Sustaining Health Sector Reform in Ukraine

Inefficient and low quality healthcare is a burden for the poor and vulnerable population in Ukraine. In 2015 a big healthcare reform was launched. In the first phase a new financial mechanism for the primary healthcare was introduced, considerably improving access to primary healthcare services, affordable drugs and available vaccines, increasing patients’ satisfaction and doctors and nurses salaries. The first phase of the reform has resulted in strengthening and empowering the family medicine system in the country. The second phase of the health reform with introducing hospital care outcome based financing, just started in the middle of the Covid-19 pandemic. Coupled with political turbulence, reform implementation pace has significantly slowed down.

A key challenge ahead is to continue the healthcare system transformation with a long-term strategic guidance at the level of the Government of Ukraine.

Supporting health reform efforts, is the foundational element needed to sustain and increase effects of all Swiss supported health interventions in Ukraine.

Ministry of Health of Ukraine, Parliamentary Health Committee, healthcare experts, academia and citizens for engagement.

National Health Service of Ukraine, Central Procurement Agency, Public Health Centre.

Hospital networks, primary and secondary level healthcare service providers, healthcare managers.

Ukrainian citizens benefiting from more efficient and patient-oriented care.

Project Objective 1. Strengthening Health Sector Governance and Stewardship.

Swiss Objective: supporting more inclusive governance arrangements, participatory citizen’s engagement and building people’s trust.

Objective 2. Health Financing efficiency improvement.  

Swiss Objective: contributing to poverty reduction with increased affordability of healthcare services and reduced corruption.

Objective 3. Service Delivery/Quality of care improvement.

Swiss Objective: improving health outcomes, empowering communities and individuals in adopting health-seeking behaviour and increasing society commitment to hold authorities accountable in delivering quality and affordable services.

Resultados previstos:  

National Health Strategy 2030 is developed in participatory manner (at least 20 partners).

Health benefit package is regularly updated based on the previous implementation period.

Annual healthcare financing review and review of national health account is available.

Service Delivery Indicators findings are put into policy implementation.

Establishment of an independent multi stakeholder health reform dialogue platform.

Resultados de las fases anteriores:  

Technical assistance has to be tailored to specific country needs and be flexible to support the reform taking into account regional differences.

Despite political instability, economic crisis, military conflict and Covid-19 pandemic, healthcare reform support has to continue utilising adaptive project management approaches.

An independent health reform dialogue platform is important to guarantee reliable healthcare transformation analysis and documentation.

Healthcare financing must be analysed based on the state budget spending, out-of-pocket payments, fund allocations and utilisation, fair health workforce remuneration mechanisms, etc.

Improving quality of healthcare service provision should be one of the core areas in contributing to building population trust in the healthcare system.

Digitalisation of processes has to continue, improving performance of the healthcare system