A new monitoring tool, developed by WHO and the Public Health Center of Ukraine (UPHC), is revealing how the different regions in Ukraine responded to COVID-19. Launched in October 2020, the Public Health Response Monitor (PHRM) was developed based on a regional tool, WHO/Europe’s Health System Response Monitor (HSRM).

The PHRM allows Ukraine to systematically monitor the policies and epidemiological situation across the different regions of the country. Using the findings, national and regional authorities can adjust the country’s COVID-19 response.

“We welcome tools that facilitate coordination and help us to respond effectively to the virus,” said Ukraine’s Deputy Minister of Health, Viktor Liashko, who added, “We are discovering the opportunities of regional monitoring, which we will consider integrating into the daily work of emergency coordination centres to support our public health response”.

Providing insights into new outbreaks

Several rounds of data collection began in the regions in May 2020. The WHO Representative in Ukraine, Dr Jarno Habicht, highlights the importance of this information in helping national and regional authorities to coordinate health-related interventions, policies and messages to support Ukraine’s COVID-19 response.

“The tool could also be a useful resource to help investigate a new outbreak in a given region,” he adds, “illustrating, for instance, how relaxing public health measures and allowing people to congregate, results in high infection rates in subsequent weeks”.

Emergency coordination centres at the Ministry of Health and the UPHC can also use the tool to compare governance and financing arrangements by region, and see whether these differ from national standards and policies.

Reflecting capacity and leadership

The PHRM consists of a questionnaire with six blocks of questions covering areas including regional management and coordination, funding, planning of services, case management and supporting essential health services during the pandemic. Public health data is supplemented with data on the epidemiological situation in each specific region.

The findings so far show a considerable variation in the implementation of COVID-19 measures in the regions of Ukraine, reflecting regional capacity and leadership. The next step will be a detailed study of the measures taken by the regional authorities in critical areas, such as school reopening and ensuring access to basic medical services.

The tool facilitates in-depth analysis of public health information alongside epidemiological data. It builds on a joint initiative between WHO/Europe, the European Commission, the European Observatory on Health Systems and Policies and the HSRM.

In collaboration with Uppsala University, WHO/Europe has published new technical guidance that outlines why and how Member States should collect refugee and migrant-specific health data through their national health information systems (HIS).

As a result of increased mobility, societies have become more diverse – as have their health needs. The principle of leaving no one behind in the Sustainable Development Goals (SDGs) and the advancement towards universal health coverage, one of the European Programme of Work’s core priorities, promote the inclusion of refugees and migrants in public health goals.

Progress towards these goals cannot be measured without systematically collected data on both health and health-related indicators for refugees and migrants.

Inclusion of core variables promotes effective public health programmes targeting refugees and migrants

The new publication suggests integrating a set of core variables into HIS, which will facilitate disaggregation of data by migratory status, offering insights into the health status of refugees and migrants, which can then be translated into evidence-informed policies. These core variables include:

• country of birth
• country of citizenship
• year and month of arrival
• country of birth of both parents.

The publication is an important example of WHO/Europe collaborating closely with partners including the International Organization for Migration (IOM) Global Migration Data Analysis Centre, the United Nations High Commissioner for Refugees (UNHCR), the European Centre for Disease Prevention and Control (ECDC) and members of academia, to develop evidence-based documents that can guide Member States’ efforts to ensure the right to health for all.

Statement by Eva Åkesson, Vice-Chancellor of Uppsala University

“The International Maternal and Child Health (IMCH) Unit of the Department of Women’s and Children’s Health at Uppsala University, is a leading research and education division committed to disseminating knowledge that can contribute to creating a more just and equitable society. Translating knowledge into strategies and practical action for global health and migration is one of IMCH’s goals.

“Recently, IMCH has been working with WHO/Europe to promote the health and well-being of refugees and migrants. The latest output of the current collaboration is the development of the ‘Collection and integration of data on refugee and migrant health in the WHO European Region. Technical guidance’.

“Reliable and good quality data is essential to reduce health inequality among all, including refugees and migrants, and to achieve the SDGs. Consistent data is needed to ensure policies are sound and that operational and legislative responses effectively reach those they are intended to help. The publication aims to assist decision-makers in developing evidence-informed policies and actions to ‘leave no one behind’.

“The technical guidance highlights the current status quo and offers practical solutions to address the gaps related to migration health data and HIS in the European Region. It provides practical guidance to integrate migration health data into national HIS, which present a valuable mechanism and offer information to develop targeted health interventions not only for refugees and migrants, but for the entire population, including other vulnerable groups.

“Uppsala University is honoured to support WHO/Europe in its efforts to safeguard and promote the health of refugees and migrants.”