Sustaining progress towards universal health coverage amidst a full-scale war: learning from Ukraine

Area of Science:

• Public Health
• Health Policy
• Health Systems Strengthening

Background:

• Ukraine implemented health financing reforms based on universal health coverage (UHC) principles following the 2014 Revolution of Dignity.
• These reforms established new systems and institutions largely before Russia's full-scale invasion in February 2022.

Purpose of the Study:

• To explain how Ukraine's UHC-based health financing reforms strengthened the health system's response to the impacts of the 2022 war.
• To highlight the role of UHC principles in enhancing health system resilience during conflict.

Main Methods:

• This commentary analyzes the established health financing reforms and their impact on the Ukrainian health system's resilience.
• The analysis focuses on the period following the 2014 reforms and the onset of the full-scale invasion in 2022.

Main Results:

• The established health financing reforms and institutions provided a resilient framework for Ukraine's health system.
• These UHC-aligned systems facilitated a more robust response to the health challenges posed by the war.

Conclusions:

• Ukraine's experience demonstrates that health financing arrangements aligned with universal health coverage (UHC) principles are crucial for building resilient health systems.
• Implementing UHC reforms proactively can significantly enhance a nation's capacity to withstand and respond to crises, including armed conflict.