Ukraine’s prosthetic crisis highlights procurement as a key factor in rehab access during conflict

A new paper in Frontiers in Rehabilitation Sciences argues that the way assistive products are bought and distributed can be as important as funding or clinical capacity in determining whether patients actually receive them.

Using Ukraine’s prosthetics sector as a case study, the authors say procurement arrangements are an overlooked part of rehabilitation policy, particularly when demand rises sharply during conflict. Since Russia’s full-scale invasion in 2022, Ukraine has...

faced a surge in the need for prosthetic and other assistive services, adding pressure to a system that has had to expand quickly while still operating under wartime conditions.

The paper says that procurement design matters because fragmented purchasing can make supply chains harder to manage, obscure pricing and limit the ability of the system to scale efficiently. In practice, that means a rehabilitation service may have the money and staff to treat patients, yet still struggle to secure the right devices at the right time.

That argument is echoed by Ukraine’s broader procurement experience during the war. According to reporting on the country’s ProZorro platform, public purchasing continued in 2022 despite extreme instability, with hospitals and clinics still buying essential medical goods and competitive procurement procedures remaining in use. Even so, the system’s resilience did not remove the underlying complexity of sourcing specialised items, especially when supply chains depended heavily on imports.

The authors propose several reforms they say could strengthen rehabilitation systems beyond Ukraine. These include pooled purchasing, framework agreements, better demand forecasting and digital procurement platforms. The aim, they suggest, is to improve cost efficiency and coordination while reducing the fragmentation that can leave patients waiting.

The issue is especially pressing in prosthetics, where the Ukrainian government has sought to improve access and modernise provision. Officials have said they want to expand the market for bionic prostheses and simplify access for both civilians and military personnel. Humanitarian and private-sector programmes have also stepped in, reflecting the scale of need and the high cost of advanced devices.

Associated Press reported that around 20,000 Ukrainians had lost limbs since February 2022, with demand for bionic limbs remaining far above supply. That gap has helped push domestic production and new rehabilitation initiatives, but it has also underlined the central point of the Frontiers paper: financing more services is not enough if the procurement machinery behind them is weak.

In southern Ukraine, thousands of people were still being referred for assistive rehabilitation equipment in 2022, demonstrating both the reach of the system and the administrative burden involved in accessing it. The new study suggests that such processes should be treated not as background bureaucracy, but as a core determinant of rehabilitation outcomes.

Source: Noah Wire Services