Since 2017, Ukraine has reformed health financing to improve access and reduce out-of-pocket costs, with support from WHO and the World Bank. This third joint review assesses progress, challenges, and adaptations amid the 2022 war. Despite the conflict, reforms have shown resilience, with key achievements and recommendations outlined.
Ukraine embarked on comprehensive health financing reforms in 2017 with the Law on Government Financial Guarantees of Healthcare Services, establishing the Programme of Medical Guarantees (PMG) and the National Health Service of Ukraine (NHSU). The reform aimed to:
- Improve access to essential healthcare services
- Reduce out-of-pocket (OOP) healthcare expenditures
- Ensure financial protection for citizens
- Enhance efficiency and transparency in health financing
The World Health Organization (WHO) and the World Bank have conducted three joint reviews assessing the impact and progress of these reforms. The third review, issued in 2024, evaluates Ukraine’s health system’s resilience amid the war, highlights key achievements, identifies challenges, and outlines recommendations for further improvements. Key achievements:
✔ Expansion of the Programme of Medical Guarantees (PMG): Service packages increased from 33 to 44, covering emergency care, rehabilitation, mental health, and infectious diseases treatment.
✔ Enhanced financial protection: The Affordable Medicines Programme (AMP) has improved access to essential medications, reducing financial burdens for patients.
✔ Adaptation to war-related challenges: Strengthened rehabilitation services, mobile pharmacies, and digital health solutions have expanded healthcare accessibility in war-affected areas.
Challenges remain in key areas, including persistent high out-of-pocket payments, which still account for nearly 50 percent of healthcare expenses, increasing financial hardship. Funding constraints remain a concern, with the health budget declining from 11 percent to 4.9 percent of public spending between 2021 and 2023, necessitating efficient resource allocation and long-term sustainability planning. Healthcare access disparities continue, particularly in rural and conflict-affected regions, where pharmacy shortages and uneven medical service distribution persist.
Strategic priorities include ensuring sustainable health financing through a balance of government revenues and external support, expanding access to essential medicines through enhanced primary healthcare investments, and strengthening governance and transparency to minimize informal payments and improve service delivery.
Ukraine remains committed to advancing healthcare reform and ensuring an efficient, equitable, and financially sustainable healthcare system for all citizens.
For further details, access the full report [here].