa wylis gamoyeneba (mln m )
2001
2002
2003
2004
wylis aReba wylis bunebrivi obieqtebidan
16773
32059
25663
19046
maT Soris miwisqveSa obieqtebidan
437
547
1237
520
15525
gamoyenebuli wyali sul
maT Soris saWiroebisaTvis:
374
sayofacxovrebo-sameurneo
151
sawarmoo
15000
sarwyavi da sasoflo-sameurneo da sxva
30869
24700
18704
379
253
30237
391
165
24144
368
193
18143
saqarTvelos miwisqveSa wyaroebidan aRebuli wyali miewodeba qsels gawmendis
gareSe, Tumca didi qalaqebis umravlesobaSi gamoiyeneba dezinfeqciac. patara da
saSualo dasaxlebul punqtebSi, sxvadasxva mizezebiT, ZiriTadad qloris Sesyidvasa an
qloris meurneobis funqcionirebasTan dakavSirebuli teqnikuri sirTuleebis gamo
miwodebuli wylis dezinfeqcia ar xdeba an xorcieldeba sezonurad. Tumca adgili aqvs
wylis aRebas zedapiruli wyaroebidanac (Tbilisi, baTumi, borjomi), sadac wylis
xarisxi gacilebiT dabalia, rac moiTxovs wylis gawmendas da dezinfenqciis gamoyenebas.
87
sakmaod xSiri praqtikaa momxmareblebisaTvis wylis miwodeba pirdapir
WaburRilebidan (patara dasaxlebul punqtebSi), an uSualod meore rigis satumbi
sadgurebis gavlis Semdeg, amis gamo arsebobs aramdgradi da araefeqturi
wyalmomarageba, da Tu ar arsebobs qselis zonireba, kontr-rezervuarebi da
wyalsaqaCi sadgurebi _ saxezea momsaxurebis dabali done.
wyalsadenebisa da wyalsaqaCi mowyobilobebis udidesi nawili amortizirebulia
da saWiroebs Secvlas, magram satumbi mowyobilobis gasaaxleblad saxsrebi ar
gamoiyofa ukve didi xnis manZilze. amortizebuli wyalgamanawilebeli qselebis
rekonstruqciis an maTi Secvlis samuSaoebis saTanado doneze daufinansebloba iwvevs
wylis did danakargs. wylis danakargi da aRuricxavi wylis odenoba uaxlovdeba
miwodebuli wylis saerTo moculobis 50-60%-s. es maCvenebeli 4-5-jer aRemateba
`normaluri danakargebis~ zRvars, romelic damaxasiaTebelia dasavleT evropis
swored eqsploatirebul da hidravlikurad gamarTuli qselisaTvis da 1,5-2 jer
aRemateba wyalmomaragebis sistemis danakargebs, rac dafiqsirebulia dsT_s bevr
qalaqSi.
Senobebis Sida qselebis cudi mdgomareoba aseve imsaxurebs saTanado yuradRebas,
radgan saxezea sayovelTao wylis gadaxarjvebi, maT Soris Camketi da sanitaruli
armaturis naklebi simWidrovis gamo, rac iwvevs sistemaSi wnevis dawevas.
wyali, romelic miewodeba momxmareblebs centraluri wyalmomaragebis
sistemebidan, xSirad ar Seesabameba mikrobiologiur da sxva standartebs, anu saxezea
seriozuli problemebi sasmeli wylis traspotirebisa wylis wyarosgan an wylis
momzadebisa sadguridan momxmareblamde.
wylis xarisxis TandaTanobiTi gauareseba, mas Semdeg rac izrdeba manZili saTao
nagebobidan saboloo momxmareblamde, gansakuTrebiT igrZnoba did qalaqebSi. amis
mTavari mizezia wyalgayvanilobis qselis aradamakmayofilebeli mdgomareoba _
milebis mniSvnelovani amortizeba. amgvarad, sinjebis 98-99%-i ar Seesebameba
saxelmwifo standartis moTxovnebs.
aranaklebi mniSvneloba aqvs im faqts, rom did qalaqebSi wylis mniSvnelovani
nawili modis zedapirul wylebze (wyaroebze), romlebic TavisTavad ukve
dabinZurebulia, radgan bevr did da patara qalaqSi Camdinare wylebis gamwmendi
sistemebi ar arsebobs. im SemTxvevaSi, roca araskmarisia mdinareebis da sxva wyaroebis
TviTgawmendis saSualebebi – pirvel adgilas dgeba saTave nagebobebze wylis
xarisxiani momzadebis sakiTxi, romelsac Tan unda erTvodes dezinfeqcia, raTa
moxerxdes wylis sanitariul-epidemologiuri maCveneblebis SenarCuneba saTanado
doneze (cxrili 57).
cxrili 57.
Camdinare wylis CaSveba bunebrivi zedapiruli wylis obieqtebSi (mln m3)
2001
2002
2003
2004
17820
24174
30372
14702
Camdinare wylis CaSveba zedapirul
wyalsatevebSi - sul
maT Soris:
360
415
408
389
dabinZurebuli
17453
23754
29963
14307
normatiulad sufTa (gawmendis gareSe)
7
6
1
6
normatiulad gawmendili
wlidan wlamde SenarCunebuli wyalsadenebis sanitarul-teqnikuri mdgomareobis
gauaresebis tendenciam negatiuri zegavlena iqonia mosaxleobis janrmTelobaze. Tu
1992 wlamde masobrivi nawlavuri infeqciuri daavadebebis SemTxvevebi arc ATu ise
bevri iyo, dawyebuli 1992 wlidan am daavadebaTa SemTxvevebma miaRwies aTeul da bevr
SemTxveveaSi aseulis niSnuls. sanitaruli statistika mowmobs, rom aucilebelia
Sesabamisi zomebis miReba, maT Soris wyalsadenebis reabilitacia da qselSi miwodebuli
sasmeli wylis usafrTxoebis uzrunvelyofa.
88
2004
3.3. maionebeli gamosxivebis mdgomareoba
saqarTveloSi yofili sabWoTa kavSiris samxedro bazebisa da nawilebis
teritoriebis radioaqtiuri nivTierebebiT dabinZurebisa da sxvadasxva samrewvelo
sawarmoebis teritoriebze gamouyenebeli radioaqtiuri nivTierebebis arsebobis gamo
aRniSnuli sakiTxi sakmaod problematuria.
2004 wels dRemde saqarTvelos teritoriaze bunebrivi radiaciuli fonis
anomalia ar SemCneula da is meryeobs 508 mikrorentgen/saaTSi (barSi) 10-15
mikrorentgenamde saaTSi mTian regionebSi.
dasavleT saqarTvelos zogierT raionSi (q.foTi, sof.grigoleTi, q.senaki, daba
jvari, q.quTaisi, sof.gelaTi, daba xoni) niadagis radionuklidebiT teqnogenuri
dabinZureba SeiniSneba, romelic gamowveulia Cernobilis avariiT. dabinZurebuli
laqebi dafiqsirebul iqna Cais plantaciebSi, simindis yanebSi, bostnebSi da a.S. marto
cezium-137 radionuklidis Semcveloba niadagSi 30-jer aRemateba dasaSveb normas daba
grigoleTSi, 17-jer q.senakSi, 12-jer quTaisis avtoqarxnis yofili aeroportis
teritoriaze, 10-jer sof.gelaTSi. absoluturi analogia arsebobs dasavleT evropis
iseT ekonomiurad mZlavr qveynebSi, rogoricaa SvedeTi, dania, avstria da a.S.
Cernobilis katastrofis Semdeg dabinZurebuli niadagis gawmenda dakavSirebulia
mniSvnelovan finansur xarjebTan. samwuxarod, ar tardeba wylisa da atmosferos
radionukliduri Semcvelobis monitoringi.
mcire teritoriebis teqnogenuri radiologiuri dabinZurebis likvidaciebs
axorcielebs birTvuli da radiaciuli usafrTxoebis samsaxuri. 2004 wels
gasufTavebuli iqna rusTavis metalurgiul kombinatSi arsebuli Sps `Tuji XXI~-is
teritoria (farTobi 300 kvadratuli metri), romelic dabinZurebuli iyo cezium-137
radionuklidiT. analogiuri samuSaoebi Catarebuli iqna vazianis aeroportis
terioriaze (farTobi 4 heqtari), romelic dabinZurebuli iyo radium-226 izotopiT.
2004 wels aseve mimdinareobda ukontrolo radioaqtiuri wyaroebis saZiebo
samuSaoebi. 2004 wlis ganmavlobaSi napovni, gauvnebelyofili da uxifaTo adgilze
ganTavsebuli iyo 28 erTeuli radiaqtiuri wyaro, romelTa aqtivoba I milikiuridan 10
kiurimde icvleba. 1996 wlidan saqarTvelos teritoriaze moZiebulia da
gauvnebelyofilia 280 radioqtiuri ukontrolo wyaro.
2004 wels daiwyo maionebeli gamosxivebis wyaroebis saregistracio samuSaoebi.
dReisaTvis registrirebulia aRmosavleT saqarTvelos yvela raionSi arsebuli
maionebeli gamosxivebis saSualebebi: radioaqtiuri wyaroebi da rentgeno-aparatura,
romelic gamoiyeneba sawarmoo, samecniero-kvleviTsa da saswavlo dawesebulebebSi.
Seqmnilia da aprobirebulia kompiuteruli programa, romelSic gaerTianebulia
maionebel gamosxivebaTa saSualebebis Sesaxeb yvela informacia.
qveyanaSi radioaqtiuri nivTierebebis samarxis ar arsebobis gamo maTi
izolirebulad Senaxva aRmoCenis adgilebSi xdeba. 2004 wels daiwyo radioaqtiur
nivTierebaTa centralizebuli Sesanaxis mSenebloba fizikis institutis yofili atomuri
reaqtoris teritoriaze. es obieqti 2006 wlis bolosaTvis gaSvebuli iqneba
eqspluataciaSi, rac saSualebas mogvcems ukontrolo da gamouyenebli raioaqtiuri
wyaroebis saimedo ganTavsebisa. mimdinareobda radiaciuli saqmianobiT dakavebul
organizaciaTa licenzireba
da inspeqtireba. 2004 wels licenzia mieniWa 12
organizacias. inspeqtireba Catarebuli iqna 40 organizaciaSi.
2004 wels,
2003 welTan SedarebiT, adgili hqonda medicinaSi maionebeli
gamosxivebis wyaroebis mqone obieqtebisa da rentgenologiuri gamokvlevebis
raodenobis zrdas (2003 w. - 267862, 2004 w. - 294332) raodenobis matebas, Tumca qveynis
masStabiT srulad ar aris aRricxuli yvela gadasatani rentgenoaparati, sacxovrebel
saxlebSi ganTavsebuli stomatologiuri rentgenkabinetebi da sxva.
rentgenkabinetebis umetesoba ar aris uzrunvelyofili Sesabamisi raodenobis da
xarisxis individualuri da stacionaruli damcavi saSualebebiT. TiTqmis arc erT
stomatologiur kabinetSi ar xdeba farisebri jirkvlis dacva.
89
procedurebis dros arc Tu iSviaT SemTxvevaSi irRveva radiaciuli
usafrTxoebis iseTi ZiriTadi principebi rogoricaa: radiaciuli velis zomebis dacva;
standartebis gaTvaliswinebiT gadaRebisas kansa da fokuss Soris manZilis reJimis
SemuSaveba;
rentgeno-radiologiuri
procedurebis
dros
dabali
Zabvis
eleqtroenergiis gamoyenebisas diagnostikuri informaciis dakargva da ganmeorebiTi
gamokvlevebis Catareba, rac mizezi xdeba pacientis sxivuri datvirTvis gazrdisa;
sxvadasxva tipis gamokvlevebisas optimizebuli reJimebis dacva da sxva.
teqnikurad gaumarTavi, amortizirebuli aparatura, damcavi saSualebebis
ukmarisoba da sxva mosaxleobis dasxivebis saSiSroebas qmnis.
3.4. profesiuli saqmianoba
mosaxleobis janmrTelobaze moqmed faqtorebs Soris erT-erTi mniSvnelovani
adgili profesiul saqmianobas ukavia, Tumca profesiuli daavadebebis da sawarmoo
ubeduri SemTxvevebis aRricxvaSi arsebuli problemebis gamo am zemoqmedebis zusti
gansazRvra sakmaod Znelia.
mosaxleobis
SromiTi
saqmianobiT
gamowveuli
daavadebebi,
romlebic
profdaavadebaTa ricxvs ar miekuTvneba, sazogadoebrivi jandacvis erT-erT
umniSvnelovanes sakiTxs warmoadgens, am daavadebebis etiologia sawarmoo pirobebs
ukavSirdeba da moicavs sayrden-mamoZravebeli aparatis darRvevebs, sisxlis mimoqcevis
sistemisa da respiratorul daavadebebs, fsiqikur darRvevebsa da sxv. aqedan
gamomdinare, 1997 wlidan evropis regionSi axali tendecia gamoikveTa: profhigienis
cnebas ufro farTo mniSvneloba mieniWa, rac profdaavadebaTa da ubeduri SemTxvevebis
prevenciis warmoebaSi janmrTelobis kompleqsuri dacvisa da gaumjobesebis
CanacvlebiT gamoixata.
saqarTvelos statistikis saxelmwifo departamentis monacemebiT, 2004 wels
qveyanaSi sul dasaqmebuli iyo 1783,3 aTasi adamiani.
am wlis ganmavlobaSi iseve, rogorc 2003 wels, ar Catarebula dasaqmebul muSamosamsaxureTa samuSao adgilebis pasportizacia mavne da saSiSi sawarmoo-profesiuli
faqtorebis mixedviT, Sesabamisad, qveynis masStabiT ar aris zusti monacemebi im
momuSaveTa, m.S. qalTa,
raodenobis Sesaxeb, romlebic dasaqmebuli
arian
janmrTelobisaTvis mavne da saSiS sawarmoo-profesiul pirobebSi. qveyanaSi moSlilia
dasaqmebuli mosaxleobis saTanado samedicino momsaxurebis dinamiuri dispanseruli
meTvalyureoba, aseve im adamianTa janmrTelobis mdgomareobaze meTvalyureoba,
romlebsac uxdebaT muSaoba janmrTelobisaTvis mavne da saSiS Sromis pirobebSi,
dasaqmebul kontingentSi ar xdeba profdaavadebaTa intensiuri gamovlineba da
mkurnaloba, rac Tavis mxriv, xels uwyobs dainvalidebulTa raodenobisa da
invalidobis xarisxis zrdas. faqtiurad Sewyvetilia avadobis damuSaveba droebiTi
Sromis uunarobis maCveneblebis mixedviT.
2004 wels funqcionirebad samrewvelo da soflis meurneobis obieqtebSi muSaTa
Sromis pirobebisa da janmrTelobis mdgomareobis intensiuri Seswavla ar Catarebula,
ris gamoc praqtikulad SeuZlebelia qveynis mrewvelobisa da soflis meurneobis
sxvadasxva dargebSi dasaqmebuli mosaxleobis janmrTelobis mdgomareobis ZiriTad
maCveneblebsa da maTi cvlilebebis dinamikis gaanalizeba.
ukanasknel wlebSi qveyanaSi arsebulma mdgomareobam
garkveuli gavlena
moaxdina funqcionirebad sawarmoebSi profesiuli daavadebebis aqtiur gamovlenasa da
dadgenis procesebze. Tu gasuli saukunis samocdaaTian-oTxmocian wlebSi profesiul
daavadebaTa SemTxvevebis gamovlenisa da registraciis wliuri raodenoba saSualod
meryeobda 140-dan 160-mde, 1997-2004 wlebSi gamovlenili da dadgenili iyo profesiuli
daavadebis sul 148 SemTxveva (cxrili 58)
90
2004
cxrili 58.
profesiul daavadebaTa ganawileba mrewvelobis dargebisa da wlebis mixedviT
mrewvelobis dargebi
1997
1998
1999
2000
2001
2002
2003
2004
sul
2
-
3
3
-
1
2
2
2
1
1
2
1
3
7
2
1
9
7
1
1
12
8
1
11
2
0
12
11
5
1
1
44
36
3
16
10
6
-
4
4
4
5
5
4
1
27
1
3
1
11
9
1
12
1
19
23
1
1
40
31
3
3
148
metalurgiuli
samTomadno
qimiuri
energetikuli
manqanaTmSenebloba
msubuqi
avtosatransporto
sawarmoebi
jandacva
ganaTleba
sul
aRsaniSnavia, rom
2000 wlidan adgili hqonda profesiuli daavadebebis
gamovlenisa da dadgenis intensivobis matebas. ase magaliTad, Tu 1996-1999 wlebSi
dadgenili da registrirebuli iyo profesiuli daavadebebis sul 28 SemTxveva, 2001
wels dadgenili da registrirebuli iyo profesiuli daavadebebis 19 SemTxveva, 2002
wels – 23, xolo 2003 wels - 40, 2004 w. - 31.
2004 wels, iseve rogorc 2003 wels, profdaavadebaTa yvelaze meti SemTxveva (12)
registrirebuli iyo samTomadno mrewvelobaSi, metalurgiul mrewvelobaSi (11)
SemTxveva) da a.S.
bolo oTxi wlis ganmavlobaSi (2001-2004 w.w.) gamovlenili profdaavadebebis
yvelaze meti SemTxvevebiT xasiaTdeboda metalurgiuli mrewveloba (36 SemTxveva),
samTomadno mrewveloba (33 SemTxveva), avtotransportis sfero (15 SemTxveva).
aRsaniSnavia, rom ukanaskneli 11 wlis (1993-2004) ganmavlobaSi registrirebuli
iyo profesiuli intoqsikaciebis sul 38 SemTxveva, m.S. yvelaze meti - manganumiT
qronikuli intoqsikaciis 32 SemTxveva da sxvadasxva Sxamebis kombinirebuli moqmedebiT
gamowveuli intoqsikaciis 2 SemTxveva (cxrili 59).
cxrili 59.
profesiuli mowamvlebis ganawileba wlebis mixedviT
intoqsikaciis faqtori
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
2003
2004
sul
manganumiT qr.
intoqsikacia
tyviiT qr. intoqsikacia
2
1
2
1
1
-
-
2
2
7
6
8
32
-
-
-
-
-
-
-
-
-
1
-
-
1
naxSirJangiT qr.
intoqsikacia
sxvadasxva Sxamebis
kombinirebuli moqmedebiT
gamowveuli intoqsikacia
poliakriliT
intoqsikacia
amoniakis marilebiT
qr. intoqsikacia
sul
-
-
-
-
-
-
-
-
-
1
-
-
1
-
-
-
-
-
-
-
2
-
-
-
-
2
1
-
-
-
-
-
-
-
-
-
-
1
-
-
-
-
-
-
-
1
-
-
-
-
1
3
1
2
1
1
-
-
5
2
9
6
8
38
-
1996-2004 wels dadgenili profesiuli daavadebebis ganawileba asakisa da
samuSao staJis mixedviT, yvelaze meti (95) SemTxveva dadgenili iyo 50 da meti wlis
asakis mqone muSebSi, aseve 21 welze meti muSaobis staJis mqone muSebSi (cxrili 60).
gamomdinare zemoaRniSulidan, aucilebelia am mimarTulebiT farTomasStabiani
samecniero-praqtikuli samuSaoebis Catareba.
91
cxrili 60.
profesiul daavadebaTa ganawileba asakisa da muSaobis staJis mixedviT,
1996-2004 w.w.
staJi
20-30
weli
31-39
weli
40-49
weli
50 weli
da meti
sul
1-5 weli
1
0
0
0
1
6-10 weli
11-20 weli
21 weli da meti
sul
1
1
_
3
2
2
0
4
3
21
23
47
3
29
95
127
9
53
118
181
profesiuli daavadebebis diagnoziT hospitalizebulTa raodenoba ukanaskneli 5
wlis ganmavlobaSi mocemuli cxril 61-Si.
cxrili 61.
profesiuli daavadebebis diagnoziT hospitalizirebulTa raodenoba
2000-2004 w.w.
profesiuli daavadebiT mkurnalobda
pirveladi diagnozi daudginda
diagnozebi
smenis nevriti
vibraciuli daavadeba
manganumiT qr. intoqsikacia
naxSirJangiT qr. intoqsikacia
tyviiT qr. intoqsikacia
tuberkulozi
pnevmokoniozi
qronikuli laringiti
qronikuli bronqiti
mastenozebeli ligamentozi
anTrakosilikozi
filtvebis avTvisebiani simsivne
bronquli asTma
orive Tvalis diabeturi retinopaTia
angiotrofonevrozi
2000
53
12
2001
49
19
2002
39
23
2003
71
40
2004
49
31
4
1
1
0
0
0
0
1
0
0
2
1
2
0
0
5
3
2
0
0
1
2
0
0
1
3
0
2
0
0
5
2
7
1
1
0
6
0
3
0
0
0
2
0
0
3
4
6
0
0
2
0
0
12
0
11
0
1
1
0
1
2
8
0
0
0
0
0
12
0
5
0
2
0
1
92
2004
III. janmrTelobis dacvis sistema
1. saxelmwifos danaxarjebi janmrTelobis dacvaze
qveynis ekonomikur ganviTarebasa da mosaxleobis janmrTelobas Soris mWidro
urTierTkavSiri arsebobs da janmrTelobis yvela ZiriTadi determinanti swored
socialur-ekonomikur faqtorebzea damokidebuli. amitom mosaxleobis janmrTelobis
mdgomareobis gaumjobesebaze mimarTuli saxelmwifos ZiriTadi qmedebebi unda
moicavdes mosaxleobisaTvis minimalurad aucilebeli samedicino momsaxurebis
finansur da geografiul xelmisawvdomobas, socialur-ekonomikuri uTanasworobis
Semcirebisa da adamianuri potencialis ganviTarebas.
2004 wels, iseve rogorc 2003 wels, saxelmwifos mier nakisri samedicino
daxmarebis RonisZiebebi momsaxurebis tipis mixedviT dajgufebul iqna janmrTelobis
dacvis saxelmwifo programebSi, ZiriTadi mimarTulebebis Sesabamisad:
- janmrTelobis xelSewyobis, daavadebaTa prevenciis da epidkontrolis saxelmwifo
programa;
- socialuri dazRvevis erTiani saxelmwifo fondis janmrTelobis dacvis programebi
(mosaxleobis ambulatoriuli daxmarebis saxelmwifo programa, mosaxleobis
stacionaruli daxmarebis saxelmwifo programa, mosaxleobis specifikuri
medikamentebiT uzrunvelyofis saxelmwifo programa);
- socialuri sferos instituciuri da funqciuri reformebis xelSewyobis saxelmwifo
programa.
janmrTelobis dacvis saxelmwifo programebis dafinansebis gegmiuri maCvenebeli
2003 welTan SedarebiT 39%-iT gaizarda - 77 mln. laridan 107 mln. laramde.
programebis dafinansebis moculobam Seadgina 102,4 lari (2003 w. 58,2 mln. lari), rac
dagegmilis 95,8%-ia. janmrTelobis xelSewyobis, daavadebaTa prevenciisa da
epidkontrolis saxelmwifo programis dafinanseba dagegmilis 96,7%-s Seadgens,
socialuri sferos instituciuri da funqciuri reformis xelSewyobis saxelmwifo
programis – 94,3%-s, xolo socialuri dazRvevis erTiani saxelmwifo fondis xaziT
janmrTelobis dacvis programebis dafinanseba ki 96%-ia (cxrili 62).
cxrili 62.
danaxarjebi jandacvaze saxelmwifo biujetidan (aTasi lari)
programis dasaxeleba
janmrTelobis xelSewyobis, daavadebaTa prevenciisa da
epidkontrolis saxelmwifo programa
socialuri sferos instituciuri da funqciuri reformis
xelSewyobis saxelmwifo programa
socialuri dazRvevis erTiani saxelmwifo fondis
janmrTelobis dacvis programebi
SSmp samedicino daxmareba
saministros centraluri aparati, teritoriuli organoebi,
saqveuwyebo dawesebulebebi, sajaro samarTlis
iuridiuli pirebi
socialuri dazRvevis erTiani saxelmwifo fondis
administraciuli xarjebi jandacvaze
ucxoeTidan miRebuli dafinansebis wyaroebiTa da
grantebiT gansaxorcielebeli investiciuri proeqtebi
paraleluri samsaxurebi
saTemo dazRvevis proeqti
sul
gegma
2003
2004
2003
2004
2003
2004
2003
2004
2003
2004
2003
2004
2003
2004
2003
2004
2004
2003
2004
dafinanseba
4 433,0
3 365,3
7685,0
6 963,5
64915,5
96 569,0
2 386,9
3 253,0
3872,5
6 563,2
51986,3
92 568,2
3865,0
600,0
3508,3
8 360,0
1470,0
2 213,0
7955,6
3429,2
3950,2
1 019,1
117,7
97782,6
122 518,1
2322,3
599,9
3160,9
8 149,1
1455,4
2 203,0
2132,7
3960,4
1995,3
1019,1
117,7
69312,3
118315,9
%
53,8
96,7
50,4
94,3
80,1
95,9
60,1
100
90,1
97,5
99,0
99,5
26,8
115,5
50,5
100
100
70,9
96,6
janmrTelobis dacvis sistema
93
2004 wels saxelmwifo biujetSi ucxoeTidan miRebuli dafinansebis wyaroebiTa
da grantebiT gansaxorcielebeli investiciuri proeqtebi mimarTuli iyo jandacvis
sistemis xelSewyobis, tuberkulozis kontrolis, aiv/Sidsis, tuberkulozisa da
malariis prevenciisa da kontrolis, jandacvis meore proeqtis (samSeneblo samuSaoebi,
sakonsultacio momsaxureba da Sesyidvebi) saavadmyofoTa restruqturizaciisa da
socialuri dacvis reformis programebze. gegmiT gaTvaliswinebuli 3 mln laris
nacvlad daixarja 3,9 mln. lari (dagegmilis 115%).
saxelmwifo biujetidan saqarTvelos Tavdacvis, iusticiis saministrosa da
Sinagan saqmeTa saministroebis mier samedicino momsaxurebaze daixarja 1 mln. lari
(2003 w. – 2 mln.). 2004 wels amoqmedda saTemo dazRvevis proeqti 117,7 aTasi laris
RirebulebiT.
saxelmwifos
valdebuleba
mosaxleobis
winaSe
ganisazRvreba
rogorc
saxelmwifo programebis funqcionirebiT, aseve adgilobrivi, municipaluri organoebis
zrunviT mosaxleobis janmrTelobis mdgomareobaze. savaldebulo municipaluri
jandacviTi programebi ganixileba, rogorc samedicino RonisZiebebis is minimaluri
paketi, romelic savaldebuloa Sesasruleblad yvela regionisaTvis. savaldebulo
municipaluri minimumi
warmoadgens mosaxleobis janmrTelobis dacvis sferoSi
saxelmwifo valdebulebaTa nawils, romlis miReba garantirebuli aqvs saqarTvelos
nebismier moqalaqes qveynis mTel teritoriaze, aRniSnul programaSi monawile
Sesabamisi licenziis mqone samedicino dawesebulebebSi.
2004 wels qveynis teritoriuli erTeulebis biujetebidan janmrTelobis dacvis
RonisZiebebisaTvis gaweulma xarjma Seadgina 42,3 mln. lari, rac 67%-iT metia 2003
welTan SedarebiT. 15,4 mln. lari gadairicxa socialuri dazRvevis erTian saxelmwifo
fondSi ambulatoriuli da urgentuli programebis dasafinanseblad, xolo 27 mln.
lari moxmarda municipalur programebs (cxrili 63).
cxrili 63.
teritoriuli erTeulebis mier janmrTelobis dacvis RonisZiebaTa dafinansebaze
gaweuli xarjebi (aTasi lari)
saqarTvelos teritoriuli
erTeuleebis dasaxeleba mxareebis
mixedviT
afxazeTi
aWara
Tbilisi
kaxeTi
imereTi
samegrelo da zemo svaneTi
Sida qarTli
qvemo qarTli
guria
samcxe-javaxeTi
mcxeTa-mTianeTi
raWa-leCxumi da qvemo svaneTi
sul jami
2003 w.
2004 w.
zrdis %
618,7
5661,0
9825,5
906,5
2157,5
944,8
987,3
1993,2
508,9
977,7
501,8
302,2
25385,1
869,0
4763,0
17884,7
1568,5
4242,7
2335,3
1703,3
4319,4
899,3
2390,5
854,9
521,3
42351,9
140%
84%
182%
173%
197%
247%
173%
217%
177%
245%
170%
173%
167%
2004 wels saxelmwifo biujetidan jandacvaze daixarja 118,3 mln. lari (biujetis
6,1%), rac 70,6%-iT aRemateba 2003 wels biujetidan jandacvaze danaxarjebs (69,3 mln.
lari). teritoriuli erTeulebis biujetebidan municipaluri programebisaTvis daixarja
27 mln. lari (2003 wels 25,3 mln. lari), e.i. sul saxelmwifo danaxarjma jandacvaze
Seadgina 142 mln. lari (2003 w. – 94,7 mln. lari), rac mTliani saxelmwifo danaxarjebis
5,8% (2003 w. – 5,9%), xolo mTliani Sida produqtis 1,4%-ia (2003 w. – 1,1%) (nax. 85)1.
1
gaTvlebSi ar aris asaxuli humanitaruli daxmarebebi da grantebi.
94
2004
naxati 85.
jandacvaze saxelmwifo danaxarjebi saqarTveloSi
160
140
120
100
80
60
40
20
0
mln. lari
mSp-is %
1,40%
1,11%
1,08%
0,93%
0,90%
0,63%
0,32%
49,3
34,8
1,11%
0,94%
52,8
56,3
1999
2000
1,11%
142
73,5
80
94,7
2001
2002
2003
31,5
11,9
1995
1996
1997
1998
1,6%
1,4%
1,2%
1,0%
0,8%
0,6%
0,4%
0,2%
0,0%
2004
saqarTveloSi jandacvis dafinansebis dinamika cxadyofs, rom 1994 wlidan
saxelmwifo danaxarjebi, daaxloebiT, 20-jer gaizarda da 2004 wels erT sul mosaxleze
33 lari Seadgina (nax. 86), Tumca es 10-15-jer naklebia, vidre 80-iani wlebis bolos iyo.
janmrTelobis msoflio organizaciis rekomendaciiT ki, mosaxleobis minimalurad
aucilebeli samedicino momsaxurebis Tanabrad xelmisawvdomobisaTvis saWiro xarjebi
weliwadSi erT sul mosaxleze 34 dolari, anu saxelmwifo danaxarji erT sul
mosaxleze sul mcire 70 lari mainc unda iyos.
naxati 86.
jandacvis saxelmwifo danaxarjebi erT sul mosaxleze saqarTveloSi (lari)
33
22
16,7
18,36
12,67
6,1
9,3
9,1
5,8
2,2
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
mosaxleobis cxovrebis pirobebze mniSvnelovan zegavlenas axdens saxelmwifos
mier janmrTelobis dacvis sferoSiDnakisri valdebulebebi, amitom jandacvis
ganviTarebis done, janmrTelobis ZiriTadi indikatorebi (sicocxlis saSualo
xangrZlivoba, dedaTa da bavSvTa sikvdilianoba da sxv.) da samedicino daxmarebisadmi
mosaxleobis
xelmisawvdomoba
qveynis
ekonomikur
ganviTarebis
pirdapirproporciulia.
saqarvelos mier jandacvaze saxelmwifo danaxarjebis odenoba erT sul mosaxleze
10-15-jer CamorCeba baltiispireTis respublikebis, TiTqmis 5-jer ruseTisa da
belorusiis mier erT sul mosaxleze jandacvaze gamoyofil saxelmwifo danaxarjebs,
da bevrad naklebia aRmosavleT evropis qveynebze.
rac Seexeba mTliani saxelmwifo danaxarjebidan jandacvaze saxelmwifo
dafinansebis wils, “vardebis revoluciis” Semdeg saxelmwifos mier jandacvaze
95
gamoyofili dafinansebis sagrZnobi zrdis miuxedavad, saqarTvelo yofil sabWoTa
kavSiris respublikebs Soris erT-erT bolo adgilzea sasomxeTis, tajikeTisa da
azerbaijanis Semdeg. didia EU-25 wevri qveynebis – litvis (14,7%), estoneTisa (11,2%) da
latviis (9,4%) mier jandacvaze saxelmwifo danaxarjebis wili, rac dResdReobiT
saqarTvelosTvis saocnebo cifria (maTTan SedarebiT Cveni qveyana xarjavs 1,5-2 jer
naklebs). maRali procentuli wilis Sesabamisad am qveynebSi maRalia erT sul
mosaxleze jandacvaze saxelmwifo danaxarjebic (cxrili 64).
cxrili 64.
jandacvaze saxelmwifo danaxarebis wili
SvedeTi
aSS
germania
gaerTianebuli samefo
niderlandebi
7,8
6,6
8,6
6,4
5,8
jandacvaze
saxelmwifo
danaxarjebis wili
mTliani saxelmwifo
danaxarjebidan, 2003
13,6
18,5
17,6
15,8
12,4
CexeTi
ungreTi
poloneTi
bulgareTi
rumineTi
6,4
5,5
4,4
4,0
4,2
12,7
12,1
9,8
10,1
10,9
600
495
248
104
100
estoneTi
litva
latvia
ruseTi
belorusia
TurqmeneTi
yazaxeTi
ukraina
saqarTvelo (2004)*
moldova
sasomxeTi
uzbekeTi
azerbaijani
yirgizeTi
tajikeTi
3,9
4,3
3,3
3,5
4,7
3,0
1,9
3,3
1,6
4,1
1,3
2,5
0,8
2,2
0,9
11,2
14,7
9,4
9,3
8,3
12,7
9,0
10,2
6,7
11,8
5,4
7,6
2,8
9
4,8
282
267
155
98
71
60
42
40
19
18
11
9
8
8
2
jandacvaze
saxelmwifo
danaxarjebis wili
mSp-dan, 2002
jandacvaze
saxelmwifo
danaxarjebi erT sul
mosaxleze (aSS.
dolari), 2003
2684
2548
2506
2081
1926
wyaro: World Health Report 2006, WHO; Human Development Report 2005, UNDP.
* saqarTvelos monacemebi aRebulia saqarTvelos statistikis departamentis 2005 wlis
weliwdeulidan da saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros mier
mowodebuli informaciidan miRebuli gamoTvlebis Sedegad.
mosaxleobam rom igrZnos xelisuflebis zrunva samedicino momsaxurebis
xelmisawvdomobis realuri gaumjobesebis TvalsazrisiT, saWiroa gaizardos jandacvis
saxelmwifo danaxarjebis wili mTlian Sida produqtTan da saxelmwifo biujetTan
mimarTebaSi, rac gazrdis jandacvaze saxelmwifo danaxarjebs erT sul mosaxleze da
xels Seuwyobs janmos rekomendaciebis Sesrulebas.
96
2004
2. momsaxurebis miwodeba
saqarTveloSi, iseve, rogorc mTeli evropis regionSi, mimdinareobs
janmrTelobis dacvis sistemis reformireba im ZiriTadi strategiebis Sesabamisad,
romlebic samedicino momsaxurebis miwodebis ekonomikur efeqturobas zrdis. kerZod,
samedicino momsaxurebis sabaziso paketis SemuSaveba, marTvis decentralizacia, sabazro
meqanizmebis danergva, stacionaruli momsaxurebis reorganizacia da pirveladi
jandacvis prioritetuloba, pacientisaTvis samedicino momsaxurebis mimwodeblis
arCevis ufleba, maRali teqnologiebis danergva da xarisxis gaumjobeseba. ukanaskneli
wlebis ganmavlobaSi ukve ganxorcielda mravali institucionaluri da funqciuri
cvlilebebi, romlebic mimarTulia saTanado donis samedicino momsaxurebis miwodebis
gaumjobesebaze, mis efeqturobasa da xelmisawvdomobaze.
2.1. samedicino kadrebi
2004 wels saqarTvelos mosaxleobas emsaxureboda 21396 eqimi (mosaxleobis
eqimebiT uzrunvelyofis maCvenebeli – 489,4) da 21622 saSualo samedicino personali
(maCvenebeli – 594,6). 1988-1999 wlebSi saSualo samedicino personalis raodenoba
TiTqmis orjer Semcirda, ukanasknel wlebSi eqimTa Sefardeba saSualo samedicino
personalTan ucvleli rCeboda - 1:1,2, 2004 wels ki 1:1,01 gaxda (nax. 87).
naxati 87.
samedicino kadrebis raodenoba
eqimebi
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
2
saSualo medpersonali
1:1.8
1:1.6
1:1.4
Sefardeba
1:1.4
1:1.3
1:1,2
1:1,2
1:1,2
1,5
1:1,05
1:1,01
21396
21622
21296
20962
23356
20225
23260
19513
26179
21063
28638
21520
28642
20824
21706
29775
19062
29978
38541
21252
1
0,5
0
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
saqarTvelos mosaxleobis samedicino kadrebiT uzrunvelyofis Sedareba
evropis sxvadasxva qveynebis analogiur maCveneblebTan cxadyofs, rom garda imisa, rom
saqarTveloSi aSkarad gamoxatulia eqimebis siWarbe, amave dros eqimebisa da saSualo
medpersonalis Sefardeba gacilebiT naklebia evropis regionis qveynebis analogiur
maCvenebelze (nax. 88).
naxati 88.
evropis regionis zogierTi qveynis samedicino kadrebiT uzrunvelyofis maCveneblebi
1:5,6
3000
6
2500
5
1:2,9
2000
1500
1000
4
1:2,7
1:2
1:2,1
1:1,9
1:1,01
1:2
1:2,1
1:1,3
3
2
500
1
0
0
saqarTvelo
(2004)
azerbaijani
(2002)
ruseTi
(2002)
eqimebi
latvia
(2002)
dania (2002)
safrangeTi
(2002)
saSualo medpersonali
norvegia
(2002)
germania
(2002)
Evropa
(2002)
Sefardeba
ax. dam.
qveynebi
(2002)
97
unda aRiniSnos, rom wina welTan SedarebiT, 2004 wels dafiqsirda eqimTa da
saSualo medpersonalis umniSvnelo kleba qirurgTa, kardiologTa, anesTeziologTa,
travmatolog-orTopedTa, urologTa, pediatrTa, onkologTa, ofTalmologTa,
stomatologTa, mean-ginekologTa mcire klebis xarjze (cxrili 65).
cxrili 65.
samedicino kadrebis raodenoba
1999
2000
saSualo med. personalis raodenoba
28638
26179
eqimebi (fizikuri piri)
21520
21063
m. S.
Terapevti
2625
2553
qirurgi (bavSvTa qirurgebis CaTvliT)
1128
1132
anesTeziolog-reanimatologi
938
930
travmatolog-orTopedi
336
328
kardiologi
600
594
urologi
229
222
onkologi
243
233
pediatri
2309
2295
infeqcionisti
412
408
otolaringologi
377
362
nevropaTologi
709
684
ofTalmologi
387
371
stomatologi
1698
1569
mean - ginekologi
1693
1644
fTiziatri
208
196
dermato-venerologi
312
285
fsiqiatri
250
250
endokrinologi
271
276
2001
2002
2003
2004
23360
23356
20225
19513
2354
2421
1057
1861
905
922
305
313
576
545
211
211
227
228
2067
2096
348
340
344
354
631
593
345
357
1483
1436
1476
1534
161
192
259
266
234
193
275
267
cnobari.
21906
20962
2256
1108
21396
21622
2470
1011
881
261
621
212
249
1812
279
324
658
362
1306
1450
166
270
228
279
922
298
591
221
253
1867
315
348
655
355
1412
1466
171
245
205
255
1200
1003,1
eqimebiT uzrunvelyofis maCvenebeli gansakuTrebiT maRalia TbilisSi (1003,1),
xolo dabalia Sida qarTlSi (149,7). saSualo samedicino personaliT uzrunvelyofis
maCvenebeli maRalia TbilisSi (701,4), aWaraSi (653,0) da raWa leCxumsa da zemo svaneTSi
(594,9), xolo dabalia Sida qarTlSi (210,5). aRsaniSnavia is garemoebac, rom Tbilissa da
kaxeTSi eqimebis raodenoba Warbobs saSualo samedicino personalis raodenobas
(Sefardeba 1,43:1 da 1,1:1 Sesabamisad) (nax. 89).
naxati 89.
eqimebiTa da saSualo medpersonaliT uzrunvelyofa mxareebis mixedviT
eqimebi
saSualo med. personali
200
494,6
489,4
265,5
207,2
336,4
268,6
210,5
149,7
399,3
201,8
561,1
327,7
447,6
355,9
387,5
268,2
323,9
294,5
363,4
400
247,6
333,5
600
637,7
800
701,4
1000
saqarTvelo
qvemo
qarTli
mcxeTamTianeTi
Sida
qarTli
samcxejavaxeTi
raWaleCxumi
imereTi
samegrelo
kaxeTi
guria
aWara
Tbilisi
0
2004 wels saqarTveloSi muSaobda yvela profilis 1011 qirurgi (bavSvTa
qirurgebis CaTvliT). qirurgiuli uzrunvelyofis saSualo maCvenebeli 100 aTas sul
98
2004
mosaxleze 40,6-s udrida. saqarTveloSi aSkarad gamoxatulia qirurgTa siWarbe, rasac
TvalnaTliv adasturebs
erT qirurgze operaciebis saSualo raodenoba wlis
ganmavlobaSi. Tu 1991 wels erTi qirurgi weliwadSi saSualod 78 operacias akeTebda
(rac metad dabali maCvenebeli iyo), 2000 wels erTi qirurgi saSualod akeTebda
mxolod 35 operacias, 2004 wlisaTvis es ricxvi 51,2-mde gaizarda (nax. 90). msgavsi
operaciuli aqtivoba uaryofiTad moqmedebs qirurgTa kvalifikaciaze.
naxati 90.
qirurgiuli operaciebis raodenoba 1 qirurgze
100
80
60
40
20
0
78
63
56
54
58
51
41
41
37
35
41
44
43
51,2
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
2.2. dawesebulebaTa qseli
2004 wlis monacemebiT saqarTveloSi funqcionirebda 275 stacionari,
romelTagan 263 Sromis, janmrTelobisa da socialuri dacvis saministros, xolo 12
sxva uwyebebis daqvemdebarebaSi iyo (cxrili 66).
cxrili 66.
saqarTvelos samkurnalo-profilaqtikuri qselis struqtura
samkurnalo - profilaqtikuri dawesebulebebi
sul
maT Soris
saministro
sxva uwyebebi
stacionaruli dawesebulebebi
275
263
12
saavadmyofoSi Semavali poliklinikebi
102
97
5
dispanserebi
76
76
0
damoukidebeli poliklinikuri dawesebulebebi
183
175
8
damoukidebeli stomatologiuri poliklinikebi
93
93
0
damoukidebeli saswrafo daxmarebis sadgurebi
31
30
1
soflis saeqimo ambulatoriebi
453
451
2
saferSlo - sabebio punqtebi
1
1
0
sisxlis gadasxmis sadgurebi
7
6
1
Cvil bavSvTa saxlebi
2
2
0
samecniero-kvleviTi institutebi
20
20
0
samkurnalo centrebi
52
52
0
Semavali saeqimo janpunqtebi
14
14
0
Semavali soflis saeqimo ambulatoriebi
229
229
0
Semavali saferSlo-sabebio punqtebi
381
381
0
2004 wels sawolebis raodenoba, 2003 welTan SedarebiT, 2%-iT Semcirda.
saqarTveloSi sawolebis datvirTvis saSualo maCvenebelia 118,7. qveynis saSualo
maCvenebelTan SedarebiT is SedarebiT maRalia), imereTSi (156,1) samcxe-javaxeTsa (144,0)
da TbilisSi (133,4) (cxrili 67).
99
cxrili 67.
stacionarebis qselis struqtura wardgenili angariSebis mixedviT
sawolTa
raodenoba
wlis bolos
datvirTva
sawolze
dayovneba
brunva
17841
7122
1642
345
255
1230
183
663
1094
2266
775
909
50
1307
118,7
133,4
117,3
100,2
94,9
94,0
74,0
144,0
78,1
156,1
85,5
103,5
66,9
100
8,36
8,6
9,1
8,2
7,8
7,8
5,3
11,8
6,5
9,8
6,3
9,2
5,4
11,6
13,7
15,5
12,8
14,0
12,2
11,5
14,1
12,2
12,1
16,0
13,6
11,2
12,4
8,0
saqarTvelo
Tbilisi
aWara
guria
raWa-leCxumi
samegrelo
mcxeTa-mTianeTi
samcxe-javaxeTi
qvemo qarTli
imereTi
kaxeTi
Sida qarTli
afxazeTi
sxva uwyebebi
sawolTa profilis mixedviT datvirTvis maRali maCvenebliT xasiaTdeba
tuberkulozis (307,0), mozrdilTa fsiqiatriuli da narkologiuri (286,2), pediatriuli
(133,5), nevrolouri (199,0) onkologiuri da radiologiuri (112,8) sawolebi. sawolze
datvirTvis dabali maCvenebelia dermato-venerologiur (13,8) da otolaringologiur
(37,9) sawolebze (cxrili 68).
cxrili 68.
stacionaris muSaoba
sawolTa profili
Terapiuli
pediatriuli
qirurgiuli
onkologiuri da radiologiuri
infeqciuri
tuberkulozis
sameano-ginekologiuri
nevrologiuri
fsiqiatriuli da narkologiuri
otolaringologiuri
ofTalmologiuri
sawolTa
raodenoba
datvirTva
sawolze
(dReebSi)
dayovneba
brunva
3060
1814
4441
627
1185
549
3371
580
1236
261
224
25
85.0
133.5
83.2
112.8
98.1
307.0
104.5
119.0
286.2
37.9
104.2
13.8
7.9
10.0
6.8
18.6
8.5
61.5
5.0
10.3
84.6
1.6
4.5
5.7
10.9
13.8
12.4
6.6
12.3
5.0
20.9
11.4
3.3
29.1
23.2
2.4
dermato-venerologiuri
2004 wels samkurnalo-poliklinikur dawesebulebebSi
registrirebuli iyo
1444941, xolo hospitalizebuli - 245082 avadmyofi. wina welTan SedarebiT
registrirebul avadmyofTa saerTo raodenoba 9,1%-iT, xolo hospitalizebulTa
raodenoba 13,1%-iT gaizarda (cxrili 69).
100
2004
cxrili 69.
registrirebul da hospitalizirebul avadmyofTa raodenoba
2003
daavadebaTa ZiriTadi klasebi IX dsk-s mixedviT
2004
registri
rebuli
sul
hospitalizebul
i sul
êregistr
irebuli
sul
hospitalizebul
i sul
1323926
216515
1444941
245082
68674
13487
78080
16580
simsivneebi
endokrinuli sistemis, kvebis, nivTierebaTa cvlis
da imunitetis darRvevebi
37852
8594
40902
9402
148438
2921
158603
3343
sisxlis da sisxlmbadi organoebis daavadebebi
14696
936
16175
960
nervuli sistemis da grZnobaTa organoebis
daavadebebi
101118
4265
106921
4136
123590
9382
143783
10624
250072
22997
283921
27765
sasunTq organoTa daavadebebi
304217
33533
306984
38395
saWmlis momnelebel organoTa daavadebebi
103803
23054
113272
26269
Sard-sasqeso sistemis daavadebebi
60127
3093
69913
9207
orsuloba, mSobiaroba da mSobiarobis Semdgomi
periodis garTulebebi
5689
58116
7329
63979
kanis da kanqveSa ujredisis daavadebebi
31177
1754
33859
2426
31978
3182
6438
1653
4020
5724
5815
2592
39948
18836
sul
ZvalkunTovani sistemis da SemaerTebel
26077
2929
qsovilTa daavadebebi
5822
1588
perinatalur periodSi warmoqmnili
3690
5052
mdgomareobebi
simptomebi da arazustad aRniSnuli
4878
1884
mdgomareobebi
34007
16936
daavadebaTa ZiriTadi klasebis mixedviT registrirdebuli avadmyofebis umetesi
wili modioda sasunTqi organoebis daavadebebze (306984) da endokrinuli sistemis,
kvebis, nivTierebaTa cvlis da imunitetis darRvevebze (158603). hospitalizaciis xvedriT
wilSi, iseve rogorc gasul wels, wamyvani adgili eWira orsulobas, mSobiarobasa da
mSobiarobis Semdgomi periodis garTulebebs (63979 SemTxveva), sasunTqi organoebis
(38395), sisxlis mimoqcevis sistemis (27765), saWmlis momnelebel organoTa (26269),
infeqciur da parazitul (16580) daavadebebs.
2004 wels saqarTvelos stacionarebSi hospitalizebul iqna 245082 avadmyofi
(maCvenebeli – 5580,4, letaloba 1,9%).
2004 wels saqarTvelos stacionarebSi gakeTda 90790 operacia (letaloba 0,68),
maT Soris 10945 bavSvebSi (letaloba 0,4). zogadi narkoziT gakeTda 43030 operacia
(letaloba - 0,027). 1991 wlidan operaciebis raodenoba ganuxrelad klebulobda da 2000
wlisaTvis gakeTebuli operaciebis ricxvma 1991 welTan SedarebiTY 61,5%-iT daiklo.
miuxedavad ukanaskneli wlebis ganmavlobaSi gakeTebuli operaciebis raodenobis
matebisa, 2004 w. klebam 1991 w. SedarebiT 49,4% Seadgina. (cxrili 70).
101
cxrili 70.
qirurigiuli Carevebi
maCvenebeli
saerTo
saerTo
letaloba
letaloba
zogadi
1000 sul
bavSvebi raodenobis
raodenobis
%
narkoziT
%
mosaxleze
%
%
179377
33,1
0,5
26082
14,5
69549
38,8
0,01
137218
26,6
0,6
17286
12,6
42318
30,8
0,01
114796
22,3
0,8
14227
12,4
28387
24,7
0,01
108194
21,0
0,7
13018
12,0
28286
26,1
0,02
97583
18,9
0,7
10774
11,0
32360
33,2
0,01
79087
15,5
0,7
10057
12,7
24400
30,9
0,01
79114
15,3
0,7
8875
11,2
30864
39,0
0,01
79046
15,3
0,8
9810
12,4
32363
40,9
0,04
74234
16,1
0,8
9219
12,4
31974
43,1
0,02
69360
15,6
0,8
9262
13,4
32213
46,4
0,02
75905
17,2
0,7
10415
13,7
34173
45,0
0,02
77657
17,8
0,7
10463
13,5
35261
45,4
0,03
82626
19,1
0,7
10970
13,3
39386
47,7
0,03
90790
20,8
0,7
10945
12,05
43030
47,4
0,027
janmrTelobis dacva, saqarTvelo, 2004, statistikuri cnobari.
wlebi
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
wyaro:
sul
0
31
48
9
49
31
0
63
104
68
47
1
2
453
3
10
11
22
66
5
36
6
15
36
19
0
0
229
damoukidebeli
qalTa
konsultacia
16
10
5
0
5
1
5
6
14
8
4
2
0
76
damoukiSemavali
debeli
s/k instituti
128
16
5
3
19
3
10
12
29
20
12
11
8
276
soflis saeqimo
ambulatoria
samkurnalo
centri
dispanseri
Tbilisi
aWara
guria
raWa-leCxumi
samegrelo
mcxeTa-mTianeTi
samcxe-javaxeTi
qvemo qarTli
imereTi
kaxeTi
Sida qarTli
afxazeTi
sxva uwyebebi
saqarTvelo
poliklinika
saqarTveloSi pirveladi samedicino momsaxureba warmodgenilia dawesebulebebis farTo qseliT (ambulatoriebi, poliklinikebi, qalTa konsultaciebi,
dispanserebi da saferSlo-sabebio punqtebi soflad) (cxrili 71).
cxrili 71.
ambulatoruil-poliklinikuri dawesebulebebis qselis struqtura
33
3
3
0
4
1
0
2
3
2
1
0
0
52
19
0
0
0
0
0
0
1
0
0
0
0
0
20
9
0
0
0
2
0
1
0
3
0
1
1
1
18
saferSlo-sabebio
punqti
damoukidebeli
Semavali
0
0
0
0
0
0
1
0
0
0
0
0
0
1
7
162
11
1
13
25
75
21
25
7
14
20
0
381
pirveladi samedicino momsaxurebis dawesebulebaTa materialuri baza, gansakuTrebiT raionebsa da soflebSi, rogorc wesi, ar pasuxobs moqmed sanitariul normebs,
vinaidan umetesoba ganTavsebulia Seuferebel Senoba-nagebobaSi, tipiuri Senobebi ki
mouvlelobis gamo naklebad asrulebs Tavis funqciur daniSnulebas. gaZnelebulia
maTi uzrunvelyofa satelefono kavSiriT, eleqtro- da wyalmomaragebiT, sanitariuli
transportiT
da sxv. aparatura, mowyobilobebi da inventari moZvelebulia an
uvargisia.
102
2004
mosaxleobis damokidebulebac samedicino daxmarebis am rgolis mimarT
Sesabamisia - umetesoba Tavs aridebs ubnis eqims. amasTan, mosaxleobis avadobis
struqturis, da Sesabamisad, samedicino daxmarebis sxvadasxva saxeebze misi moTxovnis
Secvlam ganapiroba poliklinikebis da gansakuTrebiT ambulatoriebis personalis
dausaqmebloba.
saqarTveloSi èqimTan mimarTva~-d iTvleba saxelmwifo poliklinikaSi mimarTva. kerZo praqtikis eqimTan mimarTvebi oficialuri statistikis monacemebSi
aRricxuli ar aris. samedicino dawesebulebebSi mosaxleobis mimarTvianobis
tendenciebi naTlad
asaxavs yvela zemoCamoTvlili faqtoris aSkara
gavlenas.
qveyanaSi Zalian iklo mosaxleobis mimarTvianobam rogorc ambulatoriulpoliklinikur, ise stacionarul dawesebulebebSi. amasTan, Tu es kleba 90-ani wlebis
dasawyisSi gansakuTrebiT mkveTri iyo, momdevno periodSi igi stabiluri gaxda (nax. 91).
naxati 91.
eqimTan mimarTva 1 sul mosaxleze
8
6
8
sul mimarTvebi
7
saswrafo daxmarebis gamoZaxeba
4,7
4
4
eqimTan misvla poliklinikaSi
3,1
1,7
2
0,22
0
1990
0,04
1994
1,6
0,03
1995
1,5
0,03
1996
1,4
0,02
1,6
1,5
1,3
0,03
0,02
1997
1998
1,4
1,5
1999
1,4
1,2
0,03
2000
1,6
2
1,8
1,5
1,4
0,03
1,6
0,04 1,4 0,04
2001
2002
2003
1,8
0,05
2004
saswrafo daxmarebis gamoZaxebaTa Semcirebis tendencia, romelic grZeldeboda
1990-1997 wlebSi, SeCerda. 1998-2000 wlebSi adgili hqonda gamoZaxebaTa matebas. 2001
wels isev aRiniSna am maCveneblis kleba 11,1%-iT, 2001-2004 wlebSi dafiqsirda am
maCveneblis ganuxreli mateba, 2004 wels saswrafo daxmareba aRmouCines 218188 adamians,
rac 2001 welTan SedarebiT 1,6-jer metia (cxrili 72).
cxrili 72.
fizikur pirTa raodenoba, romelTac gaewiaT saswrafo samedicino daxmareba
pirveladi
samedicino
daxmareba
gaewia sul
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
1268859
1164685
647018
420521
217006
156920
152344
117734
123582
142695
150645
135539
162376
192641
218188
ubeduri
SemTxvevis dros
maT Soris
mSobiarobis da
ucabedi avad
paTologiuri
gaxdomis dros
dros
avadmyofebis,
mSobiareebis da
sul
%
sul
%
sul
%
sul
%
53629
54777
31991
19673
8707
7774
7701
7295
7794
10219
7982
7618
8421
10166
19560
4,2
4,7
4,9
4,7
4,0
5,0
5,1
6,2
6,3
7,2
5,3
5,6
5,2
5,3
8,9
1107048
1016856
559136
361960
196235
144533
139734
105932
111410
126644
138383
124233
147701
172589
191379
85,9
87,2
86,4
86,1
90,4
92,1
91,7
90,0
90,2
88,8
91,9
91,7
91
89,6
87,7
23583
19555
12704
6938
2986
1317
959
780
1337
1856
1366
1126
1243
2104
3137
1,9
1,7
2,0
1,6
1,4
0,8
0,6
0,7
1,1
1,3
0,9
0,8
0,8
1,1
1,4
84598
73497
43187
31950
9078
3296
3950
3727
3041
3976
2914
2562
5011
7782
4112
6,7
6,3
6,7
7,6
4,2
2,1
2,6
3,2
2,5
2,8
1,9
1,9
3,1
4,0
1,9
103
3. medikamentebis mimoqceva saqarTveloSi
janmrTelobis dacvis sistemaSi farmacevtuli seqtori erT-erTi mniSvnelovani
rgolia, romelic sxva, aseve mniSvnelovan faqtorebTan erTad, gansazRvravs adamianTa
samkurnalo daxmarebis xarisxs. Mmkurnalobis procesSi gamoyenebuli medikamentebis
xarisxi, efeqtianoba, usafrTxoeba da fasi is maCveneblebia, romlebic, saboloo jamSi,
gansazRvravs mkurnalobis xangrZlivobas, xarisxs da Rirebulebas. amitomac
janmrTelobis msoflio organizaciis politika farmacevtuli preparatebis dargSi
mimarTulia xarisxiani da efeqturi preparatebis xelmisawvdomobis uzrunvelyofasa da
samkurnalwamlo saSualebebis racionaluri gamoyenebis stimulirebaze.
dRevandel pirobebSi, rodesac farmacevtuli dawesebulebebidan, iseve rogorc
sxva komerciuli saqmianobiT dakavebuli subieqtebidan, Znelia obieqturi informaciis
miReba wamalTa realuri brunvis Sesaxeb, saqarTvelos farmacevtuli bazris Sefaseba
SesaZlebelia samkurnalo saSualebaTa importis da eqsportis monacemebis analiziT.
miuxedavad monacemTa simcirisa, maTi analizisas vlindeba fasTa dinamika, axlad
registrirebul medikamentTa gamoyenebis tendencia da sxva. janmrTelobis msoflio
organizaciis SefasebiT, saqarTvelo Sedis im saxelmwifoTa jgufSi (rumineTi,
sasomxeTi, belorusia, ukraina, yazaxeTi), romlebSic erT sul mosaxleze weliwadSi
ixarjeba 10-20 aSS. dolaris Rirebulebis wamlebi.
2004 wlis ganmavlobaSi sul saqarTvelos teritoriaze importirebuli iqna 83
milioni AaSS dolaris Rirebulebis medikamenti, amaTgan 68 milionis (78%) iyo
komerciuli importi, 15 milioni (17%) Semotanil iqna humanitaruli daxmarebis saxiT, 4,4
milioni (5%) medikamentebis reeqsports warmoadgenda.
gasuli wlebis monacemTa Sedareba cxadyofs, rom icvleba importirebuli
medikamentebis moculoba da Tanafardoba humanitarulsa da komerciul imports Soris.
1996 wlidan gaizarda komerciuli Sesyidvebi da 1997 wels man maqsimums gadaaWarba.
Semdgom ruseTis ekonomiuri krizisis gamo importis moculoba 13,4%-iT Semcirda.
Tumca 2004 wels, wina welTan SedarebiT, kvlav aRiniSna mateba. rac Seexeba
humanitarul daxmarebas, igi 1996-1997 wlebSi sakmaod maRali iyo. 1998 wels araregistrirebuli medikamentebis humanitaruli gziT importis akrZalvis Semdeg misi
moculoba importirebul medikamentebSi sakmaod Semcirda, 1999 wlidan isev daiwyo
dinamiurad zrda, Tumca 2002-2003 wels isev aRiniSna am moculobis kleba, 2004 wels ki
kvlav SeiniSna umniSvnelo mateba. (nax. 92).
naxati 92.
medikamentis saerTo importis
dinamika
importi
komerciuli
humanitaruli
100 000 000
90 000 000
80 000 000
70 000 000
60 000 000
50 000 000
40 000 000
30 000 000
20 000 000
10 000 000
0
1996
1997
1998
1999
2000
2001
2002
2003
2004
2004 wels importiorebis raodenoba, 1996 welTan SedarebiT, roca oficialurad
registrirebuli iyo 187 sabiTumo baza, Semcirda. saqarTvelos bazars ZiriTadad 13
farmacevtuli baza amaragebda, sxva danarCenebis importis wili ar aRemateboda 10%-s
(nax. 93).
104
2004
naxati 93.
medikamentebis importi importiori firmebis mixedviT
sxva 10,1%
"panacea" 1,2%
"tonusi" 1,3%
"kristali" 1,7%
"impeqsfarmi" 1,8%
"aversi-farma" 29,4%
"gea" 2,2%
"medinservi" 2,2%
"ei-bi-si" 2,7%
Sps "PSP-RICHTER" 3,34%
"medfarma plusi" 3,8%
"marji" 4,7%
Sps "PSP" 22,38%
"ji-pi-si" 13,2%
2004 wels saqarTveloSi importirebul iqna 46 qveynis mier warmoebuli
samkurnalo saSualeba. importis moculobaSi pirvel-mesame adgils inawilebs germania
(13,6%), safrangeTi (12,5%) da ungreTi (7,4%) (nax. 94). mwarmoebel firmebs Soris yvelaze
didi moculobiTaa warmodgenili aventisis (6%), hofman la roSis (4,4%), novi
nordiskis (4,2%) produqcia.
naxati 94.
medikamentebis importi mwarmoebeli qveynebis mixedviT
germania
14%
sxva
22%
safrangeTi
12%
poloneTi
4%
indoeTi
4%
ungreTi
7%
dania
5%
italia
5%
slovenia
5%
ruseTi
5%
TurqeTi
6%
ukraina
5%
Sveicaria
6%
2004 wels qveyanaSi Semosulia 15047338 aSS dolaris Rirebulebis humanitaruli
medikamenti,
romelTa
mniSvnelovani
nawili
saxelmwifo
programebisaTvisaa
gankuTvnili.
qveyanaSi 2004 wels ganxorcielda 4,4 mln. aSS dolaris medikamentebis
reeqsporti da 2,3 mln aSS dolaris medikamentebis eqsporti.
daskvna
105
IV.
daskvna
saqarTveloSi arsebulma rTulma ekonomikurma mdgomareobam da gansakuTrebiT
1998-1999 wlebis krizisma mZime mdgomareobaSi Caayena janmrTelobis dacvis sistema.
saxelmwifo jandacviTi programebis mwiri dafinansebis gamo SeuZlebeli gaxda
saxelmwifos mier Tavisi moqalaqeebis janmrTelobis dacvis sferoSi nakisri
valdebulebebis srulad Sesruleba, rasac ar SeiZleboda uaryofiTi gavlena ar
moexdina mosaxleobis udidesi nawilis ara marto janmrTelobis, aramed ekonomikur
mdgomareobazec.
2004 wels saxelmwifo biujetidan jandacvaze daixarja 118,2 mln. lari (biujetis
6,1%), rac 70,6%-iT aRemateba 2003 wels biujetidan jandacvaze danaxarjebs (69,3 mln.
lari). teritoriuli erTeulebis biujetebidan municipaluri programebisaTvis daixarja
42,4 mln. lari (2003 wels 25,3 mln. lari), e.i. sul saxelmwifo danaxarjma jandacvaze
Seadgina 160,6 mln. lari (2003 w. – 94,7 mln. lari), rac mTliani saxelmwifo danaxarjebis
6,7% (2003 w. – 5,9%), xolo mTliani Sida produqtis 1,6%-ia (2003 w. – 1,1%).
2004 wels saxelmwifo biujetSi ucxoeTidan miRebuli dafinansebis wyaroebiTa
da grantebiT gansaxorcielebeli investiciuri proeqtebi mimarTuli iyo jandacvis
sistemis xelSewyobis, aiv/Sidsis, tuberkulozisa da malariis prevenciisa da
kontrolis, jandacvis meore proeqtis (samSeneblo samuSaoebi, sakonsultacio
momsaxureba da Sesyidvebi) saavadmyofoTa restruqturizaciisa da socialuri dacvis
reformis programebze. gegmiT gaTvaliswinebuli 3 mln laris nacvlad daixarja 3,7
mln. lari (dagegmilis 123%).
saxelmwifo biujetidan saqarTvelos Tavdacvis, iusticiis saministrosa da
Sinagan saqmeTa saministroebis mier samedicino momsaxurebaze daixarja 1 mln. lari
(2003 w. – 2 mln.). 2004 wels amoqmedda saTemo dazRvevis proeqti 117,7 aTasi laris
RirebulebiT.
saqarTveloSi jandacvis dafinansebis dinamika cxadyofs, rom 1994 wlidan
saxelmwifo danaxarjebi, daaxloebiT, 20-jer gaizarda da 2004 wels erT sul mosaxleze
37,3 lari Seadgina.
saqarTvelo ekonomikuri TvalsazrisiT ganviTarebadi qveyanaa, xolo
demografiulad ganviTarebul qveynebs miekuTvneba. ekonomikurad ganviTarebuli
qveynebis msgavsad, saqarTveloSic mcirdeba Sobadoba, garkveulwilad izrdeba
sikvdilianoba. sul ufro regulirebadi xdeba Sobadoba, ojaxis formireba mTavrdeba
axalgazrda asakis qalebSi, matulobs erT da orSviliani ojaxebis ricxvi. amis Sedegad
mcirdeba axalgazrda Taobis da izrdeba xandazmulTa wili, anu mosaxleoba
demografiulad berdeba.
saqarTvelos mosaxleobis saerTo ricxvis, da rac gansakuTrebiT sagangaSoa –
bunebrivi matebis mniSvnelovani Semcireba – ukanasknel wlebSi metnaklebad
gamoxatuli iyo yvela regionSi. qveynis masStabiT bunebrivi matebis maCvenebeli 1985
wels dafiqsirebuli 51,6-dan 1993 wels 0,8-mde, xolo 2000 wels 0-mde Semcirda. 20032004w.w. bunebrivi mateba 0,1 da 0,2 iyo. 1992 welTan SedarebiT, mudmivi mosaxleobis
ricxovnoba 16,9%-iT aris Semcirebuli. es kleba qalaqis mosaxleobaSi ufro metadaa
gamoxatuli (24,9%), vidre soflad (16,5%). 2004 wels saqarTveloSi
sicocxlis
mosalodneli saSualo xangrZlivoba dabadebisas Seadgenda 71,4 wels (mamakacebSi – 67,8,
xolo qalebSi - 74,9 wels).
1990-2003 wlebSi fertilobis koeficienti 2,15-dan 1,37-mde Semcirda, 2004 w. ki
odnav moimata da 1,44 gaxda.
saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros
monacemebiT, 2004 wels sul cocxali daibada 46373 bavSvi. avadmyofi daibada an avad
gaxda 4948 bavSvi. saqarTvelos samedicino dawesebulebebma aRricxes erT wlamde asakis
834 bavSvis gardacvaleba (sikvdilianobis maCvenebeli 1000 cocxalSobilze 18,0),
miuxedavad gardacvlilTa raodenobis matebisa, es maCvenebeli Semcirda wina welTan
SedarebiT (2003w. – 18,5 yovel 1000 dabadebulze). 2004 wels daibada 722 mkvdari bavSvi
(mkvdradSobadobis maCvenebeli 15,3), rac wina wlis maCveneblebTan SedarebiT dabalia.
106
2004
2004 wels saqarTveloSi imSobiara 44396 qalma, rac wina welTan SedarebiT 2338
mSobiarobiT metia, Semcirda dedaTa sikvdilianobis maCvenebeli da is 45,3 gaxda. sul
2004 w. 21 deda gardaicvala. dedaTa sikvdilianobis maCvenebeli saqarTveloSi erTerTi yvelaze maRalia ara marto evropis regionSi, aramed yofili sabWoTa kavSiris
respublikebSic.
2004 wlis daavadebianobisa da avadobis wina wlis monacemebTan Sedareba
cxadyofs, rom zogadad qveyanaSi daavadebianobac da avadobac momatebulia daavadebaTa
yvela ZiriTad klasSi, umniSvnelod Semcirda mxolod sasunTqi organoebis
daavadebianobis maCvenebeli.
2004 w. saqarTvelos yvela regionSi, garda samcxe-javaxeTisa, aRiniSna
infeqciuri daavadebebis gavrcelebis maCvenebelTa zrda rogorc mTlian mosaxleobaSi,
ise bavSvebSi. gansakuTrebiT moimata (1,9-jer) am daavadebebma TbilisSi mcxovreb
bavSvebs Soris. infeqciur daavadebaTa gavrceleba regionebis mixedviT qveynis saSualo
maCvenebelze maRali iyo Tbilissa da mcxeTa-mTianeTSi, bavSvebSi ki – TbilisSi, Sida
qarTlsa da mcxeTa-mTianeTSi.
2004 wels registrirebuli iyo tuberkulozis 4145 axali SemTxveva, rac wina
welTan SedarebiT 127-iT metia. yofili sabWoTa kavSiris qveynebSi tuberkulozis axali
SemTxvevebis maCvenebeli sakmaod varirebs 39,8-dan (estoneTi) 185,4-mde (yazaxeTi), Tumca,
unda aRiniSnos, rom 2004 wlis saqarTvelos maCvenebeli (94,8) dsT-is qveynebis saSualo
maCvenebelze (87,1) metia. 2004 wels tuberkulozis registrirebul SemTxvevebSi
axladgamovlenilTa wili (63,4%) TiTqmis orjer aRemateba e.w. Zvel SemTxvevebs (36,6%),
rac janmrTelobis msoflio organizaciis SefasebiT tuberkulozTan brZolis
programis efeqturobaze miuTiTebs.
registrirebuli tuberkulozis 4145 axali
SemTxvevidan 27% filtvgareSe tuberkulozze modis, maT Soris axali SemTxvevebis
44,8% - tuberkulozur plevritze, xolo 29,7% ki limfuri kvanZebis tuberkulozia.
1997-1998 wlebSi saxelmwifo programis amuSavebis Sedegad sqesobrivi gziT gadamdebi daavadebebis aqtiuri gamovlenis gamo SemTxvevebis mniSvnelovani matebis Semdgom
1999-2000 wlebSi gamoikveTa klebis tendencia, rac kerebis sanaciiT iyo ganpirobebuli.
2000-2003 w.w. sifilisiTa da gonokokuri infeqciiT avadobis Sefardeba (1:0,7; 1:0,8; 1:0,9;
1:0,9) mkveTrad gansxvavdeboda saerTaSoriso monacemebisagan (1 : 2,5). es ki imaze
miuTiTebs, rom gonokokuri infeqciis gamovlineba umetes SemTxvevebSi ar
xorcieldeboda. 2004 wels aRiniSna am Sefardebis cvlileba da is 1:1,4 gaxda.
2003 welTan SedarebiT, aiv-inficirebisa da Sidsis registrirebuli SemTxvevebis
raodenoba 31,3%-iT gaizarda da 2004 wlis bolos 508 SemTxveva iyo registrirebuli, am
diagnoziT 2004 w. gardaicvala 55 adamiani.
2004 wels avTvisebiani simsivneebis diagnoziT aRricxvaze imyofeboda 28853
avadmyofi, gamovlenilia sicocxleSi pirvelad dadgenili diagnozis 5726 SemTxveva,
rac 9%-iT metia wina welTan SedarebiT. avTvisebiani simsivnis diagnozis dadgenidan
pirvel wels gardaicvala avadmyofTa 38%. 2004 wels kontingentis saerTo raodenobis
43,2% xuTi da meti wlis ganmavlobaSi aRricxvaze myofi avadmyofi iyo.
sisxlisa da sisxlmbadi organoebis daavadebebis gavrcelebis dinamikis analizi
cxadyofs, rom 2000 da 2003 wlebSi umniSvnelo klebis miuxedavad qveyanaSi aRiniSneba
am daavadebebis mateba. 2004 wlis daavadebianobis maCvenebeli 1,7-jer aRemateba 1997
wlis analogiur monacemebs. 2004 wels sicocxleSi pirvelad dadgenili diagnoziT
aRricxul avadmyofTa raodenobam, 2003 welTan SedarebiT, moimata da mTlianad
registrirebul avadmyofTa 53% Seadgina. sisxlisa da sisxlmbadi organoebis
daavadebebis registrirebuli SemTxvevebis 90% anemiebia.
2004 wlis monacemebiT, saqarTveloSi endokrinuli sistemis daavadebebis, kvebis,
nivTierebaTa cvlis da imunitetis darRvevebis diagnoziT registrirebuli iyo 129346
avadmyofi, aqedan sicocxleSi pirvelad dadgenili 21,3% iyo. Tu 2003 wels, wina
wlebTan SedarebiT, aRiniSna axali SemTxvevebis kleba rogorc saerTod, ise bavSvebSi,
2004 wels moxda axali SemTxvevebis umniSvnelo mateba, bavSvebSi axali SemTxvevebis
18%-iani klebis fonze. registrirebul SemTxvevaTa 39% - farisebri jirkvlis gadideba
da dauzustebeli Ciyvi iyo, 28% - insulindamoukidebeli Saqriani diabeti, 10%
daskvna
107
insulindamokidebuli Saqriani diabeti, 8,4% - Tireotoqsikozi CiyviT da Ciyvis gareSe,
5,4% - aratoqsiuri kvanZovani Ciyvi.
saqarTveloSi nervuli sistemisa da grZnobaTa organoebis
daavadebebis
aRricxul SemTxvevaTa mniSvnelovani klebis Semdeg daiwyo maCveneblebis mateba da 2004
wels man eqvsjer da metad gadaaWarba 1995 wlis monacemebs.
sisxlis mimoqcevis sistemis daavadebebis gavrcelebis dinamikis analizi
cxadyofs, rom Tu
1996 wlamde aRiniSneboda avadmyofTa raodenobis Semcirebis
tendencia, 1997 wlidan is Seicvala daavadebulTa raodenobis matebiT, rac
registraciis gaumjobesebasa da Sesabamisi saxelmwifo programebis amoqmedebasTan
unda iyos dakavSirebuli. 2004 wels, wina welTan SedarebiT, aRiniSna rogorc
daavadebianobis, ise avadobis maCveneblebis mateba.
2004 wels saqarTveloSi gulze gakeTda 739 operacia (letaloba 3,1). Ria gulze
Catarda 142 operacia, maT Soris 131 kardiostimulatoris implantacia da 184
endovaskuluri balonuri dilatacia. sisxlZarRvebze Catarda 1359 operacia (letaloba
– 3,2).
gulis iSemiuri daavadebis axlad gamovlenili SemTxvevebis 2,4% gulis mwvave
infarqtia, xolo 8,7% - stenokardia. stacionarebSi miokardiumis mwvave infarqtis
diagnoziT Semosuli 3608 avadmyofidan daavadebis dawyebis pirvel 24 saaTSi, rodesac
saeqimo dakvirvebas da saTanado specializebul mkurnalobas gadamwyveti mniSvneloba
aqvs, Semovida avadmyofTa mxolod 45,1%.
2004 wels, wina welTan SedarebiT, aRiniSna sasunTqi organoebis daavadebebiT
gamowveuli daavadebianobisa da avadobis maCveneblebis umniSvnelo kleba, Tumca
maRalia am daavadebebis registrirebuli SemTxvevebi.
1988-2004 wlebSi saWmlis momnelebeli sistemis daavadebebis maCveneblebs
gadaxris didi amplituda axasiaTebs. avadobis maCvenebeli, rogorc mTel
mosaxleobaSi, aseve bavSvebSi ori pikiT (1990 weli da 1994 weli) xasiaTdeba. 1995
wlidan saWmlis momnelebeli sistemis daavadebaTa sicocxleSi pirvelad dadgenili
diagnoziT aRricxuli SemTxvevebi iwyebs klebas da 2000 wlisaTvis minimalur
mniSvnelobas aRwevs, Tumca 2001 wlidan kvlav daiwyo maCveneblebis mateba. 2003 wels
dawyebuli klebis fonze kvlav dafiqsirda saWmlis momnelebeli sistemis daavadebaTa
sicocxleSi pirvelad dadgenili SemTxvevebis raodenobis mateba bavSvebSi.
1989-1996 wlebSi Sardsasqeso sistemis daavadebebis aRricxuli SemTxvevebis
ricxvma 2-jer iklo da, Sesabamisad, daavadebianobis maCvenebeli 1768,4-dan – 787,6-mde
Semcirda, rac aRricxvianobis sistemis moSlasTan unda yofiliyo dakavSirebuli. 1999
wels, wina welTan SedarebiT, dafiqsirda avadmyofTa ricxvis 29,2%-iani mateba, rasac
2000 wels mohyva rogorc daavadebianobis, ise avadobis maCveneblebis garkveuli
kleba. 2001-2004 wlebSi dafiqsirda rogorc daavadebianobis, ise avadobis maCveneblebis
umniSvnelo mateba. registirebul avadmyofTa saerTo raodenobidan 45%-s sicocxleSi
pirvelad daudginda diagnozi.
1996-2004 wlebSi saqarTvelos ambulatorul-poliklinikur dawesebulebebSi
registrirebul fsiqikur avadmyofTa kontingentis saerTo raodenoba TiTqmis 2-jer
gaizarda, xolo 8-jer gaizarda registrirebuli axali SemTxvevebis raodenoba
bavSvebSi.
sxvadasxva lokalizaciis travmebis, damwvrobebisa da mowamvlebis axal
SemTxvevaTa Soris yvelaze xSiri iyo Wrilobebis, sisxlZarRvTa dazianebebis,
zedapiruli travmebis, daJeJilobebis da daCeCqvilobebis SemTxvevebi, rac am klasis
daavadebebis 56,6%-s Seadgenda.
2004 wels, devnilTa Soris samedicino dawesebulebebSi mimarTvianobam 255120
Seadgina, rac 2003 welTan SedarebiT, 35,1%-iT metia. aseve gaizarda (44,69%-iT)
pirveladi mimarTvianobac. devnilTa demografiuli maCveneblebidan sayuradReboa
Sobadobis arasaxarbielo mdgomareoba – Sobadoba 1,5; sikvdilianoba 2,4.
2004 wels SesaZleblobis SezRudviT invalidad pirveladad cnobil pirTa
ricxvma 20198 Seadgina, rac 2003 w. SedarebiT, 2509 adamianiT metia. ukanasknel wlebSi
gaizarda socialuri pensiis mimReb SezRuduli SesaZleblobis statusis mqone pirTa
raodenoba da 2004 w. man 29,3 aTasi adamiani (2003 w. – 23,3 aTasi) Seadgina.
108
2004
sikvdilianobis struqturaSi wamyvani adgili, iseve rogorc wina wlebSi, ekava
sisxlis mimoqcevis sistemis daavadebebs (62,4%; maCvenebeli 100000 sul mosaxleze –
707,9) da simsivneebs (11,3%; maCvenebeli – 128,3), Semdgom modis sunTqvis organoebis
daavadebebi (8,2%; maCvenebeli – 92,8), es maCveneblebi wina welTan SedarebiT gaizarda,
Semcirebulia endokrinuli sistemis, kvebisa da nivTierebaTa cvlis darRveviT, saWmlis
momnelebeli organoebis daavadebebiT gamowveuli sikvdilianobis maCveneblebi.
2004 wlis saqarTvelos mosaxleobis janmrTelobis mdgomareobis Sesaxeb
erovnul moxsenebaSi moyvanili monacemebi cxadyofs, rom adamianis janmrTeloba
mWidrod aris dakavSirebuli socialur-ekonomikur determinatebTan (siRaribe,
dasaqmeba, ganaTleba, fsiqo-socialuri faqtorebi da sxv.), cxovrebis wesTan, garemos
mavne zemoqmedebasTan.
109
gamoyenebuli informaciis wyaroebi
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2004.
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3. ekonomikuri ganviTarebisa da siRaribis daZlevis programa, Tbilisi, 2003.
4. erovnuli moxseneba saqarTvelos mosaxleobis janmrTelobis mdgomareobis Sesaxeb,
2003, Tbilisi, 2004.
5. narkoviTareba saqarTveloSi - 2004. wliuri angariSi.
6. saqarTvelos ganaTlebisa da mecnierebis saministros informacia, 2004.
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informacia, 2004.
dacvisa
da
bunebrivi
resursebis
dacvis
saministros
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2004

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