HEALTH CLUSTER BULLETIN

2021 HRP Overview

1.3 million people targeted by the Health

Cluster in 2021

473,260 people benefited from healthcare

services in the first quarter of 2021

(January-March, 2021)1

20 projects approved for 2021 HRP

USD 28,7 million funds requested

USD 4,4 million funds received (15,2% of

requested)

Health Cluster 2021

Number of partners: 69

CO Health Cluster – Summary

Health Cluster and WHO continued to coordinate health

partners throughout Ukraine and particularly in the

eastern conflict area (ECA). In April and May, the Cluster

conducted four coordination meetings, including

questions and answers (Q&A) sessions on relevant

health topics such as quality assurance process for

personal protective equipment, laboratory diagnostics of

COVID-19 in Donetska and Luhansk oblasts, GCA and

WHO Emergency Care System Framework.

Health Cluster developed the Incident Management

COVID-19 5W Dashboard to visualize COVID-19 related

activities and supplies. The dashboard reflects COVID-19

activities from all Health Cluster partners and includs

inputs from WASH and Protection Clusters. With support of partners, the Cluster also completed data collection and

analysis of HRP activities for Q1 2021.

1 This number represents reports from partners received as part of Q1 HRP reporting, collected during January-March, 2021.

INGO28%

Donor23%

NNGO19%

United Nations13%

Others/Observers7%

National authorities6%

IGO4%

HEALTH CLUSTER UKRAINE BULLETIN # 12

April-May 2021

Ukraine Emergency type: Protracted Emergency Reporting period: April-May, 2021 2018

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Health Cluster in partnership with REACH Initiative initiated an assessment to analyze Donetsk and Luhansk GCA

residents’ perceptions about health status, access to healthcare and healthcare services. The assessment will contribute

to a wider-scale Health Assessment coordinated by the Health Cluster and aims to fill information gaps defined in the

Public Health Situation Analysis (PHSA).

From 19 to 30 April Health Cluster conducted a two-weeks mission to Donetska and Luhanska oblasts, GCA. Objectives

of the mission included meeting Health Cluster partners, assessing COVID-19 and humanitarian health response, visits to

primary and secondary health facilities and assessment of Emergency Medical Services. Results of the mission are

currently being applied for informing preparedness and response operations.

From 3 to 15 May Health Cluster in partnership with WHO

conducted Rapid Assessment of ten health facilities in

Donetska and Luhanska oblasts, GCA. The assessment was

conducted using a specific tool designed for on sites visits.

Assessment findings will be considered for the 2022

Humanitarian Need Overview (HNO).

Health Cluster conducted consultations related to

potential escalation of the conflict in eastern Ukraine. As

a result, the cluster developed a sectoral contingency plan,

to become part of the inter-agency plan of the Inter-Cluster

Coordination Group (ICCG).

COVID-19 situation overview

Epidemiological situation in ECA In Government-Controlled area (GCA) situation has started to stabilize. In Donetska oblast number of confirmed cases has increased (89,342 cases as of 31.05.2021 comparing to 57,998 cases on 30.03.2021). According to the UPHC, in Donetska oblast, cumulative test positivity rate is 26.1%. Number of recovered cases is 83,694, number of death - 2,250 as of May 31. As for health care workers, there are 3,011 confirmed cases, of which 2,904 recovered and 42 died. In Luhanska oblast, 26,147 confirmed cases have been reported (11.4% - test positivity rate), 23,906 patients recovered and 893 died. As for health care workers, there are 1,500 confirmed cases, of which 1,460 recovered and 17 died.

Donetska oblast, GCA

0

500

1000

1500

2000

Suspected

0200400600800

1000120014001600

Confirmed

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Confirmed Recovered Deaths Active 14-day

incidence rate

Case fatality

rate

Active cases per 100,000 population

Number of

available beds

Bed occupancy

rate

89342 83694 2250 3398 132.7 2.5% 180.9 3139 30.1%

Luhanska oblast, GCA

Confirmed Recovered Deaths Active 14-day

incidence rate

Case fatality

rate

Active cases per 100,000 population

Number of

available beds

Bed occupancy

rate

26147 23906 893 1348 111.7 3.4% 200.5 1312 25.7%

Limited case-based data is being provided regarding Non-Government Controlled Area (NGCA), impacting the possibility of further analysis. In Donetsk, 38,851 cases have been reported as of 30 May, including 31,401 recovered and 2,927 died. In Luhansk, 4,767 cases have been reported on 30 May, including 4,136 recovered and 439 died. High infection rate among healthcare workers remain one of the of the major concerns reported in NGCA. For health care workers in Donetsk NGCA, 126 cases have been reported.*2

Public health situation

The COVID-19 situation in eastern conflict area is gradually stabilizing: new infection, hospitalization and death continue

to decline in both Donetska and Luganska oblasts, GCA. Starting first week of May, more patients are discharged than

2 * signifies that the number may not be representative of the real situation due to lack of information available.

Donetska oblast, NGCA

Confirmed Recovered Deaths Active

New cases including

arrived from GCA

New cases including

arrived from Russia

Case fatality

rate

Cases among health care

workers

38851 31401 2927 4523 -* -* 7.5% -*

Luhanska oblast, NGCA

Confirmed Recovered Deaths Active

New cases, including

arrived from GCA*

New cases, including

arrived from Russia*

Case fatality

rate

4767 4136 439 192 - - 9.2% -

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newly admitted. The situation is expected to continue on the same trajectory at least till mid-summer. Significant

proportion of cases are reported from major urban towns and cities although reporting at rural level is quite poor.

Vaccine acceptance among the population of Luhanska and Donetska oblasts, GCA hasn’t significantly changed

since August 2020. According to WHO’s Behavioural Insights (BI) study on COVID-19 in Eastern oblasts of Ukraine, 59%

of respondents in Luhanska oblast and 42% in Donetska oblast stated to be prone to get a COVID-19 vaccine if it becomes

available. These findings are coherent with the 48% average acceptance rate across all Ukraine. Majority of respondents

stated to not planning to receive a COVID-19 vaccine due to fears over adverse effects followed by concerns about the

country of production of the vaccine.

On May 4 the Mariinsky Central District Hospital in Krasnogorivka, eastern Ukraine, came under shelling

In the night between 4 to 5 May 2021, an attack on the

Mariinsky Central District Hospital took place in

Krasnohorivka (Donetksa Oblast). The city is located in

close proximity to the “contact line” (0-5 km,

government-controlled areas). Luckily, all 45 patients

who were in the facility did not sustain injuries. The

hospital is COVID-19 designated and there were 45

patients, out of which 38 COVID-19 patients in need of

oxygen therapy. From the start of the conflict in 2014

health facility periodically suffered from artillery shelling.

The incident was reported in the WHO global system for

attacks on healthcare (SSA). On 7 May, following the

accident, Humanitarian Coordinator in Ukraine, Ms.

Osnat Lubrani, issued a statement calling for the protection of critical civilian infrastructure in eastern Ukraine.

Government response

On 16 May Ukraine received the first vaccines from COVID-19 under the COVAX mechanism. The supply of vaccines from

various manufacturers under COVAX will continue, and it is expected that by the end of 2021 these supplies will allow to

cover up to 20% of the population of Ukraine.3 In total, as reported by the Ministry of Health on 11 May, Ukraine has made

deals for 42 million doses of vaccines by the end of 2021, under direct contracts between the Ukrainian Government and

vaccine manufacturers. More specifically, there will be 20 million doses of Pfizer vaccines, 2 million doses of AstraZeneca,

10 million doses of NovaVax and 1.9 million doses of Sinovac/CoronaVac vaccines. And also 8 million doses of vaccines

from the global initiative COVAX.4

Government of Ukraine is set to improve provision of emergency medical care across Ukraine. As reported by the Prime

Minister Denys Shmyhal on May 21, funding for emergency medicine in 2021 has increased by almost 2,5 times: from 6

billion UAH in 2019 to 14 billion UAH in 2021. Among other things, the additional budget will cover increase in payments

to doctors, purchase of new cars, repairs of emergency departments and installment of high-quality equipment.5

3 Ukraine received the first vaccines from COVID-19 under the COVAX mechanism. (2021, April 16). Ministry of Health in Ukraine. https://moz.gov.ua/article/news/ukraina-otrimala-pershi-vakcini-vid-covid-19-v-ramkah-mehanizmu-covax 4 Ministry of Health of Ukraine. (2021, May 11). Cabinet of ministers of Ukraine - Ukraine has made deals on 42 mn doses of COVID-19 vaccines. Gov.ua. https://www.kmu.gov.ua/en/news/moz-ukrayina-zakontraktuvala-42-mln-doz-vakcin-proti-covid-19 5 Communications Department of the Secretariat of the CMU. (2021, May 21). Prime minister: Funding for emergency medical care has increased significantly. Cabinet of ministers of Ukraine. https://www.kmu.gov.ua/en/news/premyer-ministr-finansuvannya-ekstrenoyi-medichnoyi-dopomogi-suttyevo-zbilshilosya

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On May 29, 2021 Government launched three mass

vaccination centers against COVID-19: in Kyiv on the basis of

International Exhibition Center, in L’viv on the basis of Arena

L’viv Stadium and in Odessa on the basis of Odessa Law

Academy Stadium. These centers will be open on weekends.

They will vaccinate citizens who have signed up for the COVID-

19 vaccination waiting list in the app or through the Ministry

of Health's contact center. Pilot vaccination centers are being

opened to test the algorithm of mass vaccination in large

premises. When Ukraine receives more vaccines, such centers

are to be established in other large cities.6

Key Cluster Updates and Initiatives

Health Cluster missions to the eastern Ukraine

1) Data collection mission to the eastern Ukraine, GCA (5-9 April, 2021)

From 5 to 9 April, Ms. Iryna Koval, Partnerships Coordination, Planning and M&E Consultant and Ms. Oleksandra

Abrosimova, National Consultant Information Manager, supported by the WHO field officers Mr. Oleh Mikhalov and Dr.

Igor Novikov, conducted a one-week data collection mission to Donetska and Lukanska oblasts, GCA. The mission was

organized as part of a broader Health Assessment and aimed to obtain regional level data on key public health topics,

including mortality, vaccination, HIV/TB, mental health, sexual and reproductive health. The data obtained from the

mission will be inputted into Health Cluster Monitoring and Evaluation (M&E) Framework and will inform various sectoral

analysis produced by the Health Cluster.

2) Coordination mission to the eastern Ukraine, GCA (5-9 April, 2021)

6 Ministry of Health of Ukraine. (2021, May 28). Pilot centers for mass vaccination against COVID-19 open in Kyiv, Lviv and Odessa. moz.gov.ua. https://moz.gov.ua/article/news/pilotni-centri-masovoi-vakcinacii-proti-covid-19-vidkrivajutsja-v-kievi-lvovi-j-odesi

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From 19 to 30 April, Health Cluster Coordinator Dr. Emanuele Bruni conducted a two-weeks mission to Donetska and

Luhanska oblasts, GCA. As part of his visit, Dr. Bruni met main Health Cluster partners operating in the area (UNHCR, MDM,

MSF, PUI, etc..), monitored COVID-19 and humanitarian health response, visited primary and secondary health facilities

and assessed Emergency Medical Services across the two oblasts. Detailed presentation from the visits is available here.

Results of the mission are currently being applied for informing health and response operations.

Health Cluster contribution to the Inter-Agency Contingency Plan (IACP)

In March 2021, the geopolitical context of the armed conflict in eastern Ukraine deteriorated including an increased

bellicose political rhetoric, scaled up military presence along the eastern and southern border with the Russian Federation

coupled with intensification of military clashes and use of heavy weapons. Following the decision of the Ukraine

Humanitarian Country Team (HCT) to strengthen emergency response preparedness, Health Cluster as part of the Inter-

Cluster Coordination Group (ICCG) undergone a review of the Inter-Agency Contingency Plan (IACP), requesting additional

USD 3.5 million for new and existing health activities which need to be scaled up in case of potential escalation of the

conflict. The IACP is currently being finalized and will be shared with all Health Cluster partners once ready.

The Incident Management COVID-19 5W Dashboard

Health Cluster developed the Incident Management COVID-19 5W Dashboard to

visualize distribution of COVID-19 related activities and supplies. The online

dashboard was developed using Power BI technology (presented below) and

incorporates inputs from Health, WASH and Protection Clusters. As of May 2021,

the dashboard reflects information from 20+ partners, covering up to 500 health

facilities, 200 settlements and almost 1 million medical supplies. The platform is

being updated regularly, with a frequency of eight weeks.

The Incident Management COVID-19 5W Dashboard is available here.

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Rapid assessment in selected health facilities of Donetska and Luhanska oblasts, GCA

From 3 to 15 May, Health Cluster in partnership with WHO conducted rapid assessment in selected health facilities across

Luhanska and Donetska oblasts, GCA. The aim of the mission was to conduct in-depth assessment of the situation and

conditions in selected health facilities and identify potential areas of intervention by WHO/Health Cluster partners.

In total, the mission targeted 10 health facilities within 0-20 km from the ‘contact line’, particularly:

Donetska oblast:

• Toretsk Centre of Primary Medico-sanitary Aid (CPMSA)

• Toretsk City Hospital

• Nikolske Central Raion Hospital

• Manush Centre of Primary Medico-sanitary Aid (CPMSA)

• Zoria Outpatient Clinic of General Practice – Family Medicine

• Luhanska oblast:

• Markivsky Centre of Primary Medical and Sanitary Care

• Troitsky Centre of Primary Medical and Sanitary Care

• Troitsky hospital

• Milovsky Central District Hospital

• Milovsky Centre of Primary Medical and Sanitary Care

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Questions and Answers (Q&A) Session on quality assurance process for personal protective equipment

On 14 April, Health Cluster in partnership with WHO conducted a Q&A

session dedicated to quality assurance process for personal protective

equipment (PPE). As part of the session Dr. Svitlana Pakhnutova,

Medicines Policy Officer at WHO CO in Ukraine, briefed partners about

WHO project on assessment of quality of PPE, Ukrainian PPE

manufacturers who have passed testing in the EU laboratory, WHO

quality assurance procedure for PPE and specifications on masks and

respirators, as well as conclusions and recommendations for partners

and MOH in Ukraine. Detailed presentation and minutes from the

meeting are available here.

Questions and Answers (Q&A) Session on laboratory diagnostics of COVID-19 in Donetska and Luhanska

oblasts, GCA

On 28 April, Dr. Artem Skrypnyk, Technical Officer on Laboratory, National

Professional Officer at WHO CO in Ukraine, briefly discussed COVID-19

diagnostics in Ukraine, specifying points of care, situation with capacities of

laboratories and existing needs. The presentation attracted a lot of interest

among partners and raised additional questions such as availability of data

on performance of laboratories, availability of PCR tests at points of care and

nessecity to scale up testing and contact-tracing. More information can be

found in the presentation and meeting minutes available here.

WHO presentation on SARS CoV 2 Transmission in Ukraine: Estimation and Projections

On 28 April, Mr. Aron Aregay, WHE Information Management & Risk

Assessment Officer, presented the outcomes of the latest modelling on SARS-

COV-2 transmission in Ukraine, covering projections for April – June 2021. In

summary, all models present evidence for decline in transmissions, but many

regions remain vulnerable (including Donetska and Luganska oblasts). The

projections were further reviewed in May and will be presented at the

upcoming cluster meetings. Detailed presentation and minutes from the

meeting are available here.

Questions and Answers (Q&A) Session on WHO Emergency Care System Framework and Assessment Tool

On 26 of May, WHO Representative Dr. Israel Gestoso presented WHO’s

Emergency Care System Framework - a systematic approach to emergency

care, centered on acuity-based triage, early recognition and resuscitation, and

simple initial management and referral. In his presentation, Dr. Gestoso

adressed key benefits and challenges of the EMS framework, as well as current

situation of the Emergency Care System in Ukraine. Detailed presentation and

minutes from the meeting are available here.

HEALTH CLUSTER BULLETIN

Presentation of Protection against sexual exploitation and abuse (PSEA) initiative

On 26 of May, WHO Specialist in Emergency Medical Services and

Clinical Management Dr. Israel Gestoso presented WHO’s initiative to

combat sexual exploitation and abuse. As part of his presentation, Dr.

Gestoso spoke about WHO’s ethical principles and code of conduct

(including personal conduct principles), role of managers in situations

of harassment and sexual exploitation and abuse, principles of

whistleblowing and protection against retaliation, as well as process,

roles and responsibilities in reporting concerns of unethical behavior.

Detailed presentation and minutes from the meeting are available

here.

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Humanitarian Programme Cycle 2022: preparations started!

Health Cluster together with Inter-Cluster Coordination Group (ICCG) began working on Humanitarian Programme Cycle

2022. The tentative calendar of the HPC process is presented below.

Update from the MHPSS TWG

Mental Health and Psychosocial support working group continues to regularly conduct its monthly coordination meetings

at national level and once two months on a regional level (covering partners operating in Donetska and Luhanska oblasts).

In April MHPSS TWG together with Child Protection (CP) sub-cluster within the piloting project of “Save the children” held

a meeting on strengthening referral pathways for the partners working in the field in psychosocial support (PSS) response

with various target groups. Partners expressed the challenges in the referral mechanisms between non-governmental and

governmental organizations and the importance of having unified at all levels referral form. Taking into account the

demand, MHPSS TWG will continued working on the service map to support the strengthening the referral mechanisms

for partners operating in the field.

The updated MHPSS service map that was developed with the data support of Health and Protection cluster, as well

contains the additional and updated layer of the GBV services all over the country from the respective sub-cluster. The

user guides were also developed and disseminated among the partners. The group is aiming to improve the tool for

referral purposes and planning the workshops for the partners operating in the fields to increase the practical features of

the map. The tool is available following the link.

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Useful Links and Resources

• Updated Health Cluster Page on Humanitarian Response Info website

• Monitoring COVID-19 vaccination: Considerations for the collection and use of vaccination data

• COVID-19 vaccine checklist: for frontline health workers planning a COVID-19 vaccination session.

• Roadmap to improve and ensure good indoor ventilation in the context of COVID-19

• COVID-19 vaccination: supply and logistics guidance

• Definition and categorization of the timing of mother-to-child transmission of SARS-CoV-2

• Community needs, perceptions and demand: community assessment tool for COVID-19

• COVID-19: Occupational health and safety for health workers

• Interim Guidance on Public Health and Social Measures for COVID-19 Preparedness and Response Operations in Low Capacity and Humanitarian Settings

• IASC Key Messages to Fast-Track Health and Aid Workers and Supplies at Borders and in Countries

Contacts

Health Cluster MHPSS Working Group TB/HIV Working Group

Emanuele Bruni Health Cluster Coordinator brunie@who.int Iryna Koval Partnerships Coordination, Planning and M&E Consultant kovali@who.int Oleksandra Abrosimova National Consultant Information Manager abrosimovao@who.int

Alisa Ladyk-Bryzgalova MHPSS Working Group ladykbryzghalovaa@who.int Oksana Dmytriak MHPSS Working Group dmytriako@who.i

Martin Donoghue TB/HIV Working Group donoghoem@who.int