WHO and European Observatory support financing of rehabilitation care in Ukraine

New research launched by WHO Ukraine, in collaboration with the European Observatory on Health Systems and Policies and the WHO Barcelona Office for Health Systems Financing, will map the current landscape of rehabilitation services in a sample of European countries. The goal is to leverage these experiences to outline policy decisions that can inform and shape Ukraine's own financing of rehabilitation care.

"There is no universal health coverage without health financing, because it is with good health financing that we can ensure equitable access to quality health care and protect people from financial hardship, regardless of where they live or their social or economic background," said Dr Natasha Azzopardi-Muscat, Director of the Division of Country Health Policies and Systems at WHO/Europe.

"But there is a significant knowledge gap when it comes to leveraging health financing to scale up rehabilitation services. This study will provide much-needed evidence on sustainable financing models for rehabilitation services, which can support the efforts of Ukraine and other countries across the WHO European Region."

The research and data collection come against the backdrop of global and complex health challenges such as population ageing, climate change, the rise of chronic conditions, and increased health emergencies. It is in this context that WHO has underscored the importance of integrating robust rehabilitation services across the continuum of health care. This is aligned with WHO's "Rehabilitation 2030: a call for action", which calls for worldwide efforts to make rehabilitation a fundamental component of national health systems.

The study focuses on 3 key areas:

• patient pathways and settings of care, particularly for conditions like stroke, back pain, and amputations;
• coverage, eligibility, and benefits offered to people; and
• the purchasing of services, including how different rehabilitation service providers are paid.

"Since the Russian Federation's full-scale invasion of Ukraine in February 2022, people's needs for rehabilitation care have increased dramatically. Despite the war, Ukraine continues to implement transformative health reforms, focusing on trauma-related rehabilitation and stroke recovery," said Dr Jarno Habicht, WHO Representative in Ukraine.

"This comparative research will provide insights from selected European countries on rehabilitation financing and system organization, supporting policy-making in Ukraine. It also aims to align rehabilitation funding and payment mechanisms with Ukraine's health reforms agenda."

Financing for rehabilitation

In line with global efforts to make rehabilitation a central component of health systems, this study underscores the vital role that rehabilitation plays in reducing disabilities.

"There is a real gap in knowledge on financing of rehabilitation services, yet rehabilitation has a crucial role to play in strengthening health systems. This work will inform policy decision-making not just in Ukraine, but across Europe, and allow policy-makers to ensure that rehabilitation services are sustainably integrated and adequately financed within national health systems," said Dr Ewout van Ginneken, Coordinator at the Berlin University of Technology hub of the European Observatory on Health Systems and Policies and its Director-elect (from January 2025).

"We are delighted to collaborate with the WHO Country Office in Ukraine and the WHO Barcelona Office for Health Systems Financing to conduct a comparative study aimed at learning from other countries' experiences how to build up rehabilitation services in a sustainable and equitable way."

To ensure a robust evidence base, experts from across Europe will provide country-specific data using a standardized template. These findings will culminate in a Policy Dialogue in Kyiv on 22 November 2024, where stakeholders from Ukraine and Europe will discuss the results and explore policy options for Ukraine.

The outcomes of this study will also contribute to future global strategies aimed at improving the organization and financing of rehabilitation services, ensuring that they are sustainably integrated into national health systems worldwide.

WHO's technical assistance on rehabilitation health financing in Ukraine is supported by the Directorate-General for Neighbourhood and Enlargement Negotiations as part of a project titled "Inclusive strengthening and resilience building of rehabilitation services in Ukraine".

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