Human-geographical peculiarities of the healthcare system of Ukraine in the conditions of modern challenges

Keywords: health care system, insurance medicine, World Health Organization, GDP per capita, Ukraine, post-socialist countries


Relevance. The paper examines the issues of the health care system development of Ukraine in the context of modern challenges. Today, there are many global environmental, socio-demographic, and economic problems threatening the existence of human civilization. One of the problems was the spread of coronavirus infection COVID-19, which demonstrated unpreparedness of Ukraine and post-socialist countries' health care systems. These countries are undergoing health care transformations, but they do not meet modern world norms and standards.

The purpose of the article is to establish the key features of the health care system of Ukraine during its transformation given the positive experience of medical systems in the world, from the positions of human geography to identify current challenges and to assess the ability to respond to social demand and the threat of the global crisis in the form of new diseases, the spread of epidemics threatening to human health, quality and life expectancy.

Methods. This research is conducted on the basis of human-geographical approach with use of the set of methods and tools to analyze the health care system, which is extremely important for obtaining verified and scientifically sound results. In particular, the authors used methods of induction and deduction, comparison, formalization, analogy, analysis, systematization, including ranking and grouping, historical, graphical, mathematical and statistical, SWOT-analysis methods.

Results. Scientific novelty and practical significance. The features, advantages and disadvantages of existing models of health care systems in different countries were identified. In particular, models of medical systems were considered: a model of the single-payer, model of obligatory insurance, and hybrid system. The peculiarities of the formation of the health care system of Ukraine were determined, the key features and principles of the M.O. Semashko’s system were identified, its positive and negative features preserved to this day were outlined. The distribution of European and post-socialist countries was analyzed according to the indicators of state budget expenditures on health care and GDP, number of doctors, hospital beds per capita. The transformational processes in the health care system of Ukraine, the peculiarities of the medical reform in Ukraine were revealed, the peculiarities of the development of the medical system in the conditions of the pandemic were characterized. The SWOT analysis identified the strengths and weaknesses of the Ukraine’s health care system in terms of reform and transformation, its opportunities and threats in the light of current challenges.


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Author Biographies

Liudmyla Niemets, V. N. Karazin Kharkiv National University

DSc (Geography), Professor

Oksana Bartosh, Royal Roads University

Associate Faculty

Kateryna Sehida, V. N. Karazin Kharkiv National University

DSc (Geography), Associate Professor

Kostiantyn Niemets, V. N. Karazin Kharkiv National University

DSc (Geography), Professor

Liudmyla Kliuchko, V. N. Karazin Kharkiv National University

PhD (Geography), Associate Professor

Kateryna Kravchenko, V. N. Karazin Kharkiv National University

PhD (Geography), Associate Professor

Ievgeniia Telebienieva, V. N. Karazin Kharkiv National University

PhD (Geography), Associate Professor


Budgetary space for health in Ukraine. Policy document to support budget preparation dialogue for 2021 (2020). Health Policy Paper Series No. 20/01. World Health Organization. Regional Office for Europe. Available at: [in Ukrainian].

Dolbneva, D.V., Goncharuk, S.M. (2016). Neobkhidnist ta osnovni napriamky vdoskonalennia poriadku formuvan-nia ta vykorystannia resursnoho potentsialu okhorony zdorovia v Ukraini. [The necessity and main directions for improving the order of the formation and use of resource potential of health care in Ukraine]. Ekonomika ta up-ravlinnia natsionalnym hospodarstvom, Problemy ekonomiky [Economics and management of the national econ-omy, Problems of economy], 3, 46-52. Available at: [in Ukrainian].

Bogdan, D., Boyko, A., Vasilkova, A. et al. (2019). Kadrovi resursy systemy okhorony zdorovia v Ukraini. Sytuatsi-inyi analiz. Proekt USAID «Pidtrymka reformy okhorony zdorovia» [Human resources of the health care system in Ukraine. Situational analysis. USAID Health Care Reform Support Project]. Kiev. Available at: [in Ukrainian].

Korniychuk, O.P. (2013). Transformatsiia systemy okhorony zdorovia Ukrainy: stan ta perspektyvy [Health care transformation in Ukraine: the state and prospects]. Ukrainskyi medychnyi chasopys. Aktualni pytannia medych-noi praktyky [Ukrainian medical journal. Current issues of medical practice], 4 (96), VII/VIII. Available at: [in Ukrainian].

Melnichenko, A. (2017, October 9). 10 stran s luchshej sistemoj zdravoohranenija v mire [10 Countries with the best healthcare system in the world] Available at: [in Russian].

Mechanic, A. (2011, August 1).Pyramyda Semashko [Semashko’s Pyramid]. Expert, 30-31 (764). Available at: [in Russian].

Natsionalna stratehiia reformuvannia systemy okhorony zdorovia v Ukraini na period 2015-2020 roky [National strategy for reforming the health care system in Ukraine for the period 2015-2020]. Available at: [in Ukrainian].

Niemets, K. A., Sehida, K. Yu., Niemets, L. M. (2016). Multidimensional analysis in human geography (non-traditional methods): monograph [Bahatovymirnyy analiz u suspilʹniy heohrafiyi (netradytsiyni metody): monohr-afiya], Kharkiv, V.N. Karazin Khrakiv National University, 120 [in Ukrainian].

Official web-site of the World Health Organization. Available at:

Pandemiia dovela: u medychnykh vyshakh Ukrainy vidnovliat navchannia virusolohiv [The pandemic proved: training of virologists will be resumed in medical universities of Ukraine] (2020, May 13). Novynarnia. Available at: [in Ukrainian].

Pravovi zasady reformuvannia haluzi okhorony zdorovia: stan, problemy, perspektyvy rozvytku [Legal bases of health care reform: state, problems, prospects of development]. Available at: [in Ukrainian].

Pro derzhavni finansovi harantii medychnoho obsluhovuvannia naselennia [About the state financial guarantees of medical service of the population] 2168-VIII. Vidomosti Verkhovnoi Rady [Information of the Verkhovna Rada], № 5, art.31 (2018) [in Ukrainian].

Sazonets, I., Zyma, I. (2018). Identification of problems and main directions of reform health care system of Ukraine. Elektronnyi zhurnal «Derzhavne upravlinnia: udoskonalennia ta rozvytok» [Electronic journal "Public Administration: Improvement and Development"], 12,

Torhun, A. (2020, January 24). Four models of health insurance. Which one did the new government choose? NV. Available at:

Atun, R. (2015, October 1,). Transforming Turkey's hHealth Ssystem. The New England Journal of Medicine, 373 (14), 1285-1289,

Bertens, R.M., Vonk, R.A.A. (2020). Small steps, big change. Forging a public-private health insurance system in the Netherlands. Social Science & Medicine, 266, 113418,

China’s Progress Report on Implementation of the 2030 Agenda for Sustainable Development (2019): Ministry of Foreign Aff airs of the People’s Republic of China. Available at:

Cockerham, W.C., Hinote, B.P., Cockerham, G.B., Abbott, P. (2006). Health lifestyles and political ideology in Bela-rus, Russia, and Ukraine. Social Science & Medicine, 62 (7), 1799-1809,

Cybulska, A. (2016). Korzystanie ze świadczeń i ubezpieczeń zdrowotnych. KOMUNIKATzBADAŃ, NR 112. Availa-ble at:

Dózsa, C., Jankus, K., Helter, T.M. (2019). Structural Changes in the Hungarian Healthcare System Between 2000 and 2017. Value in Health Regional Issues, 19, 92-98.

Gheorghita, E. (2013, January 21). Bugetul Ministerului Sănătăţii, mai mare cu 80,95% în 2013. Available at:

Inoue, S., Xu. H., Maswana, J., Kobayashi, M. (2016). Construction of System Dynamics Model for Medical Care System of Japan. Value in Health, 19 (7), A820,

Kerner, Á., Csákvári, T., Betlehem, J., Molics, B., Danku, N., Endrei, D et al. (2017). Description Of The Chinese Health Care System After The Health Care Reform. Value in Health, 20 (9), A514,

Kostrikov, S., Niemets, L., Sehida, K., Niemets, K., Morar, C. (2018). Geoinformation Approach to Urban Geograph-ic System Research (Case Studies of Kharkiv region, Ukraine). Visnyk of V. N. Karazin Kharkiv National University, series "Geology. Geography. Ecology", 49, 107-124,

Lanea, J., Andrews, G., Orange, E., Brezak, A., Tanna, G., Lebese, L., et al. (2020). Strengthening health policy de-velopment and management systems in low- and middle- income countries: South Africa's approach. Health Policy OPEN, 1, 100010,

Lekhan, V., Rudiy, V., Richardson, E. (2010). Ukraine. Health system review. Health Systems in Transition, 12 (8).

Liu, Y. (2011, November 1). China’s Health Care Reform: Far From Sufficient. The New York Times. Available at:

Lucka, J., Peabodybc, J.W., DeMariabc, L.M., Alvaradoa, C.S., Menond, R. (2014). Patient and provider perspec-tives on quality and health system Luck, J., Peabody, J.W., DeMaria, L.M., Alvarado, C.S., Menon, R. (2014). Pa-tient and provider perspectives on quality and health system effectiveness in a transition economy: Evidence from Ukraine. Social Science & Medicine, 114, August 2014, 57-65,

Lukić, T., Lukić, A., Basarin, B., Ponjiger, T., Blagojević, D., Mesaroš, M., Milanović, M., Gavrilov, M., Pavić, D., Zorn, M., Komac, B., Miljković, Ð., Sakulski, D., Babić-Kekez, S., Morar, C. & Janićević, S. (2019). Rainfall ero-sivity and extreme precipitation in the Pannonian Basin – preliminary results. Open Geosciences, 11(1), 664-681,

McMahon, J. (2020, August 5). 5 Facts about healthcare in Romania. The Borgen Project. Available at:


Mehtap, T., Mollahalilog˘lu, S. (2011). The Health Insurance System in Turkey. Angluinfo Turkey. Available at:

Memia, F. (2015). Health Care Insurance System in the Republic of Albania and Development Perspective. Journal of Educational and Social Research, 5 (1), January 2015.

Morar, C., Dulca, M., Nagy, G. (2016). Brownfields Regeneration, between Sustainable Urban Development and Cultural Heritage, the former military sites in Oradea, Romania. Journal of Urban and Regional Analysis, VIII (1), 75-84, / JURA.2016.8.1.6

Morar, C., Nagy, G., Dulca, M., Boros, L., Sehida, K. (2019). Aspects Regarding the Military Cultural-Historical Heritage in the City of Oradea, Romania. ANNALES – Annals for Istrian and Mediterranean Studies – Series His-toria et Sociologia, Issue 2, 303-323, Available at:


Morar, C. Lukić, T., Basarin, B., Valjarević, A., Vujičić M., Niemets, L., Telebienieva, I., Boros, L., Nagy, G. (2021). Shaping Sustainable Urban Environments by Addressing the Hydro-Meteorological Factors in Landslide Occur-rence: Ciuperca Hill (Oradea, Romania). International Journal of Environmental Research and Public Health, 18(9), 5022;

Morar, C., Nagy. G., Boros, L., Gozner, M., Niemets, L., Sehida, K. (2021). Heritage, Culture and Regeneration of the former Military Areas in the city of Oradea (Romania). Architektúra & urbanizmus, 55, 1-2.

Nemets, L., Kobylin, P., Segida, K. (2014). Analysis of development trajectory for social infrastructure of Kharkiv region. Actual Problems of Economics, 161 (11), 409-418.

Niemets, K., Kliuchko, L., Kulieshova, G. (2015). Features of social and geographical researches of health care system of the border region. Economic Annals-XXI, 1-2 (1), 93-97. Available at:

Niemets, K., Sehida, K., Niemets, L., Krainyukov, O., Telebienieva, I., Kobylin, P. (2018). Some Issues of the For-mation and Implementation of the Development Strategies of Ukraine’s Regions Taking into Account European Experience. Proceedings of the 32nd International Business Information Management Association Conference (November 15-16, 2018, Seville, Spain,), 314-327. Available at:

Niemets, K., Yakovleva, J., Niemets, L. (2014). The analysis of the research results of sociogeographical features of Donetsk region's social development as an old industrial region. Actual Problems of Economics, 162 (12), 271-280.

Niemets, L., Mezentsev, K., Morar, C., Sehida, K., Husieva, N., Peresadko, V. (2018). Innovation and Investment Po-tential of Region as a Factor of its” Smart Transformation”: Kharkiv Region Case Study (Ukraine). Visnyk of V. N. Karazin Kharkiv National University, series "Geology. Geography. Ecology", 49, 137-159,

Popchenko, T. On the priority areas for improving the domestic health sector.Analytical note. National Institute for Strategic Studies. Available at:

Quantitative and qualitative analysis of Ukraine’s emergency medical services to assess current capacities and opportunities for future development (2020). World Health Organization. Regional Office for Europe. Available at:

Sheiman, I. (2013) Rocky road from the Semashko to a new health model. Bull World Health Organ, 91, 320–321,

Slaybaugh, C. (n.d.). International Healthcare Systems: The US Versus the World. Axene Health Partners. Available at:

Stankov, U., Vasiljević, Ð., Jovanović, V., Kranjac, M., Vujičić, M., Morar, C. & Bucur, L. (2019). Shared Aerial Drone Videos — Prospects and Problems for Volunteered Geographic Information Research. Open Geosciences, 11(1), 462-470,

Tomini, S. M., Groot, W., Pavlova, M., Tomini, F. (2015). Paying out-of-pocket and informally for health care in Al-bania: the impoverishing effect on households. Frontiers in Public Health, 28 August 2015,

TOP 10: Countries with the best healthcare system. Available at:

Tran, L.D., Zimmerman, F.J., Fielding, J.E. (2017). Public health and the economy could be served by reallocating medical expenditures to social programs. SSM - Population Health, 3, 185-191,

Ukraine: review of health financing reforms 2016–2019 (2019). WHO–World Bank Joint Report. Available at:

Vujičić, D. M., Vasiljević, D. A., Hose, T.A., Tasić, N., Morar, C., Ðurić, A., Marković, S. B. (2018). A multi-criteria decision analysis with special reference to loess and archaeological sites in Serbia (Could geosciences and ar-chaeology cohabitate?).Open Geosciences, 10(1), 333-343,

World Bank national accounts data, and OECD National Accounts data files.

Xiao, Y., Chen, X., Li, Q., Jia, P., Li, L., Chen, Z. (2021). Towards healthy China 2030: Modeling health care acces-sibility with patient referral. Social Science & Medicine, 276, May 2021, 113834,

How to Cite
Niemets, L., Bartosh, O., Sehida, K., Niemets, K., Kliuchko, L., Kravchenko, K., & Telebienieva, I. (2021). Human-geographical peculiarities of the healthcare system of Ukraine in the conditions of modern challenges. Visnyk of V. N. Karazin Kharkiv National University, Series "Geology. Geography. Ecology", (54), 206-223.

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