Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households
The paper presents some results of the research concerning the availability and effectiveness of social protection in Ukraine for working-age people living with HIV (PLHIV) and members of their families.
Gespeichert in:
| Datum: | 2015 |
|---|---|
| 1. Verfasser: | |
| Format: | Artikel |
| Sprache: | English |
| Veröffentlicht: |
Iнститут соціології НАН України
2015
|
| Schriftenreihe: | Социология: теория, методы, маркетинг |
| Online Zugang: | http://dspace.nbuv.gov.ua/handle/123456789/142138 |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Назва журналу: | Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| Zitieren: | Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households / G. Chepurko // Социология: теория, методы, маркетинг. — 2015. — № 4. — С. 140-158. — Бібліогр.: 22 назв. — англ. |
Institution
Digital Library of Periodicals of National Academy of Sciences of Ukraine| id |
irk-123456789-142138 |
|---|---|
| record_format |
dspace |
| spelling |
irk-123456789-1421382018-09-29T01:23:00Z Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households Chepurko, G. The paper presents some results of the research concerning the availability and effectiveness of social protection in Ukraine for working-age people living with HIV (PLHIV) and members of their families. 2015 Article Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households / G. Chepurko // Социология: теория, методы, маркетинг. — 2015. — № 4. — С. 140-158. — Бібліогр.: 22 назв. — англ. 1563-4426 http://dspace.nbuv.gov.ua/handle/123456789/142138 364.013 en Социология: теория, методы, маркетинг Iнститут соціології НАН України |
| institution |
Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| collection |
DSpace DC |
| language |
English |
| description |
The paper presents some results of the research concerning the availability and effectiveness of social protection in Ukraine for working-age people living with HIV (PLHIV) and members of their families. |
| format |
Article |
| author |
Chepurko, G. |
| spellingShingle |
Chepurko, G. Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households Социология: теория, методы, маркетинг |
| author_facet |
Chepurko, G. |
| author_sort |
Chepurko, G. |
| title |
Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households |
| title_short |
Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households |
| title_full |
Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households |
| title_fullStr |
Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households |
| title_full_unstemmed |
Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households |
| title_sort |
accessibility and effectiveness of social security granted to people living with hiv and members of their households |
| publisher |
Iнститут соціології НАН України |
| publishDate |
2015 |
| url |
http://dspace.nbuv.gov.ua/handle/123456789/142138 |
| citation_txt |
Accessibility and Effectiveness of Social Security Granted to People Living with HIV and Members of Their Households / G. Chepurko // Социология: теория, методы, маркетинг. — 2015. — № 4. — С. 140-158. — Бібліогр.: 22 назв. — англ. |
| series |
Социология: теория, методы, маркетинг |
| work_keys_str_mv |
AT chepurkog accessibilityandeffectivenessofsocialsecuritygrantedtopeoplelivingwithhivandmembersoftheirhouseholds |
| first_indexed |
2025-07-10T14:12:55Z |
| last_indexed |
2025-07-10T14:12:55Z |
| _version_ |
1837269545373401088 |
| fulltext |
Gul’barshyn Chepurko
Accessibility and effectiveness of social security granted to people living with HIV
GUL’BARSHYN CHEPURKO, UDC 364.013
Doctor of Sciences in Sociology, Leading Re -
search Fellow of the Social Expertise Centre,
Institute of Sociology, NAS of Ukraine
Accessibility and Effectiveness of Social Security
Granted to People Living with HIV and Members
of Their Households
Abstract
The pa per pres ents some re sults of the re search con cern ing the avail abil ity and ef fec -
tive ness of so cial pro tec tion in Ukraine for work ing-age peo ple liv ing with HIV
(PLHIV) and mem bers of their fam i lies. The re search in Ukraine was car ried out by
the So cial Ex per tise Cen tre at the In sti tute of So ci ol ogy of the Na tional Acad emy of
Sci ences (NAS) of Ukraine with the fi nan cial and tech ni cal sup port of the In ter na -
tional La bour Or gani sa tion (ILO). This re search was a part of the global re search con -
ducted in 2012–2013 ac cord ing to the ILO Programme on HIV/AIDS and the World
of Work (ILO/AIDS) to gain the in for ma tion about the life sit u a tion of work ing-age
peo ple liv ing with HIV and their fam i lies, as well as about the cur rent state of so cial se -
cu rity for these per sons. Ukraine was one of the four coun tries par tic i pat ing in this
global research, together with Guatemala, Indonesia and Rwanda.
To tally, 800 PLHIV (in clud ing 349 per sons work ing in the for mal econ omy, the same
num ber of those who were work ing in the in for mal econ omy and 102 un em ployed from
five ad min is tra tive-ter ri to rial units of Ukraine such as Donetsk, L’viv, Odesa, Kyiv re -
gions, the Au ton o mous Re pub lic of Cri mea and the city of Kyiv) took part in the re -
search. It was con ducted from Au gust to Oc to ber 2013 in com pli ance with the re search
eth ics. In par tic u lar, re spon dents (peo ple liv ing with HIV) were in ter viewed only with
their con sent; con fi den ti al ity of their answers was scrupulously preserved.
The au thor con cen trates her at ten tion on the fol low ing as pects: what types of in sur -
ance ben e fits/as sis tance, state so cial as sis tance and so cial ser vices are pro vided to the
peo ple liv ing with HIV, de pend ing on whether they are em ployed or not; where do the
re spon dents spend the re ceived in sur ance ben e fits/as sis tance or state so cial as sis -
tance and how do they use so cial ser vices; what kinds of ob sta cles de prive peo ple living
with HIV of social security.
Keywords: so cial se cu rity, in sur ance ben e fits/as sis tance, state so cial as sis tance, so -
cial ser vices, peo ple liv ing with HIV, Hu man Im mu no de fi ciency Vi rus.
140 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Ukraine is one of the coun tries in Eu rope and in the Com mon wealth of
Independent States (CIS) mostly af fected by the HIV ep i demic. Dur ing
1987–2013, 234,257 per sons liv ing with HIV (PLHIV) were reg is tered in
Ukraine, while 62,288 were re ported as AIDS pa tients. The num ber of PLHIV
un der med i cal su per vi sion at the health care in sti tu tions is grow ing ev ery year.
As of July 1st 2013, there were reg is tered 134,302 PLHIV (or 2948 per sons per
1,000,000 of pop u la tion) in clud ing 27,181 AIDS pa tients (597 per sons per
1,000,000 of pop u la tion)1.
The prev a lence rate of HIV is vary ing from re gion to re gion; the high est rate
is reg is tered in the south ern and east ern parts of the Ukraine (cov er ing Dnipro -
petrovs’k, Donets’k, Odesa, and Mykolaiv re gions, as well as the city of Seva -
stopol’ and the Au ton o mous Re pub lic of Cri mea). How ever, some re gions with
lim ited ac cess to HIV test ing may in fact have higher num ber of new HIV in fec -
tions than pre sented in of fi cial sta tis tics2.
The HIV ep i demic con tin ues to be con cen trated in the three key groups: in -
ject ing drug us ers (IDU), com mer cial sex work ers (CSW) and men who have sex
with men (MSM). The prev a lence rate is also high among prison in mates. Re cent
re ports in di cate a grow ing num ber of the PLHIV in fected through sex ual con -
tacts, which pro vokes se ri ous con cern be cause the ep i demic is be com ing gen er al -
ised. As of De cem ber 2012, 51.1% HIV car ri ers be came in fected from un pro -
tected sex ual con tacts and 28.6% — from in ject ing drugs. Sex ual trans mis sion is
mostly con nected with harm ful sex ual be hav iour of IDU and their sex ual part -
ners, es pe cially women be ing in fected through un pro tected sex with HIV-pos i -
tive male drug us ers3.
The HIV and AIDS Rec om men da tion, 2010 (№ 200) urges ILO Mem ber
States to de velop, adopt and ef fec tively im ple ment na tional pol i cies/pro gram -
mes for PLHIV and AIDS pa tients in the busi ness world, cov er ing all per sons
work ing in both for mal and in for mal sec tors of econ omy and their fam i lies.
In 2011 the tri par tite part ners in Ukraine — gov ern ment agen cies, em ploy -
ers’ as so ci a tions and trade un ions — adopted the Na tional Tri par tite Co op er a -
tion Strat egy on HIV and AIDS in the World of Work. This strat egy pro vides
the ba sis for a co or di nated re sponse in main ar eas of em ploy ment. They also
adopted the Na tional Strat egy for Con trol ling the Spread of HIV/AIDS in clud -
ing the HIV Pre ven tion Programme, treat ment, care and sup port of HIV-in -
fected peo ple and AIDS pa tients for the pe riod of 2009–2013. At first, the fight
against the HIV/AIDS ep i demic was ac cepted by law. This fact con firms pri or ity
of the state in the area of health pro tec tion and so cial de vel op ment.
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 141
Accessibility and effectiveness of social security granted to people living with HIV
1 HIV-Infection in Ukraine. Newsletter № 40, 2013 // [Electronic resource]. — Access
mode: http://ucdc.gov.ua/attachments/article/86%29.pdf.
2 The Ministry of Health of Ukraine. Harmonised National Report on Progress in the
Implementation of Measures in Response to AIDS. Reporting period: January 2010 — Decem -
ber 2011–2012.
3 Analysis of Spreading HIV in Ukraine // [Electronic resource]. — Access mode:
http://infolight.org.ua/content/analiz-poshirennya-vil-infekciyi-v-ukrayini.
In ad di tion, the Cab i net of Min is ters of Ukraine adopted the De ci sion of
July 11, 2007 es tab lish ing the Na tional HIV/AIDS/STI/TB1 Coun cil, a con sul -
ta tive and ad vi sory body un der the Cab i net of Min is ters.
The sys tem of so cial se cu rity in Ukraine is very com pre hen sive. Dif fer ent
priv i leges, so cial ben e fits and so cial ser vices are avail able, reg u lated by 58 laws
and more than 120 by-laws. Uni ver sal health care is pro vided to all Ukrai ni ans
un der the Act 280 I-XII (1992).
So cial se cu rity equally cov ers all cit i zens in Ukraine, in clud ing men and
women liv ing with HIV.
The Act of 1991 (amended in 2010) pro vides for pre ven tion, treat ment, care
and sup port for HIV-re lated ill nesses, as well as en sures le gal pro tec tion and so -
cial se cu rity for PLHIV. The Act guar an tees the rights to in for ma tion, work and
free antiretroviral ther apy (ART) for PLHIV.
Med i cal as sis tance seems to be the most im por tant as pect of so cial se cu rity
since it plays an im por tant role in HIV pre ven tion and re duces the vul ner a bil ity
of tar get group. Med i cal as sis tance is pro vided by health care in sti tu tions of the
Min is try of Health of Ukraine, AIDS cen tres, and by HIV/AIDS non-gov ern -
men tal or gani sa tions (NGOs). The vast ma jor ity (95%) of re spon dents, ir re spec -
tive of their em ploy ment sta tus, were re ported to have ac cess to ART (97% of
men and 93% of women), even though they might not cur rently use it.
The above re search also re vealed that 82% of PLHIV re ceived as sis tance
from the na tional pub lic health or gani sa tions, 26% from Ukrai nian NGOs, 24%
from the so cial se cu rity in sti tu tions, 15.5% from in ter na tional or gani sa tions, 4%
from mu nic i pal util i ties, 2% from em ploy ers, and 0.6% from trade un ions.
The pro por tion of PLHIV who re ceived so cial in sur ance ben e fits/as sis tance
is sig nif i cantly greater (31%) com pared with 8.5% who re ceived state so cial as -
sis tance. State so cial as sis tance re ceived by PLHIV is mainly spent on food, daily
needs, util ity ser vices, trans por ta tion and pay ments for doc tor con sul ta tion and
med i ca tion.
The Ukrai nian leg is la tion also pro vides for wide use of sub sti tu tion ther apy
(ST) for in jected drug us ers to re duce the risk of HIV-in fec tion and im prove at ti -
tude to wards ST among pop u la tion.
One of the goals of our re search was to find out what types of in sur ance ben e -
fits/as sis tance, state so cial as sis tance or so cial ser vices are re ceived by PLHIV
de pend ing on whether they are em ployed or un em ployed.
A spe cial role in the sys tem of so cial se cu rity be longs to so cial se cu rity mea -
sures, which in their turn con sist of in sur ance ben e fits/as sis tance and state so cial
as sis tance.
The so cial se cu rity mea sures are clas si fied ac cord ing to the types of so cial
risk: dis ease, preg nancy and child birth, care and up bring ing of chil dren, job loss
and un em ploy ment, work place in jury, dis abil ity, death of a bread win ner, and an
old age.
The types of in sur ance ben e fits/as sis tance in cluded into the ques tion naire
are as fol lows:
— un em ploy ment ben e fits;
142 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
1 Acquired Immunodeficiency Syndrome/Sexually Transmitted Infections/Tuberculosis.
— so cial pen sions;
— dis abil ity pen sions;
— pen sions paid in the case of a bread win ner’s loss;
— fu neral costs;
— tem po rary dis abil ity ben e fits;
— to tal and per ma nent dis abil ity ben e fits;
— ma ter nity ben e fits (in the case of preg nancy and child birth);
— paid sick leave in the case of fall ing ill;
— ben e fits for in dus trial in ju ries and oc cu pa tional dis eases.
— State so cial as sis tance in cludes the fol low ing sub si dies:
— state as sis tance to par ents with de pend ents;
— low-in come fam ily sup ple ment;
— fi nan cial aid for in va lids since the child hood and for chil dren with dis abil i -
ties;
— monthly al low ances for HIV-in fected chil dren and chil dren with HIV-re -
lated dis eases;
— so cial as sis tance to the dis abled and per sons who are not el i gi ble for a pen -
sion.
Table 1
Social insurance benefits/assistance and state social assistance
received by respondents in the last 12 months, according to the
employment type and gender, %
Vari ants of so cial ben e -
fits/as sis tance and so cial
as sis tance
ni deyol p
m
E
la
mrof eht
ro tces
ni deyol p
m
E
la
mro fni eht
ro tces
deyol p
m en
U
To tal By gen der
N % Men Women
1 2 3 4 5 6 7 8
So cial in sur ance ben e fits/as sis tance
Un em ploy ment ben e fits 2 3 2 22 3 3 3
So cial pen sions 0 0 1 1 0.1 0.2 0
Dis abil ity pen sions 15 18 25.5 142 18 18 17.5
Pen sions paid in the case
of a bread win ner’s loss 1 0.3 0 4 0.5 0 1
Fu neral costs 0 0.3 1 2 0.3 0 0.5
Tem po rary dis abil ity
ben e fits 0.6 0.3 1 4 0.5 0.7 0.3
To tal and per ma nent dis -
abil ity ben e fits - - - 1 0.1 0 0.3
Ma ter nity ben e fits 1.4 2 8 20 2.5 0 5.2
Paid sick leave 13 1 2 50 6 6 7
Ben e fits for in dus trial in -
ju ries and oc cu pa tional
dis eases
1 0 0 4 0.5 0.5 0.5
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 143
Accessibility and effectiveness of social security granted to people living with HIV
1 2 3 4 5 6 7 8
State so cial as sis tance
Low-in come fam ily sup -
ple ment 0.6 2.3 1 11 1.4 1 2
State as sis tance to par -
ents with de pend ents 2 1.4 0 11 1.4 0.2 2.6
Fi nan cial aid for in va lids
since the child hood and
for chil dren with dis abil i -
ties
0.3 0.3 0 2 0.3 0.2 0.3
Monthly al low ances for
HIV-in fected chil dren
and chil dren with
HIV-re lated dis eases
0.6 0.6 1.0 5 0.6 0 1.3
So cial as sis tance to the
dis abled and to the per -
sons who are not el i gi ble
for a pen sion
2 5 6 30 4 4.1 3.4
The as sis tance is not re -
ceived al though the re -
spon dent is el i gi ble
44 38 48 334 42 44 40
The as sis tance is not re -
ceived be cause the re -
spon dent is not el i gi ble
for it
9.5 10 0 68 8.5 8.6 8.4
The as sis tance is not re -
ceived and there is no
idea whether the re spon -
dent is el i gi ble or not for
it
17 21.5 9 144 18 18 18
N (total number of respondents) = 800.
So, what so cial in sur ance ben e fits/as sis tance or types of state so cial as sis -
tance are re ceived by peo ple liv ing with HIV?
Experience of Receiving Social Insurance Benefits/Assistance
Ac cord ing to the re search, 31% of re spon dents re ceived so cial in sur ance ben -
e fits/as sis tance in their own name, 8% of re spon dents — in the name of their
spouses, 3.5% — in the name of the re spon dent’s chil dren and 17% re spon dents —
in the name of other mem bers of the re spon dent’s fam ily.
Among the above-men tioned types of so cial in sur ance ben e fits/as sis tance
the re spon dents mostly re ceive dis abil ity pen sion (18%), paid sick leave (6%),
un em ploy ment ben e fits (3%) and ma ter nity ben e fits (2.5%).
Struc ture of the re spon dents’ an swers to this ques tion does not cor re late
with gen der, with the ex cep tion of “state aid to par ents with de pend ents”, which
is paid to women in most cases (2.6% com pared with 0.2% of men). Men’s share is
144 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
End of table 1
slightly big ger than women’s one among those who do not re ceive ben e fits/as sis -
tance de spite be ing en ti tled to them.
The struc ture of the re spon dents’ an swers to this ques tion var ies slightly de -
pend ing on the re spon dents’ cat e gory (em ployed in the for mal/in for mal sec tor or
un em ployed).
So, dis abil ity pen sion tops the list of so cial in sur ance ben e fits/as sis tance re -
ceived by all cat e go ries of re spon dents. Then fol lows paid sick leave (for re spon -
dents em ployed in the for mal sec tor), un em ploy ment ben e fits (for those who
work in the in for mal sec tor), and ma ter nity ben e fits paid mostly to un em ployed
young women (43% un em ployed women are from 25 to 35 years of age).
Experience of Receiving State Social Assistance
The re sults of our re search show that 8.5% of re spon dents re ceived state so -
cial as sis tance in their own name, 1% — in the name of their wives/hus bands, 7%
of re spon dents — in the name of their children, and 1% of — in the name of other
fam ily mem bers.
Among the pro posed list of the state so cial as sis tance types the re spon dents
mostly re ceive (in their own name) so cial as sis tance to the dis abled and to the
per sons who are not el i gi ble for pen sion (4%), low-in come fam ily sup ple ment
(1.4%) and as sis tance to par ents with de pend ents (1.4%).
There are only 0.6% of re spon dents, mainly HIV-in fected chil dren and chil -
dren with HIV-re lated dis eases, who re ceive monthly al low ances. To day this as -
sis tance does not ex ceed 170 UAH per month.
The an swers given by re spon dents to the ques tion about re ceiv ing state so -
cial as sis tance are mainly the same ir re spec tive of the re spon dent’s cat e gory
(work ing in the for mal/in for mal sec tor, the un em ployed).
In ac cor dance with the na tional leg is la tion, all cit i zens of Ukraine, ir re spec -
tive of whether they work in the for mal or in for mal sec tors of econ omy or are un -
em ployed have the right to ap peal to the state au thor i ties and re quest so cial se cu -
rity ben e fits or ser vices bud geted for in the na tional bud get or lo cally (in clud ing
state as sis tance to par ents with de pend ents, low in come fam ily sup ple ment and
as sis tance for chil dren with dis abil i ties). This as sis tance also in cludes pro vi sion
of em ploy ment ser vices, pro fes sional train ing and skills im prove ment ser vices, as
well as sub si dies for hous ing and util ity ser vices, etc.
The in ter views show that a sig nif i cant por tion (42%) of re spon dents did not
re ceive any in sur ance ben e fits/as sis tance or state so cial as sis tance, al though
they are el i gi ble for them. All the rea sons for which the el i gi ble re spon dents did
not re ceive in sur ance ben e fits/as sis tance or state so cial as sis tance can be di vided
into three groups: 1) rea sons re lated to poor re spon dents’ aware ness of their per -
sonal rights; 2) pro ce dural rea sons when peo ple have to deal with com pli cated
ap pli ca tion pro ce dures and long queues; 3) un will ing ness to dis close their HIV
sta tus be cause of fear of be ing dis crim i nated.
Thus, ana lys ing var i ous kinds of so cial se cu rity, one should pay at ten tion to
the fact that the dom i nant type of so cial se cu rity for PLHIV is in sur ance ben e -
fits/as sis tance be cause the share of PLHIV who re ceive them is sig nif i cantly
greater (31%) in com par i son with those who re ceive state so cial as sis tance
(8.5%). How ever, such a sit u a tion is com mon to all forms of so cial se cu rity, where
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 145
Accessibility and effectiveness of social security granted to people living with HIV
the dom i nant role be longs to so cial ben e fits and priv i leges. These types of so cial
se cu rity have been com mon ever since the So viet times, and they are based
mainly on a “for mal” ap proach ig nor ing real needs of ma te rial as sis tance for so -
cially dis ad van taged cat e go ries of the pop u la tion (in clud ing PLHIV), as well as
the real value of pro vided ben e fits and ser vices.
The Re spon dents’ Es ti ma tions on the Size of So cial In sur ance
Ben e fits/As sis tance and State So cial As sis tance
Ac cord ing to the Con sti tu tion of Ukraine (Ar ti cle 46), cit i zens have the
right to so cial se cu rity, which in cludes the right to re ceive an as sis tance in the
event of to tal, par tial or tem po rary dis abil ity, loss of a bread win ner, un em ploy -
ment due to cir cum stances be yond their con trol, as well as in case of get ting old
age and in other cases stip u lated by the law. The ex er cise of this right is guar an -
teed by gen eral, com pul sory state so cial in sur ance funded through in sur ance pre -
mi ums paid by cit i zens, en ter prises, in sti tu tions and or gani sa tions, as well as
from the na tional bud get and other fund ing sources for so cial se cu rity sys tem; be -
sides, through es tab lish ment of a net work of state, mu nic i pal and pri vate in sti tu -
tions for the care of in ca pac i tated peo ple. Pen sions and other types of so cial pay -
ments and as sis tance that are the main sources for sup port ing life of this cat e gory
must be suf fi cient to en sure the stan dard of liv ing not lower than sub sis tence
level es tab lished by the law.
Table 2
The re spon dents’ es ti ma tions on the monthly size of in sur ance ben e fits/
as sis tance and state so cial as sis tance (ac tual and de sired), in UAH
Variants
Working in
the formal
sector
Working in
the informal
sector
Un em -
ployed Received Desired
Re ce -
i ved
Desir
ed
Recei
ved
Desir
ed
Re ce -
ived
De -
sired Total Men Wo -
men Total Men Wo -
men
In sur ance
ben e fits/
as sis tance
427 2193 399 2071 539 2283 432 419 446 2155 2158 2151
State so cial
as sis tance 425 2360 439 2195 544 2411 439 389 492 2299 2300 2297
Do social insurance benefits/assistance or state social assistance received by
respondents enable to maintain living standards at least at subsistence level
established by the law?
Ac cord ing to the in ter views with PLHIV re spon dents (See Ta ble 2), the av -
er age size of in sur ance ben e fits/as sis tance re ceived by them amounts to 432
UAH per month.
The larg est av er age size of in sur ance ben e fits/as sis tance is 539 UAH (for the
un em ployed). Em ploy ees in the for mal sec tor re ceive on av er age 427 UAH per
month, while those who work in the in for mal sec tor — only 399 UAH.
146 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
De sired size of in sur ance ben e fits/as sis tance, in re spon dents’ opin ions,
should be al most five times larger — about 2155 UAH per month1.
Ac cord ing to the re spon dents’ an swers, the av er age size of state as sis tance is
equal to 439 UAH per month, which is al most the same amount as be ing paid in
the form of in sur ance ben e fits/as sis tance. But its de sired size should be five times
more — 2299 UAH.
The larg est av er age size (544 UAH per month) of state so cial as sis tance is
pro vided to the un em ployed. The small est (413 UAH) is paid to those who work
in the in for mal sec tor of econ omy. Em ploy ees in the for mal sec tor re ceive on av -
er age 425 UAH per month.
It is also nec es sary to note that av er age in sur ance ben e fits/as sis tance and
state so cial as sis tance for women (446 UAH and 492 UAH per month re spec -
tively) are a bit higher than those for men (419 UAH and 389 UAH). So, ac cord -
ing to the re search re sults, the av er age size of both in sur ance ben e fits/as sis tance
and state so cial as sis tance paid to PLHIV is quite low. De pend ing on the cat e -
gory of re spon dents, dif fer ence in the av er age monthly size of in sur ance ben e -
fits/as sis tance and state so cial as sis tance may be about 100–150 UAH.
We would like to re mind that PLHIV to gether with their fam ily mem bers re -
ceive dif fer ent kinds of in sur ance ben e fits/as sis tance and state so cial as sis tance.
There fore, one would as sume that the stan dard of liv ing of these fam i lies is ad e -
quate to meet their ba sic needs (food, cloth ing, med i cal care, etc.) and does not
fall be low the sub sis tence level.
How ever, con sid er ing the level of ag gre gate monthly in come per house hold
mem ber, we saw that one third (34%) of the re spon dents re ceived less than 1108
UAH (that is the sub sis tence level). In come of the other 44% of re spon dents did
not ex ceed 2000 UAH.
At the same time, there are twice as many un em ployed PLHIV (75%) with
in come be low or equal to the sub sis tence level as those who work in the in for mal
sec tor of econ omy (38%) and four times as many as those who work in the for mal
sec tor of econ omy (19%).
What is the ma jor cause of such a sit u a tion? Ac cord ing to the re sults of
in-depth in ter views with key in for mants, al most all ex perts be lieve that most of
the ben e fits, so cial and com pen sa tory pay ments stip u lated by the law are not suf -
fi cient to mit i gate the neg a tive con se quences of eco nomic trans for ma tion in
Ukraine and prac ti cally are not able to re duce pov erty among this cat e gory of
pop u la tion.
“These ben e fits seem very small, ac tu ally mis er a ble. I think they can not
improve liv ing stan dards and qual ity of life of these peo ple. Food, med i cines,
and other things that these pa tients need are too ex pen sive to day, so, it is quite
clear that com pen sa tions that they re ceive are in suf fi cient” (state em ployee,
man).
Let us con sider where re spon dents spend the money they re ceived as in sur -
ance ben e fits/as sis tance and in the form of state so cial as sis tance. The re spon -
dents’ an swers were dis trib uted as shown be low:
— buy ing food — 80%;
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 147
Accessibility and effectiveness of social security granted to people living with HIV
1 Minimum wage in Ukraine at the time of interview was 1147 UAH (i. e. 143 USD).
— cov er ing other daily needs — 76%;
— pur chas ing med i cines — 69%;
— util ity pay ments — 61%;
— trans por ta tion pay ments — 54%;
— pay ing for doc tor con sul ta tions — 23%.
Table 3
The an swers given by re spon dents to the ques tion:
“Where do you spend in sur ance ben e fits/as sis tance or state so cial
assistance that you re ceive?”, %
Variants
ni gnikro
W
la
mrof eht
rotces
ni gnikro
W
la
mrofni eht
rotces
deyolp
men
U
Total
N = 281 By gender:
N % Men Women
Buying food 75 82 90 225 80 80 80
Covering daily expenses 71 80 80 213 76 78 73
Purchasing medicines 62 74 75 194 69 70 69
Utility payments 58 59 75 171 61 57 64
Transportation payments 46 61 55 151 54 56 52
Paying for doctor
consultations 25 21 25 65 23 17 29
As can be seen in Table 3, the structure of respondents’ answers is almost the
same irrespective of the category they belong to. Insurance benefits/assistance
and state social assistance received by respondents are spent to satisfy their basic
needs (food, medicines, etc.) and to cover other daily expenses.
The share of women who spend in sur ance ben e fits/as sis tance and state so cial
as sis tance on doc tor con sul ta tions is al most twice as large as those of men (29%
and 17% re spec tively). Be sides, 64% of women vs. 57% of men spend their ben e -
fits to pay for util i ties.
The re search re sults show that in sur ance ben e fits/as sis tance and state so cial
as sis tance re ceived by re spon dents do not re ally con trib ute to rais ing liv ing stan -
dards of PLHIV and their fam i lies. Fi nan cial con di tions (34%) of these peo ple re -
main quite poor, es pe cially it con cerns fam i lies with chil dren un der the age of 18
and fam i lies with dis abled or out-of-work per sons. This fact dem on strates that
the mech a nisms of so cial sup port pro vided by the state are in ef fi cient to day. Cer -
tain types of so cial ben e fits/as sis tance are granted with out due re gard to real in -
comes of cit i zens (house holds) who ap ply for as sis tance.
Available Types of Social Services
So cial ser vices as an other com po nent of the gen eral so cial se cu rity sys tem are
granted to all cit i zens of the coun try who en coun ter life dif fi cul ties and can not
cope with them in or der to solve their life prob lems. The list of these ser vices was
148 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
pre sented in the ques tion naire in ac cor dance with the pro vi sions of the Law of
Ukraine “On So cial Ser vices”1.
The main forms of so cial ser vices also in clude fi nan cial aid.
Ac cord ing to the Law of Ukraine “On so cial ser vices” the fol low ing ser vices
can be pro vided:
— so cial do mes tic ser vices such as: home de liv ery of food prod ucts and hot
meals, hard and soft goods, means of small-scale mecha ni sa tion; trans por -
ta tion ser vices, so cial do mes tic pa tron age, fa cil i ta tion of so cial and home
ad ap ta tion, call for a doc tor, pur chase and de liv ery of med i cines, etc.;
— coun sel ling and psy cho log i cal ser vices: con sul ta tions on men tal health
prob lems and ad vice on im prov ing re la tions with so cial en vi ron ment, us -
ing psychodiagnostic meth ods for study ing socio-psy cho log i cal char ac -
ter is tics of a per son with the aim of his/her psy cho log i cal cor rec tion or
psy cho log i cal re ha bil i ta tion, meth od olog i cal sup port;
— socio-ped a gog i cal ser vices: iden ti fy ing and pro mot ing fur ther de vel op -
ment of di verse in ter ests and needs of per sons en dur ing ad verse life cir -
cum stances, or gani sa tion of in di vid ual train ing, ed u ca tion and cor rec tion,
ar range ment of lei sure, sports, rec re ational, tech ni cal and ar tis tic ac tiv i -
ties, etc., as well as en sur ing in volve ment of these per sons into work of var -
i ous in sti tu tions, NGOs and stake holders;
— socio-med i cal ser vices: con sul ta tions on pre vent ing emer gence and de vel -
op ment of or ganic men tal dis or ders among PLHIV, main tain ing, sup port -
ing and pro tect ing health of these per sons, im ple men ta tion of pre ven tive,
ther a peu tic and health-im prove ment mea sures, oc cu pa tional ther apy;
— socio-eco nomic ser vices aimed at sat is fac tion of ma te rial needs of per sons
en dur ing ad verse life cir cum stances. These ser vices are pro vided in the
form of fi nan cial aid or in-kind sup port (food, cloth ing, med i cines, fur ni -
ture, etc.) and as one-time com pen sa tory pay ments;
— le gal ser vices: con sult ing on cur rent leg is la tion is sues, pro tec tion of rights
and in ter ests of per sons who are in dif fi cult life cir cum stances, fa cil i ta tion
of the state co er cion and en force ment of le gal li a bil ity of those who have
re sorted to il le gal ac tions in re spect of the per son with HIV/AIDS (prep a -
ra tion of ju rid i cal doc u ments, pro tec tion of rights and in ter ests of the per -
son, other types of le gal aid, etc.);
— job search ser vices: find ing suit able jobs, em ploy ment as sis tance and so -
cial sup port for em ployed per sons;
— in for ma tion ser vices: pro vid ing the in for ma tion needed to solve dif fi cult
life sit u a tions (ref er ence ser vices); dis tri bu tion of ed u ca tional and cul -
tural knowl edge (in struc tive ser vices); dis sem i na tion of the ob jec tive in -
for ma tion con cern ing cus tomer prop er ties and types of so cial ser vices,
formation of cer tain ideas and at ti tudes of the so ci ety to wards so cial prob -
lems (ad ver tis ing and pro mo tion ser vices);
— other so cial ser vices.
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 149
Accessibility and effectiveness of social security granted to people living with HIV
1 See for details: Proceedings of the Verkhovna Rada (Supreme Council) of Ukraine, 2003,
№ 45, Art. 358.
The en ti ties pro vid ing so cial ser vices can ren der them in other forms, not
stip u lated by this ar ti cle of the law, but des ig nated by the Cab i net of Min is ters of
Ukraine as be long ing to the list of charge able so cial ser vices.
The Law of Ukraine “On So cial Ser vices” has cre ated an op por tu nity to in -
volve some non-gov ern men tal or gani sa tions and in sti tu tions into pro vid ing so -
cial ser vices. In ac cor dance with Ar ti cle 12 of the Law of Ukraine “On So cial Ser -
vices”, the sphere of so cial ser vices is based on the use and de vel op ment of all
forms of own er ship and con sists of pub lic and non-gov ern men tal sec tors.
Pub lic sec tor of so cial ser vices in cludes state-owned en ti ties man aged by
cen tral ex ec u tive bod ies.
Com mu nal sec tor of so cial ser vices in cludes mu nic i pally owned in sti tu tions
and es tab lish ments sub or di nated to the lo cal self-gov ern ment au thor i ties.
Un der Ar ti cle 9 of the Law of Ukraine “On So cial Ser vices”, in or der to get
needed so cial ser vices that are pro vided by the state and com mu nal en ti ties, a
per son should ap ply in writ ing to the lo cal ex ec u tive au thor ity or to the lo cal
self-gov ern ment body.
The non-gov ern men tal sec tor in cludes NGOs, char i ties, re li gious or gani sa -
tions and in di vid u als whose ac tiv i ties are re lated to the pro vi sion of so cial ser -
vices. Man age ment of this sec tor is car ried out in the man ner pre scribed by cur -
rent leg is la tion and rel e vant stat utes.
In or der to get so cial ser vices pro vided by non-state en ti ties, a per son that
needs them should ad dress to the rel e vant en tity.
In case a per son who needs so cial ser vices due to his/her age or for health rea -
sons is un able to make a de ci sion whether or not to re ceive these ser vices, such a
de ci sion may be taken by a guard ian or trustee as well as by guard ian ship or
tutorship agen cies, but in ac cor dance with the pro vi sions of cur rent leg is la tion.
Ac cord ing to the re search data, the over whelm ing ma jor ity (82%) of re spon -
dents (655 per sons) re ceived so cial ser vices/as sis tance from pub lic health or -
gani sa tions. The sec ond place was oc cu pied by non-gov ern men tal or gani sa tions
(26% of re spon dents ap plied to them), the third place by so cial se cu rity in sti tu -
tions (24% of re spon dents ad dressed to them), the fourth place went to in ter na -
tional or gani sa tions (15.5% of re spon dents re ceived so cial ser vices/fi nan cial aid
from them) and the fifth place (4% of re spon dents) — to mu nic i pal util i ties
(hous ing so ci ety man age ment units, trans por ta tion fa cil i ties, etc.). The share of
em ploy ers and trade un ions among so cial ser vice pro vid ers was in sig nif i cant:
only 2% and 0.6% of re spon dents, re spec tively, ap plied to them for as sis tance
(See Ta ble 4)1.
As can be seen in Ta ble 4, socio-med i cal ser vices (doc tor con sul ta tions, pre -
ven tive and ther a peu tic mea sures, ART, etc.) pro vided by na tional pub lic health
or gani sa tions took the first place, since 96.5% of re spon dents have re ceived these
ser vices from these in sti tu tions in the last 12 months.
So cial do mes tic ser vices (de liv ery of food prod ucts, trans por ta tion ser vices,
pur chase and de liv ery of med i cines, etc.) were pro vided mainly by in ter na tional
or gani sa tions (77% of re spon dents ap plied to them), so cial se cu rity in sti tu tions
150 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
1 Sum of percentages exceeds 100, because respondents could receive social services/finan -
cial aid from several organisations.
(67.5% of re spon dents ad dressed to them), Ukrai nian NGOs (55% of re spon -
dents re ceived ser vices from these or gani sa tions) and mu nic i pal util i ties (49% of
re spon dents ap plied there).
Ta ble 4
Social services received by respondents or their family members
from different organisations in the last 12 months, %
The list of
variants
reyol p
me eht
mor
F
,)ecal pkro
w eht ta(
N
71
=
,no inu edart eht
mor
F
N
5
=
u ces lai cos eht
mor
F
-
,noi tu tit sni ytir
N
191
=
la p ici nu
m eht
mor
F
na
m gn isuoh( yt ilitu
- a tro psnart ,tne
mega
-
,).cte ,noit
N
53
=
bup lanoi tan eht
mor
F
- ,noi ta sina gro htlaeh cil
N
556
=
nai niark
U eht
mor
F
,
O
G
N N
012
=
lanoi ta nre tni eht
mor
F
,noi ta sina gro
N
421
=
So cial do mes -
tic ser vices 29 60 67.5 49 20 55 77
Psy cho log i cal
ser vices 6 20 38 20 14 45 10.5
Socio-ped a go -
g i cal ser vices 6 - 15 3 1 4 2
Socio-med i cal
ser vices 35 20 52 31 96.5 51 16
Socio-eco no -
mic ser vices 18 - 36 3 7 8 2
Le gal ser vices 6 - 24 - 3 41 6
Job search
ser vices 23.5 - 11.5 - 0.3 4 1
In for ma tion
ser vices - - 18 31 27 54 8
Only 17 persons from the total number of respondents received social ser -
vices from their employers and 5 persons from trade unions. These are basically
social-domestic and socio-medical services.
It should be noted that the re spon dents’ an swers con cern ing so cial ser -
vices/as sis tance were dis trib uted al most in the same way ir re spec tive of the cat e -
gory the re spon dent be longs to (work ing in the for mal/in for mal sec tor or un em -
ployed) and gen der.
Thus, ac cord ing to the re search data, now the state-owned sec tor is the ma jor
pro vider of so cial ser vices in Ukraine since it cov ers the needs of the vast ma jor ity
of re spon dents (as pre vi ously men tioned, 82% of them re ceived so cial ser vices
from the na tional pub lic health or gani sa tions and 24% from the so cial se cu rity in -
sti tu tions). An other dis tinc tive fea ture of the so cial ser vices mar ket is a large
num ber of in ter na tional or gani sa tions and NGOs pro tect ing the in ter ests of
those who en dure ad verse life cir cum stances: 15.5% of re spon dents re ceived so -
cial ser vices from var i ous in ter na tional or gani sa tions and 26% from NGOs. Pub -
lic sec tor pro vides mainly socio-med i cal ser vices, while so cial do mes tic, con sult -
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 151
Accessibility and effectiveness of social security granted to people living with HIV
ing and le gal ser vices be long to the com pe tence of in ter na tional or gani sa tions
and NGOs.
The Main Problems on the Path
to Receiving Social Services/Assistance
Al though the ma jor ity of re spon dents have ac cess to so cial ser vices, al most
20% (ev ery fifth re spon dent) noted that these ser vices were in ac ces si ble. As
shown in Fig. 1, so cial ser vices are less ac ces si ble to those who work in the for mal
econ omy. The un em ployed and women com pared with men (20% and 17% re -
spec tively) have the least ac cess to these ser vices. Such a sit u a tion causes se ri ous
prob lems for them.
Fig. 1. The respondents’ estimations on the accessibility of social services/assistance to them
and their family members
The re search has re vealed a slight dif fer ence in rank ing prin ci pal prob lems on
the path to re ceiv ing so cial ser vices/as sis tance de pend ing on the or gani sa tion
type (state-owned in sti tu tions or non-gov ern men tal or gani sa tions; for more de -
tails see Ta ble 5). How ever, the struc ture of re spon dents’ an swers does not dif fer
sig nif i cantly de pend ing on whether the re spon dent works (in the for mal/in for -
mal econ omy) or is un em ployed). Cor re la tion be tween the prin ci pal prob lems in
re ceiv ing so cial ser vices/as sis tance and the re spon dent’s gen der was not sig nif i -
cant ei ther. At the same time, lack of cer tain ser vices con cerns more men than
women (23% and 14% re spec tively of those who ap plied to the state in sti tu tions,
15% and 2% of those who ad dressed to non-gov ern men tal or gani sa tions). Be -
sides, male re spon dents are more con cerned about the lack of flex i ble work sched -
ule, which hin ders the re spon dent’s op por tu ni ties in ap ply ing for so cial as sis -
tance (10% of men com pared with 5% of women who ap plied to the state in sti tu -
tions and 13% of men com pared with 2% of women who ad dressed to non-gov -
ern men tal or gani sa tions men tioned this prob lem).
152 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
67% of re spon dents who ap plied to the state in sti tu tions and 51% of those
who ad dressed to non-gov ern men tal or gani sa tions iden ti fied the lack of in for ma -
tion about avail able types of so cial ser vices/as sis tance as the main ob sta cle to re -
ceiv ing as sis tance.
25% of re spon dents who of fi cially ap plied to the state in sti tu tions for as sis -
tance re ported that the ap pli ca tion pro ce dure was too com pli cated for them. It
was the sec ond main ob sta cle to re ceiv ing so cial ser vices/as sis tance. 18% of re -
spon dents noted the ab sence of nec es sary ser vices or types of so cial as sis tance,
and 16% were dis sat is fied with qual ity of ser vices/as sis tance they re ceived.
15% of re spon dents who ad dressed to non-gov ern men tal or gani sa tions
noted that these in sti tu tions are lo cated too far from their place of res i dence.
Then fol lowed too com pli cated ap pli ca tion pro ce dure and the ab sence of nec es -
sary ser vices or types of so cial as sis tance (11% and 8% re spec tively were con -
cerned with these prob lems).
The prob lem of too re mote lo ca tion of non-gov ern men tal or gani sa tions pro -
vid ing so cial ser vices/as sis tance for PLHIV is rather acute. Most NGOs are
based in big cit ies, there fore those who live in small towns or vil lages can not re -
ceive the ser vices (or as sis tance) they need.
Table 5
The respondents’ estimations of basic obstacles
to accessing social services/ assistance from the state institutions
and non-governmental organisations, %
Basic
obstacles
State institutions, N = 147 (18.4%) HIV/AIDS non-governmental
organisations, N = 84 (10.5%)
eht ni gn ikro
W
ro tces la
mrof
eht ni gn ikro
W
ro tces la
mro fni
deyol p
m en
U
la to
T
By gender eht ni gn ikro
W
ro tces la
mrof
eht ni gn ikro
W
ro tces la
mro fni
deyol p
m en
U
la to
T
By gender
ne
M
ne
mo
W
ne
M
ne
mo
W
1 2 3 4 5 6 7 8 9 10 11 12 13
Lack of in for -
ma tion about
avail able
types of so -
cial ser -
vices/as sis -
tance
60 73 68 67 67 68 49 43 79 51 50 52
Too com pli -
cated ap pli -
ca tion pro ce -
dure
17 33 23 25 27 23 9 6 29 11 10 11
Ab sence of
nec es sary ser -
vices/types
of so cial as -
sis tance
21 15 23 18 23 14 9 6 14 8 15 2
Poor ser vice
qual ity 19 18 5 16 17 16 9 0 7 5 5 5
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 153
Accessibility and effectiveness of social security granted to people living with HIV
1 2 3 4 5 6 7 8 9 10 11 12 13
The in sti tu -
tion pro vid -
ing so cial ser -
vices/as sis -
tance is too
far from the
re spon dent’s
place of res i -
dence
12 15 5 12 14 10 9 23 14 15,5 18 14
The re spon -
dent can not
of fi cially ap -
ply for so cial
as sis tance for
the fear of be -
ing dis crim i -
nated in the
work place
12 9 0 9 9 9 9 3 0 5 3 7
Man da tory
reg is tra tion
for re ceiv ing
so cial ser vi c -
es/as sis tan ce
9 9 14 9,5 9 10 3 0 7 2 3 2
The re spon -
dent has no
op por tu nity
to ap ply for
as sis tance
due to the
lack of flex i -
ble work
sched ule
9 8 5 7,5 10 5 11 6 0 7 13 2
The re spon -
dent has no
op por tu nity
to ap ply for
as sis tance be -
cause of in -
con ve nient
work ing
hours
9 3 5 5 1 9 0 0 0 0 0 0
Cer tain ser -
vices are too
ex pen sive for
the re spon -
dent (or his/
her fam ily)
0 6 9 4 4 4 0 3 0 1 3 0
The re spon -
dent does not
re ceive any
so cial ser -
vices/as sis -
tance
0 3 0 1 3 0 14 31 0 19 18 21
154 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
Continuation of table 5
1 2 3 4 5 6 7 8 9 10 11 12 13
The re spon -
dent has not
en coun tered
any prob lems
while ap ply -
ing for as sis -
tance
2 0 0 0 1 0
As al ready men tioned, the ma jor ob sta cle to re ceiv ing so cial as sis tance is lack
of in for ma tion about avail able types of so cial ser vices/as sis tance. There fore, in
or der to im prove the pro vi sion of so cial ser vices/as sis tance for PLHIV both
state-owned in sti tu tions and non-gov ern men tal or gani sa tions should or gan ise
var i ous in for ma tion cam paigns among peo ple liv ing with HIV aimed pri mar ily at
ex plain ing how to ap ply for so cial as sis tance. These steps would keep PLHIV in -
formed about ben e fits and ser vices avail able to them, as well as about reg is tra tion
and ap pli ca tion pro ce dures nec es sary to re ceive so cial ser vices/as sis tance.
Ac cord ing to Ukrai nian leg is la tion, so cial ser vices are pro vided both free of
charge and on a fee-pay ing ba sis. The cit i zens who are not able to take care of
them selves due to old age, ill ness, dis abil ity and do not have any work ing-age rel -
a tives who can give them help and sup port, have the right to free so cial ser vices.
So cial ser vices that are not in cluded into the list of free ser vices stip u lated by
na tional stan dards should be de liv ered on a fee-pay ing ba sis. So cial care de part -
ments pro vide nec es sary ser vices on a fee-pay ing ba sis to se niors who have work -
ing-age rel a tives that should care for them.
Table 6
The answers given by respondents to the question:
“Were social/medical services provided to you free of charge?”,%
The list of prob lems
(ob sta cles)
State-owned
in sti tu tions N = 778 (97.3%) HIV/AIDS non-gov ern men tal
organisations, N = 452 (56.5%)
eht ni gn ikro
W
ro tces la
mrof
eht ni gn ikro
W
ro tces la
mro fni
deyol p
m en
U
To tal
eht ni gn ikro
W
ro tces la
mrof
eht ni gn ikro
W
ro tces la
mro fni
deyol p
m en
U
To tal
N % N %
Yes, al ways 74 78 76 594 76 79 84 89 371 82
Yes, though there
were some cases
when I had to pay
16 14 21 123 16 3 6,5 9 24 5
No, I al ways had to
pay for these ser -
vices
9 8 3 61 8 18 9,5 2 57 13
Fee-paying social services defined by national standards are provided with
the use of differentiated fees. The procedure for provision of social services with
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 155
Accessibility and effectiveness of social security granted to people living with HIV
End of table 5
the use of differentiated fee system was approved by the Decree of the Cabinet of
Ministers of Ukraine, № 1184 (December 19, 2012). The fees for providing social
services to a person who needs them shall be at the rate of 12% of his/her average
monthly income for the last 6 months. Differentiated fees are calculated on the
basis of tariffs for chargeable social services.
Ac cord ing to the re search re sults, the over whelm ing ma jor ity of re spon -
dents, ir re spec tive of their em ploy ment sta tus, al ways re ceive so cial/med i cal ser -
vices on a free ba sis: 76% of re spon dents from state-owned in sti tu tions and 82%
from NGOs (See Ta ble 6).
The share of re spon dents who al ways had to pay for so cial or med i cal ser vices
was higher among those who ap plied to the HIV/AIDS non-gov ern men tal or -
gani sa tions (13%) com pared with those who ad dressed to the state in sti tu tions
(8%).
Conclusions
In gen eral, the re search re sults con firm that peo ple liv ing with HIV face nu -
mer ous prob lems in their daily lives. Though ben e fits and rights for this cat e gory
of peo ple are guar an teed by Ukrai nian leg is la tion, many of them en coun ter dif fi -
cul ties when try ing to re ceive so cial ser vices/as sis tance they need. Some peo ple
are not even aware of so cial as sis tance, home care ser vices, var i ous ben e fits and
com pen sa tory pay ments as an im por tant com po nent of the so cial se cu rity sys tem
where HIV-in fected per sons should ap ply, es pe cially due to change in their em -
ploy ment sta tus.
Lack of in for ma tion about avail able types of so cial ser vices/as sis tance for
PLHIV, com pli cated ap pli ca tion pro ce dures, dis crim i na tion and stigma they ex -
pe ri ence when try ing to re ceive so cial and health care ser vices, dif fi cul ties in ac -
cess to many kinds of so cial se cu rity ben e fits, brib ery in ci dences they en coun ter
when ap ply ing for so cial or med i cal as sis tance, low ben e fits and com pen sa tory
pay ments along with other prob lems ex ist ing in the so cial se cu rity sys tem should
not re main un solved since they es sen tially im pair liv ing stan dards of PLHIV and
their fam i lies. The re search has shown that un sub stan ti ated and mostly neg a tive
ideas of the so cial se cu rity sys tem ex pressed by re spon dents do not quite ob jec -
tively re flect the real sit u a tion in this sphere.
Ac cord ing to the re search data, the amount of so cial se cu rity ben e fits (so cial
and health care ser vices, in sur ance ben e fits, com pen sa tory pay ments, etc.) makes
a sig nif i cant por tion of the ag gre gate in come of PLHIV, es pe cially among un em -
ployed re spon dents. So, the share of so cial se cu rity ben e fits in ag gre gate house -
hold in come av er aged 16% for the re spon dents work ing in the for mal econ omy,
20% for those who work in the in for mal sec tor, and 38% for the un em ployed.
The money re ceived by re spon dents as in sur ance ben e fits/as sis tance and in
the form of state so cial as sis tance is spent mainly for buy ing food, cov er ing other
daily needs, pur chas ing med i cines, pay ing for doc tor con sul ta tions, util ity pay -
ments and trans por ta tion pay ments.
How ever, nei ther in sur ance ben e fits/as sis tance nor the state so cial as sis -
tance can im prove liv ing stan dards of PLHIV and their fam ily mem bers. In most
cases, they are only able to main tain liv ing stan dards of this cat e gory of pop u la -
tion at sub sis tence level es tab lished by the law. Ma te rial cir cum stances of the one
156 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
third (34%) of PLHIV fam i lies re main quite poor, es pe cially it con cerns fam i lies
with chil dren un der the age of 18 and fam i lies with dis abled or out-of-work per -
sons. This fact dem on strates that mech a nisms of so cial sup port pro vided by the
state are in ef fi cient to day. Be sides, cer tain types of so cial ben e fits/as sis tance or
state so cial as sis tance are granted with out due re gard to real in comes of cit i zens
(house holds) who ap ply for as sis tance. This is sue re quires spe cial con sid er ation
in the course of so cial se cu rity re form.
Ac cord ing to the re spon dents’ es ti ma tions, socio-med i cal ser vices (con sul ta -
tions on pre vent ing emer gence and de vel op ment of or ganic men tal dis or ders
among PLHIV, main tain ing, sup port ing and pro tect ing health of these per sons,
im ple men ta tion of pre ven tive, ther a peu tic and health-im prove ment mea sures,
oc cu pa tional ther apy, etc.) pro vided by na tional pub lic health or gani sa tions take
the first place among all types of so cial ser vices for PLHIV. More over, the great
ma jor ity of re spon dents re ceive these ser vices in clud ing antiretroviral ther apy
free of charge.
How ever, one can not avoid men tion ing the fact that al most ev ery fifth re -
spon dent has no ac cess to cer tain so cial/med i cal ser vices. Most re spon dents
think that the ma jor ob sta cle to re ceiv ing so cial as sis tance from rel e vant in sti tu -
tions is lack of in for ma tion about avail able types of so cial ser vices/fi nan cial aid.
Hence, in or der to im prove the pro vi sion of so cial ser vices/fi nan cial aid for
PLHIV both state-owned in sti tu tions and non-gov ern men tal or gani sa tions
should or gan ise in for ma tion cam paigns among pop u la tion in clud ing peo ple liv -
ing with HIV. These steps would make PLHIV aware of ben e fits and ser vices
avail able to them, as well as of reg is tra tion and ap pli ca tion pro ce dures nec es sary
to re ceive so cial as sis tance.
Apart from var i ous dif fi cul ties in ac cess to cer tain kinds of the so cial se cu rity
ben e fits or state so cial as sis tance, re spon dents re ported ex pe ri enc ing bi ased at ti -
tude and un friendly treat ment to wards them selves, bribe pay ment re quests
when ap ply ing for so cial or med i cal as sis tance. Such a sit u a tion in di cates the
need to carry out in struc tional and ed u ca tional ac tiv i ties, first of all for med i cal
staff and so cial work ers in or der to fos ter more tol er ant at ti tudes to wards peo ple
liv ing with HIV.
Be sides, de vel op ment of HIV/AIDS pre ven tion programmes for Ukrai nian
en ter prises and im ple men ta tion of the health care re form are also of ex treme im -
por tance.
Ref er ences
The Con sti tu tion of Ukraine // Vidomosti Verkhovnoi Rady (The Of fi cial Bul le tin of the
Verkhovna Rada of Ukraine). — 1996. — № 30. — P. 141.
The Law of Ukraine № 1972-XII “On Pre ven tion of Ac quired Im mune De fi ciency Syn -
drome (AIDS) and So cial Pro tec tion of Pop u la tion”, 12 De cem ber 1991 (since 23 De cem ber
2010 the amended Law “On Coun ter act ing the Spread of HIV-Re lated Dis eases and Le gal and
So cial Pro tec tion of Peo ple Liv ing with HIV”).
The Law of Ukraine № 2017-III “On State So cial Stan dards and So cial Guar an tees”, 5
Oc to ber 2000.
The De cree of the Pres i dent of Ukraine № 717/2000 “On the Main Di rec tions of So cial
Pol icy un til 2004”, 24 May 2000.
Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4 157
Accessibility and effectiveness of social security granted to people living with HIV
The Law of Ukraine № 137-V “On Rat i fi ca tion of the Eu ro pean So cial Char ter (re vised)”,
14 Sep tem ber 2006.
The Law of Ukraine № 1105-XIV “On Com pul sory State So cial In sur ance against Ac ci -
dents at Work and Oc cu pa tional Dis eases En tail ing a Loss of Work ing Ca pac ity”, 23 Sep tem -
ber 1999.
The Law of Ukraine № 1058-IV “On Com pul sory State Pen sion In sur ance”, 9 July 2003.
The Law of Ukraine № 1057-IV “On Non-State Pen sion Se cu rity”, 9 July 2003.
The Law of Ukraine № 3668-VI “On Mea sures of Leg is la tive Sup port of the Pen sion Sys -
tem Re form”, 8 July 2011.
The Law of Ukraine № 1533-III “On Com pul sory State Un em ploy ment In sur ance”, 2
March 2000.
The Law of Ukraine № 2240-III “On Com pul sory State So cial In sur ance against Tem po -
rary Dis abil ity and Cov er ing Costs Re lated to Child birth and Fu neral Needs”, 18 Jan u ary
2001.
The Law of Ukraine № 1768-III “On State So cial As sis tance to Low-In come Fam i lies”, 1
June 2000.
The Law of Ukraine № 2811-XII “On State So cial As sis tance to Fam i lies with Chil dren”,
21 No vem ber 1992.
The Law of Ukraine № 2109-III “On State As sis tance to Per sons Dis abled since Child -
hood and Chil dren with Dis abil i ties”, 16 No vem ber 2000.
The Law of Ukraine № 966-IV “On So cial Ser vices”, 19 June 2003.
The De cree of the Cab i net of Min is ters of Ukraine № 852 “On Monthly State Al low ances
for HIV-In fected Chil dren and Chil dren with HIV-Re lated Dis eases”, 12 Sep tem ber 2012.
The Law of Ukraine № 1026-VI “On Ap proval of the State Programme of HIV Pre -
vention, Treat ment, Care and Sup port to Peo ple Liv ing with HIV/AIDS for the Years
2009–2013”, 19 Feb ru ary 2009.
The Law of Ukraine № 4999-VI “On Im ple men ta tion of the Programmes Fi nanced by the
Global Fund to Fight AIDS, Tu ber cu lo sis and Ma laria in Ukraine”, 21 June 2012.
The Law of Ukraine № 4888-VI “On Amend ments to the Law of Ukraine “On Ap proval of
the State Programme of HIV Pre ven tion, Treat ment, Care and Sup port to Peo ple Liv ing with
HIV/AIDS for the Years 2009–2013”, 5 June 2012.
The Draft Con cept of the State Tar get So cial Programme on Coun ter act ing HIV/AIDS
for the Years 2014–2018. [Elec tronic re source]. — Ac cess mode:
http://www.moz.gov.ua/docfiles/proect_consepcii.pdf.
The Law of Ukraine № 1708-VII “On Ap proval of the State Tar get So cial Programme on
Coun ter act ing HIV/AIDS for the Years 2014–2018”, 20 Oc to ber 2014.
The ILO Code of Prac tice on HIV/AIDS and the World of Work. — Geneva: In ter na -
tional La bour Of fice, 2001.
Edited by Olha Maksymenko
158 Со ци о ло гия: те о рия, ме то ды, мар ке тинг, 2015, 4
Gul’barshyn Chepurko
|