• O. Kolomiiets
  • S. Boiko
Keywords: health care, medical provision, financing, reforming, risks, quality of health care services


The issue of the medical sector reforming arose in the first years of Ukrainian independence: under the conditions of insufficient financing, the system of full free medical care could not meet contemporary standards of medical care provision. After a significant decline in the development of the industry, the mechanical increase in funding leads to resource inefficiency only. The higher quality of medical services can be possible after a radical restructuring of the organizational and financial mechanism of the industry functioning. Recently, long-term negative trends in the development of the health care system have been expanded by the latest challenges such as social and medical-demographic problems caused by Russian aggression. In 2017 there were several significant reasons for the health care reform implementation: a decrease in the quality of medical services in the context of increasing household’s consumption expenditures on health care; the signing and the entry into force of Ukraine–European Union Association Agreement; realization of the program "Health – 2020: Ukrainian choice", developed on the basis of the European strategy "Health – 2020"; low wages for medical workers and a decrease in the professional qualification of the industry. Under such preconditions, the main task of medical reform is to form and develop a health financing system that could provide the general population with universal access to all health care services without endangering the economic security of households. In addition, the new legislation provides for the improvement of the technical equipment of health facilities, especially in rural areas due to the implementation of telemedicine projects. Medical reform also involves the direct financing of health facilities for their services provided by the National Health Service.


1. Dopovid shchodo sytuatsii z pravamy liudyny v Ukraini 16 travnia – 15 serpnia 2017 roku [Report on the situation of human rights in Ukraine May 16 – August 15, 2017]. Upravlinnia Verkhovnogo komisara Orhanizatsii Obiednanykh Natsii z prav liudyny – Office of the United Nations High Commissioner for Human Rights. from [in Ukrainian].

2. Donbas lidyruie v Ukraini za kilkistiu Vil-infikovanykh [Donbass is the leader in Ukraine in terms of the number of HIV-infected people]. (n.d.). Retrieved from [in Ukrainian].

3. Under-Secretary-General and Emergency Relief Coordinator Stephen O’Brien Statement on Ukraine. (n.d.). Retrieved from [in English].

4. Sytuatsiia z prohramamy profilaktyky ta likuvannia VIL/TB/VGS/ZPT u Donetskiy ta Luhanskiy oblastiakh (na 27.01.2016) [HIV/TB/HCV/HCT prevention and treatment in Donetsk and Luhansk oblasts (as of January 27, 2016)]. (n.d.). Retrieved from [in Ukrainian].

5. Skladne stanovyshche tsyvilnoho naselennia, yake postrazhdalo vid konfliktu na skhodi Ukrainy [The difficult situation of the civilian population affected by the conflict in Еastern Ukraine]. Orhanizatsiia z bezpeky ta spivrobitnytstva v Yevropi. Spetsialna monitoryngova misiia v Ukraini – Organization for Security and Cooperation in Europe. Special Monitoring Mission in Ukraine. (n.d.). Retrieved from [in Ukrainian].

6. Ukraine: MSF refused permission to work in Lugansk, leaving vulnerable people deprived of essential healthcare and medicines. (n.d.). Retrieved from [in English].

7. Samootsinka naselenniam stanu zdorovia ta rivnia dostupnosti okremykh vydiv medychnoi dopomohy u 2017 r. [Self-assessment by the population of health status and availability of certain types of medical care in 2017]. Derzhavna sluzhba statystyky Ukrainy – State Statistics Service of Ukraine. (n.d.). Retrieved from [in Ukrainian].

8. Natsionalni rakhunky okhorony zdorovia (NROZ) Ukrainy u 2016 rotsi [National Health Accounts (NROs) of Ukraine in 2016]. Derzhavna sluzhba statystyky Ukrainy – State Statistics Service of Ukraine. (n.d.). Retrieved from [in Ukrainian].

9. WHO, Resolution WHA58.33. Sustainable health financing, universal coverage and social health insurance. In: Fifty-eighth World Health Assembly, Geneva, 2005, May 16–25 (WHA58/2005/REC/1). (n.d.). Retrieved from [in English].
How to Cite
Kolomiiets, O., & Boiko, S. (2018). CHALLENGES TO THE HEALTH CARE SYSTEM UNDER RUSSIAN AGGRESSION. Strategic Priorities, 48(3-4), 84-91. Retrieved from