Характеристика стосунків органів місцевого самоврядування із закладами первинної медичної допомоги

Abstract

At the current stage of the development of health care systems, it is believed that local governments should be included in any reform plans. The World Health Organisation emphasizes the important role of local governments in reforming primary care while maintaining the primary responsibility for building national central government health systems. The purpose of the study is to characterize the relations of primary health care facilities with local governments by the heads in the context of reforming the health care system in Ukraine and identifying problem areas in them that require improvement. Materials and methods. The study was carried out in two stages: focusing interviewing heads of primary health care facilities with a high level of competence to determine the set of characteristics that form the relationship between of the local governments and primary health care facilities; a survey of 100 heads of primary care facilities using a questionnaire drawn up based on the results of the first stage of the study. Statistical analysis was carried out using descriptive and analytical statistics. Results and discussion. Comprehensive reform of local self-government and primary health care in Ukraine faces certain difficulties and requires coordination of relations between the local governments and primary health care facilities. Twelve main characteristics of the relationship between local governments and primary health care system of the community were identified. Of the total number of respondents, 72% did not give a satisfactory assessment of the competence of the representatives of local governments in the organization of medical services; 36% – the attitude of local governments to primary care facilities; 32% – response of local governments to the needs of primary health care facilities; 78% – understanding by the owner of the contribution of the primary health care to the prosperity of the community; 52% – priority of health development for community; 12% of the respondents noted that their facilities did not receive additional funding from local budgets for the development of the institution and improvement of the quality of medical care. In general, 68% of the surveyed primary health care managers assessed positively the relationship with the owner; 19% – negatively. Conclusion. The study identified problems in the relationship between the local governments and primary care facilities during the reform of the health care system, which need to be addressed. It was revealed that the main problem is the lack of awareness of the local governments of the importance of primary health care for the community, which is primarily due to the low competence of representatives of local authorities on health issues