WHO in Ukraine has been supporting the National Health Service of Ukraine (NHSU) to conduct costing studies with primary health care (PHC) providers in Ukraine in order to safeguard free access to PHC services for the entire population.
The study aims to inform the development of the PHC payment system based on objective costs to ensure that all necessary costs of delivering the PHC services in the benefit package are being covered.
“Investment in PHC improves access to health-care services and enhances social well-being,” explained Dr Jarno Habicht, WHO Representative in Ukraine. “Current PHC service costing studies are particularly important in order to adjust payment systems amid changing health needs and care models.”
Dr Habicht added, “WHO in Ukraine is prioritizing PHC, and in the past years has provided capacity-building to health-care workers and has enabled service outreach to areas regained by the Government of Ukraine during the war for patients with chronic diseases. WHO is also facilitating innovation in order to have better access to digital tools for health, and has supported the development of indicators to monitor the system’s adaptation and development.”
The NHSU has set a priority to develop a PHC costing methodology, which will provide an in-depth look at the costs associated with delivering PHC services in Ukraine. Following a request from the NHSU and in cooperation with WHO, up to 100 health service providers have agreed to share their cost data.
The findings will help the NHSU make necessary adjustments, and the recommendations will improve the national payment system to strengthen health-care delivery.
A family doctor reflects on investments in quality PHC
Dr Mykhailo Danylchuk, one of the participants in the PHC costing study, is a doctor in the city of Shumsk who runs a private practice that serves more than 3000 people. Involvement in the study has benefited him through extensive trainings that have strengthened his understanding of financial management principles, enabling him to improve the financial reporting of his facility. Furthermore, providing the data improved his understanding of the costs associated with running his own practice.
“There have been times when I’ve been a patient myself and have seen what can be done to improve the patient experience. Large-scale reforms of PHC in Ukraine started in 2018 and gave me an opportunity to work independently, to make my own decisions, and when I started my practice, I decided to ensure patients feel as comfortable as possible when they come for a consultation,” explained Dr Danylchuk.
“I have constantly invested in the development and improvement of the quality of services, patient experience, and patient satisfaction. But I had never thought about how much revenue I was investing in my practice and spending on providing quality services until I began preparing cost information for the NHSU within the PHC costing study. Compiling the cost data gave me a full picture of my medical practice’s financial health.”
Family doctors are often the first point of contact for a patient, and Dr Danylchuk estimates that a majority of health issues can be solved during examinations with a PHC provider. Through revenues from the NHSU, Dr Danylchuk has equipped his centre with the equipment needed to provide comprehensive health care.
Originally from a bigger city called Ternopil, Dr Danylchuk enjoys having his practice in the small, remote town of Shumsk, as he has managed to build authentic relationships with his patients.
“In small towns, doctors are often considered to be opinion leaders, and this is something that I value a lot. For instance, I was very positively surprised that two thirds of my patients, the majority of whom are elderly and chronically ill, got vaccinated against COVID-19. It means that they actually listen to my recommendations and trust them.”
The initiative is part of the United Nations Joint Programme “Promoting strategic planning and financing for sustainable development on national and regional level in Ukraine”, implemented in Ukraine by 4 United Nations agencies including WHO. Furthermore, the initiative is part of WHO Primary Health Care Systems Strengthening programme supported generously by the Government of Canada.