Ukraine: staying the course on universal health coverage amidst war
Published by WHO
6 September 2023
On 31 August, some 50 experts from Ukrainian governmental bodies gathered in Bukovel, a town in the Carpathian Mountains in western Ukraine. The goal? To ensure affordable health care, spare people living in the war-torn country from financial hardship, and make sure Ukraine stays the course on its march towards universal health coverage.
Participants followed a curriculum consisting of presentations, practical group exercises and interactive discussions. A version of the flagship WHO Barcelona Health Financing Course for Universal Health Coverage tailored to the Ukrainian context, it aimed to strategically address the country’s current health-care challenges.
Diminishing the blow with financial protection
People need access to the full range of health services in times of war and peace alike. However, during a full-scale armed conflict that is likely to lead to growing numbers of people foregoing health care, as well as greater numbers of out-of-pocket payments for health care, it becomes all the more challenging for the state to deliver these services and for its citizens to access them.
What can diminish the blow on individual households is a complex set of health financing policies for the present as well as for future recovery. Getting those policies right will be key to successful health-care reforms and will contribute to ensuring affordable access to health services for the entire population, said Dr Tamás Evetovits, Head of the WHO Barcelona Office for Health Systems Financing.
Dr Evetovits explained, “By adapting the lessons learned from practices across Europe and assessing reform options for Ukraine, the Course prepared participants to address challenges and adjust implementation with clarity and consistency about the ultimate objectives of improving access to health care and financial protection at the same time.”
Change governed by need
For days, the Ukrainian policy-makers – from the Ministry of Health, the National Health Service of Ukraine (NHSU), the Ministry of Finance, the Verkhovna Rada (Parliament) and 7 other governmental bodies – discussed the application of health financing concepts in Ukraine, financial protection, coverage policy, revenue generation and pooling, strategic purchasing, and fiscal governance.
What Mr Andrey Kudrya from the Parliamentary Committee on National Health found most important was the firm message that the focus of any change needs to be based on people’s needs.
He added, “Working with legislation and amendments requires expert support in the form of policy analysis, international experience and best practices. Thanks to the Course, we as staff of the Parliamentary Committee on National Health have deepened our understanding of the expertise that WHO can provide and gained knowledge of the impact of specific policies.”
Aspiration for reforms
Despite the war, the aspiration for continued health reforms alongside early recovery was palpable, according to WHO Representative in Ukraine Dr Jarno Habicht. “The Course, bringing together health sector stakeholders, provided an excellent platform for participants to engage in a dialogue about the latest evidence and the vision for the future of the health system in Ukraine and health financing in particular,” he said.
Participants had the opportunity to draw on theory and international best practices to identify challenges and propose solutions for health financing in Ukraine. Ms Natalia Husak, Head of the NHSU, pointed out that in the recovery phase after the war, health care will play a crucial role, and that certain needs have already become evident, such as mental health care and rehabilitation.
Ms Husak concluded, “Today, health-care professionals face new challenges that require a clear and in-depth understanding of the organizational and management principles of the health-care system. The principles laid down in the WHO Course are aimed at helping us accumulate resources in accordance not only with these needs, but also to bring medical care even closer to every Ukrainian.”
About the Course
The WHO Barcelona Health Financing Course for Universal Health Coverage, initially launched 12 years ago, draws on global and regional policy experiences. It reviews an array of effective policy tools aimed at advancing universal health coverage, improving service quality and ensuring financial protection for the population. It emphasizes best practices in health financing to enhance equity in both financing and the utilization of health services.
The latest edition of the Course in Ukraine was made possible through financial support from Germany, the Swiss Agency for Development and Cooperation, the Universal Health Coverage Partnership, and a joint European Union–WHO initiative focused on health system development in Ukraine.