ReLAB-HS launches in Ukraine!

23 September 2021

On September 14 2021, over 70 stakeholders from the worlds of rehabilitation, assistive technology, health systems and national government gathered for the online launch of ReLAB-HS in Ukraine.

The event highlighted ReLAB-HS’ plan to develop innovative, cost-effective solutions that will dramatically improve the ability of the Ukrainian health system to provide vital rehabilitation, as well as life changing assistive technology.

Key speakers at the webinar included Kirsten Lentz, Senior Advisor for Rehabilitation, USAID/Washington DC; Larisa Mori, Deputy Director of the Office of Health, USAID/Ukraine, Oksana Zholnovych, Head, Department of Social Policy and Health of the Office of the President of Ukraine, and Satish Mishra, Technical Manager – Disability and Rehabilitation, WHO Regional Office for Europe.

USAID continuous support

ReLAB-HS is funded by USAID, and Kirsten Lentz, Senior Advisor for Rehabilitation (USAID/Washington) said she was inspired by the number of people joining for the launch event in Ukraine. “It is a testament to the growing interest in physical rehabilitation, the integration of physical rehabilitation into health systems, and the acknowledgement of the important role that physical rehabilitation plays in comprehensive health services,” Lentz added.

She emphasized that Ukraine has made significant strides in recognizing the need to professionalize rehabilitation professions, build a culture of evidence-based practice, and to incrementally incorporate rehabilitation services at secondary care levels.

Lentz said “USAID is pleased to be investing in the physical rehabilitation sector in Ukraine and sees ReLAB-HS as a continuation of the past investments that will continue to support Ukrainian Government initiatives to transform physical rehabilitation and assistive technologies in the health system.”

Larisa Mori, Deputy Director of the Office of Health, USAID/Ukraine pointed out that the need for physical rehabilitation and assistive technologies, especially amongst vulnerable populations is an urgent and growing global issue and one of vital importance to Ukraine’s future development. For the last five years, USAID has partnered with the Government of Ukraine, the private sector and civil society partners to confront challenges and access to the rehabilitation services and improve accesses to care among vulnerable groups, including veterans.

She added “ReLAB-HS reflects USAID’s continuing commitment to strengthening access to rehabilitation services in Ukraine. This activity has an ambition goal to transform the lives of the people with disabilities, by improving their access to physical rehabilitation services and assistive devices.”

Challenges and perspectives

In Ukraine, there is a high demand for quality rehabilitation services. Many Ukrainians need rehabilitation services, including those who have lost the ability to be independent in the performance of daily tasks, to participate in education, work, leisure, and other activities important to them.

The rehabilitation and assistive technology sectors have only recently begun to develop in Ukraine: the Soviet-inherited centralized health care system is underfunded and overly bureaucratized, and rehabilitation services have traditionally been based on the biomedical disability model, rather than also looking at societal barriers to those with disabilities.

Oksana Zholnovych, Head of Department of Social Policy and Health of the Office of the President of Ukraine, talked about the current challenges rehabilitation system faces in Ukraine and shared expectations for future cooperation.

She explained that in Ukraine, there were no systems to rehabilitate a person from the first days of injury – the rehabilitation system functions so that this service becomes available to a person only when he/she receives the official status of “disability”.  However, it takes four to five months to receive this status from the moment of illness. Time is wasted when people are in need of support.

However, the Parliament of Ukraine passed the “About Rehabilitation in Healthcare” law in 2020, which defines new rules and principles for building a rehabilitation system in the country. It allows a person to receive rehabilitation services from the first day of the need.

“Now we need to make efforts to establish rehabilitation according to international standards. It means building rehabilitation centers, and rehabilitation departments in hospitals where such assistance will be provided, developing good rehabilitation packages funded by the National Health Service, and designing protocols based on evidence and clinical trials. The support of public organizations and international partners will help to perform this work faster and with more efficiency,” Ms. Zholnovych concluded.

About ReLAB-HS

To overcome these challenges,  ReLAB-HS will support the Ukrainian government’s initiatives to transform the field of rehabilitation and assistive technologies.

The project will run for five years, and will work closely with relevant national and subnational actors at all health-care levels in the project catchment area to collaboratively implement and evaluate assistive technology-inclusive rehabilitation service delivery models, support rehabilitation sector leaders to catalyze and strengthen a national agenda for rehabilitation in the health system, support workforce capacity development to improve rehabilitation care, generate new evidence about the integration of rehabilitation into health systems, and engage with stakeholders to use this new evidence for policy and planning.

Dr Abdulgafoor Bachani, Director of Johns Hopkins International Injury Research Unit and the ReLAB-HS Program said “With USAID’s generous support ReLAB-HS will contribute to the global efforts to strengthen rehabilitation in health systems and support the development of health systems that are inclusive of rehabilitation care including assistive technology”.

The second part of the event was held in the format of the stakeholder discussion panel and dedicated to the advantages/gains and weaknesses/gaps in the rehabilitation system and assistive technology provision in Ukraine, and finding ways for coordination.

Speakers included Tetyana Barantsova, Government Commissioner for the Rights of Persons with Disabilities, Antonina Saleeva, Director of Ukrainian Research Institute of Prosthetics, Prosthetic Making and Rehabilitation, Olga Mangusheva, Chairman of the Board of Ukrainian Society of Occupational Therapist, and Svitlana Dudnyk, Head of the Division of Interaction with External Experts, Department for Program of Mеdical Guarantees Development of National Health Service of Ukraine.

The panellists welcomed the ReLAB-HS focus on developing a national policy for providing rehabilitation services and assistive technologies, introducing standards, and especially mechanisms for effective interaction between different ministries.

Olga Mangusheva highlighted the need for educational work among health professionals, as well as the general population, to explain the purpose, means, and expected results of rehabilitation services.

Svitlana Dudnyk said currently certain group of patients can receive rehabilitation services free of charge under the Medical Guarantee Program.

Medical Guarantee Program includes:

• Medical rehabilitation of infants born prematurely and/or sick, during the first three years of life
• Medical rehabilitation of adults and children from three years old with disabilities of the musculo-skeletal system
• Medical rehabilitation of adults and children from three years old with damaged nervous
  system

Ms Dudnyk also outlined a list of tasks that need to be addressed to improve rehabilitation in Ukraine:

• Legal framework development and modern standards implementation.
• Coordination between different authorities and institutions.
• Research on the demand for rehabilitation services and assistive technologies. What devices and services are needed?
• Finance issues and understanding how much investment is needed to implement the measures.

Tetyana Barantsova emphasized the importance of the psychological aspects of rehabilitation.