UKR-mapSlightly smaller than Texas, the Eastern European country of Ukraine is home to some 44.4 million people. Health outcomes are poor, with Ukrainians on average living 11 fewer years than other Europeans.

Non-communicable diseases (NCDs), such as cardiovascular disease, diabetes, and cancer, currently account for 86 percent of all deaths in Ukraine each year. The World Bank reports that the vast majority of these “excess deaths” occur at relatively young ages, between 15 and 60, noting that about 85 percent of all deaths in 2012 were linked to cardiovascular disease, cancer, and external causes, including accidents and poisoning. Other contributing factors include a high prevalence of tobacco and alcohol use, physical inactivity, and unhealthy dietary choices. This underscores the need for strong primary care and prevention services, coupled with effective patient education and outreach programs — particularly for children and adolescents.

Ukraine has long been one of the countries in the region that has been the hardest hit by the global HIV/AIDS pandemic. Approximately 1.2 percent of adults between the ages of 15 and 49 are living with HIV, which translates to an estimated 290,000 people. About 6,800 children under the age of 14 are living with the virus.

According to WHO’s European Observatory on Health Systems and Policies’ health system review (HiT), the country’s health system is largely still rooted in the Soviet model with one main difference — extreme decentralization of financing. Ukraine’s healthcare expenditures are low by regional standards and have not increased significantly in proportion to gross domestic product (GDP) since the mid-1990s. While access to health facilities or trained healthcare providers is not a problem, increasing rates of preventable morbidity and mortality serve to highlight existing health system weaknesses.

AIHA has a long history of implementing successful capacity building programs in Ukraine thanks to support from USAID, CDC, WHO, GIZ, UNICEF, and the International AIDS Alliance, which was the principle recipient of the Global Fund.

Snapshot of Key Accomplishments of AIHA’s Programs in Ukraine:

  • In the context of active health system reforms in Ukraine, under our Twinning Center Program, the Kyiv City Health Administration and Kyiv City Blood Center initiated assessment of 29 hospital blood banks in Kyiv City to promote quality improvement. AIHA experts in Ukraine adapted the assessment forms from forms used in the Central Asia Region under a similar AIHA project. The assessment was an important step toward the implementation of European Union requirements on the quality and safety of blood. 
  • Through our Technical Assistance Support for the Strengthening of Blood Transfusion Services in Selected Countries Under PEPFAR, AIHA provided training on the costing of blood, participated in a scientific conference sponsored by the Association of Blood Services in Ukraine, and worked with State Services to develop a plan for a new computer information management system for which we coordinated training and development of user requirement specifications.
  • AIHA participated in the VI-th International Medical Forum Congress in Kiev and co-organized sessions on transfusion medicine with the National Medical Academy of Postgraduate Education (NMAPE). The project-trained, local experts presented on topics, including the clinical use of blood, hemovigilance, and quality management systems.
  • Series of trainings on blood services, quality management, and technical operations for local health workers, and infrastructure strengthening for the Ministry of Health
  • Manual for Organization of Transfusion Care at Health Facility (2nd Edition) developed by AIHA-trained local experts and edited by the Head of the Ukrainian National Medical Academy of Postgraduate Education’s Department of Hematology and Transfusion, Prof. Stanislav Vydyborets and AIHA Blood Safety Technical Expert Oleksandr  Serhiienko. (Available only in Ukrainian: ОРГАНІЗАЦІЯ ТРАНСФУЗІОЛОГІЧНОЇ ДОПОМОГИ В ЗАКЛАДАХ ОХОРОНИ ЗДОРОВ’Я, За загальною редакцією проф. С. Видиборця, к. мед. н. О. Сергієнка. 2019)
  • 10 Primary Care or Family Medicine Centers established in Donetsk, Kharkiv, Kyiv, L’viv, Odessa, and Uzhgorod; many tailored services to meet specific needs of local populations, such as student health in Kharkiv and miner’s health in Donetsk; some served as clinical training sites
  • 7 Women’s Wellness Centers established in Kramatorsk, Kyiv (2), L’viv, Odessa, and Uzhgorod; special breast health centers established in Kyiv, L’viv, and Odessa in response to high rates of breast cancer in these cities
  • 3 EMS Training Centers established in Donetsk, Kyiv, L’viv
  • 6 Neonatal Resuscitation Training Centers in Dnepropetrovsk, Donetsk, Kharkiv, Kyiv, L’viv, and Odessa; the training curriculum adopted by the Ministry of Health as the national standard for medical education
  • Transfusiology curriculum currently under development in collaboration with the National Medical Academy of Postgraduate Education, activities for harmonization of local policies with EU directives for blood services
  • Reduced mother-to-child transmission of HIV by 75 percent at PMTCT pilot sites in high-prevalence oblasts throughout the country
  • Odessa WWC pioneered community-based HIV care and support for women living with HIV at a time when the only treatment sites were AIDS Centers; they also established the Southern Ukrainian AIDS Education Center, which was a regional center of excellence in PMTCT

Click here for a printable overview of our work in Ukraine.



International Twinning Center Blood Safety Project under PEPFAR

Under AIHA’s Twinning Center Program, the main objectives of this project were accreditation of the blood establishments of Ukraine, strengthening the national blood system through the provision of technical assistance (TA) to the PHC, provision of TA to the Blood Safety Coordination Working Group of Experts at the Ministry of Health of Ukraine, and training and ensuring the sustainability of the proper clinical use of blood components and the organization of transfusion  care in health care institutions.

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In the context of active health system reforms in Ukraine, including in the blood service sector, AIHA has managed to successfully respond to 100% of requests for technical assistance made by the MoH of Ukraine and PHC as major partners in project implementation at the national level.

Key successes included:

• The National Blood System Strategy of Reform and Development, to which AIHA has significantly contributed from the very start of its development was officially approved by the Cabinet of Ministers of Ukraine on February 20, 2019.

• The National Blood System Strategy of Reform and Development, to which AIHA has significantly contributed from the very start of its development was officially approved by the Cabinet of Ministers of Ukraine on February 20, 2019.

• All trainings developed by AIHA were institutionalized in higher post-graduate medical education establishment’s curricula.

• Strong sustainability of project achievements is shown by the project pilot sites, where Kyiv City Blood Center being the strongest, recommended as a Center of Excellence in blood service in Ukraine.

To read the final closeout report of AIHA’s Twinning Center Program, click here.

Project to Strengthen Blood Services in Central Asia, Ukraine, and Cambodia
(2013 – 2018)

Under our CDC-supported Project to Strengthen Blood Services in Central Asia, Ukraine, and Cambodia, AIHA began providing technical assistance to Ukraine in 2013, focusing primarily on improving clinical use of blood, computer information management systems, local infrastructure, quality management capacity, laboratory equipment usage, donor management, and applied research.

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In December 2012, AIHA traveled to Ukraine and met with representatives from CDC/Headquarters and CDC/Ukraine to kick off the project and discuss the approach, the current status of blood safety in Ukraine, etc. AIHA returned to Ukraine in February 2013 to meet with the Ministry of Health and conduct a national stakeholder meeting in order to introduce the project and the baseline assessment. 

After completing the baseline assessment, AIHA sponsored a three-day stakeholder meeting in October 2013, gathering representatives from the pilot sites, the MoH, State Service of Ukraine to Counter-act HIV/AIDS and other Socially Dangerous Illnesses (SSH), National Medical Academy of Postgraduate Education (NMAPE), non-governmental organizations, and the public relations group MCG. The purpose of the meeting was to present the findings and recommendations of the assessments conducted earlier in the year and to begin developing work plans based on these recommendations.

Following a meeting with the MoH, seven blood centers and their hospitals with the highest blood use were selected as pilot sites for the project. The blood centers are Kyiv City Blood Center, Kyiv OBC, Zhytomyr OBC, Rivne OBC, Lviv OBC, Lugansk OBC, Odessa OBC, and OHMATDIT – a national specialized children’s hospital in Kyiv. 

AIHA concluded its support to Ukraine under this PEPFAR-funded blood safety project in 2018.

To read more on the quality management key focus of the blood safety project in Ukraine, click here.  For the full closeout report for Central Asia and Ukraine, click here.

EurasiaHealth AIDS Knowledge Network
(2004 – 2013)

AIHA’s EurasiaHealth AIDS Knowledge Network (EAKN) served as a central clearinghouse of evidence-based Russian language guidelines and other resources for health professionals working in HIV/AIDS care in Eastern Europe and Central Asia from 2004 through 2012. During this time, EAKN’s expansive online catalog represented a preeminent resource in the region.

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EAKN’s expansive online catalog included hundreds of documents and resources that were translated into Russian and other regional languages, including many HIV/AIDS treatment guidelines from WHO and U.S. agencies such as the Department of Health and Human Services, CDC, and the National Institutes of Health, as well as other leading international organizations.

To facilitate knowledge exchange, cooperation, and networking among HIV/AIDS experts, organizations, and patients, EAKN’s website offered information on regional projects, funding opportunities, and conferences. Interactive discussion forums and an HIV/AIDS Community Network linked scientists, community activists, government officials, and other experts working on HIV-related projects in Eurasia.

Many national, regional, and international leaders in HIV/AIDS medicine collaborated to ensure rational use of limited funds. These efforts led to the creation of a core document library that included textbooks, guidelines, and other research widely recognized as the preeminent evidence-based reference material on HIV/AIDS treatment, care, and prevention currently available.

Key examples included:

  • Textbook of Pediatric HIV Care;
  • The Pocket Guide to Adult HIV/AIDS Treatment 2007;
  • 2007 Medical Management of HIV Infection; and
  • The WHO/HHS/CDC PMTCT Generic Training Package.

National PMTCT Scale-up Project
(2005 – 2007)

AIHA launched a USAID-funded pilot PMTCT project to improve quality of care in Odessa Oblast by expanding collaboration between healthcare facilities and nongovernmental organizations providing services to people living with HIV/AIDS. This pilot project adopted a comprehensive medical-social model and was replicated in eight high-prevalence regions nationwide in cooperation with Ukraine’s Ministry of Health and with support from USAID-Ukraine.

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With the overarching goal of lowering the vertical transmission rate to 5-8 percent at each participating site, the project focused on:

  • strengthening human resource capacity and organizational effectiveness;
  • expanding high-quality PMTCT clinical and support services;
  • improving collaboration among healthcare facilities and NGOs; and
  • coordinating efforts of international donors and stakeholders.

Replication was launched in Cherkassy, Dnipropetrovsk, Kyiv, and Mykolayiv oblasts in June 2005. In November 2005, the project was launched in the second-phase oblasts of Chernigiv, Crimea, Kherson, and Odessa.

Clinical training to build capacity in the target regions was conducted at the Southern Ukraine AIDS Education Center (SUAEC) as well as at selected healthcare institutions in each oblast. SUAEC—which has been recognized by WHO and other international organizations as a center of PMTCT excellence in the region—was established in June 2003 at the Odessa Oblast Clinical Hospital by AIHA and various strategic partners.

Through the project, AIHA provided technical assistance in the development of comprehensive community-based PMTCT operational plans that effectively organized the activities of all key stakeholders including the non-governmental sector for each project site. In addition, AIHA supported the development of model programs and methodological centers of excellence in each oblast that incorporated quality improvement processes and evidence-based practices, directly reached large numbers of women, and served as replication and training sites for staff at affiliated programs in underserved areas.

To read more on this project, click here.