Integrating MHPSS and GBV response into primary healthcare during war: lessons from Ukraine

Abstract The war in Ukraine has created an urgent need for integrated health and psychosocial support services, particularly for survivors of gender-based violence (GBV) and conflict-related trauma. HealthRight International, in partnership with national and local authorities and with the support of FHI 360, developed a scalable model - Gender-Based Violence Response and Care Units (GBV RCUs) to deliver holistic GBV, mental health, and psychosocial support (MHPSS) services integrated into primary healthcare in Eastern and Southern Ukraine. Between September 2022 and January 2025, 10 GBV RCUs were established within Primary Health Care Centers across Kharkiv, Odesa, Dnipro, Mykolaiv, and Zaporizhzhia. Each RCU is staffed by multidisciplinary teams, including coordinators, psychologists, child psychologists, social workers, and lawyers, providing services onsite, through outreach, and online. Services include psychosocial crisis support, emergency psychological assistance, case management, medical counseling, legal aid, and referrals to specialized services. Capacity-building activities were conducted in collaboration with the Ministry of Health and the National MHPSS Coordination Council, including webinars and trainings for healthcare workers on mhGAP, Clinical Management of Rape, and the WHO Self-Help Plus (SH+) intervention. SH+ was adapted for conflict-affected populations, with over 75 specialists trained, resulting in improved coping skills and stress management among participants. Since the project launch, over 154,000 clients have received assistance, and more than 365,000 GBV and MHPSS services have been delivered. Outreach services reached nearly 50,000 individuals. More than 700 healthcare providers were trained, with over 90% reporting improved competencies. The model was recognized as a best national practice and presented at national mental health forums organized under the patronage of Ukraine's First Lady as part of the ‘How are you?’ initiative. Key messages • Integrating gender-based violence (GBV) response and mental health and psychosocial support (MHPSS) into primary healthcare services is essential to address complex humanitarian needs during conflict. • The model demonstrates that embedding GBV and MHPSS services at the primary care level can strengthen community resilience and improve health system responses in war-affected settings.