HMAN5101 – Ukraine’s healthcare system: history, reconstruction, and reform

This course provides knowledge about Ukraine’s healthcare system, examining its historical development, ongoing reform processes and wartime adaptation. This course examines how Ukraine is transforming its healthcare system from the Soviet-era Semashko model toward a modern, European-aligned system, and how it maintained healthcare delivery during a full-scale war. Students learn to read a health system from an economic perspective: identifying who pays, who provides, what incentives shape behavior, what are the types and severity of market failures, and also what are the sources of resilience.

The course covers three thematic areas: the historical foundations of Ukrainian healthcare, the system’s resilience and innovation during wartime, and the ongoing process of health sector reform and European integration.

Within the historical dimension, students examine the legacy of the Semashko system, the challenges of post-Soviet transition, and the health financing reforms initiated after 2014. The wartime dimension explores how the healthcare system has maintained functionality under conflict conditions. The reform dimension addresses Ukraine’s movement toward universal health coverage, the establishment of the National Health Service of Ukraine, and the alignment with European Union health standards.

Throughout the course, students gain understanding and ability to analyze complex health system challenges, with particular attention to lessons that may inform Norwegian and European health policy and preparedness planning.

Knowledge

Upon completion, students will have new knowledge about:

• The structure and organization of Ukraine’s healthcare system, including governance, financing, and service delivery mechanisms
• The key features of the Soviet Semashko model
• The historical development through post-independence transition to current reform processes
• The principle of "money follows the patient" and its implications for efficiency, accountability, and provider behavior in healthcare systems
• The payment-by-packages model under Ukraine’s Program of Medical Guarantees, including tariff setting, contracting logic, and service coverage
• The role of family doctor declarations as a capitation-based mechanism for patient choice, provider competition, and primary care financing
• The function of the National Health Service of Ukraine as a single strategic purchaser of health services
• Differences in financing mechanisms across primary, outpatient, inpatient, and emergency care in post-reform Ukraine
• The role of ProZorro as a national public procurement system in improving transparency, efficiency, and anti-corruption in healthcare purchasing
• Ukraine’s policies to maintain core health system functions under war.
• The role of digital health infrastructure (eHealth) in enabling health system resilience and reform implementation
• Mental health challenges in Ukraine and system responses in conflict-affected populations
• Post-war reconstruction of Ukrainian health care in accordance with European principles

Skills and competence

Students will be able to:

• Describe and discuss alternatives for health system funding mechanisms.
• Contribute informed perspectives on the strengths and weaknesses of alternative provider payment mechanisms
• Describe key aspects of health system resilience strategies and identify lessons transferable to other settings
• Identify, describe and communicate health system challenges to diverse audiences.
• Contribute informed perspectives to policy discussions concerning health sector reconstruction in conflict-affected countries
• Conduct comparative analysis of health financing mechanisms and reform strategies across different country settings
• Evaluate the effectiveness of health system resilience strategies and identify transferable lessons for other contexts

This course is only available for students at the following master programmes:

• European Master in Health Economics and Management (master)
• Health Economics, Policy and Management (master)
• Folkehelsevitenskap og epidemiologi (master)
• Helseadministrasjon (master – experience based)
• International Community Health (master)

Students who are admitted to study programmes at UiO must each semester register which courses and exams they wish to sign up for in Studentweb.

If you are not already enrolled as a student at UiO, please see our information about admission requirements and procedures.

Teaching methods

The course employs a combination of:

• Lectures: Core theory and concepts
• Seminars: Problem-solving and case discussions
• Guest lectures from Ukrainian researchers, health leaders or bureaucrats with international experience
• Group work (student-organized): Group work with problem sets is encouraged

Written examination

Examination and grading at The Faculty of Medicine.