Facilitating transformation of the health system through stronger governance amidst war in Ukraine

Abstract Since 2016, the UHC Partnership has supported the transformation of Ukraine's health system, focusing on accessible and affordable care. These efforts have continued even in a highly environment following the Russian Federation's invasion and aggression in February 2022. A significant focus has been on strengthening health system governance. The UHC partnership has facilitated the adaptation and adoption of WHO normative guidance and best practices in Ukraine. It has also supported the generation of data and evidence on the most pressing health needs, assess the status of the health system and foster resilience by building of relationships across the system. These achievements have been driven by sustained policy dialogue with local and international partners, aimed at improving health system performance and coordinating aid effectively. Key outcomes of this work include the development of Health Strategy 2030 and its adoption in 2025, as well as the review of health financing arrangements and the Programme of Medical Guarantees. These efforts have produced actionable recommendations to strengthen governance, enabling the government to make the best decisions towards universal health coverage, with an emphasis on optimizing limited financial resources and ensuring the purchase of health services and medicines is conducted in a way that supports equal access, quality improvement, efficiency and modernization. In essence, the partnership has supported better decision-making in a resource-constrained environment.