In-country news
Ukraine | Tackling NCDs through improved healthcare services, access to medicines and patient education
Ukraine’s achievements and country priorities in combating NCDs were discussed at the National Conference on Non-Communicable Diseases (Kyiv, Ukraine, 28-29 May 2019). The Ministry of Health of Ukraine organized and hosted the event together with the World Health Organization (WHO) and with support from the Swiss Agency for Development and Cooperation. Participants represented a wide range of stakeholders, including the World Bank, development agencies, international experts and national partners, as well as doctors and teachers from all over Ukraine.
WHO estimates that NCDs account for 84% of all deaths in Ukraine. The country has one of the highest mortality rates from cardiovascular diseases (CVDs) in Europe, with 772.1 deaths per 100’000 males and 440.9 deaths per 100’000 females. Almost 35% of men who die from NCDs are under 60, causing the “missing men” phenomenon. NCDs are largely preventable by reducing the four common risk factors, namely: tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. Ukrainian youth is particularly at risk with 31% of 15-years old boys and 13% of girls smoking at least once a week, and 12% of 11-year old boys and 9% of girls being overweight or obese.
The burden of NCDs on the social and economic development of Ukraine is also significant. Without adequate prevention, the costs of care will increase. International evidence demonstrates that NCDs are largely preventable and could be reduced by controlling the main underlying behavioural risk factors. The WHO estimates the cost of inaction in lower and middle-income countries as high as 7 Trillion USD, or roughly up to 25% of the GDP of this group of countries. From our own linear estimates, for Ukraine this could represent up to 25 Billion USD per year. The health system needs strengthening on improved prevention and better control especially at the Primary Healthcare (PHC) level. In Ukraine, some progress was already observed in the shift from the curative care to health promotion and disease prevention with the recently approved National NCDs Action Plan and Public Health Development Concept. Both documents tackle the burden of NCDs by (i.) implementing integrated multi-sectorial actions to reduce the exposure of the population to the main NCDs risk factors, (ii.) by increasing the level of responsibility of individuals for their own health, and by (iii.) enhancing the health system’s responsiveness to population needs.
Over the past three years, the health reform has already shown concrete results: important legislation has been passed improving the healthcare financing model with the introduction of a guaranteed healthcare benefit package. More is envisaged to strengthen primary and emergency care, to rationalize hospital infrastructure, to build workforce capacities, to increase access to quality PHC services and to shift priorities from curative care to health promotion and disease prevention, with a focus on NCDs. With the introduction of a transparent health financing mechanism, the Government of Ukraine is providing additional motivation and incentives to improve PHC service provision and stimulate better NCDs indicators. Furthermore, the new public health regulatory framework will allow National and Regional Public Health Centres to compete for international grants and/or use private-public development partnership for a quick response to community needs.
The “NCDs Prevention and Health Promotion” project 2013-2019 implemented by WHO in Ukraine, contributed to creating a supportive policy and legal environment for NCDs prevention and better control at the PHC level. Family doctors and nurses were familiarised with WHO PEN protocols. NCDs prevention and a health promotion/communication strategy was elaborated with specific thematic campaigns piloted. A comprehensive approach to school health was developed to raise health literacy, encourage physical activity and promote mental wellbeing. The project paved the way and created favourable conditions and opportunities for new interventions to be implemented through SDC support, defining clear gaps to be addressed and setting strategies and action plans for continuing NCDs related interventions. It is a good momentum for SDC to use this opportunity in supporting the Ministry of Health efforts to reduce the NCDs burden countrywide.
Further resources
Contact
Petro Ilkiv, National Programme Officer
Embassy of Switzerland, Swiss Cooperation Office in Ukraine
