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Ukraine

Ukraine: Public Health Situation Analysis (PHSA) (August 2024)

Attachments

1. SUMMARY OF THE CRISIS AND KEY FINDINGS

concerning with increasing needs and a growing number of people requiring humanitarian assistance. Although Ukraine has witnessed previous war escalations, the one in 2022 has resulted in increased death, destruction, and human suffering across the country, especially in frontline communities in the north, east and south.

Since 2022, at least 11,500 have died and 24,000 have been injured, although establishing accurate numbers of civilian casualties has been challenging.1 Attacks by at least several dozen drones have become a near nightly ordeal for Ukrainians. As of August 2024, there are an estimated 3.7 million internally displaced persons (IDPs) and 4.4 million returnees within Ukraine.

At least 82% of IDPs have been displaced for over a year, with a median displacement length of 750 days.2 Aerial attacks, artillery shelling, and the prevalence of mines and UXOs continue to significantly impact the daily lives of women, men and children. Older people and people with disabilities (PWDs) are disproportionately affected by protection risks, as they are those most likely to remain in frontline settlements or are among the first to return. Safety and security concerns increased over the last year, with lack of safe places in communities mentioned as a primary concern by both women (67%) and men (57%).3 Access to clean water remains a significant issue in Ukraine, particularly in frontline areas, due to damaged infrastructure and logistical challenges.4 As of February 2024, 9.6 million people require essential water and sanitation services.5 The situation is further exacerbated by ongoing shelling, rising costs, and shortages of both equipment and skilled labor, particularly in rural regions. While 83% of health facilities have full WASH services, certain areas like Khersonska (76%), Kirovohradska (61%), and Kyivska (59%) report much lower rates.6 Additionally, 8% of facilities, especially in Donetska and Khersonska, struggle with waste treatment services due to insufficient equipment and funding.7 The war has equally caused a housing crisis with hundreds of thousands of homes being destroyed, leaving many without adequate shelter to protect from extreme weather, reduce the risk of communicable diseases, and promote physical and mental well-being.8 This has affected vulnerable groups, such as the older people and people with disabilities including people with limited mobility the most. An estimated 7.9 million people need shelter assistance in 2024.

However, significant gaps remain in meeting these needs. The winter months pose additional challenges, as many displaced people and those in conflict-affected areas struggle to find adequate housing for cold conditions. Expected electricity cuts across the country, are expected to affect healthcare facilities and people at home in need of energy powered assistive devices and support, e.g. oxygen. People with disabilities in home-based care may be affected significantly by these cuts.

Although the Health Cluster identified 7.8 million people in need of health humanitarian assistance, needs are estimated to be much higher as the war intensifies.10 Among vulnerable groups and people with disabilities, the MSNA 2024 indicates health as key need across households with a member or at risk of disabilities. In addition, households were reported to face significant barriers (62% and 37% HH without a member with disabilities) accessing healthcare and/or medicine. For example, the lack of pharmacies in rural areas or physical access barriers affected rural households with members with disabilities significantly. Major barriers were reported more across households with members with disabilities in comparison to households without members with disability.

A surge of traumatic injuries, including fractures, amputations, and spinal cord injuries, has increased the number of people requiring specialized trauma care and extensive physical rehabilitation and mental health services.
Persons with disabilities report health care among their top three priorities (59%), compared to households without members with disabilities, 19%. It is anticipated that the number of persons with disabilities (PWDs) in Ukraine, including existing people and those who will experience new disabilities, will continue to rise. This has implications for the way in which all health services are provided and in terms of the provision of specific services such as rehabilitation and mental health support