"Strengthening the health care system and preserving life" (HEAL Ukraine)


The purpose of the project:

Service quality improvement

Key spending unit
Ministry of Health of Ukraine
Functional classification of expenditures and budget crediting
Target priority of the government
020400 - Відновлення пошкодженої в наслідок збройної агресії Російською Федерацією соціальної інфраструктури в секторі "охорона здоров’я", підсектору "медична допомога" (забезпечення надання екстреної медичної доп...
Score
5.9875

Basic data

Detailed description of the project

The project is aimed at ensuring better access to new urgent areas of help (psychiatric care and rehabilitation services), will contribute to the improvement of the health of the population in the short and long term, which will enable more productive employment and increase well-being both at the individual level and at the level of society as a whole, providing financial protection against high out-of-pocket costs for health care.

The project will bring special benefits to low-income individuals, from whom such expenses take a significant share of income.

In addition to supporting the provision of priority health care services, and thus the preservation of accumulated human capital, support for national institutions of the health sector will help preserve the institutional capacity of Ukraine to ensure full recovery and sustainable reconstruction after the end of the war.

Part 1 will fund activities: aimed at strengthening and reconfiguring the delivery methods of rehabilitation and mental health services to better respond to the current crisis situation and create better delivery platforms services in the future, in particular: purchase of necessary equipment and vehicles to support rehabilitation services; conducting restorative work in institutions providing services in the field of mental health care and rehabilitation, training medical staff of health care institutions at the inpatient and outpatient level, providing technical support to the Ministry of Health and the National Health Service of Ukraine (NHSHU) in determining the scope and development of service provision standards at the inpatient and outpatient levels; updating procedures for checking electronic medical records; development of concepts and plans for the modernization of services in the field of mental health care and rehabilitation at the level of primary and specialized medical care.

Part 2 provides for: the purchase of equipment and the satisfaction of other needs of primary care facilities, as well as the performance of repair work to restore the functioning of primary care facilities, selected in accordance with the criteria set forth in the Operational Manual of the project of restoration and provision of equipment to 80 damaged PHC facilities in need of major repairs and procurement and installation of solar panels in at least 100 PHC sites selected according to the criteria set out in the Operational Manual Designing, Training and Deploying Mobile Teams to Provide Basic Health Services in the Most Affected Areas the current emergency situation, as well as in remote areas, the development of a medium-term plan for the recovery and reconstruction of the primary health care network in Ukraine, including the development of technical specifications for the new expanded model of primary health care or "PMSD Plus".

Part 3 provides, in particular:  development of sectoral planning of the hospital network, technical specifications and project documentation to support in the selection of hospitals to be repaired and in carrying out repair works, restoration of individual hospitals using technical specifications prepared in accordance with Part 3 (a), which may include, among other things, improving energy efficiency and providing access to alternative energy sources, constructing new buildings as part of existing facilities that do not require the acquisition of new land, strengthening pre-hospital emergency services by, in particular, procurement of vehicles and relevant equipment and construction works for emergency medical care centers.

Measures of part 4 of the project will be aimed at:

Development of electronic health care and digital innovations, in particular, implementation of digitization projects that will improve efficiency, transparency and control over the provision of services and make health care services more convenient for users. Establishing standardization of service quality and technical assistance with development of the potential of key health care institutions. Providing support to the Ministry of Health of Ukraine for the implementation and management of the project.

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Problems

Current status, description of problems and needs for their solution
The project is aimed at solving the following problems in the field of health care: critical load on the national health care system caused by significant destruction of health care facilities; the destruction of civilian infrastructure affecting access to services, increasing the number of individuals requiring mental health and rehabilitation services as a nest of invasion; increase in the number of health care facilities damaged as a result of the war; non-compliance by the population of Ukraine with quality medical services; insufficient level of integration of digital health care systems, insufficient level of cybersecurity of health-related patient data, need for new modules of the health care system for disability and rehabilitation; increasing the number of palliative patients.
A detailed description of the project goal and the way to achieve it
The goal of the Project is to restore and improve access to basic medical services; meeting new and urgent needs in medical services; and providing financial protection in an emergency

Coordination of the project with strategic documents

Sphere development strategies
Activities within the framework of the HEAL Project are fully consistent with the general purpose of the Strategy: "creating a barrier-free environment for all population groups, ensuring equal opportunities for each person to exercise their rights, receive services on an equal basis with others by integrating physical, informational, digital, social and civic, economic and educational barrier-free access to all spheres of state policy" and basic provisions
Another regulatory document
The project corresponds to the Plan of Ukraine within the framework of the European Union support program "Ukraine Facility" (Ukraine Facility) for 2024-2027, in particular in terms of the need to make investments in the restoration and modernization of state and communal health care facilities damaged as a result of hostilities as one of the main ways of stimulating the economy, both directly in the post-war period and in the long term.
Priority action plan of the government
The Project's activities correspond to the Government Priority "MODERN MEDICINE", in particular as regards: creation of mental health centers in cluster hospitals within the framework of the national program of mental health and psychosocial support; Reconstruction and modernization of a capable network of health care institutions, in particular, destroyed as a result of the armed aggression of the Russian Federation against Ukraine; improvement of the material and technical condition of hospitals of a capable network of health care institutions.
National Strategy for Regional Development of Ukraine
According to the report, the damage to the health care sector is estimated at US$1.4 billion, with an additional US$17.8 billion in damages (costs for clearing debris and demolishing destroyed facilities, loss of revenue for private health facilities, losses , related to the financing of facilities, as well as additional damage to public health due to the failure to provide assistance and increased threats to public health). The total needs of the health care sector, including accumulated damage to infrastructure and health care, as well as the expansion of critical medical services for the population of Ukraine, are estimated at 14.1 billion US dollars.

Involved organizations

Organization
UKRAINIAN STATE MEDICAL AND SOCIAL CENTER FOR WAR VETERANS
Roles
  • A balance holder
EDRPOU code
05480766
Organization
NATIONAL SPECIALIZED CHILDREN'S HOSPITAL "OHMATDYT" MOH OF UKRAINE
Roles
  • A balance holder
EDRPOU code
01994089

Demand for the service and its dynamics

Category
Year
Rating
Measure
Annual demand for services/infrastructure
2022
50
ліжк
Annual demand for services/infrastructure
2024
170
тис. люд
Annual demand for services/infrastructure
2024
250
трансп

Project indicators

Indicator
Base value
Target value
pip.indicators.other
0
25

Risk assessment

Risk
Category
Degree
Probability
Strategy
Impact on the environment due to increased waste from medical facilities
Ecological risk
Considerable
Medium
Reduction
Insufficient funding for the purchase of the necessary equipment
Financial risk
Critical
High
Reduction
Lack of technical resources to implement changes in management
Technical risk
Considerable
Low
Reduction
Non-compliance of new buildings or reconstructions with technical requirements or standards
Technical risk
Minor
Low
Reduction
Lack of spare parts for equipment maintenance
Operational risk
Considerable
Medium
Reduction
Changes in rules and regulations affecting the implementation of new programs
Political risk
Considerable
Medium
Reduction
Changes in legislation governing mental health care and rehabilitation
Political risk
Minor
Low
Avoidance
Lack of technical support for new systems
Technical risk
Minor
Low
Reduction
Insufficient quality of technical specifications or project documentation
Technical risk
Minor
Low
Reduction
Lack of qualified personnel to provide services
Social risk
Critical
High
Reduction
Lack of standards for new rehabilitation services
Technical risk
Minor
Low
Reduction
Problems with the organization of training and personnel training
Operational risk
Considerable
Medium
Reduction
Delay in receiving funding for primary care
Financial risk
Considerable
Medium
Reduction
Uncertainty in the development of the medical services market
Market risk
Considerable
Medium
Reduction
A decrease in economic stability, which will affect the implementation of the project
Economical risk
Considerable
Medium
Transfer
Technical malfunctions in new equipment
Technical risk
Minor
Low
Reduction
Delays in carrying out repairs or supplying materials
Technical risk
Considerable
Medium
Reduction
Unforeseen expenses for support and maintenance of new systems
Financial risk
Minor
Low
Reduction
Instability of prices on the market of medical equipment
Market risk
Considerable
Medium
Reduction
Changes in the economic situation affecting the availability of financing
Economical risk
Considerable
Medium
Reduction
Problems with the integration of new systems into the existing infrastructure
Technical risk
Critical
High
Reduction
Incorrect planning of work or resources
Operational risk
Considerable
Low
Reduction
Low speed of introduction of new systems and processes
Operational risk
Minor
Low
Reduction
Problems with the integration of new information systems into existing structures
Technical risk
Considerable
Medium
Reduction
Policy decisions that change legislative or regulatory requirements
Political risk
Considerable
Low
Acceptance
Insufficient funding to restore and improve primary care
Financial risk
Critical
High
Reduction
Emissions or waste from new technologies or equipment
Ecological risk
Minor
Low
Reduction
Unforeseen expenses for the modernization and repair of health care facilities
Financial risk
Considerable
Medium
Acceptance
Unstable demand for services due to changes in the economic situation
Market risk
Minor
Low
Reduction
Increase in the cost of equipment due to inflation or exchange rate changes
Financial risk
Considerable
Medium
Reduction
Changes in specifications or technical requirements
Technical risk
Considerable
Medium
Reduction
Problems with the integration of telemedicine systems into already existing medical systems
Technical risk
Minor
Low
Reduction
Military operations and attacks on medical infrastructure
Social risk
Critical
High
Reduction
Insufficient support from government agencies
Political risk
Minor
Low
Reduction
Delay in funding from donors
Financial risk
Critical
Medium
Reduction
Technical problems in new control systems
Technical risk
Considerable
Low
Reduction
Incorrect integration of new equipment into the existing infrastructure
Technical risk
Minor
Low
Reduction
Economic instability in the country, which affects the financing of the project
Economical risk
Critical
High
Acceptance
Lack of integration of new technologies with existing systems
Technical risk
Considerable
Medium
Reduction
Unforeseen changes in the supplier or contractor market
Market risk
Considerable
Medium
Transfer
Incorrect understanding of new services by patients
Social risk
Considerable
Medium
Reduction
Administrative barriers to the implementation of new initiatives
Social risk
Considerable
Medium
Reduction
Emissions from treatment of medical waste after recovery
Ecological risk
Minor
Low
Reduction
Negative reaction of medical workers to changes in the organization of services
Social risk
Considerable
Medium
Reduction
Failure to comply with environmental standards during the construction of new facilities
Ecological risk
Minor
Low
Reduction
Inadequacy of new programs and technologies for training medical personnel
Technical risk
Considerable
Medium
Reduction
Problems with disposal of construction waste
Ecological risk
Considerable
Medium
Avoidance
Difficulties with the integration of new systems into existing structures
Technical risk
Considerable
Medium
Reduction
Uncertainty in the policy of supporting medical institutions
Political risk
Considerable
Low
Acceptance
Lack of proper coordination between project participants
Operational risk
Considerable
Medium
Reduction
Problems with project management and coordination between different participants
Operational risk
Considerable
Medium
Reduction
Lack of funding to complete all planned works
Financial risk
Critical
Medium
Reduction
Improper planning or management of resources
Operational risk
Considerable
Medium
Reduction
Problems with the organization of logistics for the provision of medical resources
Social risk
Considerable
Medium
Reduction
Problems with providing reliable communication for telemedical consultations
Technical risk
Considerable
Medium
Reduction
Risk of delay in the receipt of funding
Financial risk
Considerable
Medium
Reduction
Lack of market demand for the services of reconstructed primary care centers
Market risk
Minor
Low
Acceptance
Incorrect distribution of funding between project components
Financial risk
Considerable
Medium
Reduction
Disagreement of local authorities with plans to improve primary health care
Social risk
Considerable
Medium
Reduction
Economic difficulties affecting the implementation of projects in rural areas
Economical risk
Considerable
Medium
Reduction
Lack of qualified specialists to work in restored institutions
Social risk
Considerable
Medium
Reduction
Protests or social discontent due to non-compliance with standards or delays in project implementation
Social risk
Considerable
Medium
Reduction
Recovery costs exceed previous estimates
Financial risk
Considerable
Medium
Reduction
Insufficient support from the state for the implementation of reforms
Political risk
Considerable
Medium
Reduction
Influence of external political factors on project financing
Political risk
Critical
High
Transfer
Incorrect distribution of funding among primary care facilities
Financial risk
Considerable
Medium
Reduction
Social instability, which complicates the provision of services in some regions
Social risk
Considerable
Medium
Reduction
Changes in the political situation affecting the implementation of the project
Political risk
Considerable
Low
Acceptance
Insufficient level of personnel qualification for the introduction of new services
Ecological risk
Critical
High
Reduction
Policy decisions that change legislative or regulatory requirements
Political risk
Considerable
Medium
Reduction
Lack of proper monitoring and assessment of the quality of the services provided
Operational risk
Considerable
Medium
Reduction
Political instability affecting project implementation
Political risk
Critical
High
Acceptance
Overcrowding of health care facilities due to increased demand
Social risk
Considerable
High
Reduction
Insufficient number of suppliers of equipment and materials
Operational risk
Considerable
Medium
Reduction
Inadequacy of new technologies for rehabilitation to the needs of patients
Technical risk
Minor
Low
Reduction
Impact on the environment from construction works in primary care institutions
Ecological risk
Considerable
Medium
Reduction
Exceeding the budget due to unforeseen expenses
Financial risk
Minor
Low
Reduction
Increase in costs for imported goods due to exchange rate fluctuations
Economical risk
Considerable
Medium
Reduction
The wrong choice of technological solutions for the management of primary medical care
Technical risk
Considerable
Medium
Reduction
Insufficient funding for the development and implementation of telemedicine systems
Financial risk
Considerable
Medium
Reduction
Delays in delivery or poor technical equipment
Technical risk
Considerable
Medium
Reduction
Technical problems with the implementation of new accounting and monitoring systems
Technical risk
Considerable
Medium
Reduction
Non-fulfillment of grant or funding conditions due to political instability
Financial risk
Minor
Low
Transfer
Lack of standards for new equipment and technologies
Technical risk
Critical
High
Reduction
Costs to ensure energy efficiency are higher than planned
Financial risk
Considerable
Medium
Reduction
Misunderstanding of new standards and procedures
Social risk
Considerable
Medium
Reduction
Incorrect choice of technological solutions for providing medical services in rural areas
Technical risk
Considerable
Medium
Reduction
Lack of spare parts for medical equipment
Technical risk
Considerable
Medium
Reduction
Outdated equipment in existing institutions that does not meet modern requirements
Technical risk
Critical
High
Reduction
Inconsistency of the technical specifications of the equipment with the requirements of the new standard
Technical risk
Minor
Low
Reduction
Insufficient quality of repair work or equipment
Technical risk
Considerable
Medium
Reduction
Lack of qualified personnel to work in primary care facilities
Market risk
Considerable
Medium
Reduction
Changes in currency exchange rates that may affect the cost of imported materials and equipment
Financial risk
Considerable
Medium
Reduction
Lack of technical personnel to service new equipment
Technical risk
Considerable
Medium
Reduction
High costs for energy efficiency or alternative energy sources
Technical risk
Considerable
Medium
Reduction

Project plan

Implementation
Budgeting
Financing
Assessment
Preparation
Technical design
Feasibility study
Appraisal
1470 days
1286 days
1286 days
120 days
102 days
36 days
13 days
6 days

Documents

Name
Date
URTF Grant No. TF0C0814 First Amendment to the Grant Agreement .pdf
Common document
16.08.2024
08:31:54 UTC
URTF Grant Agreement 06.06.2023.pdf
Common document
16.08.2024
08:31:54 UTC
Grant Agreement_sign_GFF.pdf
Common document
16.08.2024
08:31:54 UTC
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Gallery

DREAM Code

DREAM-UA-150824-20D15B82

Status

Active

Create date

15.08.2024

Estimated budget

14'633'441'606,85

Project creator

MINISTRY OF HEALTH PROTECTION OF UKRAINE

Initiator

MINISTRY OF HEALTH PROTECTION OF UKRAINE

Implementer

MINISTRY OF HEALTH PROTECTION OF UKRAINE

Project implementation period

12.22 - 12.26

Geography

The territory of Ukraine

Classification of sectors of economic activity according to the taxonomy of the World Bank

HQ - Health Facilities and Construction