Strengthening NCD screening in Ukraine through a Public Health System Strengthening Collaborative

Abstract Cardiovascular diseases, diabetes, and cancer account for 91% of all deaths in Ukraine. However, less than 40% of the population use essential health services at the primary healthcare (PHC) level, with only 9% accessing prevention services. A 2023 Community Health Needs Assessment by Pact identified hypertension, heart disease, diabetes (34-76% of respondents), and cancer (29-75%) as major health concerns, especially in rural areas, alongside risky behaviors like tobacco use, alcohol abuse, and unhealthy diets. To address this, Pact launched the Public Health System Strengthening (PHSS) Collaborative in June 2024, uniting multidisciplinary teams from nine communities across eight regions. Using a quality improvement approach, the Collaborative aims to strengthen early detection and care for hypertension, diabetes, cancer (breast, cervical, colorectal), and mental health conditions. Key questions include: 1. What proportion of the population is at risk of NCDs? 2. How can screening rates be increased? Interventions focus on raising community awareness, boosting participation in PHC screenings, and improving access to mental health services. Systems improvements, such as better data collection, streamlined processes, and digital tools for tracking individuals with NCD risk factors, support more effective service delivery. Since October 2024, family doctors have surveyed over 25,000 residents (10% of population), identifying NCD risk factors in 80%. Nurses and mobile teams extended reach into rural areas, achieving 60%-98% coverage in targeted communities. Collaboration between medical and non-medical sectors significantly improved NCD screening and risk identification. Early detection and digital innovation are critical for shifting healthcare priorities towards prevention-focused, integrated care and reducing Ukraine's NCD burden. Key messages • The PHSS Collaborative developed practical interventions to increase NCD screening and improve linkage to care in urban and rural settings, offering adaptable solutions for different contexts. • Digital tools facilitate tracking individuals with NCD risk factors and enable timely detection and follow-up.