Five years after development of the national disability, health and rehabilitation plan for Ukraine: Achievements and challenges.

Abstract

In 2015, technical consultation to support development of the National Disability, Health and Rehabilitation Plan in Ukraine was carried out by the Rehabilitation Advisory Team of the International Society of Physical and Rehabilitation Medicine. Recommendations for actions and projects to improve rehabilitation services within the healthcare system in Ukraine were developed, proposed and implemented. The achievements in the subsequent 5 years include establishing, training and enabling employment at healthcare facilities for new rehabilitation professionals (physical and rehabilitation medicine physicians, physical therapists, occupational therapists), commencing implementation of the International Classification of Functioning, Disability and Health (ICF), and increasing rehabilitation knowledge among Ukrainian communities and decision-makers. The main challenges include inappropriate healthcare legislation for developing modern rehabilitation services, gaps in the clinical environment and quality control for training rehabilitation professionals, and the slow pace of implementation of the ICF. A general facilitator is the ongoing healthcare reform in Ukraine, especially its continuation to secondary and tertiary healthcare levels. Future high-priority activities will include amendments to basic healthcare legislation, and introducing a bio-psycho-social approach for the provision of rehabilitation services at all healthcare levels and all rehabilitation treatment phases, starting with the most debilitating health conditions. It will be important to continue the collaboration with European and international partners. LAY ABSTRACTUkraine developed a National Disability, Health and Rehabilitation Plan (NDHRP) in 2015. Since then, the recommended actions and projects have been implemented in the country. Some achievements can be seen, including the establishment of new rehabilitation professions (i.e. physical and rehabilitation medicine (PRM) physician and ergotherapist (the Ukrainian terminology for occupational therapist); implementation of the International Classification of Functioning, Disability and Health (ICF); and commencement of implementation of rehabilitation at different levels of healthcare. However, some challenges still need to be addressed, including the introduction of legislation to enable the delivery of effective and safe rehabilitation services, continuing education for rehabilitation professionals, and raising awareness of the ICF implementation, which is based on introducing a biopsycho-social model into the entire clinical process of rehabilitation. With the support of international partners, including European PRM bodies and other international organizations, the outlook for improvement in the field of rehabilitation in Ukraine is very positive.