Assessment of Patient Barriers to Health Care in the Conflict-Impacted Areas of Eastern Ukraine, 25 June 2021



The ongoing conflict in Eastern Ukraine has impacted population wellbeing and migration as well as infrastructure across sectors in Donetsk and Luhansk. The USAID Health Reform Support (HRS) project, co-funded by UK Aid and implemented by Deloitte Consulting LLP, theorized that people living in these conflict-impacted regions face unique barriers in accessing health care. To drive greater accessibility within the health care system in Ukraine, the HRS project undertook a mixed-method assessment to better understand the barriers to care in the Government-Controlled Area (GCA) of Eastern Ukraine. The assessment identified and mapped barriers to the ten dimension of access – approachability of care, patients’ ability to perceive health needs, acceptability of care, patients’ ability to seek care, availability and accommodations, patients’ ability to reach care, affordability, patients’ to pay, appropriateness, and patients’ ability to engage. With this comprehensive approach, the assessment found that patients in Eastern Ukraine face some major barriers that are similar throughout the country, such as poor signage at health care facilities (HCFs), low health literacy, lack of trust in health care providers, poor attitude of providers, lack of knowledge on health reforms and how to seek care, informal payments, lack of money to pay for health care, insufficient patient adherence, and low digital literacy. But patients in Eastern Ukraine also face some unique barriers, such as insufficient provider outreach and information-sharing,