Institutional Approach to Combating Corruption in the Health Sector of Ukraine

The article examines the institutional approach to combating corruption in the health sector of Ukraine as a complex scientific and practical problem that is at the intersection of public administration, law enforcement and social policy. It is emphasized that in conditions of martial law, large-scale budget expenditures and an extreme need for a rapid response from the health system, corruption risks tend to grow. In such conditions, the need not only to strengthen administrative control, but also to build an effective institutional environment in which transparent, accountable and interconnected public authorities with anti-corruption powers would operate becomes urgent. The activities of the main institutions, in particular the National Agency for the Prevention of Corruption, the National Health Service of Ukraine, the State Audit Service, as well as local self-government bodies that perform control and regulatory functions in the field of health care, were analyzed. It was found that despite the presence of specialized structures, the lack of proper coordination between them, the fragmentation of powers and the weak integration of information resources significantly reduce the effectiveness of the implementation of anti-corruption policy. Special attention was paid to the institutionalization of internal control mechanisms in medical institutions, in particular the implementation of compliance programs, internal audit and codes of ethics, as important elements of reducing the corruption vulnerability of the system. The role of the public, the media and patient organizations as participants in institutional interaction in the fight against corruption was investigated. It is determined that only if conditions are created for real influence of citizens on management processes, including through tools of access to information, participation in supervisory boards and monitoring programs, effective de-shadowing of the medical sphere is possible. In addition, the article emphasizes the need to develop anti-corruption education among heads of medical institutions and officials of government bodies responsible for making management decisions in the health care sector. It is concluded that the institutional approach allows for a systematic assessment of the state’s ability to form conditions under which compliance with integrity requirements becomes not an exception, but a mandatory element of management culture. The proposals developed in the article have practical significance for improving regulatory and legal support, strengthening coordination between institutions, stimulating anti-corruption activity at the local level, as well as for strategic planning of reforms in the health care sector.