Community health needs in Ukraine in the war context

Abstract

Abstract The full-scale russia's invasion in Ukraine caused the migration of people, partially destroyed the medical infrastructure, disrupted access to services, so there is a need to connect people tocare. The e-tools allow to monitor the capacities of the healthcare system and utilization of services. However, there is insufficient data on the population's needs. The CHNA was conducted in March-May 2023 in 16 communities across 8 regions of Ukraine. It was based on the adapted methodology of the Philadelphia Healthcare Federation and applied the following research methods: statistical analysis of the operating PHC facilities, availability of medical staff, and current gaps in service delivery; structured survey of the community residents; FGDs with community decision makers and residents; in-depth interviews with heads of PHC facilities. The assessment results demonstrated limited access to healthcare services in remote settlements, and thus the need to develop new formats of healthcare provision. The study showed a difference in the perception of PHC services accessibility between decision makers and the population. The biggest need identified was for MHPSS services for IDPs and local residents. CHNA is critical to inform programming. To improve access to essential services, the USAID Public Health System Recovery & Resilience project will support new approaches to PHC service delivery, including through mobile teams and task shifting to expand the role of nurses. To increase availability of MHPSS services, the project builds the capacity of the workforce and supports the delivery of evidence-based interventions such as mhGAP, CETA, Selfhelp+, CBT. Key messages • The developed CHNA is an effective tool for decision-makers to understand the main gaps in the availability of health services and to develop targeted interventions, especially in times of war. • Community-based MHPSS interventions are critical in time of war.