Medical attendance for the population.

The public health service in YaNAD disposes of 64 hospitals and polyclinics with 5447 beds and acceptance ability of 8742 patients a day, 126 first aid posts, 20 ambulance stations and 5 ambulance departments, the Centre of AIDS and other infections prophylaxis, the Bureau of forensic medicine experts, the Centre of Social Rehabilitation and the House of a Child.

1783 physicians (48.5% of them have attestation categories) and 5640 doctor's assistants are practicing in Autonomous District.

The medical establishments in Autonomous District are manned with physicians by 94.5% and with assistants - by 96.8%. Considering the need of medical personnel, the Department of Health Service sends the young people, who have completed the course of local secondary schools, to Tiumen Medical Institute and other medical institutes of Russia. In the recent years 164 representatives of Autonomous District were sent to medical institutions on the initiative of the Department of Health Service.

The doctor's assistants are trained in Salekhard Medical College and in its branches in Novy Urengoi and Tarko-Sale.

The main problem of local medical service is the lack of financing. The expenditures on health service in the last five years are compensated only by 50-70%. The capital construction and reconstruction of medical facilities is stopped, while 40% of hospital buildings are old and dilapidated.

In the last year the rise of the birth rate by 3% was stated and at the same time the babies' death rate rose from 18.1 per 1000 babies in 1995 to 19.3 in 1996. In comparison with 1995 the sickness rate in 1996 increased from 1073.3 to 1187.8.

Tuberculosis is becoming a menacing sanitary problem in Autonomous District. Over 70% of patients with tuberculosis are the people of able-bodied age. Since 1993 the tuberculosis sickness rate in YaNAD increased in 1.7 times.

One of the disturbing problems of Autonomous District is drunkenness and alcoholism. The alcoholic drinks' use is growing and this process becomes uncontrollable. In some regions of YaNAD the pure alcohol consumption dose per head of the population reached 15 litres when the maximum permissible dose is 8 litres.

The use of super-high doses of alcohol (50% of which is of inferior quality) leads to the growth of casualties, caused or provoked by hard drinking. On the whole this casualties make 50% of YaNAD death rate.

The rapid growth of venereal diseases is the next urgent problem of local health service. To the end of 1996 26 cases of AIDS infection were registered in YaNAD. The diphtheria sick rate is also increasing. In 1996 this index showed 45.7 per 100 000 persons (in 1995 - 36.8). The number of diphtheria lethal cases grew twofold comparing with 1995. The outbreaks of whooping-cough and hepatitis were also registered in YaNAD.