Keywords
public administration
healthcare
local state administrations
local self-government bodies
decentralization
Program of Medical Guarantees
healthcare financing
social equity
accessibility
public policy
public administration mechanisms
medical services
healthcare system
medical reform
medical infrastructure
financing
war
digitalization
health insurance
human resource potential
treatment
healthcare institutions
system
doctor
patient
How to Cite
Abstract
The article examines the distinct characteristics of regional mechanisms for implementing state health policy in Ukraine, concentrating on the executive responsibilities of local state administrations and self-government bodies that facilitate the practical implementation of national decisions in the healthcare sector. The relevance of this study arises from the ongoing decentralization processes, the reform of the national healthcare system, and new social challenges brought by the war, demographic decline, and economic instability. Under these conditions, the regional level of governance has become crucial in determining the overall efficiency of the healthcare sector – particularly in ensuring public access to quality services, maintaining safety standards, and strengthening the financial sustainability of local communities. The main objective of the research is to examine the structure, mechanisms, and guiding principles of public health management at the regional level and to identify the key factors that influence the effectiveness of policy implementation in this domain. The analysis highlights the leading functions of local state administrations, including the execution of national programs, coordination of healthcare institutions, budget management, and monitoring of the epidemiological situation. It also reveals the important role of self-government bodies in maintaining and developing municipal healthcare institutions, financing local health programs, and involving the public in decision-making processes. The findings demonstrate that the current model of regional healthcare governance in Ukraine has evolved into a multi-level system that integrates both national and local interests. Decentralization has contributed to greater autonomy of territorial communities, enhanced transparency and accountability, and improved adaptability of managerial decisions to the real needs of citizens. At the same time, the efficiency of this system largely depends on the financial capacity of local budgets and the effectiveness of state support mechanisms. The Program of Medical Guarantees plays a central role in this regard, ensuring targeted allocation of funds to priority areas of healthcare – including primary, emergency, specialized, palliative, rehabilitative, and pharmaceutical services. Based on the conducted analysis, the study proposes a set of recommendations aimed at improving regional healthcare governance mechanisms. These include strengthening intersectoral cooperation, advancing electronic monitoring systems, enhancing the financial resilience of local communities, and implementing transparent reporting procedures. The realization of these measures is expected to improve access to healthcare, promote social equity, and contribute to the sustainable development of public administration in the health sector.
References
1. Babenko, M. M. (2022). Rozvytok publichnoho upravlinnia systemoiu okhorony zdorovia ta farmatsii v Ukraini [Development of public administration of the healthcare and pharmaceutical system in Ukraine]. Farmatsevtychnyi zhurnal, 77(4), 3–10. https://doi.org/10.32352/0367-3057.4.22.01 (in Ukrainian)
2. Chupryna, S. L. (2025). Mekhanizmy realizatsii derzhavnoi polityky u sferi okhorony zdorovia v umovakh sotsialnykh vyklykiv [Mechanisms for implementing state policy in the field of healthcare under social challenges]. Economic Scientific Journal, (1), 141–146. https://doi.org/10.32782/2786-765X/2025-10-18 (in Ukrainian)
3. Didyk, N. D. (2024). Derzhavna polityka u sferi hromadskoho zdorov’ia: transformatsiia vektoriv v umovakh voiennoho stanu [State policy in the field of public health: Transformation of vectors in conditions of war]. Vcheni zapysky TNU imeni V. I. Vernadskoho. Seriia: Publichne upravlinnia ta administruvannia, 35(74), 42–47. https://doi.org/10.32782/TNU-2663-6468/2024.2/08 (in Ukrainian)
4. Duliba, Ye. (2022). Osoblyvosti orhanizatsii diialnosti mistsevykh orhaniv vykonavchoi vlady ta orhaniv mistsevoho samovriaduvannia pid chas voiennoho stanu [The Peculiarities of Organization of Activity of Local Executive Authorities and Local Self-Government Authorities During the Martial Law]. Actual Problems of Law, 4(32), 46–55. http://doi.org/10.35774/app2022.04.046 (in Ukrainian)
5. Kabinet Ministriv Ukrainy. (2025). Derzhbiudzhet-2025: okhorona zdorovia [State Budget 2025: Healthcare]. https://www.kmu.gov.ua/news/derzhbiudzhet-2025-okhorona-zdorovia (in Ukrainian)
6. Kolisnichenko, N. T. (2022). Tendentsii rozvytku publichnoho upravlinnia u sferi okhorony zdorovia: hlobalnyi kontekst [Trends in the development of public administration in the field of healthcare: global context]. Naukovyi visnyk: Derzhavne upravlinnia, 2(12), 38–52. https://doi.org/10.33269/2618-0065-2022-2(12)-38-52 (in Ukrainian)
7. Kuibida, V. (2010). Problemy ta perspektyvy funktsionuvannia mistsevykh orhaniv vykonavchoi vlady [Problems and prospects of functioning of local executive authorities]. Osvita rehionu: politolohiia, psykholohiia, komunikatsii, (4). https://social-science.uu.edu.ua/article/331 (in Ukrainian)
8. Ministerstvo finansiv Ukrainy. (2023). U 2023 rotsi vydatky na okhoronu zdorovia stanovly 217,4 mlrd hrn [In 2023, healthcare expenditures amounted to UAH 217.4 billion]. https://mof.gov.ua/uk/news/minfin_u_2023_rotsi_vidatki_na_okhoronu_zdorovia_stanovili_2174_mlrd_griven-4492 (in Ukrainian)
9. Ministry of Health of Ukraine. (n.d.). Upravlinnia litsenzuvannia ta kontroliu yakosti nadannia medychnoi dopomohy MOZ Ukrainy [Department of Licensing and Quality Control of Medical Care, Ministry of Health of Ukraine]. https://moz.gov.ua/uk/kontrol-jakosti-nadannja-medichnoi-dopomogi (in Ukrainian)
10. Petrukha, N., Mazur, A., Kushneruk, O., Stakhova, K., & Tarasenko, M. (2021). Digital and Marketing Steps of Social Cluster Development Institutions in Circular Rural Economy Conditions. In The circular economy as the primary economic model in the context of digital transformation (pp. 57–85). Truskavets: POSVIT.
11. Petrukha, N., Petrukha, S., Alekseienko, N., Kushneruk, O., & Mazur, A. (2023). Social imperatives of public finance: war adaptation and principles of post-war recovery. Financial and Credit Activity – Problems of Theory and Practice, 3(50), 358–371. https://doi.org/10.55643/fcaptp.3.50.2023.4031
12. Petrukha, S. V., Paliichuk, T. V., & Petrukha, N. M. (2020). Miscevi finansy v umovakh koronakryzy: nova biudzhetna arkhitektonika ta finansova spromozhnist rehuliatsii sektoralnykh i sotsialno-ekonomichnykh protsesiv [Local finance in the conditions of the corona crisis: new budgetary architecture and financial capacity of sectoral and socio-economic regulation]. Finanse of Ukraine, (12), 83–105. https://doi.org/10.33763/finukr2020.12.083 (in Ukrainian)
13. Polkovnikova, N. O. (2019). Povnovazhennia orhaniv derzhavnoi vlady ta mistsevoho samovriaduvannia u sferi okhorony zdorovia: Rozmezhuvannia y rivni peretynu [The government authorities and local self-government in the field of health protection: Borders and levels]. Pravo ta derzhavne upravlinnia, (4), 263–269. https://doi.org/10.32840/pdu.2019.4.41 (in Ukrainian)
14. Prystaia, M. (2023). Osoblyvosti publichnoho administruvannia u sferi okhorony zdorovia [Peculiarities of public administration in the field of healthcare]. Uzhhorod National University Herald. Series: Law, 1(80), 557–562. https://doi.org/10.24144/2307-3322.2023.80.1.85 (in Ukrainian)
15. Prystaia, M. M. (2023). Systema orhaniv publichnoho upravlinnia zakladamy okhorony zdorov’ia [System of bodies for public administration of health care institutions]. Iurydychnyi naukovyi elektronnyi zhurnal, (9), 257–259. https://doi.org/10.32782/2524-0374/2023-9/63 (in Ukrainian)
16. Siryi, Yu. M. (2024). Aktualni pytannia diialnosti mistsevykh orhaniv vykonavchoi vlady v umovakh voiennoho stanu [Current issues of local executive authorities’ activities under martial law]. Naukovyi visnyk Natsionalnoi akademii vnutrishnikh sprav, 35(74(3), 123–127. https://doi.org/10.32782/TNU-2707-0581/2024.3/20 (in Ukrainian)
17. State Expert Center of the Ministry of Health of Ukraine. (n.d.). Derzhavnyi ekspertnyi tsentr MOZ Ukrainy [State Expert Center of the Ministry of Health of Ukraine]. https://www.dec.gov.ua (in Ukrainian)
18. State Service of Ukraine on Medicines and Drugs Control. (n.d.). Derzhavna sluzhba Ukrainy z likarskykh zasobiv ta kontroliu za narkotykamy [State Service of Ukraine on Medicines and Drugs Control]. https://www.dls.gov.ua (in Ukrainian)
19. State Statistics Service of Ukraine. (n.d.). Derzhavna sluzhba statystyky Ukrainy [State Statistics Service of Ukraine]. https://www.ukrstat.gov.ua (in Ukrainian)
20. Verkhovna Rada Ukrainy. (1997). Pro mistseve samovriaduvannia v Ukraini [On Local Self-Government in Ukraine]. Law of Ukraine of May 21, 1997 No. 24. https://zakon.rada.gov.ua/laws/show/280/97-%D0%B2%D1%80#Text (in Ukrainian)
21. Verkhovna Rada Ukrainy. (1999). Pro mistsevi derzhavni administratsii [On Local State Administrations]. Law of Ukraine of April 9, 1999 No. 586-XIV. https://zakon.rada.gov.ua/laws/show/586-14#Text (in Ukrainian)
22. Yakovchuk, Ya. V. (2021). Mistsevi derzhavni administratsii yak subiekty publichnoho administruvannia [Local executive authorities as the subjects of the public administration]. Uzhhorod National University Herald. Series: Law, (65), 261–265. https://doi.org/10.24144/2307-3322.2021.65.48 (in Ukrainian)
23. Zhovnirchyk, Ya. F., Dolot, V. D., & Antonov, A. V. (2022). Osnovni napriamy transformatsii systemy publichnoho upravlinnia sferoiu okhorony zdorovia v Ukraini v umovakh voiennoho stanu ta zbroinoi ahresii Rosiiskoi Federatsii proty Ukrainy [Main directions of transformation of the system of public governance in the field of healthcare in Ukraine in conditions of martial status and arms of armed weapons]. Public Administration and Regional Development, (16), 443–465. https://doi.org/10.34132/pard2022.16.08 (in Ukrainian)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2025 Zoryana Buryk, Nina Petrukha, Myroslav Buryk