By Ramesh Jaura
BERLIN | 25 February 2025 (IDN) — While European leaders travelled to Kyiv on the third anniversary of Russia’s invasion of Ukraine, assuring President Zelensky of the continued flow of money and weapons, and President Emmanuel Macron of France pleaded with President Trump in Washington not to ignore Europe while brokering a peace deal with President Putin, a blind eye is being turned to pressing health needs of Ukrainians.
The UN Health Organization WHO calls for the support of international partners, asserting that: “Health is the foundation of peace and recovery. Rebuilding health systems means restoring hope and dignity and securing the future. We do not wait for the war to end. We are engaged in recovery, response, and reform simultaneously. Every delayed intervention worsens the situation and increases future costs.”
WHO has sounded an alarm: Healthcare access is increasingly unequal, particularly in front-line areas. The most damaged and dysfunctional healthcare facilities are along the front line, where the remaining population often faces multiple vulnerabilities, including being elderly or living with disabilities.
These facilities suffer from frequent disruptions in medical supplies, shortages of healthcare workers, and significant barriers to care. In ten front-line oblasts, 68 per cent of adults report worsening Health. Healthcare refusal rates are highest in Kherson (43 per cent), followed by Kharkiv (24 per cent) and Zaporizhzhia (18 per cent). “The continued disruptions in these areas underscore the urgent need for sustained support and interventions,” says WHO.
Ukraine’s healthcare system is facing unprecedented challenges. There is an escalating demand for mental health support, trauma care and rehabilitation. WHO has recorded over 2,254 assaults on health care in Ukraine since the start of the war three years ago.
An overnight strike in Odesa on 19 February, which disrupted vital services by denting the region’s largest and most innovative children’s clinic, highlights the persistent risks and obstacles facing healthcare workers and the persistent interruptions in the delivery of medical services across Ukraine.
WHO quotes Olha Zavyalova, an emergency physician and surgeon from the Dnipro region: “Being a doctor in wartime means returning home after each shift, wishing the war had never happened and praying for its swift end. The patients and healthcare workers are exhausted. Yet, as medical professionals, we do not have the luxury of being tired. Our patients need us to keep going, and we must push through the fatigue to continue delivering the care they deserve.”
Everchanging health needs
According to the latest WHO Ukraine health needs assessment (October 2024), 68% of Ukrainians report a decline in their Health compared to the three years ago pre-war period. The most prevalent health issues are mental health concerns, with 46 per cent of people affected, followed by mental health disorders (41 per cent) and neurological disorders (39 per cent).
Noncommunicable diseases (NCDs) have resulted in 84 per cent of all deaths in Ukraine — because of the unavailability of services and the high cost of medicines, leaving those with chronic conditions vulnerable to disruption in care and irreversible health deterioration.
The war has intensified health needs, particularly in areas such as trauma care and rehabilitation. The country’s Ministry of Health estimates that by mid-2024, 100,000 amputations were performed due to the war. “The severe shortage of trauma specialists, prosthetics and rehabilitation services has further exacerbated the crisis. Healing is often a matter of time but can also be a matter of opportunity. Long-term rehabilitation services for war-injured people will be essential for both physical and psychological recovery,” WHO said in a news release.
Resilient health system
The UN Health Organization is addressing Ukraine’s growing health needs, ensuring access to quality health care for all Ukrainians, focusing on strengthening primary health care to combat the prevalence of NCDs and expanding access to vital mental health and rehabilitation services. “We also support building a resilient health system by collaborating with the Ministry of Health and the National Health Service of Ukraine to update reimbursement packages, including rehabilitation, and standardize assessment tools. This ensures that resources are allocated where needed most, laying a stronger foundation for quality care.”
Key achievements in mental Health include developing the Target Model of the Mental Health and Psychosocial Support System of Ukraine and the 2024–2026 National Mental Health Action Plan, along with 24 oblast-level plans. “Rehabilitation is a key highlight of our efforts to build the capacity of professionals.” By the end of 2024, WHO trained multidisciplinary rehabilitation teams from 28 non-specialized inpatient rehabilitation departments from 11 oblasts.
A key milestone was the reform of Ukraine’s stroke care system, with WHO leading technical discussions, conducting clinical audits and supporting the monitoring of over 50 healthcare facilities to improve acute care.
WHO has also introduced a Package of essential NCD interventions, emphasizing integrated care for low-resource settings. The National Action Plan on antimicrobial resistance was approved, with ongoing training for healthcare workers and facility modernization. WHO also supported primary healthcare financing through costing exercises, payment design, and network development, culminating in the Ministry of Health’s approval of a capitation rate methodology in July 2024.
Displacement and vulnerability
WHO maintains that access to health care remains a critical issue across Ukraine. One in four people report a decrease in access to medical services since the start of the full-scale invasion in February 2022. The cost of medicines and treatment continues to be a significant obstacle to care, with 35 per cent of people in October 2024 indicating that they had postponed medical care due to financial challenges.
Internally displaced persons (IDPs) are among the most vulnerable groups. Thirteen per cent of IDPs lack access to primary healthcare facilities, compared to just 6 per cent among host communities. Similarly, 9 per cent of IDPs have no access to a family doctor (compared to 4 per cent of locals), and 12 per cent have not signed a declaration with a family doctor, compared to 5 per cent in host communities. While IDPs report better changes in healthcare quality than locals, their access to primary care and preventive services remains lower.
Response, recovery and reforms
Last year, WHO shifted focus from emergency relief to capacity building, prioritizing primary care and critical areas such as NCDs, immunizations, mental Health, HIV, tuberculosis, infection control, and antimicrobial resistance. WHO is collaborating with Ukrainian authorities to enhance health responses and recovery efforts, including installing 29 modular primary health clinics in affected regions.
WHO also supports health finance reforms, including capacity building, procurement transparency and strategic planning to strengthen Ukraine’s health system, ensuring it remains resilient amid ongoing challenges. In addition, professional development opportunities for nurses and healthcare workers are being expanded to address workforce shortages and bolster the overall health system. [IDN-InDepthNews]
Photo credit: WHO / Christopher Black
