O. М. Sahach, L. I. Lavrynenko The Features of the Development of the Ukrainian Health Care System in the 20th Century (the Case of Chernihiv Region)

DOI: 10.20535/2307-5244.49.2019.189551

Chernihiv Regional Institute of Postgraduate Pedagogical Education of K. D. Ushynskyi

Using the case of the Chernihiv Region, the authors chronologically analyzed
the processes in healthcare as part of broader developments in the healthcare
system in Ukraine during the twentieth century. The research presents patterns
of development of the health care system in the 20th century, describes the spectrum
of medical and preventive establishments, characterizes health servicing,
and analyses the institutional setting, as well as staff policy.
The Ukrainian healthcare system during the investigated period functioned in
a rather complicated socio-political situation. The country was in a constant political
change, beginning with its division in the early twentieth century between
two empires — Russian and Austrian, the proclamation of the Ukrainian People’s
Republic (UNR in Ukr.) in 1917 and its connection with the West Ukrainian People’s
Republic (ZUNR in Ukr.) in 1919, continuing with more than seventy years
in the USSR and, finally, gaining independence in 1991.
The researchers concluded that the health care system in the studied period
could not be assessed unambiguously. However, the general tendency of its development
was overall positive. The health care system, based on the principles,
which are put forward by N. Semashko, was quite effective. Its priorities were
first aid and reducing mortality, which eventually eliminated threats of cholera,
smallpox, plague, poliomyelitis, typhus. The system of diagnostics of patients
with general illnesses was also efficient. The principle of the territorial precinct
provided an opportunity to bring health care closer to the people and to consolidate
the polyclinics with hospitals, which ensured sustainability.
In rural areas, the district hospitals opened specialized departments. The negative
experience of implementing state policy in this area was primarily related
to the financing mechanism of health care, which was command-administrative
and based on the budget support of medical institutions. The budget covered all
expenses for the provided services, labor of medical workers, and hospital stays.
At the same time, funds for equipment and medications were minimal.
Keywords: health care, prevention of mortality, doctor, zemstvo medicine,
prevention of mortality, hospital, clinic, medical district.


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