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Title: UKRAINE'S INTERNATIONAL LIABILITIES ON INITIATION OF MEASURES FOR PUBLIC HEALTH PROTECTION AND THE ROLE OF LOCAL AUTHORITIES IN IMPLEMENTATION OF HEALTH CARE POLICY.
Author: Deshko L, Vasylchenko O, Sherbak I, Galai V, Medvid A.
Journal: Georgian Med News; 2021 Mar; (312):163-168. PubMed ID: 33964846.
Abstract:
The article examines the international obligations of Ukraine to implement measures to protect public health and the role of local governments in implementation of health policy. Emphasis is placed on Ukraine's implementation of the Sustainable Development Goals being a member of the UN, the Association Agreement between Ukraine and the EU, and the commitment to develop cooperation in the field of health care undertaken by Ukraine, radical health care reform and decentralization reform in Ukraine. The purpose of the article is to determine the role of local governments in implementation of health policy in the context of decentralization reform and the second stage of health care reform in Ukraine, to identify shortcomings in Ukrainian legislation and the practice that lead to violations of regional communities residents' rights for health care and medical aid, as well as violations of the rights of medical personnel for labor. The object of the study is social relations that arise when the local authorities implement the health care policy. The methodological basis of the conducted research is the general methods of scientific cognitivism as well as concerning those used in legal science: formal logic, methods of analysis and synthesis, comparative law etc. The role of local governments on the implementation of health policy in the context of decentralization reform and the second stage of health care reform in Ukraine is defined: currently local governments are one of the key elements of the organizational and legal mechanism to ensure the rights of every resident for health care and medical aid. They develop and implement regional and local public health programs, directly influencing the state of the health care system. As a part of the decentralization reform, local self-government authorities have gained greater financial autonomy, and radical model of health care financing is being introduced as a part of radical reform of the health care system. Deficiencies in the legislation of Ukraine and the practice of its application, which lead to violations of the rights of residents of territorial communities to health care and medical aid, as well as violations of rights of medical personnel for labor: 1) inconsistency of Ukrainian legislation with the new system of administrative-territorial structure; 2) lack of clear delineation of powers, revenues and expenditures of local governments at the basic (regional), district and sub-regional levels, duplication of powers; 3) the absence of requirements to the content of regional plans for prevention and treatment of diseases that cause the greatest negative socio-demographic and economic impact within current legislation, as well as to the target programs of city councils, reports on their implementation. Emphasis is also placed onto inadequate and untimely funding for secondary link care facilities, existing barriers to the financial success of secondary health care facilities, and quality control of their medical services. Basing on the analysis of the case Law of the European Court of Human Rights, it is established that the stay of patients at medical institutions that are not supplied with the necessary equipment to ensure proper care, transfer of patients from one ward to another without an established diagnosis, failure to provide appropriate treatment because of difficult situation (lack of staff, malnutrition, poor living conditions in the hospital) is a violation of Article 2 of the Convention for the Protection of Human Rights and Fundamental Freedoms.

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