The protection of motherhood and childhood occupied a significant place in the zemstvo medical practice of the late XIX — early XX c. It was “zemsky” doctors who were first to investigate the risk factors for maternal and child health in a Russian village. These included, first of all, the imperfect system of obstetrics, the incorrect feeding of infants, and the prevalence of acute childhood infections. For the protection of the health of the mother and child, work has been directed to organize skilled obstetric care, establish nursery-shelters, prevent acute childhood infections, support breastfeeding, and prevent orphanhood. At the same time, a number of zemstvo medico-social programs (organization of obstetric centers, nurseryshelters) were ineffective. The reasons for these failures were cultural traditions, peculiarities of the economic system, and the poverty of the Russian peasantry. More significant success was achieved in the prevention of acute childhood infections, medical care for pupils of rural schools and orphans. With the help of serum therapy, zemstvo doctors were able to reduce mortality from diphtheria. In addition, a vaccine against scarlet fever was being tested in Saratov region. The establishment of permanent medical supervision of children in Saratov orphanage resulted in 20—30 % mortality reduction. Many initiatives of zemstvo doctors: support of breastfeeding, prevention of orphanhood, mass immunization are being used in modern maternity and childhood protection systems.
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