The Ministry of Health of Ukraine presented a methodology for a comprehensive study of the outcomes of the primary healthcare reform, launched in 2018. The assessment will cover funding, staffing levels, the state of medical infrastructure, the organisation of healthcare facilities, and the accessibility and quality of services. Based on the results of the study, the Ministry plans, in particular, to identify the communities that need targeted support for the development of primary healthcare.

The study is scheduled to be completed in the first quarter of 2027. It will be conducted by the National Health Service of Ukraine (NHSU), the Centre for Public Health (CPH) and the P. L. Shupyk National Medical Academy of Ukraine, under the coordination of the Ministry of Health.

Given that primary healthcare is organised at the local level, the results of the assessment are of particular interest to communities. How accessible medical care is to residents is determined by the availability of family doctors, the condition of outpatient clinics, the provision of medical teams and the organisation of healthcare facilities.

As previously reported, with the launch of the reform in 2018, approaches to the funding and organisation of primary healthcare in Ukraine have changed. Patients have been given the freedom to choose their doctor, new mechanisms for paying for medical services have been introduced, and digital healthcare tools have been developed.

According to the Ministry of Health, the number of declarations signed with primary care doctors now exceeds 29.8 million.

Meanwhile, the operating conditions of the healthcare system have changed significantly during this period. The COVID-19 pandemic, full-scale war and other challenges have affected the needs of the population, the workload on healthcare workers, and the capacity of healthcare facilities to provide services.

This comprehensive study is intended to help identify the next steps in the development of primary care, particularly with regard to strengthening medical teams, improving the accessibility and quality of services, and optimising funding.

The assessment is based on patients’ needs: the timely detection of diseases, access to necessary treatment, and continuous medical care for people with chronic conditions.

To prepare the study, the Centre for Public Health summarised the results of 58 studies conducted between 2018 and 2026. On this basis, 64 indicators have been developed, grouped into six areas:

• funding for primary healthcare;
• staffing;
• infrastructure and resilience of healthcare facilities;
• organisation and management;
• accessibility of healthcare;
• comprehensiveness of services and outcomes for patients’ health.

This approach will assess the reform not only in terms of the number of declarations or the volume of funding, but also in terms of how the primary care system functions and to what extent it meets patients’ needs.

The financial component will be examined by NHSU. The Service will analyse data from the electronic healthcare system, including information on declarations, contracts with healthcare providers, and payments made.

The analysis will focus in particular on the relationship between funding and the actual costs incurred by providers in the regions. It will also assess the adequacy of the capitation rate and the adjustment coefficients applied in the funding of primary healthcare.

This area is important for communities given the financial capacity of primary care facilities. The results of the analysis should show the extent to which the current funding mechanisms correspond to the actual costs incurred by providers in different regions.

However, the Ministry of Health has not yet announced any specific changes to the capitation rate or the funding procedure. It merely plans to assess their adequacy.

The P. L. Shupyk National Medical Academy of Ukraine will be responsible for researching staffing levels, service quality, and the organisation of primary healthcare. Experts will analyse the composition of medical teams, staff workloads, training needs, regional differences in access to services, and the interaction between primary and specialist healthcare.

This area is particularly important for communities, especially those where providing the population with GPs and other healthcare professionals remains a challenge.

The university’s work will also include analysing the regulatory framework, summarising survey results, and comparing these with international experience.

The university will coordinate the preparation of the final report and recommendations.

The Centre for Public Health will assess the preventive component of primary healthcare and its impact on public health. The research will cover vaccination, screening, the management of people with non-communicable diseases, the implementation of the “Affordable Medicines” programme, and the provision of mental health care at the primary level.

Patients’ personal expenses for receiving care will be analysed separately. This should help to assess the level of their financial protection.

For communities, such indicators are important in terms of the actual accessibility of services. The ability to consult a GP is, after all, only one component of primary care. It is no less important whether a person can receive the necessary preventive care, treatment and follow-up medical support.

According to the Ministry of Health, the study results are intended to inform further steps to address staffing, funding, and the organisation of primary healthcare.

In particular, the comprehensive analysis should help determine:

• which communities need targeted support;
• how to improve the patient journey within the healthcare system;
• what resources medical teams need to provide a full range of services.

The study is scheduled to be completed in the first quarter of 2027. Its findings are set to form the basis for planning further decisions related to the development of primary healthcare.