[Health Situation in Ukraine Before Onset of War and Its Relevance for Health Care for Ukrainian Refugees in Germany: Literature Review, Risk Analysis, and Priority Setting].

backgroundHealth needs of refugees are not only determined by exposure to war and fleeing. Determinants during the life course also play a role. We therefore examined the health situation in Ukraine before Russia's invasion in 2022 and its relevance for health care for Ukrainian refugees in Germany from the perspective of the Public Health Service.

methodRapid search in the Medline data base, and in relevant Ukrainian and international health data bases; narrative synthesis of findings, followed by a prioritization of health problems and interventions by two medical doctors, using the risk matrix approach.

resultsImmunization coverage is low for Covid-19, resulting in outbreaks in refugee shelters. There are vaccination gaps for measles and other basic immunizations, particularly in older children; children aged 2-5 years have not received the second measles dose. HIV and TB therapies may be interrupted due to the need to flee. Among elderly refugees, insufficiently treated cardiovascular diseases and pre-existing psychological trauma as well as cancers in need of acute care predominate. Ukrainian refugees may mistrust state-associated health measures, as the vaccination gaps indicate.

conclusionRefugees should be able to access curative and preventive health care without bureaucratic obstacles and entitlement restrictions. Analyzing Ukrainian health statistics and respective scientific publications helps the Public Health Service to adapt its interventions, and to avoid inefficient allocation of resources.