Introduction:
The humanitarian crisis in Ukraine, intensified by the escalation of the armed conflict in February 2022, continues to have severe humanitarian impacts on the population. The ongoing conflict has caused large-scale displacement and destruction. According to the United Nations High Commissioner for Refugees (UNHCR), over 8 million Ukrainians have been displaced internally, while more than 5 million have sought refuge in other countries. As a result of the escalation, the humanitarian assistance required was for: 45% women, 23% children (4.1M) and 15% people living with disabilities (52% women), including older people.[1] The needs identified by OCHA include: Health (14.6M), Food Security and Livelihoods (11.1M), WASH (11M), Child Protection (3.4M), SGBV (3.6M) and Shelter and NFIs (8.3M).[2] While many men were conscripted into the military, many women and children were displaced, and were left without access to education, livelihood, employment, health and networks. The elderly and disabled lacked support from family and friends who had left or died and insufficient care giving resources.
The conflict has caused extensive damage to infrastructure, including educational and health facilities. The destruction has compounded vulnerabilities across the country, especially in areas that have endured years of hostilities. The ongoing attacks on the energy sector have disrupted heating, water, and sewage services, putting millions at risk, especially during winter.
The destruction of infrastructure, coupled with the displacement of millions of people, has led to a significant decline in economic activity. Many businesses have been forced to close, and unemployment has skyrocketed. The economic instability has made it difficult for families to access basic necessities, further deepening the humanitarian crisis.
The conflict has taken a heavy toll on the mental health of the Ukrainian population. The constant fear of attacks, the loss of loved ones, and the uncertainty about the future have led to widespread psychological trauma. The social fabric of communities has been torn apart, with families separated and communities displaced.
Humanitarian response was launched right after the conflict escalated in February 2022. The Ukrainian Red Cross Society (URCS) has been the lead Ukrainian organization in providing humanitarian assistance to the affected people, with offices, staff and volunteers operating all over Ukraine. It has been supported by the Red Cross and Red Crescent (RCRC) Movement partners. In 2023, URCS launched the One Plan 2023-2025 which is the roadmap of its response in the sectors of healthcare, rehabilitation, recovery, disaster management and protection and education, with each having its sub-sectors. The One Plan also included interventions to strengthen the structure of URCS in all Ukraine to enable it to deliver the humanitarian assistance. All sectors have objective statements with indicators and targets to measure their progress.
The Canadian Red Cross (CRC) has been among the RCRC partners supporting URCS since the escalation of the conflict in February 2022. Its support has been provided through multilateral and bilateral channels. On the multilateral side, it provided cash contributions to the International Committee of the Red Cross (ICRC) and the International Federation of the Red Cross and Red Crescent Societies (IFRC) for their programs supporting the One Plan, primarily for the relief and the cash and voucher programs. On the bilateral side, the focused areas of support have been to the following programs within One Plan that are being implemented in Cherkasy and Poltava Oblasts:
- Mobile health units (MHUs), health infrastructure rehabilitation and home-based care (HBC) under the health care sector.
- Mental health and psychosocial support (MHPSS) at community level under the rehabilitation sector.
- Shelter and settlements, and cash and voucher under the recovery sector.
- Relief under the disaster management sector.
- National society development, especially through the Branch Development Volunteer program (BraVo)
- Protection, gender and inclusion (PGI) as a crosscutting theme in the above programs
CRC has also provided bilateral support to URCS in the areas of human resource development, branch and volunteer development, digital transformation and communication development, all under the sustainable development and qualified services sector.
Outside the One Plan, CRC has been supporting the Unbroken Center in at the First Medical Union of Lviv that provides MHPSS to veterans who have sustained different types of traumas, their families, and civilians impacted by the conflict.
CRC’s presence in Ukraine started with a team of international and national staff; the international team was gradually replaced by national experts except for the Country Representative position. Technical support to the team in Ukraine is provided by CRC’s National Office advisors.
Evaluation scope
Reviews and evaluations have been conducted by URCS and the Red Cross Red Crescent Movement during the past three years, with key ones on cash and voucher, emergency response, BraVo and URCS’ inter-regional offices, to name a few. A mid-term evaluation of the One Plan was conducted towards the end of 2024. CRC conducted two internal reviews in 2023 and 2024 looking at its internal processes.
Through these terms of reference, URCS and CRC intends to conduct an external evaluation to assess the following programs that CRC has been supporting within the One Plan in Cherkasy and Poltava Oblasts:
- mobile health units
- home-based care
- mental health and psychosocial support at community level
- shelter and settlements
- PGI and CEA as cross cutting issues throughout all the above
Outside the support to One Plan, CRC intends to assess the mental health and psychosocial program it has been supporting at the Unbroken Center in Lviv Oblast.
The timeframe of the operation is from August 2022 to August 2025. This document provides information on CRC’s bilateral programs that are to be evaluated and are implemented in Cherkasy, Poltava and Lviv Oblasts, the objectives and the methodology of the evaluation, deliverables, workplan, and other administrative information.
Brief description of the bilateral programs to be evaluated
Mobile health Units (MHUs): Access to health care in Ukraine has been severely impacted due to security concerns, restricted mobility, broken supply chains and mass displacement. URCS launched the MHU program throughout the country with the support of Partner National Societies[3] (PNS) among the RCRC Movement and by the end of 2024 it had 125 functioning units in 23 regions with CRC supporting 11 units in Cherkasy and Poltava. Each mobile clinic consists of a doctor, a nurse, a pharmacist and a driver. The clinics operate through a monthly schedule visiting villages to provide selected services of primary health care. The population served are mostly elderly women (around 70% of the participants are women and around 60% are more than 60 years old) with chronic and non-communicable diseases being the most common morbidities. URCS uses different communication methods to inform the communities on the visits schedule. Between January 2023 and December 2024, the teams in Cherkasy and Poltava conducted 80,127 consultations with financial and technical support from CRC. URCS plans to reduce the number of MHUs due to sustainability issues focusing on areas close to the frontline and/or with higher number of internally displaced people (IDPs). The specific objectives of the MHU program in the One Plan are:
- To ensure the URCS auxiliary role and complementary relevant support to and strengthening of the existing public primary healthcare services.
- To develop an effective, adaptive, and transformative model of MHUs, functioning during conflict and in the post-conflict context, that both respond to the needs of vulnerable communities and public health sector priorities.
Home-based care (HBC): URCS uses social workers to provide HBC to older people with limited mobility and limited access to care from family, close social network, or social protection services, complementing the efforts of the public health and social protection sector. By the end of 2024, URCS reached 7,700 elderly beneficiaries (around 70% are women) using 1,325 social workers (mostly women) in 23 regions from a standard package depending on their conditions: within those, 518 beneficiaries in Cherkasy and Poltava were reached through CRC’s financial and technical support (85% are lonely elderly with kinship who are not around, and in need of care, 75% are females, 25% are people with disabilities). The specific objectives of the HBC program in the One Plan are:
- To ensure the URCS complementary and relevant support to, and strengthening of the existing public HBC service, through HBC activities.
- To strengthen the auxiliary role of the URCS to public health and social authorities through ensuring sustained wide coverage of the URCS HBC activities and by advocating for this role.
- To position the URCS as a provider and expert in delivering education and training on HBC both for public and the URCS staff and volunteers.
In 2024, URCS established Active Aging (AAC) that are a network of community-based initiatives jointly with communities. They aim to promote healthy, active, and fulfilling lifestyles for older adults by providing opportunities for physical, mental, and social engagement. These clubs serve as a platform for seniors to participate in activities like exercise classes, educational workshops, arts and crafts, and group outings, fostering a sense of community and belonging.
Mental Health and psychosocial support (MHPSS) at community level: Active hostilities have exacerbated chronic mental health problems and have caused high levels of acute psychological distress among all age groups, particularly children, the elderly and IDPs. URCS implements basic community-based psychosocial support through centres providing basic PSS services (such as child-friendly spaces, recreational activities, awareness raising). It also provide focused PSS to adults, and two groups of children; one group is for ages 6-10 years who have developed or are at risks of developing psychological conditions related to war, torture or forced migration, using the program “The Book About Me”, and the other is for school youth of 14-17 years through the program “Building the Future Together”. It uses different communication methods to their activities to the communities. By the end of 2024, URCS had reached more than 60,300 unique beneficiaries (each participated in at least one session) with basic PSS through 1,827 volunteers: within those, and through CRC’s financial and technical support in Cherkasy Oblast, 2,670 beneficiaries were reached with basic PSS services (58% females, 82%% children) and another 720 beneficiaries with focused PSS services (69% females, 75% adults) through 47 trained volunteers (91% females). The specific objectives of the MHPSS program in the One Plan are:
- To improve psychosocial wellbeing of the people affected by the IAC in Ukraine through community-based mental health and psychosocial support service provision.
- To ensure supportive and caring working environment is achieved and sustained for the URCS staff and volunteers through structured support.
- To ensure MHPSS programmes are sufficiently staffed, and staff and volunteers are confident, knowledgeable, and skilled.
Protection, Gender and Inclusions (PGI) and Community Engagement and Accountability (CEA): CRC worked through the Swedish RC to support URCS to mainstream PGI (Protection Gender and Inclusion) as a crosscutting issue into institutional processes and all sectors to assess, meet and monitor the differential needs of specific crisis affected groups for safety, dignity and accessibility. A URCS staff has also been allocated to support Community Engagement and Accountability for Cherkassy and Poltava. Both PGI and CEA are a part of the One Plan. Data collection tools include different profile such as sex, age groups, displacement and ability status.
Mental Health and psychosocial support (MHPSS) at Lviv Hospital: The Unbroken Center at Lviv Hospital provides a variety of services to veterans who sustained different types of trauma, and their families and to civilians, including treatment, prosthetics, physical and psychological rehabilitation, housing, and reintegration. CRC started providing financial support to the Center since October 2022 which enabled it to expand its mental health specialists by 15 positions, up from four before February 2022. In 2024, CRC’s support aimed at enabling the Center to have between 15 fulltime positions to 27 parttime positions. It now has psychiatrists, psychotherapists, psychologists, cognitive-behavioral and body-oriented therapists, as well as art therapists and psych neurologists. The Center provides various types of therapy: art therapy, Gestalt therapy, cognitive-behavioral, psychoanalytic, body-oriented psychotherapy and eye movement desensitization and reprocessing (EMDR) therapy. Between October 2022 and February 2025, the therapists at the Center conducted over 23,600 sessions to 5,700 people (77% males, 84% veterans and family members). The Center engages family members in the therapy of veterans; at the same time, family members receive care and therapy when needed. The support to the Unbroken Center is outside the URCS’ One Plan with the objective to enable the Center scale up integrating MHPSS into the physical rehabilitation of the veterans, their families and to the civilian population.
Shelter: CRC provides financial and technical support to URCS’ shelter and settlement program in both Cherkasy and Poltava Oblasts. The program has three components:
- Residential public buildings (such as those hosting IDPs, seniors and people with physical and mental disabilities, health facilities, and schools) receive rehabilitation support (such as providing generators, upgrading windows to improve insulation, floors, sanitation facilities, and installing ramps to improve accessibility), and/or refurbishing support (such as providing furniture and appliances).
- Households that host IDPs receive cash or voucher assistance based on vulnerability criteria to repair their homes and improve living conditions.
- Households, meeting vulnerability criteria, with minor and medium damage caused by aerial strikes receive construction materials to repair the damage.
In 2024, CRC supported the rehabilitation and/or refurbishing 19 public buildings in Cherkasy and Poltava (14 of them are collective centers that host internally displaced people, IDPs), 51 households with cash 47 households with construction materials.
The specific objectives of the Shelter program in the One Plan are:
- To support internally displaced people with access to safe and adequate shelter.
- To support recovery of essential community infrastructure.
A note on the available data: The above programs implemented by URCS use standard data collection systems with disaggregation by sex, age, disability and displacement status. URCS developed dashboards of key indicators for MHUs, HBC and MHPSS programs. The Unbroken Center provides monthly reports on the therapeutic sessions by type of condition and beneficiaries’ profile.
Evaluation objectives and criteria
The purpose of the evaluation is to assess the how CRC’s bilateral support to URCS has addressed the urgent humanitarian needs arising from the armed conflict, implemented within URCS’ One Plan (2023-2025) in the targeted areas. It will examine the relevance and appropriateness, efficiency, effectiveness, sustainability and impact of the interventions from the start of the support till March 2025, noting that programs started on different dates. It will examine the level of integrating key aspects of protection, gender and inclusion and community engagement and accountability across the programs.
[1] OCHA, Humanitarian Needs Overview 2023 (December 2022)
[2] Ukraine Humanitarian Needs Overview 2023 (1).pdf
[3] Red Cross and Red Crescent Societies from other countries supporting URCS
