FORMATION OF MUNICIPAL HEALTH POLICY: AN ADAPTIVE APPROACH
PDF

Keywords

public management and administration
adaptive management
digitalization
healthcare
sustainable development
territorial communities
inclusiveness

How to Cite

Demchyshyn, Y. (2026). FORMATION OF MUNICIPAL HEALTH POLICY: AN ADAPTIVE APPROACH. Public Management and Policy, (3(19). https://doi.org/10.70651/3041-2498/2026.3.03

Abstract

The article explores the process of developing an adaptive municipal health policy in Ukraine amid wartime challenges, digital transformation, and European integration reforms. Based on an interdisciplinary approach, it analyzes key concepts of modern governance – adaptive governance, complex adaptive systems, and the agile approach in the public sector. The study finds that the effectiveness of municipal health policy is ensured through a combination of flexibility, decentralization, digitalization, and partnership among the state, communities, businesses, and civil society. Particular attention is paid to analyzing the experience of Ukrainian municipalities during the war, which demonstrated institutional learning, crisis management, and digital coordination of medical services. The influence of European integration processes on the modernization of local health systems, legislative harmonization, implementation of European quality standards, and development of partnership programs with cities of the European Union is examined. A conceptual model of adaptive management is proposed, combining the principles of resilience, inclusiveness, and innovation. The results of the study have both theoretical and practical significance for developing strategies for the recovery and advancement of municipal health policy in Ukraine, focused on patient-centered care, quality, and sustainable development within the context of European integration.

https://doi.org/10.70651/3041-2498/2026.3.03
PDF

References

1. Akompab, D. A., Bi, P., Williams, S., Saniotis, A., Walker, I. A., & Augoustinos, M. (2013). Engaging stakeholders in an adaptation process: Governance and institutional arrangements in heat-health policy development in Adelaide, Australia. Mitigation and Adaptation Strategies for Global Change, 18(7), 1001–1018. https://doi.org/10.1007/s11027-012-9404-4

2. Brovko, O. (2025). Local government resilience in the face of Russian aggression: The case of Ukraine. Territory, Politics, Governance, 13(10), 1361–1380. https://doi.org/10.1080/21622671.2024.2327369

3. Carstens, C., Sonnek, K. M., Räty, R., Wikman-Svahn, P., Carlsson-Kanyama, A., & Metzger, J. (2019). Insights from testing a modified dynamic adaptive policy pathways approach for spatial planning at the municipal level. Sustainability, 11(2), Article 433. https://doi.org/10.3390/su11020433

4. Freitas, A., & Santana, P. (2022). Putting health at the heart of local planning through an integrated municipal health strategy. Urban Planning, 7(4), 42–60. https://doi.org/10.17645/up.v7i4.5829

5. Garavaglia, C., Sancino, A., & Trivellato, B. (2021). Italian mayors and the management of COVID-19: Adaptive leadership for organizing local governance. Eurasian Geography and Economics, 62(1), 76–92. https://doi.org/10.1080/15387216.2020.1845222

6. Gustafsson, M., Matveieva, O., Wihlborg, E., Borodin, Y., Mamatova, T., & Kvitka, S. (2025). Adaptive governance amidst the war: Overcoming challenges and strengthening collaborative digital service provision in Ukraine. Government Information Quarterly, 42(3), Article 102056. https://doi.org/10.1016/j.giq.2025.102056

7. Ibrahim Ismael, Z., Mamdouh El-Kholy, S., & Saeed Ahmed Abd-Elrhaman, E. (2021). Knowledge management as a predictor of organizational resilience and agility. Egyptian Journal of Health Care, 12(4), 1397–1412. https://doi.org/10.21608/ejhc.2021.209025

8. Kirilenko, A. (2025). Public administration for sustainable development: Mechanisms and strategies of state and regional administration in the conditions of war and reconstruction of Ukraine. In A. Chechel, Z. Liubov, & M. S. Michal (Eds.), Public administration for sustainable development (Chap. 4). Mariupol State University (Ukraine) & University of Economics and Humanities (Poland). https://www.repository.cam.ac.uk/handle/1810/382228

9. Kot, L. (2025). Social entrepreneurship in wartime: Adaptation strategies and economic resilience. Baltic Journal of Economic Studies, 11(3), 344–352. https://doi.org/10.30525/2256-0742/2025-11-3-344-352

10. Kulhinskyi, Y., Bobak, A., Kravchenko, L., Parkhomenko-Kutsevil, O., Yaremchuk, O., & Asoian, E. (2025). The evolution of strategic management in public administration under the influence of digital technologies and global process in the social and medical sectors. Revista Administração em Diálogo, 27(SI), 184–202. https://doi.org/10.23925/2178-0080.2025v27iSI.73206

11. Nzewi, O. I. (2025). Adaptive governance for resilient local service delivery. Journal of Local Government Research and Innovation, (6), Article a322. https://doi.org/10.4102/jolgri.v6i0.322

12. Oliveira, R., Santinha, G., & Sá Marques, T. (2023). The impacts of health decentralization on equity, efficiency, and effectiveness: A scoping review. Sustainability, 16(1), Article 386. https://doi.org/10.3390/su16010386

13. Paina, L., & Peters, D. H. (2012). Understanding pathways for scaling up health services through the lens of complex adaptive systems. Health Policy and Planning, 27(5), 365–373. https://doi.org/10.1093/heapol/czr054

14. Quirke, E., Klymchuk, V., Gusak, N., Gorbunova, V., & Sukhovii, O. (2022). Applying the national mental health policy in conflict-affected regions: Towards better social inclusion (Ukrainian case). Mental Health and Social Inclusion, 26(3), 242–256. https://doi.org/10.1108/MHSI-01-2022-0002

15. Rabinovych, M., & Bjornå, H. (2025). Navigating turbulence: Adaptive local governance responses to the consequences of Russia’s war against Ukraine in the Norwegian Arctic. Polar Record, (61), Article e26. https://doi.org/10.1017/S0032247425100119

16. Winoto, S., Muluk, M. K., & Wahyudi, L. E. (2023). Local government preparedness in response to the transition from pandemic to endemic: An adaptive governance perspective in Surabaya Municipality. Journal of Governance, 8(2), 295–311. https://doi.org/10.31506/jog.v8i2.19218

17. World Health Organization. Regional Office for Europe. (2022). Compendium of the roadmap for health and well-being in Central Asia (2022–2025) (WHO/EURO: 2022-5904-45669-65599). World Health Organization. https://www.who.int/europe/publications/i/item/WHO-EURO-2022-5904-45669-65599

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright (c) 2026 Yaroslav Demchyshyn