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Executive Summary

Note: This update to the Public Health Situation Analysis (PHSA) builds upon the rapidly-developed document published on 3 March 2022. The update adds depth to the information presented in the previous version, tracks changes in the situation, considers additional threats, and incorporates data from assessments.
There are an estimated 15.7 million people affected by the war in Ukraine in need of humanitarian assistance, of which 12.1 million are considered in need of humanitarian health care.

This analysis has identified the priority health threats to the conflict-affected population based on the current situation and their expected evolution over the next three months. In areas of active fighting, facilities struggle to cope with number of casualties. The number of COVID-19 cases and deaths has substantially decreased globally and in Ukraine, with weekly decreasing trends. Since the beginning of the war, it is important to note that testing and reporting capacities in Ukraine have been limited. It is important to note that since the beginning of the war the testing and reporting capacities have been limited. However, COVID-19 remains a substantial threat, particularly given low vaccination rates. The recently reported case of diphtheria in an internally displaced person, highlights the threat of outbreaks of vaccine preventable diseases. Despite childhood vaccination coverage reportedly being close to WHO targets in 2021, disruptions to immunization programmes due to hostilities and displacement, coupled with historical coverage gaps, place both adults and children at risk. TB and HIV programmes have been disrupted, impeding access to medicines, potentially delaying treatment due to unreported infections and risking further disease transmission in a country known to have higher rates of TB and HIV/AIDS than its regional neighbours. 4, 5 Non-communicable diseases (NCDs), such as cardiovascular disease, are the leading cause of death in Ukraine. 6 Reduced access to health care and medicines due to hostilities is likely to worsen the health status of the population, impacting quality of life and life expectancy.7 Mental health and psychosocial support needs of the affected population are intensifying as a result of the significant distress and socio-economic effects caused by the war.

Vulnerable groups are disproportionately impacted by health threats and barriers to accessing health care. Of particular concern are the elderly. It is estimated that 20% of the population of Ukraine are 60 years and older – the highest proportion of elderly persons in a humanitarian setting in the world. 8 Other vulnerable groups identified in this analysis are people with disabilities (PwD), children and youth, women and girls, Roma, health care workers, and internally displaced persons (IDPs). Each of these groups has distinctive humanitarian health care needs which demand attention.

Many of the social determinants of health, such as water, sanitation and hygiene (WASH), food security, shelter, security, restriction of movement, impact the health of displaced and nondisplaced populations. Having an understanding of the status of these determinants gives context to the health issues faced by those affected and can help inform intervention planning.

The needs of the health system are highlighted by describing the disruptions and challenges experienced by key health system components and their predicted impact over the next three months. The assessed areas include access to health care, health system management, supply chains, alert and response systems, health workforce, health facilities, and attacks on health care.

To address the needs of the conflict-affected population and the health system, Health Cluster Ukraine serves as a link between 106 partners planning or engaged in humanitarian health activities in Ukraine to better coordinate the response. The Health Cluster gathers and shares information to guide partners’ response planning. This PHSA is one of the resources developed by the Health Cluster secretariat to promote a common understanding of the public health situation in Ukraine.