Ukraine's healthcare system has faced severe challenges due to the full-scale invasion by the Russian Federation. Many medical facilities have been destroyed, and healthcare professionals are struggling with a critical shortage of resources while needing to adapt to new realities. In these conditions, primary healthcare plays a key role as the main access point to medical services for the population.
The Enhanced Primary Care (PHC+) Model aims to expand the capabilities of primary healthcare. It strengthens the roles of family doctors and nurses while integrating rehabilitation, palliative care, emergency medical assistance, and mental health services. This approach improves the quality of medical services and ensures that patients receive the necessary care without turning to secondary or tertiary levels of healthcare.
PHC+ is a community-based health center primarily focused on the needs of the community. It is not about creating another type of healthcare facility, but about changing the way primary care is delivered in the community. It's about better coordination of patient care and higher quality and depth of contact with patients and the community. PHC+ is about changing the philosophy of PHC from sporadic healthcare delivery to “primary care” as part of the welfare infrastructure in the community.
One significant advantage of the model is the expansion of nurses' authority, allowing them to perform some of the doctors' functions within their competencies. This reduces the burden on the healthcare system. While changes at the policy level are needed to formalize this role, many communities can already begin implementing this transformation within their teams under current regulations.
For medical institutions, adopting the PHC+ model leads to better resource optimization, improved interaction between different levels of care, and a more resilient healthcare system. A crucial component is coordination between healthcare professionals, social services, and local communities to provide a comprehensive approach to public health.
Primary care aims to effectively address as many of the patient's problems as possible, specifically within the community. To do this, the PHC+ model significantly expands the medical functions of the practice: from 24/7 emergency care to mental health services, rehabilitation, palliative care, ultrasound, and more.
The document provides detailed recommendations for implementing the PHC+ model in Ukraine. It will be helpful for medical institutions, local governments, and community organizations seeking to integrate modern healthcare standards.
The model will help restore medical services in war-affected communities and contribute to developing rural and small-town healthcare facilities. If specific legal and organizational barriers are overcome, full-scale implementation of the model is possible by 2030. However, many of its elements can already be introduced now.
In 2025, the UHC team will conduct a series of public discussions with stakeholders on PHC+ implementation models to provide more detailed recommendations for policymakers and local authorities.
The document, prepared by the CF “Patients of Ukraine” in partnership with the Ukrainian Healthсare Center (UHC), was realised through the project “Strengthening the Capacity of Health Care Institutions in Communities of Priority Regions in the Context of Military Aggression by the Russian Federation” with the support of the project “EU4ResilientRegions — Special Assistance Programme Ukraine.” This project is co-financed by the European Union and the German Federal Ministry for Economic Cooperation and Development (BMZ) and is implemented by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH.