Assessing the Performance of Ukraine’s Health System in an International Context

Abstract

Purpose is the comprehensive comparative assessment of the performance of the Ukrainian health system in the international context for identifieng strengths, problematic components, and potential areas for its improvement. Materials and Methods. A comparative study was conducted using 2021 data from the WHO, World Bank, OECD, Eurostat, and the Institute for Health Metrics and Evaluation. Ukraine’s health system was compared with EU-27, OECD, world averages, and World Bank income groups. Age-standardized avoidable mortality was estimated from official Ukrainian mortality and population statistics. Results. Ukraine spent 8.2% of GDP on health, but public financing represented only 52.1% of total health expenditure, contributing to high out-of-pocket payments (45.3%) and catastrophic household health expenditure (17.1%). Despite these financial constraints, the country maintained relatively good service coverage and favourable outcomes in maternal and child health and tuberculosis control. In contrast, outcomes for non-communicable diseases remained poor. Premature mortality from major non-communicable diseases reached 24.8%, while preliminary avoidable mortality was estimated at 410–435 per 100.000 population, substantially exceeding EU and OECD levels. These patterns reflect a resource-efficiency mismatch, where relatively good access to care is coupled with weak financial protection and poor population health outcomes. Conclusions. Improving health system performance requires stronger financial protection, better prevention and management of non-communicable diseases, and modernization of primary health care to reduce avoidable mortality.