Cluster activities are aimed at strengthening the institutional capacity of the Ministry of Health of Ukraine and government bodies of oblasts participating in the Project.
Main areas of cluster activities are as follows:
- Measures aimed at improving the quality of health services;
- Educational activities for medical community;
- Activities to build capacity for citizen engagement;
- Educational events, study tours and trainings for representatives of the Ministry of Health and the Project, trainings for primary health management teams.
Under the Project, the Ministry of Health of Ukraine and Duodecim Medical Publications Ltd agreed on publication of a Ukrainian translation of Evidence Based Medicine Guidelines for primary care physicians. Translation from English and the possibility of making it available on a quality resource was realized with Project funds. Modern evidence based medicine guidelines are already used by primary care physicians to make clinical decisions and positively affect the quality of health service provision to Ukrainians, in particular in situations related to cardiovascular and oncological diseases.
Also, the Project supports the process of introducing into practice of primary care physicians of the International Classification of Primary Care, Second Edition (ICPC-2). Encoding with this classification will contribute to forming qualitative statistical data, allow for efficient medical practice at the primary care level and improve the quality of service to people.
As of the end of March 2019, more than 40 regional ICPC-2 trainers have undergone training, and a number of trainings were conducted at PHC facilities throughout Ukraine (the coverage of PHC physicians amounted to 80% or about 17,000 physicians). Trainings were conducted in the form of 3-hour meetings at healthcare facilities. An educational video lecture for physicians is available on the website of the Ministry of Health of Ukraine; and the process of preparing the relevant methodological recommendations has begun.
Scheduled conferences with international participation for primary care physicians will increase the motivation of Ukrainian health professionals to use modern tools in their practice (evidence-based medicine, information systems, etc.). The opportunity to exchange experience with foreign colleagues will allow us to present examples of successful Ukrainian PHC practices and draw on the experience of European colleagues in the practical aspects of effective medical practice, postgraduate education systems and doctor self-governance.
Throughout Project implementation, representatives of the Ministry of Health and regional subprojects staff participated in international workshops and trainings for efficient Project implementation, study tours on the implementation of key changes in health care, institutional capacity building, development of management skills, electronic health system, and public health.
Thus, in March 2019, a study tour of the Ministry of Health of Ukraine and the NHSU was conducted to learn the British experience gained from the functioning of the health care system and the possibility of its applying in Ukraine. During the tour, the study group visited 11 services and facilities in London, planning, providing and evaluating the quality of health care provision, as well as offering training and continuing professional development for healthcare professionals.In particular, National Health Service (NHS), Department of Health and Social Care (DHSC), National Institute for Health and Care Excellence (NICE), Commission on Quality of Care, Villa Street Medical Centre, Whittington Hospital, Babylon Health Service, Nuffield Trust for Research and Policy Studies in Health Services and Social Care, Royal Free Hospital, British Medical Journal (MBJ) shared their experience: The group also presented the outcome of Ukraine’s healthcare system reform for employees of the Embassy of Ukraine to the United Kingdom and Northern Ireland.
Cooperation with the British Medical Journal, a powerful educational platform for physicians, allows Ukrainian physicians to acquire knowledge and skills in accordance with best international practices through distance learning. In March 2019, a contract concluded with the BMJ Company allowing 4,000 Ukrainian physicians (especially primary care physicians) to have access to online training (they will receive licenses to use educational products of ‘BMJ Best Practice’ and ‘BMJ Learning’) throughout the year beginning in March 2019. As of the end of April, 3930 physicians were connected to the BMJ platform for training, 45 additional topics (in addition to that of available on the platform) were translated into Ukrainian and are already available to the platform users.
Experience in training on the BMJ platform, as well as peculiarities of introducing continuing professional development in Ukraine, were discussed at a joint conference of the Ministry of Health of Ukraine and BMJ in May 2019.
In the process of reform, primary care facilities are expected to apply new approaches in governance, management and service provision. However, facility managers, financiers and representatives of facility owners (local administrations) lack the relevant knowledge, information and practical experience to introduce changes related to reform implementation. In response to these challenges, jointly with the USAID Health Reform Support Project a training in ‘Financial and economic, and legal framework for primary care provider operation’ was developed for primary health management teams of leading reformers.
In total, 363 physicians from all regions of Ukraine have undergone these trainings.
Taking into account the needs for capacity development of employees of the Ministry of Health of Ukraine, oblast administrations and practitioners, a number of trainings is scheduled within the framework of the cluster on project management; communications and organization of medical services; competencies of primary care professionals for stroke patients.
A separate line of cluster activities is devoted to citizen engagement in the transformation of the health care system. This is a prerequisite for implementation of any World Bank Project, as the main stakeholders are citizens of the country. Citizen engagement activities are implemented both at the central level and at the subproject level in the regions.
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