Despite the ongoing conflict, Ukraine is pursuing its reform of primary health care (PHC). On 15–16 May 2024, WHO, together with the Ministry of Health of Ukraine and the National Health Service of Ukraine, hosted the second PHC conference in Ukraine.
The event focused on the ongoing reform, which includes improvements related to PHC financing for better access and quality of care, workforce development, digitalization and transparency, and the future direction of PHC in Ukraine. It convened more than 500 PHC professionals along with health authorities and international partners.
“PHC is essential for building resilient and strong health systems,” said Dr Jarno Habicht, WHO Representative in Ukraine. “Despite the challenges posed by the war, WHO supports Ukraine in advancing the PHC reform agenda by providing policy and technical advice, strengthening its health financing mechanisms, and implementing activities to improve the accessibility and quality of services for patients.”
Dr Habicht continued, “Such initiatives, among others, include the installation of modular PHC facilities in Kharkiv and Sumy to allow quick recovery and service availability along with support for outreach teams, delivering services to address noncommunicable diseases.”
A holistic approach
Strategic directions for health system development and the importance of PHC in economic and social development were underscored at the conference, along with the need for investment. PHC is the most cost-effective approach to adapt to evolving needs caused by the war.
The conference also provided an opportunity to discuss challenges and solutions for health systems on the frontline, access to care and service delivery in disrupted and rural areas, and the humanitarian response in war-affected zones.
Participants discussed the need to establish a quality-of-care framework and explored how digitalization can enhance PHC performance, including through electronic health, reliable data, and enhanced accountability and trust.
In a session on workforce development, participants discussed challenges faced by family doctors and nurses, how to boost health workforce numbers and capacity and to expand the role of nurses, and ways to promote women’s leadership in health care.
Family doctors and nurses from across Ukraine shared testimonies of working as PHC professionals during the war, and patients gave insights into their interactions with PHC services in Ukraine.
Strengthening financing
The discussion of PHC financing underscored the critical need for securing sufficient and equitable funding through budget allocation. Many stressed that any expansions of the PHC service package must be adequately resourced, and that the design of financial incentives needs to enhance access to comprehensive care. This is especially important in areas affected by conflict or with limited access to health care, and for managing patients with priority health conditions.
The benefits of an evidence-based, transparent approach to setting and regularly reviewing PHC tariffs were also in focus. Participants emphasized the significance of covering the entire cost of delivering the PHC package under the Programme of Medical Guarantees. Discussion also centred on the essential role of engaging with PHC providers in developing financing mechanisms and ensuring adequate funding.
Finally, there was a strong emphasis on the importance of developing the PHC financing roadmap to set a clear vision of priorities for the next 5 years.
The PHC conference was an opportunity for international partners, including the European Union Delegation to Ukraine, the World Bank, the United Nations Children’s Fund (UNICEF), and the United States Agency for International Development (USAID), to discuss the continuity of essential health services and health digitalization.
The conference was organized with financial support from the Government of Canada and the Universal Health Coverage Partnership. It marked the official launch of 2 new reports aimed at advancing the ongoing health financing reform in Ukraine, with a specific focus on improving the quality and accessibility of PHC. The first report presents a thorough analysis of costs, offering key insights for revising payments to PHC providers. The second, complementary report presents the results of a survey conducted to explore the financial impact of the war on PHC services across the country.