Ukrainian PDFs Available
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Publication
Hypertension Care in Ukraine: Breakpoints and Implications for Action
(World Bank, Washington, DC, 2019-01-11)Hypertension is one of the leading causes of preventable mortality in Ukraine. It is estimated that high systolic blood pressure was responsible for 42 percent of total deaths in 2016, which is among the highest rates in the world. This report presents key findings from an analysis of the continuum of hypertension care in Ukraine, where the World Bank implements a technical assistance program to support reforms and governance in the health sector. The analysis found significant gaps in detection, treatment monitoring and treatment adherence in hypertension care. The largest breakpoints were blood pressure monitoring at the frequency recommended by the protocol (67 and 71 percent gap in compliance in Lviv and Poltava regions) and achieving normal blood pressure while on treatment (76 and 65 percent gap among patients with monitoring data in Lviv and Poltava regions). The analysis provided lessons with policy implications, including more systematic screening to detect hypertension early and link cases to effective treatment, and a monitoring focus on patients with stage 2 and 3 hypertension and those with co-morbidities like diabetes to prevent poor outcomes. Treatment for blood pressure control is cost-effective in all regions of the world, and in Ukraine improved hypertension care would save lives, reduce disability and save resources in health care. -
Publication
Cervical Cancer in Ukraine: The Continuum of Care and Implications for Action
(World Bank, Washington, DC, 2019-01-11)Cervical cancer is an important disease in Ukraine: Among all cancers in females, it ranks 5th for incidence and 6th for mortality. While first year mortality shows some decline, progress in earlier detection has been very modest. This report presents key findings from an analysis of the continuum of cervical cancer care in Ukraine, where the World Bank implements a technical assistance program to support reforms and governance in the health sector. The analysis determined the breakpoints in the care cascade from screening to long-term monitoring of cases, and identified opportunities for action. The screening gaps were 47 percent (Lviv Region) and 38 percent (Poltava Region). Due to Ukraine's cervical cancer screening eligibility from 18 years of age, screening has a low yield, and this is further reduced by the short screening intervals with almost half of the women screening at least once every year, leading to efficiency concerns. Among the diagnosed cervical cancer cases, treatment completion and negative outcomes were not sufficiently documented. Understanding of diagnosis and treatment gaps helps pinpoint solutions ranging from simplified decision-making for cancer treatment, to improved pharmaceutical supplies and access to diagnostic equipment. The analysis highlights the need for age- and risk-appropriate screening invitations and recall systems to increase the efficiency and effectiveness of the cervical cancer program in Ukraine. -
Publication
Type-2 Diabetes Care in Ukraine: Breakpoints and Implications for Action
(World Bank, Washington, DC, 2019-01-11)Ukraine faces a triple health challenge from non-communicable diseases (NCDs), infectious diseases, and the demographic situation with low fertility, out-migration, and excess adult male mortality. It also has the challenge of re-focusing its health systems from a vertical hospital-based model with high hospitalization rates and length of stay to a community-based patient-centered model, emphasizing primary health care, out-patient care and health promotion. In short, it must move a system designed for injury and infectious diseases to one designed for better management of chronic care, prevention and promotion. -
Publication
Breast Cancer in Ukraine: The Continuum of Care and Implications for Action
(World Bank, Washington, DC, 2018-04)This brief summarizes an analysis on the continuum of breast cancer care in two Regions of Ukraine. The study used the cascade framework to determine the continuum from breast cancer screening of eligible women to diagnosis, treatment initiation and completion, as well as follow-up monitoring. It provided insight into the main breakpoints in breast cancer care in Lviv and Poltava Regions, and discusses the implications for action. To do so, it also draws on global lessons on successful screening and early detection of breast cancer. Given the World Bank support project in Ukraine, this analysis provides a baseline against which progress in cancer prevention and screening can be measured. The analysis of care cascades in Ukraine also covered three other disease: cervical cancer, hypertension and diabetes.