Translation. Region: Russian Federal
Source: United Nations – United Nations –
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September 30, 2025 Healthcare
The number of Ukrainians requiring rehabilitation after injuries, strokes, and other serious illnesses is growing, but the country's medical rehabilitation system is still failing to keep up with this demand. This is according to a new report from the World Health Organization (WHO), which calls for updated approaches to funding and planning this care.
A sharp increase in needs
The WHO reminds us that rehabilitation is not a luxury, but a vital component of medical care. Demand for it among Ukrainian residents increased due to military conflict in 2014, and has skyrocketed since the full-scale invasion. In addition to war injuries, complications from strokes and civilian injuries have been added, as well as age-related diseases due to an aging population.
Over the past five years, the state has noticeably increased investments in this sector: if in 2020 rehabilitation accounted for only 1.2 percent of the budget of the Medical Guarantees Program, then in 2025, according to estimates, it will already be 4 percent – almost 6.9 billion hryvnias (about 154 million euros).
But experts acknowledge that funding doesn't always reach those who need it most. For example, in 2024, only 1.5 percent of patients with severe stroke complications were able to continue outpatient treatment after hospital discharge.
Weaknesses
The gap between inpatient and outpatient care is a major problem. According to the WHO, only 6 percent of patients who complete hospital treatment subsequently undergo outpatient rehabilitation. The rest either abandon rehabilitation altogether or are forced to return to the hospital, even though they could be treated closer to home.
There's also a lack of community-based care—at home, through primary care centers, or through mobile teams. General practitioners cannot yet directly refer patients to a physiotherapist or speech therapist; they must first make a referral to a specialist, which isn't always necessary.
Furthermore, access to free rehabilitation is still determined solely by a formal diagnosis, not by a person's actual functional capabilities. Because of this, people with serious disabilities who haven't received a proper diagnosis may be left without assistance, and doctors are sometimes forced to use specific diagnostic codes to "circumvent" the system.
European experience
The WHO recommends that Ukraine transition to a mixed model, taking into account not only the diagnosis but also the level of functional loss using specialized scales, such as the Barthel Index. This scale is already used in the Ukrainian palliative care system and is planned for implementation in the eHealth platform by the end of 2025.
The WHO report provides examples from other countries:
Croatia uses index scores for inpatient referrals. Lithuania, with the help of schools, determines the length of treatment—from 24 to 40 days for adults—based on the severity of impairments. Estonia divides care into intensive, restorative, and supportive, and prescribes 21-day cycles for patients with severe speech, cognitive, and motor impairments.
Experts believe such models help use resources more efficiently and return people to active life more quickly.
What does WHO offer to Ukraine?
The organization advises:
Establish a patient referral system so that everyone leaving the hospital has a plan for their subsequent recovery; develop single-professional services, where a single specialist, such as a physiotherapist, can manage the entire course of treatment, which is especially useful for mild cases and outpatient care; expand community and home-based rehabilitation so that people don't waste time traveling to large hospitals; and revise tariffs: instead of fixed 14-day cycles, pay for the actual duration of treatment, adjusted for the complexity of the case.
Patients and staff
The number of clinics contracted with the National Health Service of Ukraine increased from 321 in 2021 to 555 in 2025, but only half of them provide both inpatient and outpatient services. The situation also varies by region: in the Chernihiv region, 92 percent of medical institutions provide both services, while in the Kharkiv region, only 27 percent.
The majority of the budget still goes to inpatient care – around 60 percent. Outpatient care accounts for 36–38 percent, and the remaining funds go to infant services. Meanwhile, outpatient rehabilitation spending in 2025 has increased by 41 percent compared to 2024.
The number of patients is growing: from 116,000 in 2023 to 138,000 in 2024, and the number of treatment courses is increasing from 134,000 to 171,000. Most service recipients are men (71 percent in 2024), due to military injuries: military personnel are required to undergo inpatient rehabilitation.
The system still suffers from a shortage of trained specialists – physiotherapists, occupational therapists, speech therapists – and also suffers from overlapping responsibilities between healthcare and social welfare agencies.
Investment in the future
The authors emphasize that rehabilitation is an investment in human capital. It allows people after injuries and strokes to return to work, education, and normal life, reduces long-term care costs, and improves the quality of life for families.
WHO calls on the Ukrainian government and international partners to synchronize financial and systemic reforms to ensure that rehabilitation becomes accessible and sustainable even in the context of war and limited budgets.
Please note: This information is raw content obtained directly from the source. It represents an accurate account of the source's assertions and does not necessarily reflect the position of MIL-OSI or its clients.
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