As part of Health policy paper series, WHO Regional Office for Europe in collaboration with WHO Country Office in Ukraine published a policy brief titled “Aligning health and decentralization reform in Ukraine” (2021).
Considering that Ukrainian decentralization reform has increased and democratized local government responsibility for health care at the level of local government closest to communities, such governance model has increased regional and local government responsibility for public health. The report highlights that decentralization affects health system reform in three important areas: health financing, individual health services and public health.
Authors noted that decentralization reforms changed local government organization, functions and financing, directly affecting delivery of health care services. However, the Ukrainian national Programme of Medical Guarantees (PMG) has led to re-centralizing most health care financing since 2017, while most health facilities remain under local government ownership.
According to WHO summary, financing and delivery of public health services, including disease prevention, health promotion and health protection, are now a mix of central and local government responsibility. Policy recommendations presented in the fifth chapter of the report are grouped into the following three areas:
- Financing of individual health care services;
- Delivery of individual health care services;
- Decentralization of financing and delivery of public health services.
Despite the fact that the novel coronavirus disease 2019-nCoV pandemic presents national and local authorities with unparalleled public health challenges, while reforms are ongoing and incomplete, this report offers recommendations aimed at improving the status quo by guiding national and local health authorities in health system policy-making.
