Description
Acknowledgments: We would like to express our gratitude to USAID for collaborating with us on the Support Tuberculosis Control Efforts in Ukraine (STBCEU) project.
Introduction – Objectives: Russia’s invasion of Ukraine resulted in a massive number of internally displaced persons (IDPs) and a major disruption in health care. According to the IOM, at the end of August 2022, nearly 16 % of Ukraine’s population (7 million people) were internally displaced. The invasion in Ukraine came at the peak of the wave of COVID-19 caused by the Omicron strain. War significantly impeded COVID-19 pandemic control. The number of new cases and vaccination history were no longer being monitored. In addition, the health system, including primary health care, screening, and immunization programs, is strained by large numbers of internally displaced persons (IDPs).
To ensure access to COVID-19 testing, vaccination, and essential health services for IDPs, PATH implemented the USAID-funded Support Tuberculosis Control Efforts in Ukraine (STBCEU) project in collaboration with regional health authorities 1) to create multidisciplinary mobile teams, and 2) to provide primary healthcare services, including COVID-19 immunization, for IDPs by conducting visits in 10 regions of Ukraine.
Methodology: Support TB Control Efforts in Ukraine (STBCEU) project responded to these war-related challenges by organizing field visits to IDP shelters and dormitories to provide COVID-19 testing, vaccination, and other health services. The project created and piloted the multidisciplinary teams (MDTs) consisting of representatives from the Regional Centers for Disease Control and Prevention, epidemiologists, primary health care providers, and infectious diseases doctors. The MDTs conducted field visits to the IDPs shelters. They implemented risk assessments, provided on-spot services, referred to the health specialists as needed, distributed information on infectious disease prevention in temporary shelters, implemented COVID-19-specific prevention measures, and conducted vaccinations.
Results and Discussions: From March 25, 2022, to February 28, 2023, MDTs conducted 419 visits, including in Poltava (161), Lviv (64), Rivne (44), Dnipro (41), Odesa (32), Vinnytsia (25), Kirovohrad (21), Zakarpattya (17), Chernivtsi (10), and Ternopil (4) regions. A total of 36,209 people received health-related information, including information on COVID-19 prevention and vaccination; 18,223 persons (50.3%) received COVID-19 vaccinations during the visits. Specific services provided during these visits depended on the region but generally included COVID-19 vaccinations, tetanus vaccinations, diphtheria vaccinations, medical examinations (blood pressure, sugar level, and other patient-specific services), and referral for further medical assistance as needed.
Conclusions: The MDTs approach significantly increased access to COVID-19 vaccination among IDPs as well as enhanced access to medical services in conditions of limited medical care. Considering the long period expected for the restoration of services in the de-occupied territories and continuously reduced access to essential services in the regions with a high proportion of IDPs, this approach could be used in the de-occupied territories (where many medical facilities have been destroyed) to ensure access to immunization and other essential services.
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