2009; Volume 10, No 2, February

 
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Regional Report: Ukraine

MINISTRY OF HEALTH OF UKRAINE

INSTITUTE OF PALLIATIVE AND HOSPICE MEDICINE МИНЗДРАВА УКРАИНЫ

ALL-UKRAINIAN ASSOCIATION OF PALLIATIVE CARE

ALL-UKRAINIAN COUNCIL FOR PATIENT RIGHTS AND SAFETY  

 

DEVELOPMENT OF PALLIATIVE CARE IN UKRAINE IN 2008

Accordingly to WHO definition (2002), palliative care is an approach, which helps to improve the quality of life of patients and families who face incurable disease.

During the past year the information on the hospice care movement in Ukraine continued to be analyzed and k ey stakeholders on palliative care were identified .

The analysis of legislation concerning end-of-life care was continued with special attention given to the usage of opioids and recommendations for improvement were developed.

The coordination council (steering committee) on palliative care was created by Ministry of Health of Ukraine . The council’s objectives are to:

  • develop a palliative and hospice care system in Ukraine ,
  • develop a relevant governmental program,
  • coordinate palliative care providers in Ukraine ,
  • improve legislation and train staff,
  • develop a hospice network and
  • raise awareness of society.

The council unites key stakeholders – representatives of Ministry of Health, Ministry of Family, Ministry of Labor and Social Policy, patient organizations, voluntary organizations, and churches. Co-heads of the council – Deputy Minister of Health Dr. Zynovy Mytnyk and prof. MD I. Gubsky.

The coordination council on palliative and hospice care is supported by the Association of Palliative Care and the International Renaissance Foundation. The concept of palliative care development (in 2010-2014) was formulated and written with an event plan and approximate budget. The documents were approved by Ministry of Health, supported in general by the Academy of Medical Sciences , different ministries, and then returned to Ministry of Health for further improvement. In July 2008, the governmental institution for palliative care development within the structure of the Ministry of health was created as the Institute for Palliative and Hospice Medicine - a basic scientific and clinical facility of the Ministry of Health. Prof . MD Iury Gubsky was appointed as Director of the Institute. The Institute has the following aims to:

  • coordinate the preparation of the government program of palliative care development in Ukraine ,
  • improve relevant legislation ,
  • prepare the staff and
  • develop and control relevant protocols and guidelines.

A campaign to raise awareness of palliative care was started in cooperation with local , national and international mass - media. In 2007 and 2008 in cooperation with the Ministry of Health, Ministry of Labor and Social Policy the campaign was concluded. 10 regional branches of Association of Palliative Care participated. Concerts, round tables, conferences and other mass events were organized.

In cooperation with faculty of the state scientific geriatric center and institute of palliative medicine (at Hospice of San-Diego , USA ) the educational program for medical workers was developed. This program is the first educational curricula in Ukraine which can be used to train specialists in palliative care. The November 2008 workshop was organized accordingly to this program with the support of the International Renaissance Foundation and Open Society Institute. 32 future trainers in palliative care obtained certificates given by the Deputy Minister.

4 regional task forces (coordination councils, steering committees) on palliative care were established. The final goal is to create relevant local programs and palliative care development on the regional (local) level.

The number of in-patient hospice beds in Ukraine increased and work in hospice is being started in 8 regions.

One of the most important components in palliative care advocacy is cooperation with mass-media. In the last year, about 40 publications on palliative care were issued. Also, in September the national campaign “To die with dignity” started in cooperation with different national newspapers.

International experience in palliative care provision was studied. The international approaches were laid out as a basis for technical and economical calculations of the governmental palliative care program. In the study, 20 medical workers and public health decision-makers participated.

Thanks to these activities the number of palliative care facilities increased.

  • In 2002, there were 400 in - patient beds in 12 palliative care facilities ;
  • in 2007 – 550 beds in 18 facilities; and
  • in 2008 – 600 beds in 19 facilities.

Submitted by Alexander Wolf

Secretary of the coordination council on palliative and hospice care (advisory board within the structure of the Ministry of Health of Ukraine )

(phone +38 097 14 17 456, + 38 044 594 02 78 [email protected] )

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