Security aspects of primary health care service delivery under conditions of military aggression in Ukraine
DOI:
https://doi.org/10.32402/dovkil2025.04.020Keywords:
primary health care, patient safety, health system resilience, emergency, military aggressionAbstract
Background. Primary health care (PHC) is a cornerstone of the national health care system and a key determinant of the country’s socio-economic development. The resilience of the health care system in emergency conditions directly depends on the functioning of PHC. Objective. To assess the resilience of Ukraine’s health care system and the population’s access to medical services at the PHC level under prolonged military aggression. Materials and Methods. The study involved an analysis of reports from the World Health Organization (WHO) and the National Health Service of Ukraine (NHSU), scientific literature, and the authors’ previous research findings. Results. Due to active hostilities, approximately 10% of primary health care centers located in government-controlled areas of Ukraine were partially or completely destroyed. Reduced access to PHC manifested in a decline in the proportion of the population with signed declarations with PHC physicians. In the most affected regions, the coverage rate dropped to 34.7%. A general decline in PHC service utilization was also observed, with the number of patient visits in the most affected regions decreasing nearly threefold. The full-scale invasion also triggered a temporary critical decline in the availability of medications. The number of electronic prescriptions issued in March 2022 dropped by 27% compared to February, and in the most affected regions, this indicator decreased more than fourfold. However, positive developments were also noted in addressing medical service accessibility in regions close to combat zones, based on effective cooperation between Ukraine and international organizations. Conclusions. The critical situation in the most affected regions may indicate a systemic crisis in access to medical services in areas close to active hostilities. Developing effective strategies to strengthen the health care system under current challenges is of utmost importance.Downloads
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