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The National Summary Report of Ukraine under the 4th reporting cycle for Parties and non-Parties to the UNECE/WHO Europe Protocol on Water and Health was prepared with support of the EUWI+ and UNECE. The report describes the developments from 2016 until 2018 in the implementation of the Protocol on Water and Health in Ukraine. While the report states improvements in some areas under the Protocol, the report noted a deterioration in the access of citizens to improved sources of drinking water and sanitation conditions in Ukraine. For the first time, Ukraine reported an increase of 21% in the discharge of raw sewage into water bodies, and a deterioration in the quality of drinking water and natural water bodies. Positive trends are observed in the development of water legislation and the development of River Basin Management Plans. Significant progress was noted in the access to sanitation of schools and kindergartens. If this trend continues by 2020, it would be possible to provide all children's educational institutions with basic sanitation conditions.