Ukraine HiT (2015)
Since Ukraine gained independence from the USSR in 1991, successive governments have struggled to overcome funding shortfalls and modernize the health care system to meet the population's health needs. Life expectancy in Ukraine in 2012 was low by European standards (66.2 years for men and 76.2 years for women) and it was estimated that a quarter of all premature deaths in 2004 could have been avoided with timely access to effective treatment.
No fundamental reform of the Ukrainian health system has been implemented and consequently it has preserved the main characteristics of the Soviet Semashko model, but with a large proportion of total health expenditure being paid out of pocket (42.3% in 2012). Ukraine has a very extensive health infrastructure and incentives in the system favour inpatient over primary care.
The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Conflict and political instability meant the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns as more than 1 million people have been displaced by the ongoing conflict. It is hoped that greater political, social and economic stability will provide a conducive environment for addressing shortcomings in the Ukrainian health system, but that these reforms will also draw on the best available international evidence of what works to promote equity, quality and efficiency.
HiT health system reviews are country-based reports that provide a detailed description of a country's health system and of reform and policy initiatives in progress or under development. More up-to-date information on many countries can be found on our Health Systems and Policy Monitor (HSPM).