WHO calls on governments to bring health services closer to people

5 April 2019 | Kyiv — On World Health Day 2019, WHO calls on leaders to invest in primary health care as the smartest step towards universal health coverage.

Between 70 and 80% of people’s health needs throughout their lifetime can be met with strong primary health care, from health promotion to disease prevention through vaccination, treatment and management of long-term health conditions, rehabilitation, palliative care and medicines.

“Health is a human right. We can do much more to improve access to health services for the most vulnerable. Ensuring everyone can use the health services they need, when they need them, without experiencing financial hardship, is one of the Sustainable Development Goals countries have committed to reach by 2030. It is also WHO’s top goal and primary health care is at the heart of it,” says Dr Piroska Östlin, Acting WHO Regional Director for Europe.

During the last few years, Government of Ukraine made significant progress towards the people-centered model of health care services provision. In cooperation with the civil society and international partners, the national policies on immunization, management of communicable and non-communicable diseases have been improved and updated in accordance with the international recommendations and standards. In addition, procurement of medicines through the international organizations ensured timely and cost-effective supplies of vital treatments to people countrywide.

“Health and Universal Health Coverage are a cornerstone of UN engagement and support in Ukraine” says Osnat Lubrani, UN Resident and Humanitarian Coordinator in Ukraine. “As we work together to support Ukraine’s Sustainable Development Agenda by 2030, the human right to health means that everyone has the right to the highest attainable standard of physical and mental health. This right has to be protected with the strong and effective health system”, she added.

To leave no one behind, strengthen primary health care

In Ukraine, the transformation of the health system began to unfold gradually with a focus on primary health care (PHC) and ongoing support from national and international partners such as WHO, World Bank, USAID, UNDP, and UNICEF. Nearly 26 million of Ukrainian citizens have already chosen their physician and the National Health Service has paid more than UAH 6 billion to the health facilities under these contracts.

Dr. Jarno Habicht, WHO Representative to Ukraine: “WHO and development partners welcome the efforts of the Ukrainian Government in transforming the health system, including health financing. The changes – including revision of health financing regulation, creation of National Health Service, and proceeding with strengthening primary care and access to affordable medicines – are in the right direction to move towards universal health coverage”.

Out-of-pocket payments undermine access to health services

New evidence from WHO Europe shows that payments for health services, particularly for medicines, are unaffordable for many people and can cause financial hardship across the European Region, including in high-income countries. Analysis of data from Ukraine shows that in the pre-reform period of 2010-2015 up to 14,5% of households could not afford to pay for basic needs such as food, rent or utility bills after paying out of pocket for health services.

The poorest households, people with chronic conditions, older people and those living in the conflict affected areas in eastern Ukraine are most likely to experience financial hardship due to out-of-pocket payments for health care and are often unable to obtain many of the health services they need.

“For almost four years, UNDP has been assisting the Ministry of Health of Ukraine by providing life-saving medicines to those who need them the most. The health procurement process in Ukraine has become more open, transparent and effective, in turn saving more lives”, says Blerta Cela, UNDP Deputy Resident Representative to Ukraine. “We're looking forward to continuing to engage with the Ministry of Health and other partners to strengthen health sector reform in Ukraine.”

“Absence of access or delayed access to health care facilities weighs enormously on outcome of diseases, especially in young children. Intending to close critical gaps in maternal and child health, UNICEF is engaged in the development of policies aimed at improving children’s access to quality health services, and continue to support the health components of the transition stage. These efforts aimed to ensure uninterrupted access to services in the conflict-affected areas, essential packages of integrated services for children and women, and related policy and legislative standards integrated in health care reform”, states Lotta Sylwander, UNICEF Representative in Ukraine.

According to the Humanitarian Trend Analysis in Government-controlled areas of Donetsk and Luhansk regions performed by the REACH Initiative, the main barrier in accessing health care reported by the households was the cost of medicines.

Countries can put in place policies to minimize out-of-pocket payments, particularly for poor people and regular users of health services. Primary health care has a vital role to play in securing access to health services for these groups.

“WHO and partners continue to work closely with the Ministry of Health, National Health Service, National Public Health Center to ensure that expanding of the primary health care coverage takes place in Ukraine along with increasing affordability and quality of the health care services”, Dr. Jarno Habicht concludes.

For further information, contact:

Anna Borshchevska

Communications Officer

WHO Country Office in Ukraine

e-mail: borshchevskaa@who.int