Organizational and economic mechanism for using maternity certificates funds for sanatorium and spa rehabilitation of postpartum women as a tool for increasing the efficiency of regional demographic policy

Background. The article is devoted to the substantiation and development of an organizational and economic mechanism for using birth certificates to finance sanatorium rehabilitation of women after childbirth. The analysis of the current regulatory framework governing the system of birth certificates and sanatorium-resort care in the postpartum period has been carried out, systemic deficiencies have been identified. An organizational and economic mechanism has been developed to support women in the postpartum period. The economic efficiency of the proposed mechanism for the budget system of the region and for sanatorium-resort organizations is substantiated. Purpose. Justification and development of an organizational and economic mechanism for using funds from maternity certificates to finance postpartum rehabilitation at health resorts for women, thereby enhancing the economic efficiency of regional demographic policy. Materials and methods. The primary research method is structural-functional analysis. This study employs an institutional approach to assess existing regulatory constraints and identify institutional gaps in the system of generic certificates. The article is based on a range of sources, including federal laws, as well as academic publications on the economics of the health resort sector, government regulation of the service sector, and the program-targeted approach in regional demographic policy. Results. The analysis conducted revealed that there is no specialized federal law or subordinate legislation in the Russian Federation that explicitly provides for the financing of sanatorium-resort treatment for women in the postpartum period using funds from maternity certificates. The current structure of the maternity certificate includes vouchers for services at antenatal clinics, maternity hospitals, and pediatric clinics, but does not provide for a separate voucher or mechanism for allocating funds for the mother’s postpartum recovery. Regional demographic development and healthcare programs also do not contain systematic measures to integrate sanatorium-resort rehabilitation into postpartum patient care pathways, or they implement such measures as pilot projects without systematic funding. To address these identified issues, a five-stage organizational and economic mechanism has been developed to allocate funds from maternity certificates toward the payment of sanatorium-resort treatment for women in the postpartum period. The financial basis of the mechanism is the targeted reallocation of funds from the maternity certificate, supplemented, if necessary, by resources from the territorial compulsory health insurance fund and the regional budget. A procedure for coordination has been established: from the identification of medical indications and the issuance of a referral to the transfer of funds, the completion of a course of treatment, and post-treatment follow-up care. The proposed mechanism addresses the lack of targeted funding for postpartum rehabilitation, the fragmented nature of regulatory oversight, the lack of coordination among government agencies, and the limited availability of sanatorium and resort care for new mothers. The developed mechanism is scalable and can be adapted for use in any constituent entity of the Russian Federation.