LOCAL SELF-GOVERNMENT BODIES AS SUBJECTS OF THE IMPLEMENTATION OF PUBLIC POLICY IN THE HEALTHCARE SECTOR

Анотація

The ambiguous impact of decentralization and centralization on public governance mechanisms in the health sector is examined through an analysis of domestic and international experience. The article substantiates the role of local self-government bodies as actors in implementing public health policy under decentralization and martial law. Particular emphasis is placed on the «Health in All Policies» principle and the need to implement it at regional and local levels through the development of a «healthy community». The paper analyses how decentralization/centralization affects sector governance, the regulatory foundations, and the differentiation of local self-government competences (own and delegated) in health care. The methodological framework includes a systems approach, institutional and comparative analysis, and examination of national legislation and international sources. Using the Vinnytsia City Territorial Community as a case study, the article demonstrates the importance of strategic planning and municipal targeted programmes as tools for strengthening population health, ensuring service accessibility, and increasing local system resilience in Ukraine during wartime. Successful international governance practices in selected countries (Switzerland, Norway, Denmark, Finland) are also highlighted. The article concludes that a combination of subsidiarity, clear delineation of competences, and adequate resource provision for communities is a prerequisite for effective implementation of public health policy and for adapting the system to contemporary threats.

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