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Should medical services and childbirth care be provided free of charge, and what should be done if health workers demand payment for them?

Medical services during childbirth are included in the Medical Guarantees Program – a list of services that the state guarantees to the patient. Therefore, the 2021 Medical Guarantee Program provides the most important types of medical care in order to provide quality medical care to pregnant women and women in labor.

What you need to consider 

  1. Starting from April 1, 2021, labor and delivery care is covered by the state-guaranteed benefit package “Outpatient pregnancy management”. To receive the services, the woman needs to select any health facility contracted by the National Health Service of Ukraine (NHSU) for provision of the services included in the package.

Women can choose who will manage their uncomplicated pregnancies, whether it is a family doctor or an obstetrician-gynecologist in an antenatal clinic, regardless of their place of living or registration. A woman does not need an online referral to see a gynecologist.

A pregnant woman is entitled to a free choice of maternity out of those contracted by the NHSU for the provision of labor and delivery care. No charity donations or medication packages are required. All that is necessary, including medications and supplies, is covered by the state-guaranteed free benefits package.

2. Let us discuss what is included in the free benefits package of care in labor and delivery. The entire scope of medical services required during childbirth is free for the woman, including:

  • Arrangement of regular pregnancy checkups (registration, working out of an individual risk-based pregnancy management plan);
  • Pregnancy, post-partum and newborn health monitoring (including laboratory tests and instrumental investigations, consultations of other specialist physicians if required);
  • Management of physiological labor and delivery by the obstetric team on duty;
  • Management of complicated labor and delivery and delivery by C-Section;
  • Pain relief in labor, including epidural anesthesia;
  • Stabilization of the newborn condition after birth;
  • Neonatal vaccination according to the Immunization Schedule;
  • Medications included in the National List of Essential Drugs and medical supplies, and the medications procured by the Ministry of Health at the central level;
  • Meals during hospital stay.

If the newborn baby needs additional medical care – breathing support, intensive care, etc. – such care is also included in the free benefits, costs covered by the National Health Service of Ukraine. For the full scope of services under this benefit package, please access the NHSU website and select the specification in the relevant benefits package.

How to find out if the health facility has signed a contract with the NHSU?

You can find this information here in Section “Signed contracts for providing healthcare services to population”The facilities contracted by the NHSU are listed in the table.

Conduct of the patient if the healthcare provider solicits payment for medical care or refuses to provide the service.

  • First of all, approach the chief physician of the healthcare facility, preferably with a written report (complaint), demanding to remedy the violation of right to free medical care under the relevant benefit package, referring to availability of public funding received by the healthcare facility for provision of such services. The complaint must be duly registered, with an incoming registration number assigned.
  • If these efforts were not successful, you need to file a written report (complaint) to the city or oblast health department complaining about absence of response by the chief physician and demanding to remedy the violation of the right to healthcare. The healthcare department must duly register the complaint and respond to it. In fact, this is usually enough to correct the situation. 
  • If the client remains unsatisfied, he/she can approach the National Health Service of Ukraine (NHSU) and submit a complaint using the online form on the NHSU website. 

Usually, NHSU does not ignore such messages and may take measures up to terminate public funding provided to the health facility. Therefore, the administrations of health facilities try to avoid such complaints and prevent conflicts.

  • If the client remains unsatisfied, he/she can file a complaint in court.