Order matters: sequencing steps for public health workforce professionalization in Ukraine

Abstract Since 2016, Ukraine's public health system has shifted from a medicalized model to delivering essential public health functions. As in many other post-Soviet countries, the system faced an overdue need to reconsider its foundations. Establishing the Ukrainian Public Health Centre and 25 regional Centers for Disease Control and Prevention introduced new responsibilities such as health security, NCD surveillance, and AMR control - unfamiliar areas for the existing workforce. A national-level strategy was urgently needed to ensure enough competent professionals to support the system in transition. In 2023, the Ministry of Health of Ukraine (MOH), jointly with Public Health Center and World Health Organization Country Office in Ukraine, started designing the first national Public Health Workforce (PHW) Development Programme. Guided by “the WHO-ASPHER Roadmap to Professionalizing the Public Health Workforce in the European Region”, the Programme sets 22 strategic objectives to be achieved by 2030. In January 2025, the MOH officially endorsed the Programme, and its implementation plan was drafted. Even though the Programme clearly describes the levers needed for PHW professionalization in Ukraine, a core challenge emerged: in what order should actions be implemented? Rather than follow a checklist, the implementing team prioritized interdependent actions, laying out two implementation phases. Phase 1 focuses on crucial enablers: legal PHW definition, workforce taxonomy, competency-based professional and educational standards, and workforce enumeration. Importantly, it became clear that none of these steps could succeed without first clarifying which public health services the workforce must deliver - making this the Programme's priority objective. Key messages • The WHO-ASPHER Roadmap supports Ukraine’s public health workforce development policy by emphasizing strategic sequencing over checklists. • Defining public health services is key enabling factor to professionalizing the public health workforce.