Abstract
<jats:p>The article examines global drivers of transformational change in the healthcare sector in the context of intensified socio-economic, epidemiological, technological, and security challenges. Particular attention is paid to the consequences of the COVID-19 pandemic, military conflicts, digital transformation, demographic ageing, the growing prevalence of non-communicable diseases, workforce shortages, and financial instability. These factors significantly affect the functioning of national healthcare systems and individual healthcare institutions, shaping new requirements for governance, financing, and service delivery models. Healthcare is considered not only as a social sphere but also as a strategic component of economic stability and national security. The paper analyzes the interconnection between systemic transformations at the macro level and institutional changes at the micro level, emphasizing that reforms in financing mechanisms, governance models, digital infrastructure, and clinical practices are ultimately implemented at the level of healthcare institutions. The interaction between external institutional environments and internal organizational adaptations is viewed as a key determinant of overall system performance and long-term sustainability. Special attention is devoted to the development of a managerial and financial architecture that integrates risk-oriented governance, resource optimization, financial transparency, and adaptive decision-making mechanisms. Strengthening systemic resilience and security capacity requires a comprehensive approach combining institutional modernization, sustainable financing, technological innovation, human resource development, and strategic management tools. The study underlines the importance of enhancing the ability of healthcare systems to withstand external shocks, respond effectively to crises, and ensure continuity, accessibility, and quality of medical services under conditions of uncertainty and structural change.</jats:p>