State Policy Research Articles

The Constitutional Foundations of the Russian State Policy in the Field of Family Protection and Traditional Family Values

The paper presents an analysis of constitutional provisions aimed at protecting the family in various periods of Russian statehood, shows the multi-vector nature of state policy in the field of family relations in the Soviet period, characterizes the family and demographic policy of the post-Soviet period, analyzes the constitutional novelties of 2020 aimed at strengthening the family and the spiritual and moral values of Russian society. An analysis of the constitutional category of «traditional family values» is carried out from the perspective of the needs of the individual, family as a social group and the importance of family for society and the state. The institution of family is considered as an intrinsic value and a basic determinant of the formation of the spiritual and moral heritage of Russian society, the preservation of the cultural identity of the Russian nation. The author provides the data from an official survey involving Russians that testifies to the attitude towards the family. The article also outlines the results of a research conducted by domestic scientists stating the unfavorable transformational processes taking place with the institution of family in the past 30 years. These include voluntary childlessness and celibacy; postponing the birth of children to later age periods; reducing the value of a family with several children; preference among young people for actual marital relations (common-law marriage) to a registered marriage. The author considers the protection of the family and family values as a task for ensuring the national security of Russia, the solution of which is aimed at preserving the all-Russian identity, sustainable development of the state, preservation of socially significant spiritual and moral values. The author substantiates the proposal on the need to form in society the idea of the importance of the family as a value in itself, which implies a responsible attitude to marriage, birth and upbringing of children, encouragement and support of a multigenerational and large family, respect for the elderly, disapproval of the rejection of the birth and upbringing of children.

ЭВОЛЮЦИЯ РАЗОЧАРОВАНИЯ: РУССКАЯ РЕВОЛЮЦИЯ 1917 Г. ГЛАЗАМИ ДВУХ ЭМИГРАНТОК

The memoirs of two Russian émigrés, anarchist Emma Goldman and socialist Angeliсa Balabanoff, recently published in Russia, provide a perspective on the formation of Bolshevik power after the October coup that differs from the Soviet version of events, revealing little-known aspects of the 1917 revolution. Goldman, deported from the United States, highlighted the role of anarchists in revolutionary Russia, portraying them not as a chaotic force but as a socialist movement advocating an alternative to the dictatorship of the proletariat—namely, the development of self-government as called for by Mikhail Bakunin and Peter Kropotkin. Like other opponents of the Bolsheviks, the anarchists were ultimately suppressed. Balabanoff, a member of the Italian Socialist Party and the RСP(b), and secretary of the Executive Committee of the Comintern, discussed the methods of party building, particularly the Bolsheviks' influence on the split within the international socialist movement. Having arrived in Russia after the 1917 revolution to support the birth of a workers' and peasants' republic, both women were soon forced to leave, disillusioned by the policies of the Soviet state.

For Spatial Planning and Land Consolidation Issue

Planning the rational use of land's potential capabilities is one of the most important functions in Georgia. When developing the state policy in this area, it is essential to take into account that the implemented policy directly affects the country's socio-economic development. The given article states that determining the land status is part of the country's territory planning and development plan, moreover, changing the status of the land is almost impossible without making changes to the spatial planning of the territory. The article states that in most European countries, changing the designation of land is within the competence of the government and describes the needs to be addressed by various European countries (permit of the relevant state institution, compliance with the spatial development plan, imposition of a tax on the change of category, with certain exceptions, a general ban on changing the category of land, etc.). It also discusses examples of various mechanisms for land consolidation in Eastern and Central European countries. At the end of the article, the conclusion is made that under the conditions of Georgia, the state should develop a plan for the privatization of the remaining agricultural land in its possession, the primary goal of which should not be the increase of budget revenues, but rather ensuring the effective use of land resources. This process should consider: registering the landownership for the actual owner, registering land ownership for municipalities, and the alienation of land remaining in state ownership, which should ultimately contribute to the consolidation of small farms. Keywords: land, land categories, land disposal, agricultural policy, spatial planning, land consolidation, land management, agrarian territories.

Development as terracide: sacrifice zones and extractivism as state policy in Mexico

ABSTRACT Mexico's declaration of Special Economic Zones (SEZs) in 2017 marked a significant territorial shift with far-reaching geopolitical implications. The establishment of SEZs represents the culmination of a three-decade period – starting with neoliberal reforms initiated in 1992 – during which Mexican state policies have increasingly prioritized hydrocarbon and mineral extraction. The proliferation of SEZs, or designated ‘development poles’, underscores a concurrent expansion of sacrifice zones – places abandoned, polluted, rendered invisible, or outright eliminated in pursuit of ostensibly greater common goods such as economic growth, progress, and more recently, sustainable development or decarbonization. Drawing on findings from 21 semi-structured interviews, this article elucidates how green extractivism shapes spatial politics in Mexico. Moreover, it provides a systematic categorization of both existing and emerging ‘green’ and ‘indirect’ (‘grey’) sacrifice zones as the state continues its push toward development as terracide.

Social reproduction and contestation of racialized Roma exclusion: The role of civil society organizations in the Czech Republic

ABSTRACT Anti-Roma racism remains a persistent concern in numerous European countries. Despite sustained efforts by both the European Union and national governments over the past two decades to promote Roma inclusion, the effectiveness of these integration policies has largely been perceived as inadequate. This has been evident in the widespread exclusion experienced by Roma communities. Focusing on the Czech Republic, this article moves from examining state policies to the actions of civil society. In this context, the article explores the role played by Czech civil society organizations (CSOs) in both challenging and perpetuating racialized Roma exclusion. Building on Bourdieu’s concept of social habitus, this article expands it to a racialized social habitus framework. Through online interviews with CSOs and ethnographic fieldwork in four Czech cities, it explores the complex interplay between integration policies, civil society, and the racialized exclusion of the Czech Roma. The article illuminates how these organizations simultaneously contest and reinforce racialized perceptions of the Roma, thereby enriching scholarly dialogue on the complex dynamics of race and racism within civil society.

Fighting COVID-19 like a war: the role of hegemonic masculinity in Taiwan’s responses to the pandemic

ABSTRACT The COVID-19 pandemic exacerbated existing inequalities. However, the growing body of work on hegemonic masculinity (HM) has paid insufficient attention to its role in and responses to state policies in the context of a pandemic. Using a case study of Taiwan – one of the few countries in the world to have successfully eradicated domestic outbreaks throughout most of the pandemic – I investigate the extent to which HM mediated an unrecognized sovereign state’s strategy for combating the pandemic but also its reinforcement of gendered hierarchies. I argue that China’s alienation of Taiwan in the international community is a form of HM and subsequently led to Taiwan’s militarized rhetoric with respect to COVID. I also contend that such HM at the international level was mirrored at the domestic level through the collective conceptualization of which patients were “legitimate” and which citizens were loyal. Yet, the domestic social responses to COVID-19 were gendered, classed, raced, and aged, further marginalizing those with protected characteristics. The study offers implications for how HM shapes who belongs as members of society and how citizenship is tied to individuals’ contributions to collective nationhood.

Associations Between State Policies Facilitating Telehealth and Buprenorphine Episode Initiation and Duration Early in the COVID Pandemic : State Telehealth Policies and Buprenorphine.

State policies facilitating telehealth implemented early in COVID may support buprenorphine treatment of opioid use disorder. However, little empirical information is available about those policies' effects. Examine association between state policies that may facilitate telehealth use and buprenorphine treatment. Retrospective cohort study using 2019-2020 national pharmacy data on dispensed buprenorphine prescriptions. State policies implemented after March 3, 2020, public health emergency declaration requiring private insurers' telehealth reimbursement to be commensurate with in-person service reimbursement, authorizing Medicaid reimbursement for audio-only telehealth, allowing physicians to provide cross-state telehealth services, and allowing psychologists to provide cross-state telehealth services. (a) Duration of treatment episodes started between March 1 and March 13 in both 2019 and 2020, and (b) daily numbers of new buprenorphine treatment episodes from March 13 through December 31 in each year. We found little change in the number of new buprenorphine treatment episodes started in 2020 compared to 2019 and an increase in treatment duration of 10.3days (95%CI 8.3 to 12.2days) for episodes started in March 2020 before the public health emergency declaration compared to the comparable 2019 period. States implementing a telehealth parity policy in 2020 had 7.3% (95%CI - 13.3% to - 0.4%) fewer new buprenorphine treatment episodes. States joining the psychologist interstate compact in 2020 after the public health emergency declaration had treatment episodes 7.97days longer (95%CI 0.78 to 15.16) than other states. None of the other policies examined was associated with changes in new treatment episodes or treatment duration. Policies undertaken during the pandemic we examined were associated with few significant changes in buprenorphine treatment initiation and duration. Findings suggest realizing the benefits of telehealth and other policy changes for buprenorphine may require more extensive implementation and infrastructure support.

State policy on digitalization as a tool for stimulating economic growth

State policy on digitalization as a tool for stimulating economic growth

The Role of Media Diplomacy in Shaping the State’s International Image

The article attempts to determine the role of media diplomacy in shaping the state's image in the international arena. Media diplomacy under the conditions of globalization transformed geopolitical relations and changed the hierarchical system of foreign policy decision-making, highlighting the competition among states for the opportunity to influence public opinion. The information policy of the state involves not only the dissemination of positive information about it in the international information space, but also the integration of politicians, state government structures, non-state actors, famous personalities, and opinion leaders into the brand management system of the state's national policy. At the same time, the use of social media platforms in the implementation of diplomatic activities has led to the fact that any user of a social network today is not only a consumer of information, but also a direct supplier and distributor of it, meaning they have the opportunity to influence the adoption of certain decisions at the state level and shape in this way the image of the state. The article analyzes the use of media diplomacy mechanisms in the formation of Ukraine's image, identifies positive and negative aspects, and discusses prospects for its development.

Patterns, clusters, and transitions in U.S. state ENDS policy implementation: 2010-2020.

Electronic nicotine delivery systems (ENDS), such as e-cigarettes, have become increasingly used across the world. To respond to global public health challenges associated with vaping, governments have implemented numerous ENDS policies. This research highlights the patterns, clustering, and transitions in U.S. state ENDS policy implementation from 2010 to 2020. Policy data for tobacco and ENDS policies primarily from the Americans for Nonsmokers' Rights Foundation (ANRF) were analyzed for the years 2010 to 2020 for all fifty states and Washington, D.C. Patterns and clusters of policies were assessed. Latent trajectories were modeled for ENDS policies across states over time. ENDS policies commonly have analogous tobacco control policies in place prior to their implementation. ENDS policies in states were commonly implemented in "bundles." The temporal trajectories of ENDS policy implementation occurred in 3 latent forms. A majority of states were "catch-up implementers," indicating their slow initial implementation but stronger position by the end of the period of observation in 2020. These trajectories of ENDS policies were not associated with any individual tobacco control policy in place at the start of the trajectory in 2010. The development of ENDS policies in U.S. states has been temporally and geographically uneven. Many states that had initially been slow to implement ENDS policies caught up by 2020. The implementation of policy "bundles" was common. The clustering of policies in bundles has important methodological implications for analyses, which should be considered in ENDS policy evaluations.

Determining Whether State Policy Is in Line With Substance- and Alcohol-Related Best Practices for Domestic Violence Intervention Programs

Enhancing the effectiveness of Domestic Violence Intervention Programs (DVIPs) is necessary and may require up-to-date state-specific or national guidance. Currently, many U.S. states provide recommendations and requirements for DVIP length, content, and treatment curriculum through one or more of three types of documents: state laws, standards, and/or guidelines. However, these documents are updated irregularly and vary substantially in length, content, enforceability, and authorship expertise (i.e., legislators versus domestic violence [DV] experts and/or DV coalition members). Meanwhile, one robust yet controversial finding is that DV perpetrators with co-occurring substance use conditions have increased difficulty engaging with, sustaining attendance at, and benefiting from standard DVIP treatment (Jewell & Wormith, 2010). Yet, the degree to which state-specific DVIP documents address how perpetrator substance use is to be assessed and treated within DVIPs is understudied. To fill this gap, guiding state documents were obtained as available (n= 47 states; 94%); these were coded with excellent interrater reliability (agreement = 91%). Consistent with research advances, state documents generally encouraged DVIPs to assess perpetrator substance use at intake (n= 41). However, fewer documents directed DVIP facilitators to address the link between substance use and DV within their curriculum (n= 25). Some state documents even prohibited substance use-related messages to be incorporated into the DVIP curriculum (n= 19). Unfortunately, even fewer states’ documents recommended follow-up of the perpetrator’s substance use during DVIP participation or after a substance abuse-related referral (n= 14). Efforts to align DVIP-guiding documents with knowledge related to increasing DVIP treatment effectiveness are necessary as is determining adherence to guiding documents.

Incremental progress or dangerous incrementalism? The case of tire wear pollution in global environmental governance

ABSTRACT Tire wear and tear is among the largest sources of global microplastic pollution. Interviews conducted in 2024 appear to indicate ‘incremental progress’ toward improving governance of tire wear. Knowledge of the ecological and health consequences is increasing. Pressure is growing for greater producer responsibility. Global standards to limit tire abrasion are forming. Regulations are being implemented to address chemical contamination, such as in California. And some manufacturers are supporting higher standards and reengineering tires to undercut competitors and capture emerging markets for lower-abrasion tires. Yet, as a deeper analysis reveals, regulations remain highly uneven, piecemeal, and inadequate on a global scale, with new risk-taking as firms delay actions and introduce new chemicals as ‘solutions.’ Moreover, I argue, a ‘dangerous form of incrementalism’ is taking hold, where modest changes to state policy and corporate conduct are conferring legitimacy on governance processes unable to prevent tire wear pollution from escalating globally.

THE FUTURE WAR AND THE STRATEGIC ENVIRONMENT OF THE SOUTH ATLANTIC: AN ANALYSIS FOR THE DEVELOPMENT OF THE BRAZILIAN DEFENSE INDUSTRIAL BASE

This work aims to analyze the Future War, focusing on a scenario extending to 2039, and Brazil's interstate relations, with emphasis on the strategic environment of the South Atlantic, while observing classical geopolitical studies. Considering that the stability of the South Atlantic fundamentally depends on processes occurring on the western coast of Africa, this explains why Brazil's strategic environment extends to the other side of the Atlantic. This perspective also clarifies why Brazil contributes to the development of the African countries bordering the Atlantic Ocean. The study further extends its analysis to the Rio Grande Elevation Project. The entire context will serve as a foundation to examine the impacts on the development of the Brazilian Defense Industrial Base (BID). To carry out the research, the methodological approach is mixed: a qualitative perspective based on existing academic literature and field research, along with a quantitative structure, measuring data related to the BID and assessing the impacts of interstate relations on it. The direct result intended by this study is to produce new knowledge (scientific, doctrinal, and technological) in the field of defense through high-quality research, contributing to state policy. Indirectly, it aims to generate insights into Defense Studies and improve the decision-making process associated with the use of force, particularly as it relates to the BID.

The Gendered Impact of In-State Tuition Policies on Undocumented Immigrants’ College Enrollment, Graduation, and Employment

Executive Summary Assessing the impact of policies offering in-state tuition and financial aid to undocumented immigrant youth is highly pertinent from a policy perspective. Eligible immigrants arrived as children and the United States is often the only home they have ever known. Without the right to stay or a path to citizenship, they cannot achieve their full potential as productive members of society. Policies improving access to higher education have the potential to elevate their social mobility and amplify economic contributions by improving job prospects and bolstering tax revenues. Since 2001, roughly half of the U.S. states have expanded in-state college tuition benefits to undocumented immigrants. Around one-third of states have also provided financial aid; yet approximately one-tenth have imposed heightened barriers to accessing higher education. While early studies found an increase in enrollment in states with in-state tuition policies, recent studies accounting for additional state policies found no impact on enrollment. These results mask varying impacts based on gender and marital status. We assess these policies, control for Deferred Action for Childhood Arrivals (DACA), and analyze the impact of in-state tuition on college enrollment, graduation rates, employment, and self-employment. Our analysis relies on data from the 2005 to 2019 American Community Survey. To identify individuals who are the most likely to be undocumented and affected by the policy, we focus on noncitizen Hispanic youth, excluding those likely authorized (e.g., licensed professionals, veterans, and refugees). That said, we are assuming that state policies are the same for all undocumented residents, not just the Hispanics in our sample. Our findings are as follows: - In our sample, there are 17,649 likely undocumented Hispanic men (14,249 women) aged 18–22 years who completed high school and arrived in the U.S. prior to age 16 years. Approximately 75 percent of them are Mexican. - The data reveals that approximately 30 percent of men are enrolled in college. Access to in-state tuition boosts enrollment by 7.2 percentage points for Hispanic men and by 13.2 percentage points for Mexican men. This response is driven by married men. Men in general do not graduate at higher rates. - Women enroll in college at the same rate across states. However, access to lower tuition raises graduation rates by 4.7 percentage points, representing nearly a 30 percent increase compared to the average graduation rate of 15.7 percent, particularly among single women. - Among men with access to in-state tuition, single men are more likely to be self-employed, while married men respond to the policy by working less, consistent with higher enrollment rates. - On average 55 percent of single women are employed. Access to in-state tuition increases employment by 12–19.8 percentage points for single women. We find no significant impact of the policy on the employment of married women. Our research indicates that while in-state tuition policies do make a difference, there is a need for a more nuanced policy approach, particularly due to gender disparities among the intended beneficiaries, which have previously been overlooked. However, we argue that relying solely on in-state tuition policies is insufficient. Single women are driven by these policies to complete their degrees and pursue employment. If policymakers aim for a broader impact and seek to include a more diverse group of undocumented youth, including men, they should consider enhancing opportunities within formal labor markets after college graduation. In support of this argument, we document higher graduation and employment rates and lower self-employment rates among DACA-eligible youth who have legal access to formal employment.

An Economic Analysis of Maize Production across Major Producing States of India

National Food Security Mission has been taken by Government of India to increase coarse cereal Maize production in the country to meet food, feed for livestock and poultry and industrial raw material, domestic as well as global demand. The traditional and modern industrial uses have made it one of the fastest growing cash crops in the world. Considering its global as well as national importance, In this article, we have analysed the relative change, growth rate and CDVI (cuddy-della valle-index) in cost, returns, profitability and break-even production of maize during the study period 2000-01 to 2018-19 of Maize across major Maize growing states of India. The study found that Cost A1, cost A2, cost B1, cost B2, cost C1 and cost C2 of maize was found to be increased higher in Madhya Pradesh with highly significant annual growth rate during the study period than other states. These cost concepts showed low to medium instability for almost all the leading states. The findings revealed that maize was more profitable in Bihar, followed by Andhra Pradesh and Karnataka, owing to higher net income and B:C ratios than in other states. Bihar states had higher differential yield and a greater discrepancy between the cost of production and the minimum support price. In some states, actual yields were lower than break-even, and production costs were greater than the minimum support price, resulting in losses for maize growers. The study's findings would help policymakers and governments devise appropriate development strategies and effective policies for less lucrative states.

The Paradoxical Development of Liberal Governance: International Adoption Policy and Professional Social Work in Authoritarian South Korea, 1953–1976

Abstract This article explores the development of international adoption policy in post-liberation South Korea, emphasizing the roles of American and Korean professional social workers. By analyzing the orphan registry and a pivotal international adoption law, it reveals how international adoption in South Korea presents a unique opportunity to observe the formation of modern social policy in a newly liberated nation during the Cold War. The study argues that adoption policy served as a crucial locus of transnational governance, where American and Korean social workers pursued their liberal ideals of professional social work within the context of the authoritarian policies of the South Korean state. However, their quest for scientific professionalism, standardized procedures, and public oversight led to a paradoxical evolution of adoption policy, diverging sharply from the trajectory seen in Western liberal democracies where social work significantly contributed to the consolidation and expansion of the welfare state. In South Korea, embedded transnationality and ideological mismatch resulted in the state’s further withdrawal and the creation of policy workarounds that undermined the core social work principle of the child’s best interests. This case highlights the complexities and blurred moral boundaries in the shaping of modern governance and the broader journey toward modernity under postcolonial, Cold War conditions.

Dismantling labour markets from above: the case of wage policy in the European Union

Abstract Are countries reforming their labour market constrained by external political or financial institutions? This article analyses the supranational pressures impacting wage policy in European member states. Theoretically, it takes inspiration from the literature on international financial markets to analyse the key phases of a nascent multi-level policy cycle, where the European Commission plays a pivotal role. Empirically, it distinguishes between wage policy prescriptions (CSR database, 2011–2019, complemented with EUR-Lex) and reform events (LabRef database, 2008–2019) granting more or less protection to workers. Methodologically, it employs mixed regression models with country and year random intercepts finding out that: (a) the Commission, when recommending wage policy, unambiguously prefers reforms reducing workers’ protection, thus displaying preferences aligned with those of international financial institutions; (b) through external conditionality, the pressures stemming from such biased approach exert a tangible impact on national policymaking, ultimately resulting in weakened labour market institutions and reduced well-being of workers.

From Congress to the States: Explaining the Emergence and Membership of Freedom Caucuses in State Legislatures

Abstract Since 2017, Republican lawmakers in a growing number of US states have formed ideological intraparty organizations, modeled after the US House Freedom Caucus, that seek to move state policy further rightward. What explains the appearance of these state freedom caucuses, and what kinds of lawmakers are more likely to join them? We show that the creation of these caucuses was initially motivated by concerns that state-level legislative Republican parties are too ideologically heterogeneous but has since been driven by conservative entrepreneurs seeking to spread freedom caucuses nationally. We also provide evidence that conservative legislators are more likely to join a new state freedom caucus, as one would expect, but also that, in a few states, lawmakers who are more electorally vulnerable lawmakers or lack internal influence have also been more likely to join. These findings underscore how state-level ideological caucuses can appeal to members’ multiple goals and serve as instruments of vertical polarization in a federal system.

FEATURES OF THE DETERMINING THE STATE POLICY OF UKRAINE IN THE AREA OF DE-OCCUPATION

This article aims to explore the peculiarities of defining the concept of "state policy" in Ukraine in the context of de-occupation. The relevance of this research is grounded in the ongoing territorial challenges that Ukraine faces due to military aggression and the occupation of its territories. The need for a coherent and strategically sound approach to regaining control over these regions makes the issue highly pertinent. The study adopts an analytical research methodology, focusing on the theoretical foundations of state policy in the sphere of de-occupation. The research also utilizes comparative analysis, examining the different models of de-occupation that have been applied historically and internationally, including military, political-diplomatic, institutional, and economic models. The findings indicate that the concept of “state policy” in de-occupation processes is multi-faceted and requires a comprehensive approach, combining various strategies. Key components of the theoretical basis for state policy in de-occupation are identified, including the political and legal foundation, socio-economic integration, national reconciliation and cultural integration, security measures, and international support. Each of these elements plays a crucial role in the successful recovery of occupied territories and the re-establishment of state sovereignty. The study highlights the importance of synchronizing these components to ensure long-term stability and development in post-conflict regions. The practical value of the article lies in its potential to serve as a guideline for policymakers and government officials in Ukraine, offering a structured understanding of how these key components can be effectively integrated into the country's de-occupation strategy. By focusing on both theoretical and practical dimensions, the article provides a framework that can contribute to the formulation of effective policies aimed at the reintegration of occupied territories, addressing challenges such as legal ambiguity, socio-economic disparities, and security risks. This research contributes to the ongoing discourse on de-occupation by offering insights into how Ukraine can enhance its efforts in restoring territorial integrity in the face of current geopolitical challenges.

PROBLEMS OF THE ORGANIZATION OF THE STATE POLICY OF THE PROVISION OF MEDICAL SERVICES BY THE PRIMARY LINK OF MEDICAL AID IN UKRAINE

The article highlights key issues related to management at the level of primary health care in Ukraine. The focus is on aspects such as the growing role of primary care. Primary care is the foundation of the health care system, providing a patient's first contact with health services, prevention, diagnosis and treatment. It is especially important in the conditions of limited financial resources to continue the reforms of the medical industry in Ukraine. The article raises the issue of the availability of medical care: the relevance of management problems is due to uneven access to medical services in rural areas and remote regions. Improving the management of the medical field is necessary to overcome these difficulties. The article examines current problems in the field of primary medical care and ways to overcome them through the reform of state policy in the field of health care. The authors explore key challenges facing primary care, including insufficient funding, lack of qualified staff, uneven distribution of resources, and lack of effective governance mechanisms at various levels. Attention is paid to the issues of ensuring the availability of medical services, the quality of medical care and the implementation of new models of the organization of medical institutions. The article analyzes the reformative steps aimed at improving the functioning of the primary health care system, in particular, the introduction of family medicine and increasing the role of general practitioners. The role of state funding and the involvement of local communities in the management of medical institutions is considered separately. The conclusions emphasize the importance of improving the state's primary health care policy by strengthening financial support, infrastructure development, and improving the qualifications of medical workers to ensure a sustainable and effective health care system in Ukraine. The topic of economic challenges and management efficiency is interesting for analysis. Optimizing the use of financial resources requires their effective use, finding ways to increase the economic sustainability of healthcare institutions.