Chervynskyy I. S., Kondratiuk N. Yu.

ACCESSIBILITY OF PRIMARY HEALTH CARE AND PREVALENCE OF MENTAL DISORDERS IN THE CONTEXT OF MARTIAL LAW IN UKRAINE: MULTIREGRESSIVE ANALYSIS OF THE SURVEY

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About the author:

Chervynskyy I. S., Kondratiuk N. Yu.

Heading:

SOCIAL MEDICINE, ECONOMY AND HEALTH CARE ORGANIZATION

Type of article:

Scientific article

Annotation:

Russia's full-scale invasion of Ukraine (February 2022) caused a profound transformation of the healthcare system: mass displacement of the population, destruction of medical infrastructure, and an unprecedented rise in mental disorders. The aim is comprehensive assessment of the accessibility of primary medical care (PMC) and the mental health of patients through the lens of physicians from 22 oblasts and the city of Kyiv, using multiregression analysis. Cross-sectional survey of 300 primary care physicians was conducted. Methods used: descriptive statistics, Pearson's χ²-test, Mann–Whitney U-test, Kruskal–Wallis H-test, Spearman's correlation, two OLS regressions, or dered and binary logistic regressions. 56.3% of physicians reported an increase in patient numbers; 72.3% regularly encounter mental health complaints (depression 42.7%, sleep disorders 42.3%, anxiety 39.7%). The proportion of internally displaced persons (IDPs) is the only statistically significant predictor of the number of accessibility barriers (β=0.024; 95% CI [0.010; 0.038]; p=0.001; R²=0.090). Only 25.3% of physicians are fully familiar with mhGAP. Mental disorders have acquired the features of a systemic crisis at the level of primary medical care. The high proportion of IDPs constitutes an independent structural barrier to healthcare access, while the deficit in physician competencies requires systemic intervention.

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Bibliography:

1. United Nations High Commissioner for Refugees. Ukraine Refugee Situation. Geneva: United Nations High Commissioner for Refugees; 2025. Available from: https://data.unhcr.org/en/situations/ukraine.
2. Ministerstvo okhorony zdorovya Ukrayiny. Shchorichnyi zvit pro stan zdorovia naselennia Ukrainy ta epidemichnu sytuatsiiu za 2023 rik. Kyyiv: MOZ Ukrainy; 2024. 78 s. Dostupno: https://moz.gov.ua/storage/uploads/ 386da5b2-66ed-4e85-932c-d9828ba76a7a/%D0%A 9%D0%BE%D1%80% D1%96%D1%87%D0%BD%D0%B8%D0%B9-%D0%B7%D0%B2%D1 %96%D1%82-%D0%B7%D0%B0-2023 %D1%80%D1%96%D0%BA.pdf. [in Ukrainian].
3. Dale E, Novak J, Dmytriiev D, Demeshko O, Habicht J. Resilience of primary health care in Ukraine: challenges of the pandemic and war. Health Syst Reform. 2024;10(1):2352885. DOI: 10.1080/23288604.2024.2352885.
4. Charlson F, van Ommeren M, Flaxman A, Cornett J, Whiteford H, Saxena S. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet. 2019;394(10194):240-248. DOI: 10.1016/S0140-6736(19)30934-1.
5. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537-549. DOI: 10.1001/jama.2009.1132.
6. Hyland P, Vallières F, Shevlin M, Karatzias T, Ben-Ezra M, McElroy E, et al. Psychological consequences of war in Ukraine: assessing changes in mental health among Ukrainian parents. Psychol Med. 2023;53(15):7466-7468. DOI: 10.1017/S0033291723000818.
7. Ben-Ezra M, Goodwin R, Leshem E, Hamama-Raz Y. PTSD symptoms among civilians being displaced inside and outside the Ukraine during the 2022 Russian invasion. Psychiatry Res. 2023;320:115011. DOI: 10.1016/j.psychres.2022.115011.
8. Silove D, Ventevogel P, Rees S. The contemporary refugee crisis: an overview of mental health challenges. World Psychiatry. 2017;16(2):130-139. DOI: 10.1002/wps.20438.
9. Pinchuk I, Leventhal BL, Ladyk-Bryzghalova A, Lien L, Yachnik Y, Casanova Dias M, et al. The Lancet Psychiatry Commission on mental health in Ukraine. Lancet Psychiatry. 2024;11(11):910-933. DOI: 10.1016/S2215-0366(24)00241-4.
10. Silove D. The ADAPT model: a conceptual framework for mental health and psychosocial programming in post-conflict settings. Intervention. 2013;11(3):237-248. DOI: 10.1097/WTF.0000000000000005.
11. Ferris E, Winthrop R. Education and displacement: assessing conditions for refugees and internally displaced persons affected by conflict. Washington (DC): Brookings Institution; 2010. 50 p. Available from: .
12. Thornicroft G, Chatterji S, Evans-Lacko S, Gruber M, Sampson N, Aguilar-Gaxiola S, et al. Undertreatment of people with major depressive disorder in 21 countries. Br J Psychiatry. 2017;210(2):119-124. DOI: 10.1192/bjp.bp. 116.188078.
13. World Health Organization. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: mental health Gap Action Programme (mhGAP), version 2.0. Geneva: World Health Organization; 2016. Available from: https:// iris.who.int/handle/ 10665/250239.

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 1, 180, 542-559 pages, index UDC 614.2:614.254.3:616.89:303.62:519.233.5(477):355.01

DOI:

10.29254/2077-4214-2026-1-180-542-559