FORESIGHT ANALYSIS OF STRATEGIC PROSPECTS FOR THE DEVELOPMENT OF HEALTH CARE INSTITUTIONS IN UKRAINE
Abstract
This scientific article presents a comprehensive foresight analysis regarding the strategic development of healthcare institutions in Ukraine amidst the extreme uncertainty caused by the ongoing full-scale invasion as of 2026. The research aims to evaluate the healthcare system at both the sectoral and enterprise levels to develop adaptive measures for long-term sustainability. The study identifies and systematizes key drivers of change that determine the transformation of the medical environment, including the critical security situation, mass migration, demographic aging, rapid digitalization, and the expanding role of private medicine. Specific attention is paid to the systematic destruction of medical infrastructure; by early 2026, 2,551 objects within 817 health facilities were confirmed as damaged or destroyed, directly impacting service accessibility. The authors utilize scenario planning to model five potential futures for the healthcare system based on variables such as funding levels, human resource availability, institutional efficiency, and technological progress. The most optimistic scenario emphasizes the resilience of state institutions, such as the NHSU and eHealth, and the acceleration of digitalization through international grant support. In contrast, critical and catastrophic scenarios warn of management chaos, the collapse of medical reforms, and a sharp decline in care accessibility if institutions fail to adapt to military and economic challenges. A significant portion of the research is dedicated to the concept of "Gray Rhinos" – highly probable but frequently ignored systemic threats. These include the acute shortage of medical personnel, demographic shifts toward an aging population, polypragmasy, and the persistent use of non-evidence-based treatments. To counter these "rhinos," the authors propose specific management solutions: implementing transparent motivation and competitive compensation programs for staff, prioritizing geriatric and rehabilitative care, diversifying funding through private sector integration, and strictly promoting evidence-based medicine. The findings provide a robust methodological basis for developing resilience strategies to ensure the quality and accessibility of medical aid in both current and post-war perspectives.
References
Costanzo L. A., MacKay R. B. Handbook of Research on Strategy and Foresight. Elgar Publishing Limited, Edward, 2010. 576 p.
Наукова концепція розвитку та застосування форсайту в діяльності Верховної Ради України. Верховна Рада України. URL: https://research.rada.gov.ua/uploads/documents/33282.pdf. (дата звернення: 22.02.2026).
Рогачевський О. П. Концептуальна модель забезпечення методології форсайт у стратегічному розвитку національної галузі охорони здоров’я. Український журнал прикладної економіки. 2020. Т. 5, № 3. С. 304–310. URL: https://doi.org/10.36887/2415-8453-2020-3-33 (дата звернення: 22.02.2026).
Притула М. О. Інструменти запровадження форсайту в систему охорони здоров'я України. Інвестиції: практика та досвід. 2023. № 13. С. 151–156. URL: https://doi.org/10.32702/2306-6814.2023.13.151 (дата звернення: 24.02.2026).
Шестаковська Т. Управлінські патерни в системі охорони здоров’я: моделі ефективного партнерства. Development Service Industry Management. 2025. № 2. С. 288–293. URL: https://doi.org/10.31891/dsim-2025-10(38) (дата звернення: 24.02.2026).
Пархоменко-Куцевіл О. Форсайт у системі державного управління у сфері охорони здоров’я України в умовах пандемії: теоретичні засади. Науковий вісник: Державне управління. 2022. № 1(11). С. 166–185. URL: https://doi.org/10.33269/2618-0065-2022-1(11)-166-186 (дата звернення: 24.02.2026).
The influence of strategic foresight on quality of healthcare services in the presence of artificial intelligence solutions in Jordan / S. S. Alajrab et al. BMC Nursing. 2025. Vol. 24, no. 1. URL: https://doi.org/10.1186/s12912-024-02518-3 (date of access: 24.02.2026).
The promise of complementarity: Using the methods of foresight for health workforce planning / G. H. Rees et al. Health Services Management Research. 2018. Vol. 31, no. 2. P. 97–105. URL: https://doi.org/10.1177/0951484818770408 (date of access: 24.02.2026).
Reimers-Hild C. Strategic foresight, leadership, and the future of rural healthcare staffing in the United States. Journal of the American Academy of Physician Assistants. 2018. Vol. 31, no. 5. P. 44–49. URL: https://doi.org/10.1097/01.jaa.0000532119.06003.12 (date of access: 24.02.2026).
Чехун В. Ф., Россильна О. В. Сучасні драйвери медицини майбутнього в Україні: соціально-правовий аналіз. Вісник Національної академії правових наук України. 2023. Vol. 30, no. 2. P. 142–159. URL: https://doi.org/10.31359/1993-0909-2023-30-2-142 (date of access: 19.03.2026).
Кабмін схвалив пакет змін для медичної системи: більше ресурсів для лікарень і нові можливості для пацієнтів. Міністерство охорони здоров'я України. URL: https://moz.gov.ua/uk/kabmin-shvaliv-paket-zmin-dlya-medichnoyi-sistemi-bilshe-resursiv-dlya-likaren-i-novi-mozhlivosti-dlya-paciyentiv (дата звернення: 19.03.2026).
Триває відновлення медичних закладів, пошкоджених під час війни. Міністерство охорони здоров'я України. URL: https://moz.gov.ua/uk/trivaye-vidnovlennya-medichnih-zakladiv-poshkodzhenih-pid-chas-vijni (дата звернення: 20.03.2026).
Чисельність та склад населення. Державна служба статистики України. URL: https://stat.gov.ua/uk/explorer (дата звернення: 20.03.2026).
Талеб Н. Чорний лебідь. Про (не)ймовірне в реальному житті. Наш Формат, 2021. 392 с.
Wucker M. The Gray Rhino: How to recognize and act on the obvious dangers we ignore. St. Martin's Press, 2017. 284 p.
Сірий носоріг. Finterra. URL: https://www.finterra.com.ua/blog/razvitie/sirij-nosorig/ (дата звернення: 22.03.2026).
Costanzo L. A., MacKay R. B. (2010) Handbook of Research on Strategy and Foresight. Elgar Publishing Limited, Edward, 576 p.
Naukova kontseptsiia rozvytku ta zastosuvannia forsaitu v diialnosti Verkhovnoi Rady Ukrainy [Scientific concept of development and application of foresight in the activities of the Verkhovna Rada of Ukraine]. Verkhovna Rada Ukrainy. Available at: https://research.rada.gov.ua/uploads/documents/33282.pdf (date of access: 22.02.26)
Rohachevskyi O. P. (2020) Kontseptualna model zabezpechennia metodolohii forsait u stratehichnomu rozvytku natsionalnoi haluzi okhorony zdorov’ia [Conceptual model of providing foresight methodology in the strategic development of the national healthcare industry]. Ukrainskyi zhurnal prykladnoi ekonomiky – Ukrainian Journal of Applied Economics, vol. 5(3), pp. 304–310. DOI: https://doi.org/10.36887/2415-8453-2020-3-33 (date of access: 22.02.26)
Prytula M. O. (2023) Instrumenty zaprovadzhennia forsaitu v systemu okhorony zdorov'ia Ukrainy [Tools for introducing foresight into the health care system of Ukraine]. Investytsii: praktyka ta dosvid – Investments: Practice and Experience, vol. 13, pp. 151–156. DOI: https://doi.org/10.32702/2306-6814.2023.13.151 (date of access: 24.02.26)
Shestakovska T. (2025) Upravlinski paterny v sistemi okhorony zdorov’ia: modeli efektyvnoho partnerstva [Management patterns in the health care system: models of effective partnership]. Development Service Industry Management, vol. 2, pp. 288–293. DOI: https://doi.org/10.31891/dsim-2025-10(38) (date of access: 24.02.26)
Parkhomenko-Kutsevil O. (2022) Forsait u systemi derzhavnoho upravlinnia u sferi okhorony zdorov’ia Ukrainy v umovakh pandemii: teoretychni zasady [Foresight in the system of public administration in the field of health care of Ukraine in the conditions of a pandemic: theoretical foundations]. Naukovyi visnyk: Derzhavne upravlinnia – Scientific Bulletin: Public Administration, vol. 1(11), pp. 166–185. DOI: https://doi.org/10.33269/2618-0065-2022-1(11)-166-186 (date of access: 24.02.26)
Alajrab S. S. et al. (2025) The influence of strategic foresight on quality of healthcare services in the presence of artificial intelligence solutions in Jordan. BMC Nursing, vol. 24(1). DOI: https://doi.org/10.1186/s12912-024-02518-3 (date of access: 24.02.26)
Rees G. H. et al. (2018) The promise of complementarity: Using the methods of foresight for health workforce planning. Health Services Management Research, vol. 31(2), pp. 97–105. DOI: https://doi.org/10.1177/0951484818770408 (date of access: 24.02.26)
Reimers-Hild C. (2018) Strategic foresight, leadership, and the future of rural healthcare staffing in the United States. Journal of the American Academy of Physician Assistants, vol. 31(5), pp. 44–49. DOI: https://doi.org/10.1097/01.jaa.0000532119.06003.12 (date of access: 24.02.26)
Chekhun V. F., Rossylna O. V. (2023) Suchasni draivery medytsyny maibutnoho v Ukraini: sotsialno-pravovyi analiz [Modern drivers of the medicine of the future in Ukraine: socio-legal analysis]. Visnyk Natsionalnoi akademii pravovykh nauk Ukrainy – Journal of the National Academy of Legal Sciences of Ukraine, vol. 30(2), pp. 142–159. DOI: https://doi.org/10.31359/1993-0909-2023-30-2-142 (date of access: 19.03.26)
Kabmin skhvalyv paket zmin dlia medychnoi systemy: bilshe resursiv dlia likaren i novi mozhlyvosti dlia patsiientiv [The Cabinet of Ministers approved a package of changes for the medical system: more resources for hospitals and new opportunities for patients]. Ministerstvo okhorony zdorov'ia Ukrainy. Available at: https://moz.gov.ua/uk/kabmin-shvaliv-paket-zmin-dlya-medichnoyi-sistemi-bilshe-resursiv-dlya-likaren-i-novi-mozhlivosti-dlya-paciyentiv (date of access: 19.03.26)
Tryvaie vidnovlennia medychnykh zakladiv, poshkodzhenykh pid chas viiny [Restoration of medical institutions damaged during the war continues]. Ministerstvo okhorony zdorov'ia Ukrainy. Available at: https://moz.gov.ua/uk/trivaye-vidnovlennya-medichnih-zakladiv-poshkodzhenih-pid-chas-vijni (date of access: 20.03.26)
Chyselnist ta sklad naselennia [Population size and composition]. Derzhavna sluzhba statystyky Ukrainy. Available at: https://stat.gov.ua/uk/explorer (date of access: 20.03.26)
Taleb N. (2021) Chornyi lebid. Pro (ne)imovirne v realnomu zhytti [The Black Swan: The Impact of the Highly Improbable]. Nash Format, 392 p.
Wucker M. (2017) The Gray Rhino: How to recognize and act on the obvious dangers we ignore. St. Martin's Press, 284 p.
Siryi nosorih [Gray rhino]. Finterra. Available at: https://www.finterra.com.ua/blog/razvitie/sirij-nosorig/ (date of access: 22.03.26)
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