NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine
Ukraine is amid a comprehensive health sector reform to transform the current unaffordable and inefficient system into a modern, more efficient, and affordable one. The country’s health system is not addressing non-communicable diseases (NCD) and c...
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World Bank, Washington, DC
2021
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| Online Access: | http://documents.worldbank.org/curated/en/311091621216694793/NCD-Care-Continuum-and-Opportunities-for-Action-within-Health-Reform-in-Ukraine http://hdl.handle.net/10986/35587 |
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okr-10986-355872021-05-18T05:11:18Z NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine Zhao, Feng Fraser, Nicole Khan, Olga Doroshenko, Olena Poole, Laura NON-COMMUNICABLE DISEASES CONTINUUM OF CARE CHRONIC CARE MODEL PRIMARY HEALTH CARE HYPERTENSION DIABETES BREAST CANCER CERVICAL CANCER Ukraine is amid a comprehensive health sector reform to transform the current unaffordable and inefficient system into a modern, more efficient, and affordable one. The country’s health system is not addressing non-communicable diseases (NCD) and chronic conditions effectively, and NCD-related health outcomes compare relatively poorly to countries with a similar level of health financing. The paper analyzed the continuum of care for four conditions (hypertension, diabetes, breast, and cervical cancer) using the cascade framework as an analytical tool and programmatic data from two regions of Ukraine (Lviv and Poltava). It draws on global evidence of good and cost-efficient practices and includes the findings from guided discussions with Ukrainian health care planners, administrators, and providers. The analysis found significant gaps in detection, treatment monitoring, and treatment adherence in hypertension care (the largest breakpoints were blood pressure monitoring and achieving treatment targets) and similarly in diabetes care (underdiagnosis, inappropriate or incomplete treatment monitoring, sub-optimal treatment success). In breast cancer care, there was inadequate screening coverage among eligible women, post-screening losses, and a lack of documentation regarding treatment outcomes. In cervical cancer care, the screening intervals for covered women were short, creating inefficiencies, while many women were not screened despite program eligibility, and there was also a lack of long-term monitoring of women who had undergone treatment. The authors discuss the methodological approach of analyzing routine medical records and cancer registry data and triangulating data across multiple data sources. Important lessons and policy implications include the need to revise sequence of services, focus on follow up and retention in care, develop systems for managing risk factors, and strengthen the monitoring and data recording of NCD cases. Improved NCD care would save lives, reduce disability, save resources in health care, and reduce the impact of NCDs on individuals and society. 2021-05-17T16:46:47Z 2021-05-17T16:46:47Z 2020-12 Working Paper http://documents.worldbank.org/curated/en/311091621216694793/NCD-Care-Continuum-and-Opportunities-for-Action-within-Health-Reform-in-Ukraine http://hdl.handle.net/10986/35587 English Health, Nutrition and Population Discussion Paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Working Paper Europe and Central Asia Ukraine |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English |
| topic |
NON-COMMUNICABLE DISEASES CONTINUUM OF CARE CHRONIC CARE MODEL PRIMARY HEALTH CARE HYPERTENSION DIABETES BREAST CANCER CERVICAL CANCER |
| spellingShingle |
NON-COMMUNICABLE DISEASES CONTINUUM OF CARE CHRONIC CARE MODEL PRIMARY HEALTH CARE HYPERTENSION DIABETES BREAST CANCER CERVICAL CANCER Zhao, Feng Fraser, Nicole Khan, Olga Doroshenko, Olena Poole, Laura NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine |
| geographic_facet |
Europe and Central Asia Ukraine |
| relation |
Health, Nutrition and Population Discussion Paper; |
| description |
Ukraine is amid a comprehensive health
sector reform to transform the current unaffordable and
inefficient system into a modern, more efficient, and
affordable one. The country’s health system is not
addressing non-communicable diseases (NCD) and chronic
conditions effectively, and NCD-related health outcomes
compare relatively poorly to countries with a similar level
of health financing. The paper analyzed the continuum of
care for four conditions (hypertension, diabetes, breast,
and cervical cancer) using the cascade framework as an
analytical tool and programmatic data from two regions of
Ukraine (Lviv and Poltava). It draws on global evidence of
good and cost-efficient practices and includes the findings
from guided discussions with Ukrainian health care planners,
administrators, and providers. The analysis found
significant gaps in detection, treatment monitoring, and
treatment adherence in hypertension care (the largest
breakpoints were blood pressure monitoring and achieving
treatment targets) and similarly in diabetes care
(underdiagnosis, inappropriate or incomplete treatment
monitoring, sub-optimal treatment success). In breast cancer
care, there was inadequate screening coverage among eligible
women, post-screening losses, and a lack of documentation
regarding treatment outcomes. In cervical cancer care, the
screening intervals for covered women were short, creating
inefficiencies, while many women were not screened despite
program eligibility, and there was also a lack of long-term
monitoring of women who had undergone treatment. The authors
discuss the methodological approach of analyzing routine
medical records and cancer registry data and triangulating
data across multiple data sources. Important lessons and
policy implications include the need to revise sequence of
services, focus on follow up and retention in care, develop
systems for managing risk factors, and strengthen the
monitoring and data recording of NCD cases. Improved NCD
care would save lives, reduce disability, save resources in
health care, and reduce the impact of NCDs on individuals
and society. |
| format |
Working Paper |
| author |
Zhao, Feng Fraser, Nicole Khan, Olga Doroshenko, Olena Poole, Laura |
| author_facet |
Zhao, Feng Fraser, Nicole Khan, Olga Doroshenko, Olena Poole, Laura |
| author_sort |
Zhao, Feng |
| title |
NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine |
| title_short |
NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine |
| title_full |
NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine |
| title_fullStr |
NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine |
| title_full_unstemmed |
NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine |
| title_sort |
ncd care continuum and opportunities for action within health reform in ukraine |
| publisher |
World Bank, Washington, DC |
| publishDate |
2021 |
| url |
http://documents.worldbank.org/curated/en/311091621216694793/NCD-Care-Continuum-and-Opportunities-for-Action-within-Health-Reform-in-Ukraine http://hdl.handle.net/10986/35587 |
| _version_ |
1764483385332334592 |