Iryna Voloshina is a family doctor from Berdyansk, Ukraine. For the past 18 years she has been working as a physician while teaching family medicine to university students. Iryna says that while family medicine forms the foundation of Ukraine’s health-care system, patients in Ukraine still tend to overrely on specialist care.
“In countries such as Great Britain, 90% of health-care demands are actually managed by family physicians; in Ukraine, we are not used to this approach, but we are slowly moving towards it,” Iryna says.
Unlike specialists, family doctors offer a broad range of expertise and provide comprehensive, continuous and coordinated care. More importantly, they practise in and know their communities.
“Some patients believe that if they have a headache, they should see a neurologist, or that they should only consult a surgeon after undergoing surgery,” explains Iryna. “We need to learn how to cooperate with each other and understand that primary health care is not emergency care, and that patients are also responsible for their own health.”
Supporting the training and education of health workers
When the COVID-19 pandemic started, Iryna was afraid of the virus and took extra precautionary measures to protect herself and her colleagues at the hospital.
While managing their own fear of COVID-19, health-care professionals have had to care for anxious and fearful patients.
“A lot of misinformation was spreading among patients, so in addition to providing medical assistance, health-care workers had to reassure them and encourage them to stay away from ineffective self-treatment.”
In order to succeed in their delicate work, health workers such as Iryna need good training in soft skills such as communication, management and leadership. Unfortunately, in Iryna’s view, medical schools still emphasize theoretical knowledge at the expense of practical skills.
“While in medical school, I didn’t receive any training on these important skills, and I think this is an area where we can improve,” she says.
Ongoing professional development is also important. The relevance of the training received in school, even if practical, may change over time, as practices and standard procedures develop. Therefore, health workers need support also to ensure that their skills stay relevant and up to date.
“A physician should always think critically and find ways to keep up with the pace of change in science, and continuing professional development is extremely important in our field,” Iryna shares. “I am fortunate enough to be able to attend annual international congresses on family medicine and other specialties, but not all of my colleagues can count on this kind of support.”
Reforming Ukraine’s health-care system
In 2015 Ukraine initiated a series of reforms to strengthen the national health-care system, primarily to improve health outcomes and to ensure financial protection from excessive out-of-pocket payments. WHO continues to support these efforts in Ukraine through both policy advice and technical assistance.
Iryna says this has been a very positive development. The new financial mechanisms to change the delivery of primary health-care services have brought more flexibility to patients by allowing them to choose their own health-care provider.
As a result, Iryna says that more than 31 million declarations have been registered with primary health-care doctors in Ukraine.
The year 2021 has been designated as the International Year of Health and Care Workers in appreciation of and gratitude for their unwavering dedication in the fight against the COVID-19 pandemic.
This story has been developed by the WHO Country Office in Ukraine, with financial assistance from the European Union, and is part of a series of stories showcasing Ukrainian health-care workers.