APPLICATION OF THE DIALOGICAL MODEL OF CHANGES IN THE PROCESS OF REFORMING THE HEALTH SYSTEM IN UKRAINE AT THE PRIMARY LEVEL

Keywords: public; reform, the health care system, the primary level of care, the dialogical model of change

Abstract

The publication states the grounds for health care reform in Ukraine, taking into account the medical and demographic crisis and the need to preserve and improve health, not only as a result of the absence of diseases or physical defects, but also as a fact of complete physical, mental and social well-being of the population.

The key steps that have been taken in the context of the implementation of primary health care reform from a dialogical model of change are analyzed, which envisages result-oriented structured planning and stakeholder dialogue over four stages: study and engagement; development and formalization; implementation and evaluation; further development, reproduction / institutionalization. Each of the four stages of a dialogical model of change includes steps that must be followed in order for any initiative to achieve its goal. The dialogical model of change explains what needs to be taken into account in order to facilitate dialogue and result orientation.

It has been proven that the outcome of health care reform, like any other, depends on the experience of managing processes and change, a thorough understanding of the concept of change, the ability of all stakeholders in the reform process to analyze and manage information.

Summarizing the positive achievements of the health care reform - providing state guarantees for the provision of health services in accordance with the types of health care; developing an efficient and accessible network of institutions; continuous improvement of the quality of medical care; implementation of an electronic health system; providing patients with medicines and the like, emphasized on the need for comprehensive application of organizational-managerial, information-communication, financial-economic, regulatory and other mechanisms to effectively implement health care reform through the lens of a dialogical model of change.

References

1. Administrator Tsentralnoi bazy danykh eHealth Ukrainy ehealth.gov.ua Retrieved from https://ehealth.gov.ua/
2. Bykhovchenko V.P. Ivaniuk O.V Horodnycha Yu.V Stan medychnoho strakhuvannia v Ukraini ta yoho priorytetni napriamy. Hlobalni ta natsionalni problemy ekonomiky. 2016. Vyp.10. S. 733-736. global-national.in.ua Retrieved from http://global-national.in.ua/archive/10-2016/153.pdf
3. Chepelevska L.A., Rudnytskyi O.P., Dziuba O.M. Problemy demohrafichnoi kryzy v Ukraini: rehionalnyi aspekt. Ukraina. Zdorovia natsii. 2014. № 4. S. 5-9. irbis-nbuv.gov.ua Retrieved from http://irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/cgiirbis_64.exe?C21COM=2&I21DBN=UJRN& P21DBN= UJRN&IMAGE_FILE_DOWNLOAD=1&Image_file_name=PDF/Uzn_2014_4_3.pdf
4. Chepelevska L.A., Yashchenko Yu.B. Dynamika smertnosti naselennia Ukrainy na suchasnomu etapi: rehionalnyi aspekt. Ukraina. zdorovia natsii. 2013. № 2 (26). S.30-34 www.irbis-nbuv.gov.ua Retrieved from http://www.irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/ cgiirbis_64.exe?C21COM=2&I21DBN=UJRN&P21DBN=UJRN&IMAGE_FILE_DOWNLOAD=1&Image_file_name=PDF/Uzn_2013_2_6.pdf
5. Constitution of the world health organization. who.int Retrieved from https://www.who.int/governance/eb/who_constitution_en.pdf
6. Daidzhest zmin u systemi okhorony zdorovia moz.gov.ua Retrieved from https://moz.gov.ua/dajdzhest-zmin-u-sistemi-ohoroni-zdorov%e2%80%99ja
7. Deiaki pytannia shchodo dohovoriv pro medychne obsluhovuvannia naselennia za prohramoiu medychnykh harantii: Postanova KMU vidvid 25 kvitnia 2018 r. № 410 zakon.rada.gov.ua Retrieved from https://zakon.rada.gov.ua/laws/show/410-2018-%D0%BF#n52
8. Derzhavne upravlinnia okhoronoiu zdorovia v Ukraini: heneza i perspektyvy rozvytku : kol. monohr. / kol. avt. ; uporiad. prof. Ya.F. Radysh, peredm. T. D. Bakhteievoi ; za zah. red. prof. M. M. Bilynskoi, prof. Ya.F. Radysha. K.: NADU, 2013. 424 s. academy.gov.ua Retrieved from http://academy.gov.ua/NMKD/library_nadu/Monografiy/aa2d8d7f-9def-4f49-a86b-43c3db9dbd31.pdf
9. Detsentralizatsiia. Sektor medytsyna decentralization.gov.ua Retrieved from https://decentralization.gov.ua/health
10. Dialohichna model zmin. Instytut kolektyvnoho liderstva. collectiveleadership.de Retrieved from https://www.collectiveleadership.de/blog/article/the-dialogic-change-model/
11. Hladun O.M. Narysy z demohrafichnoi istorii Ukrainy KhKh stolittia : monohrafiia; NAN Ukrainy, In-t demohraf. ta sotsialn. doslidzh. im. M.V. Ptukhy. Kyiv, 2018. 224 s. idss.org.ua Retrieved from https://idss.org.ua/monografii/Gl.pdf
12. Holova Natsionalnoi sluzhby zdorovia Oleh Petrenko: «Iakshcho chesno, zaraz realizuietsia superoptymistychnyi stsenarii reformy» ukr.lb.ua Retrieved from https://ukr.lb.ua/society/2018/11/07/411769_golova_natsionalnoi_sluzhbi_zdorovya.html
13. INSTRUKTSII nszu.gov.ua Retrieved from https://nszu.gov.ua/ogoloshennya-pro-ukladennya-dogovoriv/dlya-medichnih-zakladiv/instrukciyi
14. Kniazevych V. M. Rozvytok natsionalnoi systemy okhorony zdorovia: stan, perspektyvy ta shliakhy rozbudovy Okhorona zdorovia Ukrainy. 2008. № 3 (31). – S. 5.
15. Konstytutsiia Ukrainy: Zakon Ukrainy vid 28.06.1996 № 254k/96-VR zakon.rada.gov.ua Retrieved from https://zakon.rada.gov.ua/laws/show/254%D0%BA/96-%D0%B2%D1%80# n4324
16. Korolchuk O. L. Dynamika smertnosti v Ukraini: vymoha zavershennia transformatsii systemy okhorony zdorovia. Investytsii: praktyka ta dosvid. 2015.№ 18. S. 115-120. www.investplan.com.ua Retrieved from http://www.investplan.com.ua/pdf/18_2015/27.pdf
17. Kostiuk V.S. Reformuvannia okhorony zdorovia v Ukraini v umovakh yevropeiskoi oriientatsii. Naukovyi visnyk Mizhnarodnoho humanitarnoho universytetu. 2017. Vyp. 24(2). S. 39-43 www.vestnik-econom.mgu.od.ua Retrieved from http://www.vestnik-econom.mgu.od.ua/journal/2017/24-2-2017/11.pdf
18. Lytvynenko M. V. Pryntsypy natsionalnoi systemy okhorony zdorovia v Ukraini. Teoriia ta praktyka derzhavnoho upravlinnia. 2015. Vyp. 2 (49). S.1-8. www.kbuapa.kharkov.ua Retrieved from http://www.kbuapa.kharkov.ua/e-book/tpdu/2015-2/doc/2/12.pdf
19. Metodychni rekomendatsii z pytan peretvorennia zakladiv okhorony zdorovia z biudzhetnykh ustanov na komunalni nekomertsiini pidpryiemstva moz.gov.ua Retrieved from https://moz.gov.ua/article/news/metodichni-rekomendacii-z-pitan-peretvorennja-zakladiv-ohoroni-zdorovja-z-bjudzhetnih-ustanov-na-komunalni-nekomercijni-pidpriemstva
20. Ministerstvo okhorony zdorovia Ukrainy moz.gov.ua Retrieved from https://moz.gov.ua
21. Ministerstvo zdorovia Ukrainy moz.gov.ua Retrieved from https://moz.gov.ua/
22. MOZ poinformuvalo parlamentskyi Komitet z pytan okhorony zdorovia pro pidhotovku do startu reform na pervyntsi ta formuvannia hospitalnykh okruhiv moz.gov.ua Retrieved from https://moz.gov.ua/article/news/moz-poinformuvalo-parlamentskij-komitet-z-pitan-ohoroni-zdorov%e2%80%99ja-pro-pidgotovku-do-startu-reform-na-pervinci-ta-formuvannja-gospitalnih-okrugiv
23. MOZ pokazalo detalnu prezentatsiiu pro reformu systemy okhorony zdorovia tyzhden.ua Retrieved from https://tyzhden.ua/News/179746
24. MOZ prezentuvalo hromadskosti zminy, yaki chekaiut medychnu haluz v 2017 rotsi moz.gov.ua Retrieved from https://moz.gov.ua/article/news/moz-prezentuvalo-gromadskosti-zmini-jaki-chekajut-medichnu-galuz-v-2017-roci
25. Natsionalna sluzhba zdorovia Ukrainy nszu.gov.ua Retrieved from https://nszu.gov.ua/
26. Natsionalna sluzhba zdorovia Ukrainy www.facebook.com Retrieved from https://www.facebook.com/nszu.ukr/
27. Perelik normatyvno pravovykh aktiv z reformuvannia systemy okhorony zdorovia moz.gov.ua Retrieved from https://moz.gov.ua/plan-reform
28. Premier-ministr Volodymyr Hroisman, MOZ Ukrainy ta Natssluzhba zdorovia prezentuvaly plan transformatsii medychnoi systemy na 2019 rik moz.gov.ua Retrieved from https://moz.gov.ua/article/news/premer-ministr-volodimir-grojsman-moz-ukraini-ta-nacsluzhba-zdorov%e2%80%99ja-prezentuvali-plan-transformacii-medichnoi-sistemi-na-2019-rik
29. PRES-SLUZHBA nszu.gov.ua Retrieved from https://nszu.gov.ua/pro-nszu/pres-sluzhba
30. Pro skhvalennia Kontseptsii reformy finansuvannia systemy okhorony zdorovia: rozporiadzhennia Kabinetu Ministriv Ukrainy vid 30 lystopada 2016 r. № 1013-r moz.gov.ua Retrieved from https://zakon2.rada.gov.ua/laws/show/1013-2016-%D1%80/paran8
31. Pro vprovadzhennia reformy systemy hromadskoho zdorovia – narada z rehionamy moz.gov.ua Retrieved from https://moz.gov.ua/article/news/pro-vprovadzhennja-reformi-sistemi-gromadskogo-zdorovja-%e2%80%93-narada-z-regionami
32. Proekt z pidtrymky reformy PMD healthreform.in.ua Retrieved from https://healthreform.in.ua/about/
33. Prohrama dlia Ukrainy z rozshyrennia prav i mozhlyvostei na mistsevomu rivni, pidzvitnosti ta rozvytku «U-LEAD z Yevropoiu» donors.decentralization.gov.ua Retrieved from https://donors.decentralization.gov.ua/project/u-lead/
34. Reforma systemy okhorony zdorovia ta vyvedennia ukrainskoi medytsyny na yevropeiskyi riven – odyn iz priorytetiv diialnosti Uriadu moz.gov.ua Retrieved from https://moz.gov.ua/article/news/reforma-sistemi-ohoroni-zdorov%e2%80%99ja-ta-vivedennja-ukrainskoi-medicini-na-evropejskij-riven-%e2%80%93-odin-iz-prioritetiv-dijalnosti-urjadu
35. Reformy v Ukraini: prohres u 2017, priorytety na 2018 barcelona.mfa.gov.ua Retrieved from https://barcelona.mfa.gov.ua/news/63415-reforms-in-ukraine-progress-in-2017-priorities-for-2018
36. Sherstiuk N.S. Sokolov A.V. Zdorovia naselennia Ukrainy ta yoho vplyv na demohrafichnu sytuatsiiu. Ekonomika i suspilstvo. 2016. Vyp.5. S.316-319. www.economyandsociety.in.ua Retrieved from http://www.economyandsociety.in.ua/journal/5_ukr/57.pdf
37. Spivvidnoshennia naiavnoho naselennia ta pidpysanykh deklaratsii nszu.gov.ua Retrieved from https://nszu.gov.ua/gromadyanam/elektronna-karta-misc-nadannya-pmd
38. Storinka Facebook «Natsionalna sluzhba zdorovia Ukrainy» www.facebook.com Retrieved from https://www.facebook.com/nszu.ukr/
39. Suprun Uliana. Zminyty medytsynu, shchob vyzhyty. Ukrainska pravda life.pravda.com.ua Retrieved from https://life.pravda.com.ua/columns/2016/07/13/215192/
40. Trahediia, yakoi mozhna unyknuty. Podolannia v Ukraini kryzy zdorovia liudyny. Dosvid Yevropy: zvit / pidhot. Rekkha Menon [ta in.]. K.: Verso-04, 2009. 72 s.
41. Tsiborovskyi O.M. Zdorovia naselennia i faktory ryzyku, shcho vplyvaiut na yoho stan, yak obiekt upravlinnia (ohliad literatury). Ukraina. Zdorovia natsii. 2015. № 2. S. 13-19. www.irbis-nbuv.gov.ua Retrieved from http://www.irbis-nbuv.gov.ua/cgi-in/irbis_nbuv/cgiirbis_64.exe?C21COM=2&I21DBN=UJRN&P21DBN=UJRN&IMAGE_FILE_DOWNLOAD=1&Image_file_name=PDF/Uzn_2015_2_4.pdf
42. Ukraina poinformuvala YeS pro vprovadzhennia systemnykh haluzevykh reform okhorony zdorovia moz.gov.ua Retrieved from https://moz.gov.ua/article/news/ukraina-poinformuvala-es-pro-vprovadzhennja-sistemnih-galuzevih-reform-ohoroni-zdorovja
43. Zvit Natsionalnoi sluzhby zdorovia Ukrainy 2018 Retrieved from https://nszu.gov.ua/storage/files/zvit-2018.pdf
44. Zvit Natsionalnoi sluzhby zdorovia Ukrainy 4 kvartal nszu.gov.ua Retrieved from https://nszu.gov.ua/storage/files/4-qrtl-report-2019.pdf

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Published
2020-04-07
How to Cite
Dzvinchuk, D., & Baran, M. (2020). APPLICATION OF THE DIALOGICAL MODEL OF CHANGES IN THE PROCESS OF REFORMING THE HEALTH SYSTEM IN UKRAINE AT THE PRIMARY LEVEL. Public Administration and Regional Development, (7), 89-108. https://doi.org/10.34132/pard2020.07.04