INSTITUTIONAL CHALLENGES AND WAYS TO MODERNISE UKRAINE’S HEALTHCARE SYSTEM IN WARTIME

Abstract

The article examines the current state of Ukraine’s healthcare system in the context of structural transformations, external aggression and internal challenges. The author focuses on the main institutional, personnel and financial barriers that hinder the effective functioning of the medical sector. It is emphasised that the crisis in the healthcare system is complex and requires a comprehensive strategic response at the political level.The problem of imbalance between primary, secondary and tertiary healthcare, chronic underfunding, low wages and staff turnover is analysed separately. Considerable attention is paid to the challenges associated with the COVID-19 pandemic and Russia’s armed aggression, which have exposed the weakness of the infrastructure, the system’s insufficient preparedness for crises and the decline in the accessibility of medical services.Particular attention is paid to the influence of the pharmaceutical lobby, corrupt practices in health care management, and the lack of effective communication with the public. The author emphasises that these factors contribute to a high level of public distrust of reforms and complicate their implementation in the long term.An important direction for overcoming personnel challenges is the introduction of professional self-government in the healthcare sector. Based on an analysis of the experience of the United States of America, the feasibility of creating independent professional associations that would play a role in certification, attestation, control of ethical standards, and interaction with the state is justified. This approach can increase professional motivation, reduce emigration and ensure the stability of the system.The introduction of professional self-governance is seen as a tool for strengthening institutional integrity and transparency in the healthcare system. The author emphasises its potential in combating corruption, raising professional ethics and strengthening the internal culture of the industry. The emphasis is on the need to create a regulatory framework that would enshrine mechanisms for the autonomous regulation of the medical profession.As a result, the article forms a scientifically sound concept for modernising Ukraine’s healthcare system, based on strengthening human resources, expanding public participation, ensuring financial stability and institutional renewal through professional self-regulation. The research materials may be useful for government authorities, industry experts, and civil society representatives interested in implementing effective medical policy in the context of hybrid warfare.