Ukraine. Healthcare system. Organizational overview of the structure
The Verkhovna Rada (Parliament) sets the goals, major objectives, priorities, budget guidelines and regulatory framework for the health sector, and approves the targeted national health programmes. State health policy is then implemented by the Ministry of Health. The President is responsible for ensuring that health policy is implemented in accordance with health care legislation and the Constitution through the system of executive bodies. The Cabinet of Ministers coordinates the development and implementation of comprehensive and targeted national programmes, and creates legal, economic and managerial mechanisms to promote the efficient operation of the health system.
The Ministry of Finance prepares the draft state budget, which is then submitted to the Parliament for approval. This defines the public resources to be allocated to the health sector in any given year. The Ministry of Finance is also the body which establishes the requirements for state institutions (including health care facilities) in formulating and implementing budgets.The Ministry of Health is the leading body within the executive power branch responsible for implementing health policy and administering state-owned health facilities. The health system is managed by the Ministry of Health through the regional health authorities in the 24 regional administrations and two city states of Sevastopol and Kyiv, where the departments are part of the city state administrations. There is also a separate Ministry of Health of the Crimea AR, which is part of the Crimean government. At the national level, the Ministry of Health is responsible for setting national health policies, and directly managing and funding certain specialized health care institutions which are in state ownership, higher medical educational establishments, research institutes, and state-owned medico-prophylactic facilities.
The Ministry of Health provides vertical management with basic command-andcontrol institutions which provide regulatory functions in the sphere of social health protection (for example, the State Sanitary-Epidemiological Service and the State Pharmaceuticals Quality Control Inspectorate). The Ministry of Health is also responsible for the organizational and methodological management of activities in the state medical catastrophe service. The latter, in essence, is a functional interagency body. It consists of medical forces, equipment and facilities at the central and regional levels, which are independent of local self-government and are instead under the Ministry of Health in cooperation with the Minist r y of Emergencies, the Ministry of Defence, the Ministry of Internal Affairs, the Ministry of Transport and Communications, the Council of Ministers for the Crimea AR, and state administrations for the oblast, Sevastopol and Kyiv cities. Besides this, the Ministry of Health also manages the undergraduate and postgraduate medical education programme, the medical research system and controls a significant proportion of the centralized state purchase of pharmaceuticals, medical devices and equipment for the relevant state programmes.
The Ministry of Defence, Ministry of Internal Affairs, Security Service and Ministry of Transport and Communications all have their own health care facilities for their employees and their relatives, which operate in parallel to the main statutory system under the Ministry of Health. The State Penal Jurisdiction Department is responsible for the organization of health services within the prison system.
The Ministry of Labour and Social Policy is responsible, among other things, for providing long-term residential care for elderly people and people with disabilities.The National Academy of Medical Sciences of Ukraine controls the research institutes which provide highly specialized medical services. These facilities
are financed directly from the state budget through a separate funding stream.
Local authorities include district, city district, town and village councils and state administrations. These local authorities are important actors in the system as they own and co-finance primary care services provided to their local populations.
Many nongovernment organizations (NGOs) – profe ssional medical associations and patient groups – are planned or in operation, but they are not very influential actors in the health system. There is no self-governing of the medical profession in Ukraine, although this is something that has proved important in ensuring quality and transparency in other countries of Europe.
There are many international organizations working in the Ukrainian health sector, but their activities are focused quite narrowly on specific areas such as sexual health, HIV/AIDS and TB.
The Ministry of Finance prepares the draft state budget, which is then submitted to the Parliament for approval. This defines the public resources to be allocated to the health sector in any given year. The Ministry of Finance is also the body which establishes the requirements for state institutions (including health care facilities) in formulating and implementing budgets.The Ministry of Health is the leading body within the executive power branch responsible for implementing health policy and administering state-owned health facilities. The health system is managed by the Ministry of Health through the regional health authorities in the 24 regional administrations and two city states of Sevastopol and Kyiv, where the departments are part of the city state administrations. There is also a separate Ministry of Health of the Crimea AR, which is part of the Crimean government. At the national level, the Ministry of Health is responsible for setting national health policies, and directly managing and funding certain specialized health care institutions which are in state ownership, higher medical educational establishments, research institutes, and state-owned medico-prophylactic facilities.
The Ministry of Health provides vertical management with basic command-andcontrol institutions which provide regulatory functions in the sphere of social health protection (for example, the State Sanitary-Epidemiological Service and the State Pharmaceuticals Quality Control Inspectorate). The Ministry of Health is also responsible for the organizational and methodological management of activities in the state medical catastrophe service. The latter, in essence, is a functional interagency body. It consists of medical forces, equipment and facilities at the central and regional levels, which are independent of local self-government and are instead under the Ministry of Health in cooperation with the Minist r y of Emergencies, the Ministry of Defence, the Ministry of Internal Affairs, the Ministry of Transport and Communications, the Council of Ministers for the Crimea AR, and state administrations for the oblast, Sevastopol and Kyiv cities. Besides this, the Ministry of Health also manages the undergraduate and postgraduate medical education programme, the medical research system and controls a significant proportion of the centralized state purchase of pharmaceuticals, medical devices and equipment for the relevant state programmes.
The Ministry of Defence, Ministry of Internal Affairs, Security Service and Ministry of Transport and Communications all have their own health care facilities for their employees and their relatives, which operate in parallel to the main statutory system under the Ministry of Health. The State Penal Jurisdiction Department is responsible for the organization of health services within the prison system.
The Ministry of Labour and Social Policy is responsible, among other things, for providing long-term residential care for elderly people and people with disabilities.The National Academy of Medical Sciences of Ukraine controls the research institutes which provide highly specialized medical services. These facilities
are financed directly from the state budget through a separate funding stream.
Local authorities include district, city district, town and village councils and state administrations. These local authorities are important actors in the system as they own and co-finance primary care services provided to their local populations.
Many nongovernment organizations (NGOs) – profe ssional medical associations and patient groups – are planned or in operation, but they are not very influential actors in the health system. There is no self-governing of the medical profession in Ukraine, although this is something that has proved important in ensuring quality and transparency in other countries of Europe.
There are many international organizations working in the Ukrainian health sector, but their activities are focused quite narrowly on specific areas such as sexual health, HIV/AIDS and TB.
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