How Regions Respond to the COVID-19 Outbreak: A New Analytical Tool in Ukraine

The tool helps to systematically collect, and structure collected information related to regional COVID-19 response and to store it in one place. The electronic portal PHRM was launched in October 2020 together with the Ministry of Health of Ukraine and the Ukrainian Public Health Center. It allows the Ministry of Health (MoH), UPHC, regional health authorities and other stakeholders to monitor the policies and epidemiological situation across regions in a systematic manner.

This is the first tool of its kind among the countries of the WHO European Region. It builds on the joint initiative between the WHO Regional Office for the European Region, the European Commission and the European Observatory on Health Systems and Policies, and the Health System Response Monitor (HSRM)1.

Using the findings of the tool, the national and regional authorities can adjust the COVID-19 response. WHO Representative in Ukraine, Dr Jarno Habicht, highlights that “ this tool is crucial for national and regional authorities to coordinate restriction measures, interventions, policies and messages for the COVID-19 response in Ukraine.”

As WHO Representative in Ukraine, Dr Jarno Habicht added that ”the tool could also be a useful source of information in investigation of new outbreaks in a given region, for instance relaxing public health measure and allowing big congregation of people resulting in high infection rates in subsequent weeks. With the tool, the emergency coordination centers in the Ministry of Health and the Ukrainian Public Health Center will be able to regularly check what is the epidemiological picture and for example, governance or financing arrangements on COVID-19 response in Lviv region as compared to Zhytomir and if/how these differ from national standards and policies.”

Data collection in the regions began in May 2020 and took place in several rounds. The monitoring is focused on health-related measures taken by regional authorities to cope with the outbreak.

"Сoordination of all actions with the regions is extremely important today. We welcome the tools that facilitate this coordination and help us to provide the most effective public health response to COVID-19. We're discovering the opportunities of regional monitoring and consider the possibility of integrating it into the daily work of emergency coordination centers to support our public health response.," said Deputy Minister of Health, Chief State Sanitary Doctor of Ukraine Viktor Liashko.

The findings of the tool so far demonstrate that there is considerable variation in the implementation of measures in the regions, reflecting general capacity of the region and leadership of regional authorities. Also, study identified some gaps legislation in the field of public health which should be adressed by authorities. On the positive side, in several regions (e.g. Chernivtsi, Volyn), previously neglected facilities of the Laboratory Centers of the MOH were renovated during the quarantine period.

”Large decentralized countries, such as Ukraine, face distinctive coordinating challenges. Subnational governments are responsible for critical aspects of public health measures, managing health facilities, social services, and aspects of economic development. Because such responsibilities are shared among levels of government, coordinated effort is critical. At the same time, subnational governments can have different policy priorities and capacities. Intergovernmental coordination is a constant focus of policy and politics in these countries, but the scale of the COVID-19 crisis creates novel problems, e.g. of who decides whether people can travel across regional borders within countries, or who decides how to respond to regionalized outbreaks as countries reopen”, - says Elina Dale, Health Policy Adviser, WHO Country Office in Ukraine.

The Regional Public Health Response Monitor (PHRM) consists of a questionnaire with six blocks of questions on response measures in the  areas covering management and coordination, funding, preventing transmission (restrictive measures and physical distancing, epidemiological surveillance and investigation of cases, laboratory testing, health communication), planning of services, case management and support of essential health services during the epidemic (vaccination, pregnancy and childbirth care, EMS, etc.), physical infrastructure and human resources, logistics and operational support. Also, public health data is supplemented with data on the epidemiological situation in each specific region in the dynamics.

The Ministry of Health is deeply interested in the initiative. The next step will be a detailed study of response in the most critical areas, such as schools reopening; ensuring access to basic medical services, etc. and further in-depth analysis of the data obtained in conjunction with the epidemiological situation.