Abstract
The Constitution of Ukraine and current legislation define schoolchildren’s health as a priority of state policy. However, a significant gap remains between normative declarations and practical implementation of health-preserving policy in secondary education institutions. The study analyzes the system of legal regulation of schoolchildren’s health preservation in Ukraine through qualitative content analysis of normative documents adopted during 1992-2025. The research examined 15 normative acts and identified 63 references to the concept of “health” within eight categories of legal regulation, including the right to health protection, children’s health, sanitary norms, and environmental and mental health. The study also revealed five main approaches to defining health in Ukrainian legislation and analyzed the distribution of responsibilities among state authorities at different levels. The findings identified six interrelated problems affecting the effectiveness of health policy implementation in schools. These include the inconsistency between declared goals and implementation mechanisms, institutional discoordination between the Ministry of Health, the Ministry of Education and local authorities, insufficient financial support, fragmentation of legal regulation, weak monitoring mechanisms focused mainly on documentation, and the unclear professional status of school nurses. The results confirm the need to move from fragmented regulation toward systemic integration of health-preserving approaches into educational policy. This requires the development of an interministerial strategy, coordinated governance mechanisms, targeted resource provision, and effective monitoring based on health outcomes. Schoolchildren’s health should therefore be considered not only as a pedagogical or medical issue, but also as an object of state policy and intersectoral governance requiring comprehensive institutional reform.
References
1. Baisch, M. J., Lundeen, S. P., & Murphy, M. K. (2011). Evidence-based research on the value of school nurses in an urban school system. Journal of School Health, 81(2), 74–80. https://doi.org/10.1111/j.1746-1561.2010.00563.x
2. Balabanova, D., Mills, A., Conteh, L., Akkazieva, B., Banteyerga, H., Dash, U., Gilson, L., Harmer, A., Ibraimova, A., Islam, Z., Kidanu, A., Kurteva, A., Marchal, B., McKee, M., Murthy, S., Murzalieva, G., Palafox, B., Pannarunothai, S., Rizov, M., & Brugha, R. (2013). Good health at low cost 25 years on: Lessons for the future of health systems strengthening. The Lancet, 381(9883), 2118–2133. https://doi.org/10.1016/S0140-6736(12)62000-5
3. Bonell, C., Fletcher, A., & McCambridge, J. (2007). Improving school ethos may reduce substance misuse and teenage pregnancy. BMJ, 334(7594), 614–616. https://doi.org/10.1136/bmj.f2380
4. Cabinet of Ministers of Ukraine. (2016). Pro skhvalennia Kontseptsii realizatsii derzhavnoi polityky u sferi reformuvannia zahalnoi serednoi osvity “Nova ukrainska shkola” na period do 2029 roku [On approval of the Concept for implementing state policy in the field of reforming general secondary education “New Ukrainian School” until 2029] (Order No. 988-r). https://zakon.rada.gov.ua/laws/show/988-2016-%D1%80 (in Ukrainian)
5. Cabinet of Ministers of Ukraine. (2022). Deiaki pytannia oplaty pratsi medychnykh pratsivnykiv zakladiv okhorony zdorovia [Some issues of remuneration of healthcare workers] (Resolution No. 2). https://zakon.rada.gov.ua/laws/show/2-2022-п (in Ukrainian)
6. Dadaczynski, K., & Paulus, P. (2015). Healthy principals—Healthy schools? A neglected perspective to school health promotion. In V. Simovska & P. Mannix McNamara (Eds.), Schools for Health and Sustainability (pp. 253–273). Springer. https://doi.org/10.1007/978-94-017-9171-7_12
7. Gortmaker, S. L., Wang, Y. C., Long, M. W., Giles, C. M., Ward, Z. J., Barrett, J. L., Kenney, E. L., Sonneville, K. R., Afzal, A. S., Resch, S. C., & Cradock, A. L. (2015). Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Affairs, 34(11), 1932–1939. https://doi.org/10.1377/hlthaff.2015.0631
8. Langford, R., Bonell, C. P., Jones, H. E., Pouliou, T., Murphy, S. M., Waters, E., Komro, K. A., Gibbs, L. F., Magnus, D., & Campbell, R. (2014). The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane Database of Systematic Reviews, 4, CD008958. https://doi.org/10.1002/14651858.CD008958.pub2
9. Maughan, E. D., Bobo, N., Butler, S., Schantz, S., & Zwanziger, J. (2018). Framework for 21st century school nursing practice: An overview. NASN School Nurse, 33(1), 18–24. https://doi.org/10.1177/1942602X17745511
10. Ministry of Education and Science of Ukraine. (2018). Pro zatverdzhennia Pravyl bezpeky pid chas provedennia navchalno-vykhovnoho protsesu [On approval of the Safety Rules during the educational process]. Ministry of Education and Science of Ukraine. (in Ukrainian)
11. Ministry of Education of Ukraine. (1993). Instruktsiia pro poriadok obchyslennia zarobitnoi platy pratsivnykiv osvity [Instruction on the procedure for calculating the wages of education workers] (Order No. 102). https://zakon.rada.gov.ua/laws/show/z0056-93 (in Ukrainian)
12. Ministry of Health of Ukraine. (2020). Hihiienichni vymohy do ulashtuvannia, utrymannia zahalnoosvitnikh navchalnykh zakladiv ta orhanizatsii navchalno-vykhovnoho protsesu [Hygienic requirements for the arrangement, maintenance of general education institutions and organization of the educational process]. Ministry of Health of Ukraine. (in Ukrainian)
13. Ministry of Labour and Social Policy of Ukraine. (2002). Dovidnyk kvalifikatsiinykh kharakterystyk profesii pratsivnykiv [Reference Book of Qualification Characteristics of Workers’ Professions]. https://zakon.rada.gov.ua/rada/show/va117282-02 (in Ukrainian)
14. North, D. C. (1990). Institutions, institutional change and economic performance. Cambridge University Press. https://doi.org/10.1017/CBO9780511808678
15. Shchudro, S. A. (2011). Kryterialne znachennia sotsialno-hihiienichnykh chynnykiv ta umov navchannia u formuvanni zdorovia pidlitkiv zahalnoosvitnikh zakladiv u suchasnykh umovakh [The criterion significance of socio-hygienic factors and educational conditions in the formation of health of adolescents in general secondary education institutions under modern conditions] (Doctoral dissertation abstract). Derzhavna ustanova “Instytut hihiieny ta medychnoi ekolohii im. O. M. Marzieieva AMN Ukrainy”. https://repo.dma.dp.ua/226/ (in Ukrainian)
16. Portnytska, N. F., Savychenko, O. M., & Tychyna, I. M. (2019). Do problemy zberezhennia psykhichnoho zdorovia ditei ta pidlitkiv [On the problem of preserving the mental health of children and adolescents]. Aktualni problemy psykholohii. Psykholohiia obdarovanosti, 6(16), 222–229. http://appsychology.org.ua/data/jrn/v6/i16/app_v6_i16.pdf#page=222 (in Ukrainian)
17. Richardson, E., Roberts, B., Siem, H., & McKee, M. (2013). Health care in transition. In E. Rechel, S. Thomson, & E. van Ginneken (Eds.), Health Systems in Transition: Template for Authors (pp. 245–267). European Observatory on Health Systems and Policies. https://www.researchgate.net/publication/258004432
18. Nadimianova, T. (2015). Problema zdoroviazberezhennia uchnivskoi molodi v umovakh modernizatsii osvitnoi systemy Ukrainy [The problem of health preservation of student youth in the conditions of modernization of the educational system of Ukraine]. Molod i rynok, 10(129), 69–72. http://nbuv.gov.ua/UJRN/Mir_2015_10_17 (in Ukrainian)
19. Desiatnyk, K. V. (2025). Orhanizatsiino-upravlinska praktyka v zakladakh zahalnoi serednoi osvity: Metodychni rekomendatsii dlia zdobuvachiv druhoho (mahisterskoho) rivnia vyshchoi osvity spetsialnosti A3 Pochatkova osvita [Organizational and management practice in general secondary education institutions: Methodological recommendations for applicants of the second (master’s) level of higher education in specialty A3 Primary Education]. Volynskyi natsionalnyi universytet imeni Lesi Ukrainky. https://evnuir.vnu.edu.ua/handle/123456789/28914 (in Ukrainian)
20. Verkhovna Rada of Ukraine. (1992). Zakon Ukrainy “Pro okhoronu zdorovia” [Law of Ukraine “On Health Care”]. Vidomosti Verkhovnoi Rady Ukrainy, 4, Art. 19. https://zakon.rada.gov.ua/laws/show/2801-12 (in Ukrainian)
21. Verkhovna Rada of Ukraine. (1996). Konstytutsiia Ukrainy [Constitution of Ukraine]. Vidomosti Verkhovnoi Rady Ukrainy [Bulletin of the Verkhovna Rada of Ukraine]. https://zakon.rada.gov.ua/laws/show/254к/96-вр (in Ukrainian)
22. Verkhovna Rada of Ukraine. (1997). Zakon Ukrainy “Pro mistseve samovriaduvannia v Ukraini” [Law of Ukraine “On Local Self-Government in Ukraine”]. Vidomosti Verkhovnoi Rady Ukrainy, 24, Art. 170. https://zakon.rada.gov.ua/laws/show/280/97-вр (in Ukrainian)
23. Verkhovna Rada of Ukraine. (2010). Biudzhetnyi kodeks Ukrainy [Budget Code of Ukraine]. Vidomosti Verkhovnoi Rady Ukrainy, 50–51, Art. 572. https://zakon.rada.gov.ua/laws/show/2456-17 (in Ukrainian)
24. Verkhovna Rada of Ukraine. (2017). Zakon Ukrainy “Pro osvitu” [Law of Ukraine “On Education”]. Vidomosti Verkhovnoi Rady Ukrainy, 38–39, Art. 380. https://zakon.rada.gov.ua/laws/show/2145-19 (in Ukrainian)
25. Verkhovna Rada of Ukraine. (2020). Zakon Ukrainy “Pro povnu zahalnu seredniu osvitu” [Law of Ukraine “On Complete General Secondary Education”]. Vidomosti Verkhovnoi Rady Ukrainy, 31, Art. 226. https://zakon.rada.gov.ua/laws/show/463-20 (in Ukrainian)
26. Verkhovna Rada of Ukraine. (2022). Zakon Ukrainy “Pro systemu hromadskoho zdorovia” [Law of Ukraine “On the Public Health System”]. Vidomosti Verkhovnoi Rady Ukrainy, 39, Art. 284. https://zakon.rada.gov.ua/laws/show/2573-20 (in Ukrainian)
27. Waters, E., de Silva-Sanigorski, A., Hall, B. J., Brown, T., Campbell, K. J., Gao, Y., Armstrong, R., Prosser, L., & Summerbell, C. D. (2011). Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews, (12), CD001871. https://doi.org/10.1002/14651858.CD001871.pub3
28. World Health Organization. (2021). Making every school a health-promoting school: Implementation guidance. WHO Press. https://www.who.int/publications/i/item/9789240025073
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2026 Yevheniia Slyvka