At least 1 in 10 Ukrainian refugees in Poland report significant mental health issues, and of those reporting issues, more than half would benefit from treatment, according to the most comprehensive and wide-ranging study on the health needs of Ukrainian refugees in Poland. Barriers such as lack of child care and difficulty of obtaining one-to-one appointments with Ukrainian speaking mental health professionals mean that many Ukrainian refugees are unable to access the mental health care they need.
These are among the findings of a new WHO and Statistics Poland survey on the health needs of Ukrainian refugees in Poland, carried out with the aim of obtaining health information about Ukrainian refugees who fled the war in their homeland across the Polish–Ukrainian border.
An estimated 8 million refugees crossed the border in the weeks after the outbreak of war in Ukraine on 24 February this year.
“In an extremely short period of time, Poland started hosting one of the largest refugee populations in the world. This is in a context where for decades, there have not been large numbers of refugees,” explains Dr Paloma Cuchí, WHO representative in Poland.
With an existing population of around 38 million, the abrupt and unprecedented influx of refugees placed an enormous burden and financial cost on Polish public services, both local and national. The challenges have been particularly acute in the labour market, education and the health-care system.
Reliable data and qualitative evidence about the health and welfare needs of the newly arrived refugees has been imperative in order to plan and execute the emergency response. Statistics Poland have collaborated with the WHO Country Office in Poland to conduct a study among Ukrainian refugees in the Polish border provinces of Podkarpackie and Lubelskie. The study had two aims: to collect health information about the refugees and to understand their experience of accessing health services.
“The results of the survey are critical for health partners and humanitarian actors, to ensure they can adequately plan for and meet the varied and complex health needs of the refugee population. Access to valid, accurate and timely information is critical to planning and executing the humanitarian response. The collaboration between Statistics Poland and WHO has been a success, and we hope the insights offered will be useful both to those working on the response in Poland, but also to other countries which may suddenly be responding to large refugee populations with little experience of dealing with similar situations,” adds Dr Cuchí.
“The outbreak of war in Ukraine caused an immediate and unprecedented influx of millions of refugees fleeing into Poland. This unexpected and sudden situation has created a massive strain on public services leading to considerable challenges for the state administration. State authorities and international partners urgently required reliable data and qualitative evidence about the refugees. It was vital to recognize their health needs. Responding to this challenge, Statistics Poland has started monitoring refugees who left their country across the Polish–Ukrainian border and, in cooperation with the World Health Organization, developed a health-related survey module. The collaboration and the findings proved the ability of Statistics Poland to react very quickly, use modern research techniques and anticipate information needs,” said Dominik Rozkrut, President of Statistics Poland.
Mental health – At least 10% of respondents reported that emotions and stress were causing problems with daily functioning, and over half of those (56%) said they would benefit from mental health support. However, many say that others need it more. Lack of child care is also a major barrier.
Demographics – 59% of refugees are adults, of whom 70% are women, with the 18–34 age group predominating; 41% of the refugee population are under 18, the majority of whom are 5–14 years old.
Chronic diseases and specialized care – 44% of those in need of health care had sudden illnesses such as fever, diarrhoea, cough etc., while 40% needed treatment for chronic illnesses. The chronic diseases most frequently indicated included cardiovascular diseases, diabetes, cancer and pulmonary diseases. Those needing specialized care or those with chronic diseases often had difficulties accessing necessary services, but the services provided by civil society organizations and special programmes were cited as helpful.
Information barriers to health care – The most frequently mentioned obstacles to accessing health care were lack of information, language and cultural barriers. Many respondents wanted more information about specialized care, prevention services and vaccinations. For the elderly, those with disabilities and people who do not speak Polish or English, this was a particular issue. Informal communications channels were more likely to reach Ukrainian refugees in Poland, and information from other refugees, such as through social media posts and face to face communication, was regarded as the most trustworthy.
Cost of health care – For around 1 in 3 refugees, the cost of services was a barrier. The need for prescriptions and the cost of buying medication was a challenge, although electronic prescriptions are helpful.
Disabilities – Families of children with disabilities have additional needs which are often not met due to cost, lack of disability certification, transportation challenges and lack of services for adolescents.
Vaccination – 55% of adults arriving in Poland are vaccinated against COVID-19. Among children aged 1–4 years, over 70% are vaccinated against childhood diseases, in line with the Ukrainian national average. Survey respondents wanted to understand differences in routine immunization schedules and where they can access vaccinations for both children and adults.