Policy responses for Ukraine - HSRM


Policy responses for Ukraine

2. Ensuring sufficient physical infrastructure and workforce capacity

ENSURING SUFFICIENT PHYSICAL INFRASTRUCTURE AND WORKFORCE CAPACITY is crucial for dealing with the COVID-19 outbreak, as there may be both a surge in demand and a decreased availability of health workers. The section considers the physical infrastructure available in a country and where there are shortages, it describes any measures being implemented or planned to address them. It also considers the health workforce, including what countries are doing to maintain or enhance capacity, the responsibilities and skill-mix of the workforce, and any initiatives to train or otherwise support health workers.

2.1 Physical infrastructure

On 03 February, 2020 the Cabinet of Ministers has approved the national action plan to prevent the spreading of COVID-19 in Ukraine (https://zakon.rada.gov.ua/laws/show/93-2020-%D1%80), which, among other activities, envisaged surge capacity through reorientation of the hospitals, creation of second-line response facilities, involvement of the private medical sector, etc. The regional governments are responsible to follow those actions and organize implementation.

On 12 March 2020, 51 hospitals were designated for COVID-19 cases. As of 27 March 2020, 242 and then 247 hospitals were designated as first line response hospitals for COVID-19 hospitalization. Together, as of 16 June, these have 4049 places for isolation of patients, 68 thousand beds (among them 12 000 in Infection Departments), more than 1880 ventilators and 5508 doctors, including infectious specialists, anaesthesiologists, therapists and paediatricians. The information on those hospitals can be found on the
NHSU dashboard: https://nszu.gov.ua/e-data/dashboard/likarni-covid?fbclid=IwAR0WTZ_Ks2bsk5U8HPxrTCL902Bq1S2bunryTnbzo0QXFYb97f42MK1LsZw 

On 27 May, the Government supported the decision of the Ministry of Health to extend the number of designated hospitals to 449. As of the beginning of September, there were 26,000 beds in 315 health care facilities that provide care for COVID-19 patients, and 213 hospitals in the reserve ready to accept another 9,000 COVID-19 patients. As of 09 October, the number of hospitals increased to 393 and as of 24 November extended to 582. Since the beginning of the epidemic, the number of beds for patients with COVID-19 increased 4,5 times from 12,000 to 53,445. There is a documented shortage of personal protective equipment, laboratory testing (reagents for PCR, consumables), equipment (oxygen concentrators, CPAP, disposables for ventilators). The Government of Ukraine, through the central budget, has allocated additional resources for procurement of essential commodities to respond to COVID-19. The State Reserve fund has allocated additional funds, medicines and disposables to respond to COVID-19 cases. Stockpiling of medicines, equipment and personal protective equipment is ongoing throughout the health system in Ukraine using central, regional and local funds, as well as aid from the various charities, individuals and humanitarian agencies. Export restrictions have been imposed on commodities that are needed during COVID-19 response. The analytical dashboard on hospital`s capacity and essential supplies stock (PPE, medical equipment, tests, number of beds, health workforce) across the regions are available on several published web-platforms and updated regularly based on the data collected by the State Enterprise “Medical Procurement” of the MOH:

Since 1 April 2020, the Ministry of Health has purchased 176 ventilators, on 29 April the Government agreed to allocate additional funds (UAH 100 mln / USD 3.77 mln) to MoH to buy 200 ventilators from the national producer. On 20 April 2020 it purchased more than 71,000 protective suits for healthcare workers working with COVID-19 patients. On 23 April, more than 100 tons of humanitarian cargo was delivered from the Chinese city of Tianjin, including 12 million masks - both for hospitals and pharmacies, about 260,000 safety glasses for doctors and over 100,000 suits of the fifth level of protection. On 6 May, additional shipment of 111,5 tons of medical products arrived from China. On 27 April, the Minister of Health stated that in addition to the ongoing procurement of PPE, such as biological suits, masks, respirators, the MoH will also purchase all of these items to increase the state reserve as well to ensure preparedness for further potential epidemics in future.

On 08 May, the MOH issued Order # 1103 on the set of equipment for primary care, supplemented with personal protective equipment, including insulating apron, disposable gloves, boot covers, respirator class FFP2 / FFP3, medical cap, medical mask, protective shield.
As of 10 June, according to Cabinet of Ministers data, a one-month need for health care facilities that are designated for COVID-19 was covered as follows: 98% for hand sanitizer; 83% for eye protection; 81% for respirators; 60% for medical masks; 83% for gloves and 33% for gowns. As of 09 October, hospitals are supplied with PPEs for 67,92%, with medical equipment for 88,21%.

Additional credits: Dr Elina Dale; Dr Vitalii Stetsyk; Dr Liudmyla Slobodianyk;Mr Artem Skrypnyk;Ms Olga Demeshko; Ms Anastasiya Brylova; Ms Tetiana Dolhova