In 1991, Ukraine started to transform its healthcare system, and these changes continue to this day.
In 2017, significant changes were implemented with the introduction of the law “On State Financial Guarantees of Medical Service to the Population,” which aimed to establish a single-payer system and equal coverage and accessibility to medical care.
However, Ukraine still faces several challenges, including the absence of high-level strategic documents like a national cancer control plan or nationally recognized policies of cancer prevention and screening, ineffective funds distribution, corruption, and a shortage of some specialists. These factors contribute to an increasing number of preventable deaths caused by cancer and a high rate of morbidity and mortality.
Since Feb. 24, 2022, when the Russian Federation launched a full-scale invasion of Ukraine, these problems were exacerbated.
Trying to cope with the aforementioned challenges, the Ministry of Health of Ukraine (MoH) drafted a project to rebuild and reorganize the network of healthcare facilities. If approved by the Cabinet of Ministers of Ukraine (CMU), this document will stimulate the system consolidation and the process of merging smaller oncology hospitals with bigger, general ones.
For the last two years, general hospitals got an opportunity to treat patients with malignancies after fulfilling the requirements of National Health Service of Ukraine. Hospitals that are eligible for these packages can apply to be contracted by NHSU, allowing them to provide medical help to patients with oncological diseases. Currently, twelve oncology centers are located in the temporarily occupied territories of Ukraine.
In 2022, the National Health Service of Ukraine database has showed that 860 medical care facilities provided surgical treatment for patients with malignancies. Additionally, 101 hospitals offered chemotherapy services and 33 hospitals offered radiotherapy services.
Across each oblast, there is usually one specialized oncology hospital providing all types of treatment, a regional hospital providing only surgical treatment, a few general hospitals providing surgical treatment, and one or several private clinics providing surgical and systemic anticancer treatment. In larger cities, such as Kyiv, Kharkiv, Odesa, and Lviv, regional hospitals offer all three types of anticancer treatment.
The COVID-19 pandemic had a significant impact on the education system in Ukraine, including those specialized in medicine. As of Feb. 24, 2022, most institutions switched to remote or hybrid education programs due to restrictions, but the quality of online education, particularly in universities, is still in question.
Many medical professionals had to leave the country or move to the western part of Ukraine, leading to a shortage of skilled healthcare workers. Furthermore, the evacuation of international students meant that they had to continue their studies online.
To cope with the shortage of healthcare workers, universities lowered their entrance requirements, resulting in a majority of doctors graduating with insufficient knowledge and skills.
Despite the overstaffing of the medical system before the war, the number of government medical facilities providing help for cancer patients was still excessive. According to Ukrainian laws, it is prohibited to shut down government-owned medical facilities, so the process of optimization and incorporation is still ongoing.
After almost a year of full-scale war, each central medical facility is now providing services to cancer patients under their contracts with the National Health Service of Ukraine (NHSU). Although many doctors and nurses fled to other parts of Ukraine or abroad, there is currently no shortage of oncology providers in the country.
In fact, many doctors from eastern regions found themselves working in numerous hospitals in western and central Ukraine, helping to alleviate the overload.
