POLITICAL INSTITUTIONS IN THE HEALTHCARE SECTOR OF UKRAINE DURING WARTIME: CHALLENGES, TRANSFORMATIONS AND INTERNATIONAL EXPERIENCE

Abstract

In the current conditions of full-scale war, the healthcare system of Ukraine has acquired the status not only of a social but also of a strategic institution that determines the viability of the state and the resilience of society. Ensuring continuity of medical care, supporting both military personnel and civilians, and responding to mental health and humanitarian challenges shape its role as an integral component of national security. Despite the critical role of the healthcare system, its functioning is characterized by insufficient institutionalization of military medicine, financial instability, staff shortages, and unequal access to services in frontline and rear regions. The absence of a comprehensive strategic approach to political governance in healthcare reduces the effectiveness of responses to the multifaceted challenges of war and limits the potential for post-war recovery. In academic works, Karamushka L. focuses on the mental health of personnel, Kovalchuk V. analyzes legal aspects of the functioning of institutions during martial law, and Romashka S. examines financial mechanisms of healthcare support. Bondarenko-Zelinska N., Boryslavska M., Zelinskyi A. study the right to healthcare protection for vulnerable groups, Levi B., Davidovitch N., Dopelt K. analyze the impact of medical associations on policy, while Nitzan D., Mendlovic J., Ash N. investigate the management of the trauma system during wartime. The objective is to study the peculiarities of the development of political institutions in the field of healthcare in Ukraine under conditions of war, to analyze the experience of Israel and Georgia in combining medical and security policies, and to outline prospects for their adaptation to strengthen the resilience of the Ukrainian system. The article examines the transformations of the Ukrainian healthcare system under the influence of war: staff shortages, financial vulnerability, insufficient legal regulation of the status of military medical workers, and the lack of a comprehensive policy on mental health. Positive examples of decentralization and cooperation with civil society organizations are analyzed, as well as the international experience of Israel and Georgia, which demonstrate different models of institutional adaptation of healthcare systems in crisis conditions. The study proves that political institutions are a determining factor in ensuring the resilience of healthcare during war. Ukraine needs institutional consolidation of military medicine, the development of mechanisms for interagency coordination, guarantees of social protection for medical personnel, and financial stability. The use of international experience will make it possible to create a modernized system capable of functioning effectively both in times of crisis and in the post-war period.

Keywords: healthcare, war, political institutions, military medicine, national security, mental health.