On 24 February 2022, the escalation of hostilities in Ukraine triggered a significant health emergency. Although the health system remains resilient, the war has reduced access to healthcare services and medicines, particularly for people living closer to the front line or in temporarily occupied territories.
In response to the conflict, partners expanded their operations to ensure access to healthcare for the most vulnerable and affected communities across the country, including in areas hosting the largest number of internally displaced people.
The Health Cluster in Ukraine scaled up to a nationwide presence in all 24 oblasts to coordinate the growing number of organizations involved in the humanitarian response at the national and sub-national levels. By placing sub-national coordinators in four hubs, the Cluster prioritized operational presence, localization of the response, and strengthening accountability to affected populations. Partner engagement and shared leadership improved in 2023 through NGO co-coordination at the oblast level in three hubs.
In 2022, 196 individual organizations* reported the delivery of quality life-saving healthcare to 9.4 million people and supported 1,173 health facilities in Ukraine. In 2023, the Health Cluster implemented a membership process to increase the accountability and transparency of the humanitarian health response. As of May 2023, the health cluster enables coordination for 221 partners, of which 64 are active members, nine associates and 148 observers.** With the launch of the new ActivityInfo platform, 55 partners are reporting on life-saving humanitarian health activities as of May 2023. This number is expected to grow as partners become familiar with how the platform works, and its value in coordination and accountability.
A Strategic Advisory Group was established in 2022 to provide overall strategic direction for the Health Cluster and enable decision-making for the wider membership. Eleven Technical Working Groups have ensured continuous technical guidance and support to partners during the implementation of the response. A Cash Voucher Assistance Task Team was launched to develop guidance for partners implementing cash assistance for health.
People-centred response amidst complexity and volatility
Health Cluster partners provided humanitarian health assistance in more than 900 Ukrainian towns and villages. To offer a comprehensive people-centred response and leave no one behind in an increasingly complex and rapidly changing environment, support has included the provision of life-saving medications, medical supplies and equipment, integrated primary health care through mobile approaches, treatment and referral of wounded/trauma-affected patients, mental health and psychosocial support, sexual and reproductive health care, including GBV services, risk communication and community engagement activities.
With half of Ukraine's energy infrastructure either damaged or destroyed and continued attacks on healthcare, Health Cluster partners focused on preparing health facilities for winter and mitigating adverse health outcomes. Partners distributed more than 350 generators and carried out minor rehabilitation to create a safe healthcare environment. A complex operating environment with security-related concerns, large and often unpredictable population movements, and high levels of data sensitivity made it difficult to reach the people in need. Still, partners targeted newly accessible areas with humanitarian health assistance for the most vulnerable.
Locally driven humanitarian health response
More than half of the 196 partners reported carrying out humanitarian health activities during 2022 are local organizations. Of the 53 INGOs, 11 (21%) had a local implementing partner, and of the 6 UN agencies (50%), had a local implementing partner. This demonstrates that the Ukraine humanitarian health response has been characterized by international organizations’ significant engagement with local partners.
Local NGOs comprise the largest organization type accounting for 101 organizations, followed by 75 INGOs, 6 UN agencies, and 14 others. These numbers underscore the local nature of the response, and the resulting cooperation, which has enhanced the capacity of Health Cluster partners to reach people with the highest severity of health needs, adapt the response to the local context, respond closer to the front line, and rapidly scale up humanitarian health assistance when areas are newly retaken.
The national non-governmental organizations have been key in distributing medical supplies, and practical items such as dignity and hygiene kits to women, adolescents, the elderly and the disabled. Partner efforts have also focused on facilities serving internally displaced people, training hospital staff and volunteers, and in some cases, supporting the distribution of informational flyers to the local population. Direct exchange occurs with the national and local health authorities regularly to align the health response to the priorities and the identified key health needs. The response to the crisis has been built on extensive, pre-existing networks and has allowed for faster action in delivering humanitarian aid in hard-to-reach areas.
Local health organizations in Ukraine have implemented a wide range of humanitarian health activities, including supporting new modalities of service provision such as telemedicine, identifying vulnerable groups in need of special care, especially in remote and isolated areas, and protecting the health workforce from exhaustion and mental distress through targeted MHPSS interventions. Collaborating with international organizations has further enabled Ukrainian partners to increase the scope of activities through gaining access to calls for international funding, such as the Ukraine Humanitarian Fund, and capacity strengthening through technical guidance on key issues.
The Health Cluster supports the localization of the response through subnational cluster coordination, and continuous information management to assist all partners with evidence-based decision-making. These include public health situation analyses, monthly bulletins, rapid health needs assessments, standard assessment tools, monthly presence mapping (5w), and the Health Requests Planning and Response platform, which has received 452 requests for assistance.
In Ukraine, 14.6 million people are in need of health assistance, and US$307.4 million is required for the health response.
*The cumulative number of partners who have reported completed/ongoing activities through the 5W reporting matrix.
** Observers are organizations that either decided not to become active cluster members or do not meet the minimum criteria for membership but are interested in contributing to the coordination, receiving, and sharing information on Health humanitarian response activities.