Note: This Public Health Situation Analysis (PHSA) update builds on the rapidly expanding document published on March 3, 2022. The update expands on the information presented in the previous version, tracks changes in the situation, takes into account additional threats and integrates data from assessments.
An estimated 15.7 million war-affected people in Ukraine are in need of humanitarian assistance, of whom 12.1 million are considered to be in need of humanitarian health care.
This analysis identified priority health threats to the conflict-affected population based on the current situation and their expected evolution over the next three months. In areas of active combat, facilities are struggling to cope with the number of casualties. The number of COVID-19 cases and deaths has declined significantly globally and in Ukraine, with weekly downward trends. Since the start of the war, it is important to note that testing and reporting capabilities in Ukraine have been limited. It is important to note that since the start of the war, testing and reporting capabilities have been limited. However, COVID-19 remains a significant threat, especially given low vaccination rates. The recently reported case of diphtheria in an internally displaced person highlights the threat of outbreaks of vaccine-preventable diseases. Although childhood immunization coverage is close to WHO targets in 2021, disruptions to immunization programs due to hostilities and displacement, coupled with historical coverage gaps, put adults and children at risk. Tuberculosis and HIV programs have been disrupted, hampering access to drugs, potentially delaying treatment due to unreported infections and risking worsening disease transmission in a country known to have high rates. tuberculosis and HIV/AIDS higher than its regional neighbours. 4, 5 Non-communicable diseases (NCDs), such as cardiovascular disease, are the leading cause of death in Ukraine. 6 Reduced access to health care and medicines due to hostilities is likely to worsen the health status of the population, affecting quality of life and life expectancy.7 Mental health and psychosocial support of the affected population are intensifying due to the significant distress and socio-economic effects caused by the war.
Vulnerable groups are disproportionately affected by health threats and barriers to accessing health care. The elderly are particularly affected. An estimated 20% of Ukraine’s population is aged 60 and over – the highest proportion of older people in humanitarian settings in the world. 8 Other vulnerable groups identified in this analysis are people with disabilities (PwD), children and young people, women and girls, Roma, health workers and internally displaced persons ( IDP). Each of these groups has unique humanitarian health care needs that require special attention.
Many social determinants of health, such as water, sanitation and hygiene (WASH), food security, shelter, security, movement restrictions, impact the health of displaced populations and not displaced. Having an understanding of the state of these determinants gives context to the health issues faced by those affected and can help inform intervention planning.
Health system needs are highlighted by outlining the disruptions and challenges faced by key components of the health system and their expected impact over the next three months. Areas assessed include access to healthcare, healthcare system management, supply chains, alert and response systems, healthcare workforce, healthcare facilities and attacks on healthcare health.
To meet the needs of the conflict-affected population and the health system, Health Cluster Ukraine serves as a link between 106 partners planning or engaged in humanitarian health activities in Ukraine to better coordinate the response. The Health Cluster gathers and shares information to guide partner response planning. This PHSA is one of the resources developed by the Health Cluster Secretariat to promote a common understanding of the public health situation in Ukraine.