Ukraine

Ukraine is a country in eastern Europe with a population of about 42,5 million people and an area of 603,628 km2 – making it the largest country in Europe. In recent years, important health reforms have been approved by Parliament. These reforms are being implemented at great speed and promise to deliver on much-needed changes such as altering the financing incentives in primary health care, introducing a National Health Service (NHS), e-Health and making hospitals autonomous (2019). Moreover, the Ukrainian government has shown great interest in working with the Netherlands because of the Dutch position as a top performer in healthcare. On top of that, Ukraine is receiving financial support from various international organisations to improve its healthcare systems like the World Bank, the WHO, USAID, and the European Union. This provides opportunities for Dutch companies, knowledge institutes and NGOs active in healthcare.

Key indicators

In late 2017, official reforms were passed to transform the Ukrainian health care system in a system that delivers patient-oriented health care. There has been a stable growth in health expenditure since the last 5 years. Allocation of funds chaned and payments were done on the basis of healthcare output with a case-based, global budet. The idea is that money follows the patient. Family doctors were introduced in the system and primary care, palliative care, and emergency medical care are 100% funded by the state. Public hospitals became autonomous and private providers were included in the system. In 2021, the new healthcare system became fully operational. Alongside with these tranformations, there exists a pressure towards increased efficiency in health care institutions. Managerial capacity needs to be enhanced and network optimisation needs to be implemented. Besides, there is looked with increasingly interest towards digital solutions and telemedicine.

From the perspective of the Netherlands the following market trends in Ukraine are of interest:

Trade

Priority services in Ukraine that have high prices but only a limted supply in the country include:

  • Cancer diagnostics
  • Rehabilitation
  • Palliative and end of life care
  • Stroke treatment
  • Mental health

Regional priorities

Local authorithies are important new players in the transited Ukrainian health system. They are the responsible entities for hospital (re)construction, capital investment, PPP equipment, consulting, digital solutions and hospital management. There are differences between level of development and innovativeness between regions and cities in Ukraine. Kiev, Lviv, Poltava and Vinnytsia.

In the eastern war affected regions of the country, the health care system is in need of different solutions than that in the urban areas.

Most prominent NL valuechains

1. Value Chain Accessible medical technology for sustainable health and care: Dutch organizations that produce, assemble and deliver medical devices, supplies and/or supply packages (medical kits) for diagnostics, treatments and/or rehabilitation, either high-tech or specifically designed or tailored for low resources settings (point of care).

2. Value chain Care Infrastructure: Dutch organizations that are able to develop and execute turn-key hospital and clinic projects that include project finance, build, equipment, train and operate.

3. Value Chain Public Health/Strengthening health(care) systems: Dutch organizations that have expertise and solutions for Primary & Community-level models & interventions, Health system data management (digital platforms for data collection, assimilation, interpretation), Health Policy, Financing/Payments, Monitoring & Evaluation, Procurement & Supply Chain Management, and Training & Education (vocational, university, postdoc, including research education.

Overview milestones & flagships

  • G2G (MoU, state visits)
  • Trade
  • Innovate (joint R&D projects, specific bilateral calls)
  • Invest (significant investments in the Dutch LSH sector)

Collective Trade Activities to Ukraine

2018

  • Incoming High-level delegation to World of Health Care / Health Holland Visitors Progamme

2019

  • Incoming High-level delegation to World of Health Care / Health Holland Visitors Progamme

2020

  • Healthcare Mission to Kiev (feb, 2020)

2021

  • Health~Holland Digital Meet-up Ukraine
  • Visiting Ukrainian delegation to the Netherlands (dec 2021)

The way forward

During the validation session with Dutch SMEs active in the Life Sciences & Health sector doing business or wanting to do business in Ukraine, matchmaking, trade missions and collaboration between Dutch companies came out as the types of support that were most relevant to Dutch SMEs. Besides, market reports and funding opportunities were mentioned as relevant types of support. Suggestions for other activities were educational visits with Ukraine Key Opinion Leaders and a new mission to refresh contacts.

The structural barriers that participants experienced were predominantly related to language and culture differences. Besides, barriers finding good distributor was a barrier, as well as the experience of unfair business practices. Some companies experienced problems with laws and regulation, the ability to reach key decision makers and complex product registrations.

(Preferred) actions

Expertise/Capacity/Finance

Healthcare Mission to Kyiv & Poltava