Institute for Research in International Assistance (IRIA)

“Strengthening the health system in Ukraine by promoting health sciences and effective bilateral COLLABORATION”

This project on behalf of the Federal Ministry of Health aims at supporting health care in Ukraine by promoting health sciences. A reform of the health care system in Ukraine has been on the agenda since independence of the country and beginning efforts to overcome the post-Soviet Semashko system. The health care system has to face the health challenges of the 21^st century. The average life expectancy of Ukrainians is 71.3 years, ten years less than in the countries of Central and Western Europe. Among the deaths due to tuberculosis, Ukraine is at the sad top in Europe. Resistant tuberculosis strains are spreading in Ukraine (WHO Tuberculosis surveillance and monitoring report in Europe 2019). The conflict in the east fuels the epidemic, aggravated by a simultaneous spread of HIV. The biggest challenge for the Ukrainian health care system is the country's hybrid epidemiological profile: most people are dying from noncommunicable diseases; however, the infectious diseases are still not treated adequately.

Our approach: Reasoning for sustainable personal and scientific relationships, carrying out basic analyzes of the health care system and the conflict situation in Ukraine, as well as establishing partnerships with Ukrainian universities to contribute to medical education and training. We started from established university partnerships such as Ternopil and at the same time incorporated the capital city of Kiev. The work in the subprojects is accompanied and complemented by scientific exchange, also in a series of events coordinated by IRIA.

The IRIA "German-Ukrainian Partner Project" is implemented in four subprojects:

• Subproject 1: Health System Analysis & Conflict Analysis
• Subproject 2: Joint Master Program Public Health
• Subproject 3: Scientific Partner Projects in Health Sciences
• Subproject 4: International Working Group with the Ukrainian Ministry of Health

“How to help a country that, according to the United Nations, is experiencing the world's most serious humanitarian crisis but not allows to enter because of the threatening security situation?"

The German Society for International Cooperation (GIZ) and the Akkon University of Human Sciences with its Institute for Research in International Assistance (IRIA) are working together to improve health care in Yemen on a sustainable basis.

A civil war has been raging in Yemen since 2015.

The consequences of this war are dramatic: most of the country's infrastructure has been destroyed. The health system has been particularly affected. Less than half of the health care facilities are still in operation. More than three million people are internally displaced. The child rights organisation Save the Children reports that 85,000 children have starved to death in Yemen since 2015. The United Nations estimates that 14 million people do not have enough to eat. Around two million children are considered to be at acute risk of starvation. 

War injuries and epidemics (diphtheria, cholera, measles) increase the need. Three quarters of the Yemeni population are dependent on humanitarian aid. Every ten minutes a child dies here from malnutrition, disease or the direct effects of war. Many diseases could have been avoided with better essential, qualitatively necessary medical care. 

According to WHO estimates, more than 16 million inhabitants have neither access to health care nor to appropriate medication. There is a lack of access to clean water, sanitation and adequate hygiene. Only half of the hospitals are still functioning. Even these facilities can only function to a limited extent due to a lack of staff, equipment and medicines. 

The German Federal Ministry for Economic Cooperation and Development (BMZ) doubled its support for Yemen in 2019 to 136 million Euro (2018: 62.5 million Euro). This is primarily intended to improve health care and water and sanitation services.

GIZ has been active in Yemen on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ) since 1969 and has had its own office in the capital Sana'a since 1983.  Due to the security situation, there are currently no German personnel on site. More than 129 Yemeni GIZ employees are continuing many projects.

As early as 2005, GIZ developed a quality assurance procedure for the health authorities in Yemen for the first level of health care, which needs to be further developed to meet the more stringent conditions of current challenges. This project is financed by BMZ and implemented by GIZ together with Akkon/IRIA and the German-Yemeni Medical Association (DJAEV).

The aim of this three-year project is to ensure qualitatively adapted essential medical care at the first level of care and in reference hospitals in Yemen, despite of war and resulting bottlenecks. Beyond quality assurance procedures and continuous quality improvement, practice-tested instruments for quality assurance in the health care system are to be developed for the first level of care, reference hospitals and regional health authorities, as well as to develop key groups and groups of health care professionals. In addition to that the staff of certain institutions and professional groups shall be effectively trained in medical-technical procedures in order to enable them to independently develop, apply and maintain the health-protecting "standard operating procedures" in the health care facilities. 

Please note: For safety reasons, this can only be done from outside. This Yemen project is humanitarian aid and technical cooperation in remote mode!