Assessing Ukraine’s Public Health Resilience in War: Challenges of Regional Disease Control Centers

Background

The Public Health system in Ukraine has been put under great strain due to the loss of equipment, destruction of health facilities, and disruptions to essential service delivery. At the oblast level, public health services are provided by the Regional Centers for Disease Control and Prevention (RCDCPs), created in 2021. Within the frame of the USAID-funded Public Health Systems Recovery and Resilience project, we conducted an online rapid assessment of the 25 RCDCPs to evaluate staffing, equipment, and delivery of essential public health functions in the context of war.

Methods

An online questionnaire was administered to RCDCP managers and staff in January 2022. Quantitative and qualitative data from 24/25 RCDCPs were analyzed using descriptive statistics and thematic analysis.

Results

Only 33% of RCDCPs reported sufficient capacities to perform essential public health functions, and 20% lacked staff with adequate skills for surveillance tasks. Key training needs included vaccine supply chain management, NCD surveillance, and epidemiological data analysis. Most commonly detected diseases were COVID-19, food-borne diseases, acute respiratory infections, tuberculosis, and viral hepatitis. Priority needs included improved communicable and non-communicable disease surveillance, vaccination coverage, and water sanitation. Better communication among health system actors was also identified as essential to improve responsiveness to public health threats and enable data sharing across system levels.

Conclusions

The transition from sanitary-epidemiological stations to RCDCPs introduced new functions, including vaccine supply chain management and NCD prevention and surveillance. The findings highlight critical gaps in public health capacity and identify where training and support are most needed to strengthen regional public health institutions in the context of the full-scale invasion.

Key messages

• Surveillance capacities and public health functions in Ukraine at regional and territorial level have been negatively impacted in the context of the full scale invasion.

• Sustained funding to regional public health institutions in the context of war is essential to guarantee resilient and responsive public health systems.