International Journal of Health Policy and Management

International Journal of Health Policy and Management

The Importance of Community Consultations for Generating Evidence for Health Reform in Ukraine

Document Type : Original Article

Authors
Olena Hankivsky 1, 2, 3
Anna Vorobyova 3
Anastasiya Salnykova 3
Setareh Rouhani 4
1 London School of Hygiene and Tropical Medicine, London, UK
2 School of Public Policy, Simon Fraser University, Vancouver, BC, Canada
3 Institute for Intersectionality Research and Policy, Simon Fraser University, Vancouver, BC, Canada
4 Institute of Population Health, University of Ottawa, Ottawa, ON, Canada
10.15171/ijhpm.2016.104
Abstract
Background
The paper presents the results of community consultations about the health needs and healthcare experiences of the population of Ukraine. The objective of community consultations is to engage a community in which a research project is studying, and to gauge feedback, criticism and suggestions. It is designed to seek advice or information from participants directly affected by the study subject of interest. The purpose of this study was to collect first-hand perceptions about daily life, health concerns and experiences with the healthcare system. This study provides policy-makers with additional evidence to ensure that health reforms would include a focus not only on health system changes but also social determinants of health (SDH).
 
Methods
The data collection consisted of the 21 community consultations conducted in 2012 in eleven regions of Ukraine in a mix of urban and rural settings. The qualitative data was coded in MAXQDA 11 software and thematic analysis was used as a method of summarizing and interpreting the results. 
 
 
Results
The key findings of this study point out the importance of the SDH in the lives of Ukrainians and how the residents of Ukraine perceive that health inequities and premature mortality are shaped by the circumstances of their daily lives, such as: political and economic instability, environmental pollution, low wages, poor diet, insufficient physical activity, and unsatisfactory state of public services. Study participants repeatedly discussed these conditions as the reasons for the perceived health crisis in Ukraine. The dilapidated state of the healthcare system was discussed as well; high out-of-pocket (OOP) payments and lack of trust in doctors appeared as significant barriers in accessing healthcare services. Additionally, the consultations highlighted the economic and health gaps between residents of rural and urban areas, naming rural populations among the most vulnerable social groups in Ukraine.
 
Conclusion
The study concludes that any meaningful reforms of the health sector in Ukraine must include a broad range of factors, including the healthcare system but importantly, must extend to SDH approach and include the prioritization of health promotion, limiting alcohol and tobacco availability and enforcing environmental protection.

Highlights

 

 

Watch the Video Summary here. 

 

Keywords
Ukraine
Health Crisis
Community Consultations
Public Perceptions
Citizen Engagement
Civil
Participatory Approach
Social Determinants of Health (SDH)
Health Reform
Subjects

 

 

 

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International Journal of Health Policy and Management
Volume 6, Issue 3
2017
Pages 135-145

  • Received Date 07 September 2015
  • Revised Date 29 July 2016
  • Accepted Date 01 August 2016
  • First Published Date 01 March 2017
  • Published Date 01 March 2017