Ukraine:Palliative care development Brasov, Romania October 25-28, 2011 Украина: Развитие паллиативной помощи Брашов, Румыния октября 2011 года

Demography: - Population: 45 mln persons - Life expectancy: men 62 years, women 74 years - 25% of population are up 60-years old

Mortality per year: about 560,000 deaths Oncologic diseases mortality: 100,000 deaths per year, new cases:180,000 per year Cardiovascular system diseases – 450,000 deaths per year HIV/AIDS mortality per year in : 2,500-2,800 deaths TB mortality per year :10,000 deaths

Palliative care system? NO national PC Program Around the country – about 15 Hospices and 2 pilot home care projects, about 30 palliative care units Models of palliative care services: In patients units Out patients groups – policlinics NO official statistic of palliative care patients\units\hospices 10% of cancer and 5% of non-cancer patients receive PC in 2009 the MoH of Ukraine issued an order on assigning out-of-staff regional specialists; by this moment, despite official addresses of IPCI/IRF to MoH, the Chief out- of-staff specialist on palliative care issues in Ukraine has not been assigned; During 2010 in country were three Ministers of health changed; during 2011 – two

Palliative care trainings In 2008 the Institute of Palliative and Hospice Medicine of the Ministry of Healthcare of Ukraine was established; In 2009 three training courses for enhancement of professional level in palliative care for the Training and Methodology Geriatric Center at the National Medical Academy of Post-Graduate Education were adopted; Since January 2010 the Chair of Palliative and Hospice Medicine of the National Academy of Post-Graduate Education has started to operate. In 2008: the first three-week training course in Ukraine for doctors and nurses on basics of palliative care provision In EPEC-O manual on end-of-life care for patients and oncology issues was translated and adapted In 2010: the second two-week training course for doctors on basics of palliative care In 2011: first one-week training course for nurses on basics of palliative care with ELNEC team Support training center in Ivano-Frankivsk

Problems: 1. NO oral morphine 2. NO pain relief access for patients at home and dose limitation for inj morphine 3. NO palliative care national plan 4. NO educational system for palliative care profetionals and nonmedical staff 5. NO funds for support of hospices and staff 6. “Constant” reform of health care system Preference: 1. Support of strong PC Assosiation 2. Chance to change drug regulation for medical use 3. Support of local initiatives for palliative care development 4. Support of UKR training centre in Ivano-Frankivsk 5. Potentional sooperation with Public-Private partnership