HEALTH

A visitor checks his knowledge of TB facts during a Mistechko USAID event.
A visitor checks his knowledge of TB facts during a Mistechko USAID event.
Olha Myrtsalo

THE CHALLENGE
Almost 30 percent of Ukraine's population still lives below the poverty line. Social and economic realities and an overburdened health care system challenge Ukraine’s ability to address rising rates of infectious diseases, especially TB.  Abortion rates are high in comparison to other countries in the region.

PROGRAM OBJECTIVES

  • Expand the DOTS approach to improve TB treatment outcomes and prevent TB/HIV co-infection and multidrug-resistant and extensively drug-resistant TB.
  • Reduce abortion rates through increased use of modern contraceptives.

OVERVIEW
USAID’s programs in health focus on improving the availability and effectiveness of health services and ensuring that Ukrainians are well-informed health consumers. USAID increases the ability of the Government of Ukraine (GOU) to provide quality services in family planning and reproductive health (FP/RH) and tuberculosis (TB). In addition, USAID supports civil society and government to expand access to and improve the quality of health services and advocate for an effective and efficient health management system and supply chain.

OUR PROGRAMS
Tuberculosis Prevention and Control

To date, USAID programs have increased access to quality TB prevention, diagnosis, treatment, and care services to 50 percent of the population of Ukraine and improved management of multi-drug resistant TB and TB/HIV co-infection based on the WHO-recommended Directly Observed Treatment Short Course (DOTS) strategy. Current USAID efforts focus on quality issues and systems strengthening measures that build on internationally-recognized practices in the 10 highest TB-burden regions. USAID focuses on improving TB treatment outcomes and adherence to appropriate TB treatment regimens; providing support to strengthen a laboratory network for quality TB diagnostics; mobilizing community support to TB and TB/HIV patients; and improving multidrug-resistant TB (MDR-TB) case detection and diagnosis. In addition, USAID provides technical assistance to build institutional and human resource capacity that strengthens the supply chain for TB and HIV/AIDS medicines, improves information systems, and increases the use of a pharmaceutical management information system for decision-making. 

Family Planning/Reproductive Health (FP/RH)
USAID seeks to reduce high rates of abortion and unintended pregnancies by increasing the appropriate and effective use of modern contraceptive methods. Communicating the benefits of modern contraception and reducing the fear of hormonal contraception through national and regional communication strategies is one of the major areas of USAID’s FP/RH program. USAID supports the Ministry of Health to implement the State Program for the Reproductive Health of the Nation until 2015. The USAID FP/RH program works with health providers to improve counseling skills in 13 oblasts and the city of Kyiv. Encouraging the sustainability of FP services, USAID supports local capacity building of a leading local NGO, the Women’s Health & Family Planning Foundation, and smaller regional NGOs working on women’s rights, health and youth. Recently, a local grant was awarded to bolster organizational capacity in policy and advocacy related to family planning and reproductive health. In addition, USAID recently launched a new activity to reduce alcohol and tobacco use among pregnant women and women of reproductive age in Poltava and Lugansk Oblasts through evidence-based FP/RH counseling.

PROGRAM HIGHLIGHTS
Tuberculosis

Since 2000, USAID has provided assistance to the Government of Ukraine to combat the TB epidemic by introducing and disseminating DOTS to regions with the highest TB burden:

  • Together with the Ministry of Health, USAID assistance increased access to quality TB services reaching 50 percent of the population and demonstrated the effectiveness of the DOTS-based approach in TB diagnosis and treatment. Over 10,000 individuals, including primary health care providers and laboratory specialists, were trained on the Stop TB Strategy. This training integrated best TB practices into the Ukrainian health care system.
  • Policies, guidelines, and ministerial orders were developed to improve TB/HIV co-infection management, prevention and management of MDR-TB, and infection control.
  • The laboratory network was strengthened at all levels and included both TB and primary health care laboratories. Almost 70 percent of laboratories now have improved performance in microscopy diagnosis as a result of institutionalization of quality assurance procedures.
  • An MDR-TB Center of Excellence was established in Dnipropetrovsk.
  • A successful and scalable model of community-based outreach and treatment support was developed with local partners, including the International Red Cross, which is improving treatment outcomes for marginalized populations.
  • Civil society organizations and prison health systems are working together to improve the continuity of care for released prisoners and significantly reduce high treatment default rates.
  • USAID also introduced best practices in TB recording and reporting systems to improve TB program management. The Ministry of Health adopted the USAID-supported electronic TB information system for Ukraine. This system improves case management, strengthens provision of medicines, and monitors drug prescription practices. 

Family Planning/Reproductive Health

  • During the period 2005-2011, access to modern FP services increased eight-fold from 343 health facilities to over 3,630 as a result of USAID efforts. Approximately 75 percent of Ukraine’s reproductive age population in 15 partner oblasts has been informed about modern FP practices and information.  Over 10,000 health providers were trained on reproductive health, post-partum and post-abortion FP, and counseling skills.
  • Approximately 14 million people have learned the advantages of modern FP methods. As a result, positive attitudes towards modern contraception in Ukraine have increased 10 percent. An updated post-graduate FP curriculum was introduced in 13 medical universities in Ukraine. The capacity of 30 NGOs was strengthened in health education and advocacy. As a result, the abortion rate in 2011 declined by 30 percent since 2005.
  • A National Communication Strategy was designed in partnership with the international community and key FP/RH messages have reached more than 1.9 million people of reproductive age. Regional communication strategies were also developed and some have been endorsed by regional partners.
  • An innovative life stage approach to introduce modern FP methods through clinical trainings proved to be successful, and over 1,500 health providers are actively using it while counseling their clients.
  • FP/RH educational activities conducted in cooperation with Bayer Health Care reached over 6,800 young people.
  • The current Ministry of Health Order #539 On Organization of Activities of FP/RH services System in Ukraine was updated according to existing international recommendations and submitted to the MOH for official approval. 

 

Last updated: August 18, 2014

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