Human resources are a key element of the healthcare system. At the international level, there are ongoing discussions regarding the need to develop national strategies for the development and strengthening of human resources in the healthcare system (HRHS), as provision of accessible and high-quality medical services largely depends on availability and management of HRHS. The global strategy of the World Health Organization (WHO) for HRHS until 2030 outlines four key objectives:
a) Enhancing the quality of HRHS through the implementation of proven effective human resource policies, ensuring universal access to medical services, and strengthening the healthcare system at all levels;
b) Ensuring HRHS planning in line with current and future population needs, addressing HRHS shortages, and improving their distribution;
c) Strengthening healthcare institutions at different levels for effective management of HRHS;
d) Strengthening HRHS data systems for monitoring and evaluating national and regional strategies (WHO) [1].
Currently, the national healthcare system faces significant challenges, with personnel shortages and the uneven distribution of medical professionals remaining among the most pressing issues. The quality and effectiveness of medical care at the regional level depend on the staffing of healthcare facilities with qualified and motivated personnel. The staffing of healthcare institutions with specialists in various fields, as well as with mid-level and junior medical personnel, is disproportionate between urban and rural areas. The deficit of personnel in Ukraine's healthcare system mirrors the global trend of medical staff shortages. According to WHO data, by 2035, there will be a shortage of 12.9 million healthcare workers. According to WHO experts, providing basic medical care requires 23 medical professionals for every 10,000 people. In Ukraine, the number of doctors per 10,000 people is projected to drop to around 23.4 by early 2025. The current number of junior medical staff is estimated to be between 60 and 75 per 10,000 people, compared to approximately 74.4 before the pandemic [2, p. 248]. The primary shortage of staff is observed in primary healthcare and in rural areas. Overall, across Ukraine, the secondary healthcare sector is missing on average 10% of specialists in various fields [3]. A key challenge in the healthcare sector is the persistent outflow of medical staff, characterized by both external migration and internal movement from rural areas to urban centers. Furthermore, many healthcare professionals are shifting to related industries, including clinical research, the pharmaceutical sector, and medical equipment sales.
The main reasons for the personnel shortage in Ukraine's healthcare system are:
• The emigration of specialists for work abroad (with the highest outflow occurring immediately after graduation from higher education institutions) [4].
• Disproportionate wages for medical staff compared to the volume of healthcare services provided.
• The lack of state support for young healthcare professionals.
• Inadequate social and living conditions (lack of housing) and the absence of state programs to improve them.
• Insufficient financial support for rural healthcare.
• The “aging medical workforce”, as medical professionals in Ukraine often continue working after reaching retirement age.
Moreover, national and regional statistical reporting, used for workforce planning and human resources management, only includes a minimal set of indicators from the general data collected by healthcare institutions. Key aspects such as staff turnover, retention, job satisfaction, work effectiveness, and lifelong learning are not addressed. There is also limited disaggregation of data by gender and age, as well as by urban/rural areas. Furthermore, there is no unified electronic register of healthcare professionals [5, p.10].
Given these issues, there is a need to create an effective functional and organizational model at the regional level that integrates financial incentives, improved working conditions, and social protection, essential for stabilizing the staffing potential of healthcare institutions, ensuring their future development, and enhancing their competitiveness.
The medical and social justification for the functional and organizational model (FOM) of attracting and retaining personnel at the regional level is based on the need to address the personnel shortage, imbalances in the distribution of specialists, and the aging medical workforce [6, p. 57].
The key elements of the model are:
• Targeted training of specialists funded by local communities, with a mandatory service period.
• Preferential loans, provision of official housing or land plots (especially in rural areas), and reimbursement of housing rental costs up to 100% of the rental price.
• One-time financial support payments to young specialists and doctors of deficit specialties, particularly in rural areas.
• Continuous professional development (CPD): creating conditions for ongoing education and skills development funded by healthcare institutions that are not covered by the National Health Service of Ukraine (NHSU). Nevertheless, it is important to emphasize that CPD must take place within a fair and competitive environment. Specialists should be rated according to the standard of medical care they deliver to their patients.
• Providing primary medical and sanitary care physicians with official vehicles in rural areas.
• Compensation for fuel and maintenance costs of personal vehicles used for official purposes.
To address the staffing challenges faced by healthcare institutions in Ukraine at the regional level, it is essential to implement strategic human resources management. This should be grounded in a robust personnel strategy that, through effective motivation and professional development, fosters the creation of a strong human capital base. Such a foundation is critical for achieving the sector’s development goals, enhancing the quality of healthcare, and ensuring the resilience of the healthcare system in the face of contemporary challenges.
References:
1.https://www.who.int/hrh/resources/global_strategy_workforce2030_14_print.pdf?ua=1/ дата звернення 10.04.2026р
2. Борщ В. І. Б. Управління закладами охорони здоров’я: монографія / В. І. Борщ. – Херсон : ОЛДІ-ПЛЮС, 2020. – 392 с.
3. Офіційний сайт ДП «Центр медичної статистики Міністерства охорони здоров’я України». URL: http://medstat.gov.ua, дата звернення 07.04.2026р.
4. Borshch V., Shchur R., Chuvakov O. Motivation and stimulation mechanism of medi- cal staff in developing countries: main challenges and ways of its improving in Ukraine. Baltic Journal of economic studies. 2018. Vol. 4. № 4. Pp. 56-61. DOI: https://doi.org/10.30525/2256- 0742/2018-4-4-56-61.
5. Кадрові ресурси системи охорони здоров’я в Україні. Ситуаційний аналіз / Д. Богдан, А. Бойко, А. Василькова та ін. Проект USAID «Підтримка реформи охорони здоров’я». Київ, 2019.
6. https://niss.gov.ua/doslidzhennya/regionalniy-rozvitok дата звернення 03.04 2026р.
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