Journal of Rehabilitation Medicine: Special Issue 50-4bokBW | Page 37

Responding to the WHO Global Disability Action Plan in Ukraine
in Ukraine. In addition, a stakeholder workshop
about the recommendations was held to achieve
consensus with stakeholders, including non-go-
vernmental organizations (NGOs), organizations
of people with disabilities, and representatives of
professional groups.
Consultations were held with different sta-
keholders, including representatives of the
Ministries of Public Health, Social Policy and
Education and Science, and the National As-
sembly of Invalids.
Site visits were made to the following locations:
• Regional Hospital No. 1, Kiev (acute rehabi-
litation);
• Research Institute of Orthopedics and Trauma-
tology, Kiev (subacute rehabilitation);
• District Centre for Social Rehabilitation, Kiev
(community-based and social rehabilitation);
• Clinical Sanatorium “Zhovten”, Kiev (sanato-
rium rehabilitation);
• Dnepropetrovsk Regional Centre of Medical and
Social Examination (regional level MSECs loca-
tion, medical and social examination, providing
certification of “invalidity” status for persons),
Dnepropetrovsk;
• State Institution (Ukrainian State Institute of
Medical and Social Problems of Disability
Ministry of Public Health of Ukraine), Dnepro-
petrovsk (tertiary care and research);
• Dnepropetrovsk permanent child care boarding
home, Dnepropetrovsk (children with disabili-
ties long-term care and rehabilitation);
• Ukrainian State Medical and Social Centre for
War Wounded, Tsibli.
Based on the information gained from these con-
sultations and site visits a NDHRP was drafted
setting out recommendations for actions and
projects to improve rehabilitation service provi-
sion. These recommendations were discussed and
prioritized in a stakeholder dialogue that included
the following bodies and institutions:
• Ministry of Public Health of Ukraine;
• Health Information and Emergency Response
team of the national WHO office;
• International NGOs (Handicap International;
Ecology and Health);
• Professional organizations (Ukrainian So-
ciety of Physical and Rehabilitation Medicine,
Ukrainian Association of Physical Therapy,
Ukrainian Society for Neurorehabilitation);
• Organizations of people with disabilities (Pul-
monary Hypertension Association Ukraine,
Coalition for Persons with Intellectual Disa-
bilities; Sphere of the Good (psychological
339
rehabilitation), the Association of NGOs of
Disabled People of Kiev);
• Scientific institutions (Institute of Emergency
Surgery and Rehabilitation, Ukrainian Catholic
University, School of Rehabilitation Medicine);
• Veteran organizations (Ukrainian Association
of Disabled Military Men, “the fund of veterans
“Unity Sworn” and the ATO Veterans Society”).
A comprehensive report and executive summary
were compiled based on this information and the
results of the stakeholder dialogues.
RESULTS OF SITUATION ANALYSIS
In describing the current situation of rehabilitation
service delivery, 4 main problems were identified
from consultations and site visits:
• The definition and understanding of “invali-
dity” does not coincide with the modern, in-
ternationally agreed understanding of disability
and functioning;
• Rehabilitation legislation and policies in
Ukraine are fragmented and there is a lack of
coordination between Ministries and organiza-
tions in charge;
• Rehabilitation services traditionally are delive-
red in health resorts. A comprehensive system
of rehabilitation services covering all phases
and levels of care is lacking and rehabilitation
services are not available for many persons
in need;
• The rehabilitation workforce does not match
up to international and European standards,
due to a different accreditation system and a
lack of capacity.
RECOMMENDATIONS
The report recommends the following actions
are implemented in order to improve health,
functioning and quality of life for all persons with
disability in Ukraine:
• As rehabilitation is one of 4 main health stra-
tegies and requires services within different
sectors of the health system, strong coordina-
tion is necessary within the Ministry of Public
Health (optimally concentrated within a single
department).
• As rehabilitation also concerns other areas of
life, such as social support, education, justice,
etc., strong coordination between ministries is
necessary (optimally through an inter-ministe-
rial coordination committee with a high level
of responsibility).
J Rehabil Med 50, 2018