007. Факультет охорони здоров`я, соціальної роботи і психології

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Факультет створений у 2023 році.

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Barriers and facilitators to viral hepatitis testing in Uzbekistan: scoping qualitative study among key stakeholders, healthcare workers, and the general population
(2024) Mazhnaya, Alyona; Geurts, Brogan; Brigida, Krestina; Bakieva, Shokhista; Sadirova, Shakhlo; Witzigmann, Annika; Musabaev, Erkin; Brandl, Michael; Weishaar, Heide; Dudareva, Sandra; El Bcheraoui, Charbel
Introduction In the World Health Organization European Region, an estimated 14 million people live with a chronic hepatitis B virus infection (HBV), and 12 million are affected by a hepatitis C virus infection (HCV). Uzbekistan bears a major burden of HBV and has one of the highest HCV prevalence in the region. Following a presidential decree in May 2022, significant funds were allocated to the viral hepatitis (VH) elimination program in Uzbekistan. The program expands VH testing to reach 500,000 people annually during 2022–2025 as part of the VH elimination strategy that includes the provision of free testing and affordable treatment. Exploring the existing barriers and facilitators to VH testing is pivotal for informing these interventions. Methods This study uses a cross-sectional qualitative design to identify and explore the barriers and facilitators to VH testing among the general population in Uzbekistan. We collected data during October-November 2022 through semi-structured interviews with 12 key informants (KIs) and 7 focus group discussions with two target populations: the general population and healthcare workers (HCW) in Tashkent, Uzbekistan. Results Following the capability-opportunity-motivation-behavior model (COM-B model) as a framework for the analysis, we identified major capability barriers to VH testing primarily linked to low health literacy and limited knowledge about VH types, symptoms, transmission, testing and treatment. Physical opportunity barriers included the time and financial costs associated with testing, diagnostics, and treatment. Sociocultural opportunity barriers involved anticipated negative reactions and stigmatization, particularly affecting women. Motivational barriers included a reluctance to be tested when asymptomatic and a general fear of receiving positive test results. The involvement of healthcare workers in promoting VH awareness and motivating the general population emerged as a facilitator. Conclusions A multi-pronged approach is recommended to achieve VH testing goals among the general population, focusing on raising awareness and health literacy and creating an enabling environment that ensures easy accessibility and minimizing VH testing-associated costs.
Bridging gaps: improving the access of primary health care in rural Ukraine through mobile health units
(2024) Suzyma, Valentyna; Yurochko, Tetiana
Rural healthcare is an integral part of the Ukrainian healthcare system. However, access to healthcare for the rural population is uneven due to poor development of medical infrastructure and staffing. The problem of access to medical care in rural areas has been exacerbated by the full-scale war. The objective: to study and analyze the current state of accessibility of primary health care in rural areas in Ukraine, followed by a discussion of promising areas for the introduction of mobile health units as a tool for implementing the "Medical Guarantees" program in hard-to-reach regions of Ukraine. Materials and methods. The study included data from official statistical reports, regulatory documents and scientific sources. The methodology includes bibliosemantic, medical and statistical methods and the method of structural logical analysis. Results. It has been established that the low level of access to primary health care for the rural population of Ukraine has been significantly exacerbated by the devastating impact of the war on medical and transport infrastructure, especially in the frontline and recently de-occupied rural areas, and by migration processes. The situation is complicated by the fact that most patients in rural areas are elderly people who are physically unable to use public transportation, even if it is available. The analysis of international practice has shown that mobile health units can be introduced into the public healthcare system as a temporary measure to meet the urgent needs of the Ukrainian population, especially in rural areas. Integration of mobile health units into the state program "Medical Guarantees" can effectively address the urgent health care needs to increase access to health care for the rural population of Ukraine. State regulation of the division of these units will eliminate problems such as duplication and uneven service delivery and will create a transparent system of remuneration for the staff included in these units. Conclusions. The results of the study suggest that the practice of mobile medical units should be introduced as a tool for implementing the "Medical Guarantees" program for regions/locations of Ukraine with low access to medical infrastructure, namely remote rural areas and areas that have been devastated by the war. Mobile medical units will ensure the stability of access to primary health care services and contribute to improving the health of the population.
Common strategies in empirically supported psychological interventions for alcohol use disorders: A meta-review
(2023) Nadkarni, Abhijit; Massazza, Alessandro; Guda, Rahul; Fernandes, Luanna; Garg, Ankur; Jolly, Mehak; Skovgaard Andersen, Lena; Bhatia, Urvita; Bogdanov, Sergiy; Roberts, Bayard; Tol, Wietse; Velleman, Richard; Moore, Quincy; Fuhr, Daniela
Issues: Despite the large number of effective psychological interventions for alcohol use disorders (AUD), there is still a lack of clarity concerning the strategies that make these interventions effective. Approach: The overall goal of this review was to identify, examine and synthesise the information about common strategies from evidence-based psychological interventions for AUDs by conducting a review of systematic reviews, that is, a meta-review. We isolated the relevant primary studies from eligible systematic reviews and extracted information about the interventions from these studies to understand the strategies used. Analysis was restricted to narrative summaries. Key Findings: Thirteen reviews were eligible for inclusion in our meta-review. Of these, eight demonstrated the effectiveness of a range of psychological interventions—behavioural couples therapy, cognitive behaviour therapy combined with motivational interviewing, brief interventions, contingency management, psychotherapy plus brief interventions, Alcoholics Anonymous and 12-step treatment programs, family-therapy or family-involved treatment, and community reinforcement approach. The most commonly used component strategies in effective interventions for AUDs included assessment, personalised feedback, motivational interviewing, goal setting, setting and review of homework, problem solving skills and relapse prevention/management. Implications: Evidence about commonly used strategies in evidence-based psychological interventions for AUDs offer the possibility of creating menu-driven interventions that can be tailored to respond to individual client needs and preferences in different contexts.
Current challenges in accessibility to ophthalmological care in Ukraine
(2024) Skrypnikova, Olena; Yurochko, Tetiana
Aim: The purpose of the study is to identify challenges in the organization and access to ophthalmic services through the analysis of expert opinion of practitioners and government officials. Materials and Methods: Materials developed during expert interviews with practitioners and government officials were used in the study. We also used materials worked out within the project ID 22120107 supported by Visegrád Fund. Conclusions: Despite all the challenges in access to high-quality ophthalmology services, practitioners and government officials have common opinions on how to improve the organization of eye services, how to make care more inclusive and effective, so that the development of blindness and visual impairment does not cause a burden on the state and society.
Development and Piloting of a Mental Health Prevention and Referral Program for Veterans and Their Families in Ukraine
(2023) Nguyen, Amanda J.; Russell, Tara; Skavenski, Stephanie; Bogdanov, Sergiy; Lomakina, Kira; Ivaniuk, Iryna; Aldridge, Luke R.; Bolton, Paul; Murray, Laura; Bass, Judy
Background: While growing evidence exists for the effectiveness of mental health interventions in global mental health, the evidence base for psychosocial supports is lacking despite the need for a broader range of supports that span the prevention–treatment continuum and can be integrated into other service systems. Following rigorous evaluation of the Common Elements Treatment Approach (CETA) in Ukraine, this article describes the development and feasibility testing of CETA Psychosocial Support (CPSS), a brief psychosocial prevention and referral program for Ukrainian veterans and their families. CPSS Development: CPSS development used evidence-based CETA intervention components and was informed by a stakeholder needs analysis incorporating feedback from veterans and their families, literature review, and expert consultations. The program includes psychoeducation, cognitive coping skill development, and a self-assessment tool that identifies participants for potential referral. After initial development of the program, the intervention underwent: (1) initial implementation by skilled providers focused on iterative refinement; (2) additional field-testing of the refined intervention by newly trained providers in real-world conditions; and (3) a formal pilot evaluation with collection of pre-post mental health assessments and implementation ratings using locally validated instruments. Results: Fifteen CPSS providers delivered 14 group sessions to 109 participants (55 veterans, 39 family members, and 15 providers from veterans’ service organizations). After incorporating changes related to content, process, and group dynamics, data from the pilot evaluation suggest the refined CPSS program is an acceptable and potentially effective brief psychosocial prevention and promotion program that can be implemented by trained veteran providers. Forty percent of participants required safety or referral follow-ups. Conclusion: The iterative, inclusive development process resulted in an appropriate program with content and implementation strategies tailored to Ukrainian veterans and their families. Brief psychosocial programs can fit within a larger multitiered mental health and psychosocial continuum of care that supports further referral.
Digital solutions for the development of corporate health programs
(2023) Aleksandrenko, Hlib; Shevchenko, Maryna
Introduction. The article examines the relevance and importance of the health status of employees in modern society. Considering the rapid development of digital technologies, the expediency of their use to improve health and well-being at workplaces is being investigated. Purpose. The purpose of the article is to analyze the current state of development of digital technologies for corporate health programs, as well as to present the results of the developed and implemented digital tool for the implementation of the corporate health program. Materials and methods. The research materials are: 1) regulatory and legal support for the regulation of corporate health of employees of enterprises; 2) information resources of foreign companies that use scientific and practical achievements in the field of digital technology development to preserve and strengthen the corporate health of enterprise employees. In the process of carrying out the research, the following scientific methods were used: theoretical generalization (to characterize corporate health programs and digital applications for tracking the individual corporate health of employees); formalization, analysis and synthesis (to build a model of strengthening corporate health); logical generalization of results (formulation of conclusions). Results. One of the modern trends in the field of personnel management (or, as we call it now, human resources or HR) is the implementation of a holistic approach to the well-being of employees. Companies offer innovative programs to ensure financial well-being, mental health, a healthy lifestyle (in particular, nutrition, physical activity), stress management, etc. It has been becoming a part of both the employer's corporate social responsibility and a strategy crafted to ensure the maintenance of a positive HR brand, attract and retain talents, and increase the level of employee engagement as well as efficiency. It has been confirmed by the results of the Deloitte study. The developed and implemented model of the corporate health program, one of the components of which is the use of digital tools in the form of an automated system of interaction, ensured effective communication and feedback with program participants and prompt response to their needs. Automated distribution of information, support, and personalization were carried out thanks to the proposed algorithm and the possibility of customization through the personal account of each program participant. Thus, we were able to provide a personalized approach to each of them. Discussion. The predicted economic efficiency of this program is estimated for the company's management at approximately $51,000 per year. It has been established that strategies, conditions, or activities carried out in the work environment can motivate employees to make changes that will not only have a positive effect on their health and well-being but also allow for increased productivity at the workplace.
Environmental competencies for healthcare management at a 2nd education level as a component of strategic management
(2024) Turianytsia, Solomiia; Yurochko, Tetiana; Balashov, Kostyantyn; Hulchiy, Olesya
Aim: To present the results of the analysis of educational standards and curricula of the second educational level of training of specialists, who may be managers of healthcare, on the content of the environmental component as an element of strategic management. Materials and Methods: Content analysis 24 educational standards of the Ministry of Education and Science of Ukraine for 6 fields of knowledge and 200 master’s curricula from 87 institutions of higher education of Ukraine. Conclusions: There is a distribution of basic leadership and management competencies both by types of these competencies and between specialties. The requirements for the inclusion of the environmental component in the framework documents are poorly expressed. The content of environmental issues in the curricula is insufficient.
Exploring prevalence and factors associated with postpartum depression among Ukrainian wome
(2024) Gusak, Nataliia; Kendall, Sally; Nizalova, Olena
Introduction: Postpartum depression negatively impacts maternal mental health and child development. The high prevalence of postpartum depression (PPD) in low and lower middle-income countries raises questions about its predictors. This study examines the association between PPD and breastfeeding experience, child death, unresolved pregnancy, forced displacement, COVID-19 pandemic lockdown, marital, and financial status among Ukrainian women. Methods: This online study recruited 1634 Ukrainian mothers of children aged 0–5 years through non-governmental organizations providing services to them. The Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of ≥13, was used to assess depressive symptoms in the postpartum period. Independent t-tests, chi-squared tests, one-way ANOVA, non-parametric correlations, and logistic regression tests were used to analyze the data. Results: The prevalence of depressive symptoms was 39.0% (n=1631). There was a positive association between EPDS scores and breastfeeding difficulties, pandemic lockdown, and financial difficulties. We did not find an association between PPD symptoms and unresolved pregnancy, death of a child, being affected by COVID-19, and forced displacement. We found that EPDS scores for women who did not experience forced displacement (n=1528) were significantly higher compared to displaced mothers (n=74). Conclusions: The present study of Ukrainian women shows that women experienced depressive symptoms influenced by various factors including breastfeeding difficulties, pandemic lockdown, and financial difficulties. There is a need for additional research into such factors as unresolved pregnancy, the death of a child, being affected by COVID-19, and forced displacement.
Facilitators and barriers for implementation of community-based mental health interventions in Western and Eastern Europe - a systematic literature review
(2023) Remy, Maurice Luca; Blijleven, Putu Stephanie; Coetzer, Jessica Amy; Bondarenko, Nataliia
With a high prevalence of mental health disorders in Europe and the increasing call for human-rights approaches in their treatment, the number of community-based mental health (CBMH) interventions is growing within the region. However, the implementation of these CMBH interventions differs between countries and regions, especially between Western and Eastern European countries. The reasons for these differences are based on societal and health systems, but also the design and implementation of the intervention. This systematic literature review examined the existing literature on CMBH interventions in Europe, to identify facilitators and barriers in the implementation process. Emerging themes that were found are the importance of collaboration, the availability of adequate resources, and the consideration of the community perspective in the process. The differences between Western and Eastern Europe which were discovered were mostly caused by a lack of financial and human resources and a higher existing stigma around mental health disorders in communities.
How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine
(2024) Więckowska, Barbara; Byszek, Katarzyna; Rękas, Marek; Yurochko, Tetiana; Shevchenko, Maryna; Skrypnikova, Olena; Dozsa, Csaba; Toth, Melanie
The article aims to compare payment schemes for cataract, glaucoma, vitrectomy, cornea transplantations, DME, and AMD across Hungary, Poland, and Ukraine, and to identify implementable practices in Ukraine within the context of ongoing healthcare reforms.
Meeting the long-term health needs of Ukrainian refugees
(2023) Murphy, Adrianna; Bartovic, Jozef; Bogdanov, Sergiy; Bozorgmehr, Kayvan; Gheorgita, Stela; Habicht, Triin; Richardson, Erica; Azzopardi-Muscat, Natasha; McKee, Martin
Objectives: Since Russia's full-scale invasion of Ukraine on 24 February 2022, millions of people have fled the country. Most people have gone to the neighbouring countries of Poland, Slovakia, Hungary, Romania, and Moldova. This vulnerable population has significant healthcare needs. Among the most challenging to address will be chronic non-communicable diseases (NCDs), including mental disorders, as these require long-term, continuous care and access to medicines. Host country health systems are faced with the challenge of ensuring accessible and affordable care for NCDs and mental disorders to this population. Our objectives were to review host country health system experiences and identify priorities for research to inform sustainable health system responses to the health care needs of refugees from Ukraine. Study Design: In-person conference workshop. Methods: A workshop on this subject was held in November 2022 at the European Public Health Conference in Berlin. Results: The workshop included participants from academia and non-governmental organisations, health practitioners, and World Health Organisation regional and country offices. This short communication reports the main conclusions from the workshop. Conclusion: Addressing the challenges and research priorities identified will require international solidarity and co-operation.
Organization of ophthalmological care in Ukraine
(2023) Skrypnikova, Olena; Yurochko, Tetiana
The aim: To consider the organization of ophthalmological care in Ukraine for cataract and glaucoma and +nd out whether it is appropriate to implement advanced good practices of reference countries for Ukraine. Materials and methods: The method of desk review was used, supported by secondary analysis of data, in particular legislative acts. The research included conducting expert interviews with ophthalmologist of the public and private sectors, heads of public healthcare institutions, and management of the National Health Service of Ukraine. We also used materials on good practices from partners within the project ID 22120107 supported by Visegrád Fund. Results: Since the burden of ophthalmological pathologies is increasing and processes of reforming the health care system are taking place, changes in the organization and +nancing of ophthalmological services are taking place. Within the framework of the partner project, "Access to healthcare services in the context of +nancing mechanisms. The case of ophthalmology" identi+ed good practices in the organization of ophthalmological care in the context of improving access to services and improving quality. The results of interviews with key stakeholders led to the fact that the respondents generally support all the good practices proposed by the partner countries and indicate their arguments why the proposed practices are (not)appropriate to implement in Ukraine. Conclusions: The organization and +nancing of healthcare in Ukraine still require the study and implementation of good practices so that patients can have access to quality services and treatment.
The perception of outpatient care quality by healthcare users in Ukraine
(2024) Anufriyeva, Valentyna ; Pavlova, Milena ; Stepurko, Tetiana; Groot, Wim
Background: Ukraine has been improving the quality of health care by reforming the health care system. Evidence on healthcare users’ perceptions of quality is important for future system changes. This paper aims to analyze the aspects of quality that outpatient care users find most important. Methods: Data from a longitudinal household survey ‘Health Index. Ukraine’ in 2016–2019 were used. The survey had a sample size of over 10,000 participants per wave. Data were analyzed using descriptive statistics as well as binary regression analysis. Results: Our results showed the importance of quality attributes as ‘effectiveness of treatment’ and ‘qualification of medical personnel’ as well as changes in the perception of quality attributes connected with payment policies and general management of the facility (like working hours, setting and hygiene ensuring by medical personnel). Conclusions: Our study provides new insights into the importance of healthcare quality attributes for outpatient healthcare users in Ukraine, showing the need to develop in future a national policy on quality and a national quality strategy for health care that incorporates quality aspects important to patients to make the healthcare system more responsive to the needs and expectations of healthcare users.
Understanding of perinatal mental health and its psychosocial determinants through Ukrainian women’s experience
(2024) Gusak, Nataliia; Kendall, Sally; Nizalova, Olena
Introduction: Perinatal mental health defines new mothers, their families, and the social, emotional, and cognitive development of their children. The factors contributing to Ukrainian mothers’ mental health are not well-defined in the literature. This study aims to explore how Ukrainian women understand mental health and its psychosocial determinants through their perinatal experience. Methods: This qualitative analysis is part of a larger mixed-methods study exploring perinatal mental health in Ukraine. Five online focus groups (n=30) with Ukrainian mothers of children aged 0–5 years were conducted in June–July 2020. The participants were selected from a pool of 1634 women who completed an online questionnaire and agreed to participate in further research. Informed consent was obtained. The data collected from the focus groups were transcribed verbatim and analyzed thematically using Dedoose software. Results: The study identified two themes. The first theme was: ‘Understanding perinatal mental health through women's experience’, which covers five subthemes. The second theme was ‘Psychosocial determinants of maternal mental health’, which includes six subthemes. Overall, women's feelings of guilt, blame, and shame during their perinatal journey are influenced by socio-cultural factors and can lead to mental health problems and reluctance to seek proper help. Conclusions: The study has identified some factors that can contribute to the enhancement of mental health and well-being of mothers in Ukraine during their perinatal journey. Negative emotions such as guilt, blame, and shame can have a significant impact on their ability to seek the necessary support, and should be addressed by midwives and other healthcare professionals.
Using a chatbot as a digital tool at the primary health care level
(2024) Aleksandrenko, Hlib; Shevchenko, Maryna
Aim: To analyze the feasibility of utilizing a digital tool such as a chatbot at the primary health care level as part of a health program. Materials and Methods: With the involvement of a general practitioner and the use of a digital tool, a chatbot, a three-month health program was conducted for employees of an IT company. The chatbot was used to collect information, monitor the health status of participants and provide personalized health recommendations. To evaluate the program’s effectiveness survey was conducted to compare participants answers before and after using standardized evaluation scales. A questionnaire based on the Evaluation and Management Services Guide was created to collect medical information on the health status of participants before and after the program. Results: After the program, the average total score of participants’ health complaints and symptoms decreased (from 27.1 to 16.1, p=0.019). The average severity of the chief complaint on a scale of 0 to 10 decreased from 5.08 to 2.27, or by 55.3% (p=0.00676). The frequency of individual complaints such as eye pain, decreased concentration, increased fatigue and irritability also dropped. Conclusions: The chatbot enabled the primary care physician to respond promptly to participants’ health complaints. The results demonstrated the potential of chatbots as innovative and accessible digital tools at the primary health care level for providing recommendations, monitoring health, and contacting a primary care physician in a timely manner.

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