Before initiating work on strengthening rehabilitation in communities across Kyiv and Chernihiv regions, we conducted a comprehensive assessment of the rehabilitation ecosystem in these areas.
We evaluated the accessibility of rehabilitation services at different levels of the system—from specialized hospitals to the community level—and identified key barriers that hinder access to these services. The findings were then used to support the development of rehabilitation, from inpatient care to community-based services.
So, what are the key barriers to accessing rehabilitation and related services that we identified?
The analysis showed that despite the gradual development of rehabilitation services, access to them remains uneven.
In particular:
— Underdevelopment of community-based rehabilitation: the share of patients receiving outpatient rehabilitation remains very low. In Chernihiv region, only 3.91% of patients received rehabilitation services (as of 2024), and only 45.14% of them received it on an outpatient basis. In Kyiv region, these figures were 2.67% and 60.30%, respectively;
— Logistical and transportation barriers: a significant proportion of patients undergo rehabilitation in inpatient settings due to the distance to outpatient services. 38.5% of surveyed inpatients in Chernihiv region, 50% in Kyiv region, and 57.2% in Kyiv city could care for themselves independently but chose inpatient care due to transport and logistical challenges;
— Delayed initiation of rehabilitation: according to the analysis, rehabilitation did not begin in the acute phase for most surveyed patients—57% in Kyiv region and 60% in Kyiv city. In Chernihiv region, none of the respondents reported starting rehabilitation on time;
— Lack of training opportunities for rehabilitation and prosthetics professionals: 92.3% of specialists in Chernihiv region and 90% in Kyiv region have to pay for their own professional training, indicating the need to strengthen workforce support;
— Limited access to assistive and rehabilitation devices: patients are not always able to receive prosthetic and orthotic devices in a timely manner and according to their individual needs. In Chernihiv region, 44% of respondents either purchased them at their own expense or received them from charitable organizations. In Kyiv region, this figure was 50%, and in Kyiv city—90%;
— Insufficient intersectoral coordination: cooperation between health, social protection, and education departments at the community level requires further development to ensure a comprehensive rehabilitation pathway for patients.
This list is not exhaustive. The study also identified barriers in patient referral and care pathways, awareness of available rehabilitation services, limited coverage of children at risk of disability due to the lack of follow-up (catamnestic) monitoring, and access to services related to rehabilitation (educational, social, etc.). More details on these and the previously mentioned barriers can be found in the full study.
The study findings formed the basis for further development of the rehabilitation system in Kyiv and Chernihiv regions.
Rehabilitation Report on Chernihiv and Kyiv Regions_EN_V3
In particular:
— expanding the network of rehabilitation services at the community level;
— improving patient referral and care pathways;
— strengthening workforce capacity;
— enhancing intersectoral coordination.
This approach—implementing solutions based on research findings—ensures more effective work in communities, as it is grounded in real needs.
The study was conducted as part of the project “Pathway in Rehabilitation: From Region to Community”, implemented by the Patients of Ukraine Charitable Foundation within the initiative “TRUE – Trauma Rehabilitation for Ukraine”, in partnership with the Prosthesis Hub Charitable Foundation, and with the support of the Belgian development agency Enabel.
