USAID Health Reform Support FY 2021 Q2 Quarterly Performance Report

The project, co-funded by UK Aid, provided support to the National Health Service of Ukraine (NHSU) and health care facilities (HCFs) to streamline the design and contracting of the Program of Medical Guarantees (PMG) for 2021. As a result, the PMG 2021 launched on April 1, as planned, and the NHSU is finishing the contracting process with public and private HCFs. The Government of Ukraine (GOU) continued activities in preparation for the second year of the PMG, a single-payer health reform that provides free medical services to Ukrainians via direct contracts between HCFs and the NHSU. The GOU also embarked on developing a strategic framework document, the National Economic Strategy 2030 (NES 2030), which was approved by the Cabinet of Ministers of Ukraine on March 3, 2021. The NES 2030 envisages 20 main vectors of Ukraine's development, including the health sector, and maintains the overall vector of the health reform. The COVID-19 pandemic continued to cause stress on the GOU, the health system, and the Ukrainian public, with 1,662,942 COVID-19 cases and 32,418 deaths in Ukraine confirmed by the Ministry of Health of Ukraine as of March 31, 2021. Despite the start of the vaccination campaign, the epidemiological situation worsened, and the GOU imposed a quarantine for some oblasts, including Kyiv. The USAID Health Reform Support project is tracking how this will have an impact on the current schedule of the health reforms and on priorities of the GOU while continuing to implement activities to progress the health reforms, adjusting as necessary due to the political and epidemiological environment. The project achieved several key narrative achievements during the second quarter of Project Year 3. Under Objective 1, the project improved health sector governance by streamlining NHSU contracting for ongoing health reform implementation, strengthening watchdog organizations and functions, and supporting Parliament to finalize the Public Health Law. Under Objective 2, the project supported the transformation of the healthcare financing model by driving quality improvements with Performance-Based Financing (PBF) indicators and facilitating health financing reforms through a sectoral working group. Under Objective 3, the project helped strengthen the health workforce by continuing the Graduate Education Program in Health Administration. Under Objective 4, the project enhanced the transparency, accountability, and responsiveness of the health care system by protecting the eHealth system from cyber threats, preparing for health care provider education on data security, and driving health data interoperability forward to facilitate patient choice. Under Objective 5, the project aimed to improve the service delivery system at all levels by improving HCF communications and operations through an online course, incentivizing improvements to service delivery through a grant, and optimizing hospital networks across all oblasts of Ukraine. The project worked on 40 activities from the approved Project Year 3 Work Plan, which is 68% of the activities planned for the year. Two activities are completed. The project's cumulative efforts to date have helped the GOU achieve several milestones in health reform, including 97% of public primary health care facilities and 95% of public specialized health care facilities being contracted with the NHSU for payments under the PMG financing mechanisms as of the end of March 2021, 75% of the Ukrainian population signing declarations with family doctors, and the percentage of the population reporting refusal of medical care due to lack of financial resources decreasing 1.3 times from 2019 to 2020.