Ukraine

Slightly 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.

Projects

International Twinning Center Blood Safety Project under PEPFAR
(2018-2019)

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.

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.

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.

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.