THE ROLE OF STATE POLICY IN ENSURING THE AVAILABILITY OF MEDICAL SERVICES IN UKRAINE

Abstract

The article presents a scholarly and analytical study of the role of public policy in ensuring the accessibility of healthcare services in Ukraine under conditions of profound socio-economic and institutional transformations, further intensified by the full-scale armed aggression of the Russian Federation. The relevance of the topic stems from the urgent need to reconsider approaches to public administration in the healthcare sector as a key component of national security, social stability, and public trust in state institutions. The paper examines the legal, managerial, and financial tools of public policy aimed at ensuring equitable access to healthcare services, particularly through the implementation of the Program of Medical Guarantees, the reform of primary healthcare, the development of digital services, the expansion of healthcare facility autonomy, the decentralization of sector governance, and the introduction of new financing mechanisms based on the “money follows the patient” principle. The study identifies major barriers to healthcare accessibility, including the uneven distribution of infrastructure across regions, a shortage of personnel–especially in rural areas–limited access to specialized services (notably in frontline and de-occupied territories), inadequate coordination mechanisms between levels of government, and the absence of a sustainable healthcare financing model under crisis conditions. The article highlights the potential of applying the principles of resilience, antifragility, and anticipatory governance in updating healthcare accessibility policies. Strategic directions for enhancing public healthcare policy are proposed, including: strengthening the institutional capacity of territorial communities, introducing new accessibility indicators, expanding practices of intersectoral cooperation, and encouraging public participation in the formation of local health policy. The findings may be applied in public administration practice, legislative development, and in designing recovery programs for the healthcare sector in the post-war period.