Intended for healthcare professionals


Ukraine: one in three people with chronic conditions have problems accessing healthcare

BMJ 2022; 377 doi: (Published 22 April 2022) Cite this as: BMJ 2022;377:o1040
  1. Melina Zachariou
  1. London

Two in five households remaining in Ukraine have at least one person with a chronic illness and a third of these are finding it difficult to access the care they need because of the ongoing war, a World Health Organization survey has found.

Fewer than a third of the 1000 households that have so far responded to the needs assessment survey said that they have sought health services recently, mainly (39% of respondents) because of the security situation, although around a third (27%) said there were no healthcare services in their area.

Jarno Habicht, WHO representative and head of the WHO country office in Ukraine, said that the findings show the urgent need for continued health systems support in Ukraine.

Most households (70%) surveyed are sheltering in their own homes, while one in 10 (11%) are staying with friends and family members in relatively safer areas, 8% are on the move within Ukraine, and 3% are in a shelter or camp for internally displaced people.

Since 24 February there have been more than 160 verified attacks on healthcare facilities in Ukraine, curtailing the services available. Access to reproductive, maternal, antenatal, and mental health care in Ukraine has also been severely affected by security concerns, restricted mobility, broken supply chains, and mass displacement.

Over 12 million people have been forcibly displaced by the Russian invasion with a further 2.9 million considering leaving their homes, according to the UN.

“WHO has been able to reach nearly 7.5 million people over the past eight weeks with life saving supplies, equipment, and medicines. But it is still unable to reach some of the hardest hit areas in the east where the health system has all but collapsed,” said Habicht. “It is vital to gain access to assess health needs and move vital supplies into affected areas, including Mariupol. Civilians have a right to health, even in times of war.”

Infectious disease risks in Ukraine, especially waterborne diseases, have risen in recent weeks, while the uptake of routine immunisations, including covid-19 vaccinations, has fallen.

Through donors, funders, and partners on the ground, WHO has delivered 130 000 covid-19 rapid antigen tests and 1000 vials of tocilizumab to treat severe, life threatening cases of covid-19. Specialised medical and emergency supplies have also been delivered and medical teams have been deployed in hard-to-reach areas.

Hans Henri P Kluge, WHO regional director for Europe, said, “As we respond to the immediate humanitarian needs, we must also plan for reconstruction and rehabilitation in parallel. The challenges are formidable, but WHO will work with national authorities and partners every step of the way, striving to achieve health and wellbeing for all.

“During my recent visit to Ukraine, I was deeply impressed by the resilience of the health workers I met, who are going over and above the call of duty to treat patients and serve their communities, despite the difficult circumstances.”

Three hubs in western Ukraine are supporting medical evacuations, ensuring safe medical evacuation of patients, including those with cancer, for treatment outside Ukraine.

WHO has received $26.3m (58%) of the $45m it has asked for to cover healthcare needs from March to May with a further $18m pledged.