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Background The paper presents the results of community consultations about the health needs and healthcare experiences of the population of Ukraine. The objective of community consultations is to engage a community in which a research project is studying, and to gauge feedback, criticism and suggestions. It is designed to seek advice or information from participants directly affected by the study subject of interest. The purpose of this study was to collect first-hand perceptions about daily life, health concerns and experiences with the healthcare system. This study provides policy-makers with additional evidence to ensure that health reforms would include a focus not only on health system changes but also social determinants of health (SDH). Methods The data collection consisted of the 21 community consultations conducted in 2012 in eleven regions of Ukraine in a mix of urban and rural settings. The qualitative data was coded in MAXQDA 11 software and thematic analysis was used as a method of summarizing and interpreting the results. Results The key findings of this study point out the importance of the SDH in the lives of Ukrainians and how the residents of Ukraine perceive that health inequities and premature mortality are shaped by the circumstances of their daily lives, such as: political and economic instability, environmental pollution, low wages, poor diet, insufficient physical activity, and unsatisfactory state of public services. Study participants repeatedly discussed these conditions as the reasons for the perceived health crisis in Ukraine. The dilapidated state of the healthcare system was discussed as well; high out-of-pocket (OOP) payments and lack of trust in doctors appeared as significant barriers in accessing healthcare services. Additionally, the consultations highlighted the economic and health gaps between residents of rural and urban areas, naming rural populations among the most vulnerable social groups in Ukraine. Conclusion The study concludes that any meaningful reforms of the health sector in Ukraine must include a broad range of factors, including the healthcare system but importantly, must extend to SDH approach and include the prioritization of health promotion, limiting alcohol and tobacco availability and enforcing environmental protection.

Objectives To determine whether a brief self-directed forgiveness workbook intervention could alter forgiveness, depression symptoms, and anxiety symptoms.Design A multisite randomised waitlist-controlled trial was conducted among 4598 participants. Recruitment occurred from 11 February 2020 to 30 September 2021. Final follow-up occurred on 25 October 2021.Setting Participants were recruited from community-based samples in sites in Colombia, Hong Kong, Indonesia, South Africa, and Ukraine.Participants Individuals (n=7837) were screened for eligibility. For inclusion, participants needed to be ≥18 years and have experienced an interpersonal transgression. The analytic sample consisted of n=4598 participants, median age 26 and 73% female.Interventions At each site, participants were randomly assigned to either immediate receipt of a self-directed forgiveness workbook intervention, or to receipt after a 2 week delay.Main outcomes measures The primary outcomes were unforgiveness (Transgression-Related Interpersonal Motivations Inventory-18), depression symptoms, and anxiety symptoms (Brief Symptom Inventory-18) measured at 2 weeks following intervention assignment.Results At 2 weeks follow-up, unforgiveness was lower among the immediate-treatment group compared with the delayed-treatment group (standardised mean difference=−0.53 (95% CI=−0.58 to –0.47)); similar patterns were found for depression (standardised mean difference=−0.22 (95% CI=−0.28 to –0.16)) and anxiety symptoms (standardised mean difference=−0.21 (95% CI=−0.27 to –0.15)).Conclusions A brief workbook intervention promoted forgiveness and reduced depression and anxiety symptoms. The promotion of forgiveness with such workbooks has the potential for widespread dissemination to improve global mental health.Trial registration number NCT04257773.