Abstract
<jats:p>The full-scale invasion of Ukraine by the Russian Federation in 2022 led to a significant reduction in the availability of medical services in Ukraine due to the disruption of healthcare facilities. It included the destruction of facilities restrictions on operations in life-threatening situations and a lack of electricity, water and heating. Staff shortages were also a factor, due to the death or forced migration of medical workers. The war has disrupted vital public health processes, including vaccination programmes, sanitation measures, and epidemiological surveillance. It has also negatively impacted the physical and mental health of the population, resulting in an increased premature and avoidable mortality. In the post-war period, Ukraine will inevitably face the consequences of damaged infrastructure and depleted resources. Drawing on the experience of other countries will therefore be essential for rebuilding the healthcare system and shaping effective demographic policies. Therefore, the experience of the countries of the former Yugoslavia, which underwent a series of armed conflicts between 1991 and 2001 is relevant for Ukraine. This article aims to summarise the conclusions of scientific publications on specific programmes and reforms implemented in the healthcare systems in countries of the former Yugoslavia were that affected by armed conflict at the end of the 20th century. It also aims to identify common reasons for the greater or lesser effectiveness of healthcare system reforms in these countries, and to seek and formulate applicable experiences for Ukraine. This study employed a systematic search of the PubMed and Web of Science bibliographic databases, as well as Google Scholar, to identify academic publications based on criteria relating to the study’s objectives and the comprehensiveness of the reform analysis. A content analysis of the legal frameworks of countries in the former Yugoslavia was also conducted. It has been found that successful healthcare reforms shared several features: compulsory health insurance, a focus on primary healthcare strengthening, and targeted national programmes for preventing and treating non-communicable diseases. Slovenia’s experience has demonstrated that transitioning to social insurance, improving primary care, and implementing consistent policies on non-communicable diseases can reduce mortality long-term. It has been shown that in countries where reforms have not yielded the expected results, they were characterised by chronic underfunding, inefficient resource allocation, a lack of substantial organisational change, the persistence of informal payments, and the emigration and displacement of medical staff. High mortality rates from avoidable causes suggest a combination of inadequate investment and poor communication with the population regarding prevention and timely access to care. Frequent changes in leadership in the healthcare sector, alongside political instability, have created additional obstacles to strategic development. Based on an analysis of the experience of post-war healthcare reforms in the countries of the former Yugoslavia, the following recommendations can be proposed for Ukraine: the fastest possible restoration of universal healthcare coverage with an emphasis on primary care; effective cooperation between the central government, local authorities and domestic professional associations in the process of rebuilding the healthcare system; timely and reasoned initiation of requests for assistance from international donors, and the rational use of this assistance; organisation of effective physical and psychological rehabilitation measures; development and implementation of public awareness campaigns on health issues and personal responsibility for own health.</jats:p>