Improving health and social services
Title: Special Assistance Programme for Eastern Ukraine (government-controlled areas) in Ukraine
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Lead executing agency: Ministry of reintegration of temporarily occupied territories of Ukraine
Overall term: 2019 to 2022
The Donetsk and Luhansk regions are directly impacted by the armed conflict that broke out in 2014 and are most severely affected in its aftermath. As a result of the conflict, the government-controlled areas (GCA) were cut off from the urban centres and public institutions providing health and social services. These areas are predominantly rural, structurally weak and sparsely populated, and were already facing high levels of emigration and the problem of an ageing population before the conflict.
3.5 million people live in the region. Since the outbreak of the conflict, it has also taken in around 840,000 internally displaced persons. In addition, some 200,000 people commute each week from the non-government-controlled areas into the GCA. A large number of these people do so to receive social or medical services. As a result of the continuing conflict and its economic and social consequences, the humanitarian situation is worsening. Among the worst affected are the elderly, the sick, single parents (mostly women), internally displaced persons and people with disabilities. These sections of the population, in particular, are largely dependent on social services and rely on medical care.
Access to health and social services in the government-controlled areas of Donetsk and Luhansk is improved. There is greater compliance with humanitarian standards and human rights principles.
The project aims to design the provision of health and social services more effectively, efficiently and economically. To achieve this, the project is working on structural adjustments, modernisation, capacity development, improved equipment, and infrastructure maintenance with the involvement of civil society and the local administration. In Ukraine, the health care and social system are the responsibility of the districts and municipalities. In the future, decentralisation will mean these duties are assumed entirely by the municipalities. The project is working primarily in the districts and municipalities that are willing to embrace change to ensure successful implementation. However, the Donetsk and Luhansk regions should be represented as evenly as possible.
The project has defined five fields of activity. For instance, strategies for economic viability are to be created in cooperation with the hospitals and/or primary health centres. In addition, essential measures are to be identified for training and capacity development and for the provision of additional human resources for basic medical care in rural regions. The project will create action plans for adapting the provision of social services and introducing digital solutions, which in turn will create the conditions required for the municipalities and the districts to provide social services more effectively and efficiently. Social services out in the field are also to be improved through training for social workers. Civil society will be included in this process. Finally, the project will implement construction measures for the reconstruction of infrastructure in the health and social services sector.
The project will be active in the government-controlled areas of Donetsk and Luhansk where it will work with the regional administrations as well as with districts and municipalities that have yet to be selected.