Aligning health and decentralization reform in Ukraine (2021)

Health policy paper series

Ukrainian decentralization reform has increased and democratized local government responsibility for health care at the level of local government closest to communities and has increased regional and local government responsibility for public health. Decentralization affects health system reform in three important areas: health financing, individual health services and public health.

Decentralization reforms changed local government organization, functions and financing, directly affecting delivery of (individual) health care services. However, the national Programme of Medical Guarantees (PMG) has re-centralized most health care financing since 2017, while most health facilities remain under local government ownership.

Financing and delivery of public health services (encompassing disease prevention, health promotion and health protection) are now a mix of central and local government responsibility. The novel coronavirus disease 2019-nCoV (COVID-19 virus) pandemic outbreak presents national and local authorities with unparalleled public health challenges, with reforms ongoing and incomplete.