2023-11-22-世界卫生组织-HeRAMS_Ukraine_Status_Update_Report_May_-_October_2023_162页_12mb

HeRAMS Ukraine Status Update Report Summary (May - October 2023)

Core Content

The Health Resources and Services Availability Monitoring System (HeRAMS) is a WHO initiative aimed at monitoring the availability, accessibility, and functionality of health resources in Ukraine. The report provides an overview of the status of health facilities from May to October 2023, highlighting the impact of the ongoing conflict on the healthcare system.

Main Points

• Data Collection: From November 2022 to May 2023, data was collected from 2,333 public health facilities, expanding to over 9,000 health service delivery units (HSDUs) by October 2023.
• Health Facilities Overview:
  • 96% of health facilities are fully functional.
  • 92% of HSDUs are operational and undamaged.
• Structural Damage:
  • 88% of damages are due to conflict-related incidents.
  • Damage is concentrated in the North-East, East, South-East, and South of Ukraine.
  • Kharkivska and Donetsk oblasts have the highest numbers of fully damaged health facilities (38 and 39, respectively).
• Equipment Damage:
  • 94% of health facilities have intact equipment.
  • 6% have partial or full equipment damage, primarily due to conflict-related incidents (95%) and lack of maintenance (5%).
  • Kharkivska and Donetsk oblasts have the most equipment damage.
• Water Availability:
  • 94% of health facilities have consistent access to water.
  • 74% of water unavailability is due to equipment issues, and 64% due to financial constraints.
  • The Kakhovka Dam destruction has caused significant water issues in Khersonska, Mykolaivska, and Dnipropetrovska oblasts.
• Power Availability:
  • 97% of health facilities have consistent power supply.
  • 88% of power issues are due to equipment inadequacies, and 44% due to financial constraints.
  • Khersonska, Dnipropetrovska, and Donetsk oblasts have notable power shortages.
• Heating Availability:
  • 97% of health facilities have full heating availability.
  • 3% have partial availability, and less than 1% have no heating.
  • Equipment and financial constraints are the main reasons for heating unavailability.
• Connectivity and eHealth:
  • 83% of health facilities have full digital connectivity.
  • 76% have fully available eHealth systems.
  • Financial and equipment constraints are the primary barriers to eHealth availability.
  • Emergency Medical Care Centers have 100% connectivity and 92% eHealth availability.

Key Findings

Structural Damage

• 92% of HSDUs are not damaged.
• 90% of PHC facilities are intact.
• 89% of multiprofile and 86% of monoprofile facilities remain undamaged.
• Conflict-related incidents are the main cause of damage (88% of all damages), concentrated in North-East, East, South-East, and South.
• Inadequate maintenance is a significant factor in Central and Western regions (10%).

Equipment Damage

• 94% of health facilities have intact equipment.
• 6% have partial or full equipment damage, primarily due to conflict (95%) and lack of maintenance (5%).
• Kyivska, Kharkivska, and Khersonska oblasts have the highest numbers of equipment damage.

Functionality and Accessibility

• 96% of health facilities are fully functional.
• 50% of functionality issues are due to staff shortages, 35% due to damage, and 34% due to security concerns.
• 46% of accessibility issues are due to security concerns, with 36% related to infrastructure constraints and 20% to physical barriers.
• Regions like Kharkivska, Donetsk, and Khersonska show higher numbers of partially and non-functioning facilities.

Water

• 94% of health facilities have consistent water access.
• 74% of water unavailability is due to equipment issues, and 64% due to financial constraints.
• Khersonska oblast is particularly affected, with 20% of health facilities experiencing limited access and 1% having no water supply.

Power

• 97% of health facilities have consistent power.
• 88% of power issues are due to equipment inadequacies, and 44% due to financial constraints.
• Khersonska, Dnipropetrovska, and Donetsk oblasts have notable power shortages.

Heating

• 97% of health facilities have full heating availability.
• 3% have partial availability, and less than 1% have no heating.
• Equipment and financial constraints are the primary reasons for heating unavailability.
• Sumska and Dnipropetrovska oblasts show high heating availability, while Donetsk and Zaporizka have partial and complete unavailability.

Connectivity and eHealth

• 83% of health facilities have full digital connectivity.
• 76% have fully available eHealth systems.
• 20% of health facilities lack eHealth availability.
• Equipment and financial constraints are the main barriers to eHealth.

Health Service Domains

• Trauma and General Services: 92% fully available, 7% partially available, 1% not available.
• Child Health and Nutrition: 97% fully available, 2% partially available, 1% not available.
• Communicable Diseases: 96% fully available, 3% partially available, 1% not available.
• Sexual and Reproductive Health (STIs and HIV/AIDS): 87% fully available, 7% partially available, 5% not available.
• Maternal and Newborn Care: 86% fully available, 11% partially available, 3% not available.
• Non-Communicable Diseases (NCDs): 90% fully available, 7% partially available, 3% not available.
• Mental Health and Psychosocial Support (MHPSS): 85% fully available, 11% partially available, 4% not available.

Barriers to Service Delivery

• Financial Constraints: A major issue across all domains.
• Equipment Shortages: A significant challenge, especially in Donetsk and Khersonska oblasts.
• Staff Shortages: A critical barrier in trauma, maternal care, and MHPSS services.
• Training Deficiencies: Particularly in the MHPSS domain.
• Security Concerns: Affect both functionality and accessibility.

Conclusion

The HeRAMS report underscores the resilience of Ukraine's health infrastructure despite the ongoing conflict. While most health facilities remain fully functional and accessible, there are significant regional disparities and challenges in maintaining essential services. The main issues include financial and equipment constraints, staff shortages, and security concerns. Addressing these barriers is crucial to ensuring the continued delivery of health services across the country.