Institutional European models of the performance of the main functions for the provision of public health: experience for Ukraine

Abstract

Purpose. The article examines the functioning institutional models of the implementation of the main operational functions of public health protection on the scale of the whole of Europe. The task of the article was to substantiate and investigate the European action plan for strengthening the potential and services of public health protection. Materials and methods: comparative-historical method; system analysis method; axiological approach, structural-functional approach, systemic approach Results. The article briefly presents available information on various institutional models for the implementation of operational functions of public health protection, as well as preliminary conclusions on their strengths and weaknesses and recommendations for strengthening such models. A three-dimensional study of the problem was carried out: the nature of the organization of public health care services and measures, the current mechanisms of their financing and the structure of public health care management. During the review, the most diverse forms of organization of operational functions of public health protection were observed in different European countries, which affects management, implementation of functions and financing. And while the basic infrastructure for the provision of public health services at the national, regional and local levels exists to some extent in all countries, the difference lies in the division of responsibilities between the levels, which largely reflects existing prevailing administrative structures. Conclusions. Despite the observed differences between the countries, the content of the concept of public health protection in Europe over the past decades has gradually evolved from a focus on sanitary surveillance and the fight against infectious diseases to a "new" public health protection, where ever-increasing attention is paid to health promotion I, prevention and intersectoral actions, including measures that go beyond the boundaries of the health care system. In the countries of the post-communist space of Central, Eastern and South-Eastern Europe, in many cases, public health services have collapsed, while there has been no replacement with adequate alternative services. Overall, public health in these countries still lags behind what is currently commonly thought of, and there is a clear need to strengthen the health infrastructure in a strategic and consistent manner.