More than 600 thousand terminally ill patients require palliative care in Ukraine annually. These are mostly cancer patients, elderly people, people living with HIV / AIDS, those who have diabetes, tuberculosis and other terminal illnesses.
By the standards of the World Health Organization (WHO), minimum 1000 beds are required for palliative patients per million. According to expert data, at the beginning of 2013 there were only 10 hospices and 15 specialized palliative care units in Ukraine with a total number of about 850 beds for palliative care patients with minimal need for 4,500.
Moreover, Ukraine has actually no extensive system of care for terminally ill patients at home, although, according to the Ministry of Health data, the majority of palliative patients die at home.
Besides, hospice and palliative care units are limited in resources and are not able to provide patients with sufficient medical equipment, effectual analgesics, mattresses for preventing pressures sores and other medical supplies. Unfortunately, because of lack of material and technical basis, many existing hospice and palliative care units do not meet international standards and conditions of patients in these institutions are not always satisfactory, which can be regarded as a violation of patients’ rights.
Ukraine has satisfied the need for only a small part of in and out palliative patient. As the result, hundreds of thousands of terminally ill patients with cancer and many other chronic incurable diseases, who require palliative and hospice care, are dying at home alone, suffering from pain, depression, and other symptoms, lacking sufficient analgesia, professional care, social and psychological support.
Implementation and development of palliative care services in Ukraine are impossible without creating an appropriate legal and regulatory framework governing the various areas of the medico-social care, including adequate pain relief, availability of hospice services and mobile palliative care teams, human resource development, etc.
Palliative care is governed by state programmes and is an important component of the health care system in developed countries. Ukrainian state programme of palliative care, developed in 2008, is still invalidated and not funded. The system of financing, establishment and functioning of palliative care units is not regulated by any document or order of the Ministry of Health or the Government of Ukraine.
Another urgent issue is to develop training system for those specialists involved in providing of palliative and hospice care. There is a lack of specialists with appropriate professional training in palliative care, lack of medicines, equipment, etc., not to mention inadequate sanitary conditions because of lack of relevant standards and regulations. Medical universities introduced recently the programme for under and postgraduate training for doctors and nurses on palliative care, although social workers, psychologists, chaplains and volunteers lack of appropriate education.