Lynn Lieberman Lawry, Jessica Korona-Bailey, Tiffany E Hamm, John Maddox, Miranda Janvrin, Luke Juman, Oleh Berezyuk, George Smolinski, William Brim, Tracey Perez Koehlmoos
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Abstract
Background: Ukraine's Ministry of Health formally recognized rehabilitation as an essential component of universal health coverage in 2020. However, services remain fragmented and under-resourced, particularly following the full-scale invasion by the Russian Federation in February 2022. Widespread injuries due to trench warfare, drones, and large-scale ground combat have placed unprecedented strain on the Ukrainian trauma and rehabilitation systems, which continue to lack a cohesive national strategy. This study aimed to (1) assess the trauma and rehabilitation system in Ukraine during the ongoing conflict; (2) identify current needs, gaps, and opportunities for strengthening rehabilitation services; and (3) inform national and international stakeholders-including the United States and NATO-about urgent priorities to support Ukraine's rehabilitation infrastructure, reintegration pathways, and gender-sensitive care delivery.
Methods: We conducted 36 qualitative key informant interviews across all NATO levels of care using an adapted Global Trauma System Evaluation Tool. Thematic analysis focused on rehabilitation-related domains.
Results: Respondents highlighted shortages in staff, equipment, and mental health integration. Rehabilitation remains unevenly implemented, with better access for military versus civilian patients. Care for survivors of conflict-related sexual violence and support for women's equitable access were consistently cited gaps.
Conclusions: Ukraine's growing burden of war-related injuries necessitates urgent investment in a coordinated national rehabilitation strategy. Priorities include workforce development, equipment supply, mental health integration, and inclusive care models that address the needs of women and conflict related sexual violence survivors. Evidence-based rehabilitation, supported by validated training for clinicians, is essential for long-term recovery, societal reintegration, and national resilience.
期刊介绍：
Journal of Health, Population and Nutrition brings together research on all aspects of issues related to population, nutrition and health. The journal publishes articles across a broad range of topics including global health, maternal and child health, nutrition, common illnesses and determinants of population health.
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