MoH of Ukraine presented changes in health care to international partners

Key partners of the Ministry of Health - representatives of embassies and international organizations - highly appreciate changes that have already taken place in health care and support the Ministry’s efforts in their implementation. Together with the partners, Acting Health Minister Ulyana Suprun and her Deputies Pavlo Kovtonyuk, Olha Stefanyshyna, Oleksandr Linchevskyi, Roman Ilyk discussed further steps and priorities in the work of the Ministry in 2019, and healthcare transformation during the 17 April meeting.

Changes in the health system that are currently taking place and their positive dynamics are made possible, particularly with support from the partners.

As of now, transformation results are as follows:

• The health care system becomes more patient-oriented. De-communization of the old system and creation of a system with the patient at its heart is actually taking place. The current policy focuses on the health of each particular patient rather than illness. More attention is paid to prophylaxis, early diagnosis and disease prevention.  After all, it is possible to solve most health problems at the stage of preventing acute exacerbation of chronic disease or disease prevention. And prevention is easier and less costly than cure.
• Changes that every Ukrainian is witnessing have begun with primary care. According to the sociological survey of the Kyiv International Institute of Sociology (KIIS) conducted in late March this year 27 million Ukrainians have already chosen their physician (a family doctor, a therapist or a pediatrician), and 70% of those patients who have chosen their physician are satisfied with his/her medical practitioner.  
• Changes in the primary care were experienced not only by patients. Working conditions and salaries for medical practitioners are improved where healthcare facilities have concluded a contract with NHS of Ukraine and have proactive and effective leadership. Family physicians, therapists, pediatricians and nurses working in these healthcare facilities already have a higher income.
• Systemic struggle of MoH of Ukraine with corruption in health care contributes to the establishment of a new system, where the very causes of corruption are impossible due to understandable, transparent, clear and honest new rules and procedures, which are the same for all. As a result, Ukrainians give bribes rarely, as evidenced by the results of a sociological survey conducted by Rating Sociological Group in October 2018. In October 2018, 7% ‘rewarded’ their physicians’ pocket against 20% in August 2017.
• The healthcare system becomes more transparent, making corruption cases practically impossible. Ukrainians have the right to open access to information about free medicines,  about charitable contributions to healthcare facilities. The eHealth system, which began to be implemented, provides transparent funding. An electronic register of patients in insulin therapy enabled avoiding excessive insulin requirements, preventing counterfeit recipes and availability of patients who do not actually exist. Heads of state and municipal healthcare facilities throughout the country are selected on a competitive basis rather than based on the home selection process.  Hearing reports of the heads of higher medical and pharmaceutical educational establishments and postgraduate educational establishments of MoH of Ukraine on contract compliance enabled identifying a number of offenses and abuses by the principals.
• There are more medicines now. Involvement of international organizations helped to root out corruption in centralized procurement and allowed to use up to 39% of allocated funds for additional purchases. These funds are measured in billions of hryvnias, for which additional medicines were purchased for patients and saved more lives. The difference in prices of individual medicines before the international organizations were involved in public procurement and after that is several times less. 
• Much attention is paid to vaccination in Ukraine. This is a national security matter. Such outbreaks as the outbreak of measles, which is currently continuing in Ukraine, threatens Ukrainians’ lives. Due to vaccination, the mankind managed to overcome many infectious diseases. Refusing vaccination is in the list of global threats to humanity. The National Immunization Schedule provides for the vaccination of children against 10 diseases: tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus, measles, hepatitis B, hemophilic infections, rubella, and epidemic mumps; and adults against diphtheria and tetanus. The state purchases vaccines in accordance with the Schedule, and thus guarantees the opportunity for Ukrainians to receive free vaccinations to prevent these diseases and protect their lives and lives of their children.
• The acting Government Affordable Medicines Program has improved access to treatment for Ukrainians. Patients with cardiovascular disease, type 2 diabetes mellitus and bronchial asthma may receive medicines for free or for a small fee. There are 258 pharmaceuticals in the Register, 64 of which can be obtained by patients absolutely free.
• Transformation has also begun at the level of medical education. After all, health of physicians’ future patients is dependent on the level of physicians professional training.  The strategy for medical education development prepared by MoH of Ukraine is valued by Western experts as promising and comprehensive one that can make real qualitative changes. This is the strategy with a time horizon of 10 years. The threshold for admission to universities in the medical profession has already been established,  the One State Qualification Exam (OSQE) has been introduced and continuous professional development is being implemented.
• There are changes in emergency care. Ukraine has introduced a central electronic system to optimize operation of dispatch services, and transforms the system of professional training of emergency medical personnel.