The dissertation addresses an urgent scientific problem — the development of theoretical, methodological, and applied foundations for improving the mechanisms of public governance of the strategic potential of Ukraine’s health care system under conditions of reform, digital transformation, and wartime and post-war challenges. The theoretical, methodological, and practical components of the study are aimed at forming a polycentric, adaptive, and socially oriented model of governance that ensures the resilience, effectiveness, and human-centered nature of the national health care system.
In the first chapter «Theoretical Foundations for the Development of Mechanisms of Public Governance of the Strategic Potential of the Health Care System». The conceptual and categorical framework is clarified, in particular the meanings of “public governance in the health care sector,” “strategic potential of the health care system,” “institutional capacity,” “strategic resilience,” and “adaptive governance.” An authorial definition of the strategic potential of the health care system is proposed as an integrated dynamic capability ensuring long-term stability and effectiveness through the synergy of human, financial,
institutional, and innovative resources. A classification of mechanisms of public governance of strategic potential has been developed, covering administrative organizational, economic-financial, legal-regulatory, socio-communicative, and analytical instruments.
In the second chapter «Analysis of the Mechanisms of Public Governance of the Strategic Potential of Ukraine’s Health Care System» a comprehensive assessment of the evolution of the national health care system in 2014–2024 is conducted in the context of decentralization, financial reform, digitalization, and wartime challenges. The evolutionary stages of governance - pre-war, wartime, and recovery - are defined, revealing a shift in state policy priorities from institutional strengthening and autonomy of health care facilities to mobilization readiness, inter-level coordination, and restoration of system resilience. The institutional and legal mechanism is analyzed, including the transformation of the regulatory framework (the Law “On State Financial Guarantees of Health Care Services,” the development of the National Health Service of Ukraine, the implementation of the “money follows the patient” principle, and the establishment of the eHealth system).
In the third chapter «Directions for Improving the Mechanisms of Public Governance in the Health Care Sector» a system of scientifically grounded proposals has been formulated for improving the organizational, financial, legal, and analytical mechanisms of sectoral governance. Based on a comparative analysis of health care governance models in EU and OECD countries (Beveridge, Bismarck, private insurance, and hybrid models), the feasibility of combining state responsibility, insurance mechanisms, and institutional autonomy within a polycentric governance system is substantiated. Adaptation trajectories of European experience are proposed, including: harmonization of Ukrainian legislation with EU directives; development of health insurance; strengthening of public–private partnerships; introduction of performance-based financing instruments; and enhancement of managerial capacity through health management programs. A conceptual model of the comprehensive mechanism of strategic potential governance is developed, comprising five interrelated blocks - legal regulatory, organizational-human resources, financial-economic, information analytical, and socio-communicative - functioning in a closed cycle of “data – analysis – managerial action – verification – correction.”
Key words: public administration, public policy, public administration mechanisms, healthcare, medical services, healthcare system, healthcare reform, healthcare system management, medical infrastructure, COVID-191, financing, war, digitalization, medical insurance, human resources.
