Time-use survey: summary of the analysis on time use in primary health care facilities in Ukraine, 2023

Ukraine initiated extensive primary health care reform in 2018, including implementing an explicit benefits package, privatizing primary health care centres, and introducing capitation-based payment and digital health systems. This reform granted primary health care facilities the autonomy to adopt diverse organizational structures, influenced by historical factors, legal status and staff preferences. Between December 2021 and February 2022, a pilot project conducted with 17 primary health care providers in Ukraine uncovered significant disparities in expenditure allocation, with a predominant focus on workforce-related expenses. Subsequently, a survey was undertaken to assess the allocation of tasks and time among primary health care staff, shedding light on potential improvements to costing methodologies. Key findings pointed to a significant opportunity for task-shifting, reallocating responsibilities from doctors and managers to nurses and administrative staff in order to enhance resource allocation and overall efficiency. Essential to this process is the need for refined definitions of staff roles and responsibilities, which can ultimately lead to more efficient workforce utilization and the delivery of high-quality primary health care services.