LOCAL SELF-GOVERNMENT AS AN ACTOR IN ENSURING THE RESILIENCE OF UKRAINE’S HEALTHCARE SYSTEM

Abstract

The article examines local self-government as an important institutional actor in ensuring the resilience of Ukraine’s healthcare system under conditions of contemporary security, social, demographic, and institutional challenges. The study substantiates that the resilience of the healthcare system cannot be reduced solely to centralized state policy, the availability of medical infrastructure, or the volume of financial resources. It is also determined by the capacity of territorial communities to preserve the continuity of medical services, adapt to crisis conditions, mobilize local resources, and respond to the specific needs of the population. Particular attention is paid to the institutional and legal status of local self-government in the healthcare sector. Local self-government bodies are considered not only as owners or founders of municipal healthcare institutions, but also as actors of local health policy, financial partners, coordinators, and representatives of community interests. The article emphasizes that decentralization has expanded the managerial opportunities of territorial communities, while also increasing their responsibility for the quality, accessibility, and sustainability of basic healthcare services. The article analyzes the role of territorial communities in ensuring access to primary healthcare, transport and physical accessibility, financial support for vulnerable groups, human resource capacity, digital accessibility, and the adaptation of services to wartime needs. It is argued that under martial law the functions of local self-government have acquired a crisis-management and security-oriented character, especially in relation to the restoration of damaged medical infrastructure, the support of internally displaced persons, the provision of rehabilitation and psychological assistance, and coordination with military administrations, humanitarian organizations, and state institutions.