One Step From the Second Wave of COVID-19 Epidemic: What Bothers Ukrainians About the Healthcare System (July 2020)

August 20, 2020

The survey was conducted by the Ilko Kucheriv Democratic Initiatives Foundation in cooperation with the Razumkov Center sociological service from July 3 to 9, 2020, via face-to-face interviews at the respondents’ place of residence. 2022 respondents aged over 18 y.o. were interviewed in all regions of Ukraine, except for Crimea and the occupied territories of Donetsk and Luhansk oblasts, based on a sample representative of the adult population according to the key socio-demographic indicators. The theoretical sampling error (excluding the design effect) does not exceed 2.3% with a probability of 0.95.

The survey was funded within the MATRA project of the Embassy of the Kingdom of the Netherlands.

  • 92% of polled citizens stressed that they have never been infected by the coronavirus. At the same time, 5% stated that they or their relatives were exposed to   COVID-19, and 3% could not answer.According to the regional data, residents of the Western (8.6%) and Central (5.4%) oblasts were more likely to report that they were infected than residents of the Southern (2.4%) and Eastern (2.7%) regions. In terms of age, Ukrainians over the age of 50 were more likely to express the opinion that they or their relatives had contracted the disease than members of other age groups.
  • 35% of Ukrainians believe that doctors and health workers have made the greatest efforts in combating the COVID-19 pandemic. The second place is shared by local (21%) and central government (19%). Volunteers and public organizations hold a third place (17%). The citizens’ own contribution was noted by 14% of respondents. For comparison, only 2% of polled Ukrainians named the large enterprises as the biggest contributors in fighting the COVID-19 pandemic. Local branches of political parties were mentioned by less than 1% of respondents. 15% of citizens believe that no one has made significant efforts to curb the coronavirus epidemic. In the regional context, the efforts of medical workers were rated relatively higher in the Southern (41%) and Western (39%) regions. Also, the Southern oblasts have the highest share of those, who noted the contribution of local authorities (31%); the role of the President and the Government got the best score in the Western (24%) and Central (22%) oblasts; the work of volunteers and public organizations was evenly mentioned in all macro-regions except Eastern Ukraine. It is noteworthy that the Eastern oblasts have the highest share (25%) of those who deny anyone’s contribution in containing the spread of coronavirus.
  • Most Ukrainians (51%) believe that the Ministry of Health bears the ultimate responsibility for the quality of healthcare and the preparation of medical facilities for the pandemic; 17% believe that the President of Ukraine should be responsible for these processes – that is two times higher than the share of those who assign responsibility to the Government. It is noteworthy that respondents in the Western and Central macro-regions are more likely to consider the President responsible for anti-pandemic activities.
  • Public opinion on the structure and severity of the problems in the healthcare system has hardly changed since the previous survey (June 2019). 41% of Ukrainians identify the increase in the prices for necessary medical supplies and drugs as the biggest problem. The second most important problem is the lack of qualified medical aid during the illness; it remains relevant for 27% of respondents.The third place was shared by three problems at once: 20% of citizens stated that they could pass the necessary tests or undergo the prescribed diagnosis only for money; 19% noted that making an appointment with a doctor or obtaining a medical certificate has become even more difficult and confusing, and 19% complained about deteriorating situation with prompt and high-quality emergency care. It should be noted thatthe sensitivity of the drug pricing issue increases with the age of respondents.
  • At the same time, the ability to choose a physician or family doctor remains in the first place among the positive changes that people have experienced over the last 12 months. It was reported by 39% of respondents (46% in 2019). However, the share of those who noted a reduction in the time needed to receive emergency care decreased from 8% in 2019 to 5% in 2020. The frequency of mentioning other positive changes in health care has not changed over the last year: the ability to take free tests and to pass the necessary diagnostics — 14% (13.5% in 2019), the opportunity to receive free medication — 13.5% (15.4% in 2019) simplification of appointment system and obtaining the necessary medical certificates — 12% (15% in 2019).
  • The Western regions have the highest share of those who noted the opportunity to choose a trustworthy doctor (52%). In the Eastern oblasts, demonstrated relatively better situation with free diagnostics and free medication provision (18% and 16%, respectively).
  • According to citizens, the priority measures for health care reform should be:
    — reduction in the cost of medicines — 50% (in 2019, 59% of Ukrainians thought so);
    — establishing the responsibility of doctors for the health of patients and the results of treatment — 30% (34% in 2019);
    — providing hospitals and clinics with high-quality, up-to-date equipment for treatment and diagnostics — 29% (31% in 2019);
    — providing emergency care facilities in all settlements with necessary equipment and resources — 29% (38% in 2019);
    — increase in the number of professional physicians and family doctors — 28.5% (30% in 2019).
  • Compared to 2019, Ukrainians began to pay less attention to such issues of health care reform as:
    — cessation of the practice of “voluntary” extortion in hospitals, clinics and maternity hospitals — in 2019, this issue was considered as a priority for 30% of respondents, and now only 20% pay attention to it;
    — providing mandatory, free and high-quality vaccination for all those who need it — 15% (23% in 2019);
    — increasing control over the quality of medical education — 17% (25% in 2019);
    — setting transparent and affordable prices for medical services in hospitals 17% (24% in 2019);
    — improving salaries for doctors and medical staff — 13% (21% in 2019);
    — fight against corruption and mutual cover-up among the heads of medical institutions — 12% (21% in 2019); — countering the spread of counterfeit drugs — 10% (21% in 2019);
  • At the same time, the survey demonstrates regional differences regarding the importance of certain priority measures:
    — In the Southern regions, citizens more often demanded to cease the practice of “voluntary” extortion in hospitals, clinics, and maternity hospitals as well as to introduce the responsibility of doctors for the health of patients and the results of treatment. It is noteworthy that in the South of Ukraine (as well as in the West) there are also more people who share the opinion that there is no need to pay extra to doctors in order to guarantee the quality of care in the future.
    — in the Western and Eastern regions, respondents express the need to provide hospitals and clinics with high-quality, up-to-date equipment for treatment and diagnosis;
    — In the Central regions, the demand for increasing the number of professional physicians and family doctors is considered a priority.
  • Responding to the question “How much money did your family spend on medication and treatment on average per month during the last year?”, 13% of respondents stated that they did not spend anything at all, 15% — spent up to UAH 200 per month, 24% — gave from UAH 200 to UAH 500 for medication, 19% — paid from UAH 500 to UAH 1,000, 7% — spent from UAH 1,000 to UAH 2,000, and almost 9% — gave over UAH 2,000 per month for medicines and treatment. The survey showed that medicine expenses grow with the age of respondents.
  •  More than a third of respondents (35%) confirmed that in the last 12 months, they had to pay extra for a doctor’s appointment or medical procedure. 39% did not apply for such services, 23% did not pay extra, and 3% did not answer questions.
  •  70% of citizens are convinced that there is no need to pay extra to doctors in order to guarantee the quality of medical care in the future. However, 19% believe that it is worth paying extra, and another 11% could not answer. At the same time, in the West and south of the country, 77% of respondents do not see the need for additional payment. Most of those who share the opinion that doctors should pay extra are residents of the Eastern regions (27%).
  • Answering the question “Which of the following persons defends the interests of citizens in the process of reforming the health care system?”, 19% of citizens named the incumbent Minister Maxim Stepanov, 16% — President of Ukraine Volodymyr Zelensky, 15% — doctor and blogger Eugene Komarovsky, 14% — Chief Sanitary Doctor Viktor Lyashko. Former Minister Ulyana Suprun was supported by 6%, and the Head of the Health Committee Mykhailo Radutsky — by 3%. 35% of citizens believe that none of these people defends their interests. Most skeptics live in the Southern (40.5%) and Eastern (44%) regions. Most of Komarovsky’s and Suprun’s sympathizers live in the West of the country, while women trust Komarovsky more often than men. The President is more trusted as a defender of interests in the western and central regions and among the youngest age group (18–29 years).