ЗАРУБІЖНИЙ ДОСВІД ПУБЛІЧНОГО УПРАВЛІННЯ КАДРОВОЮ СТІЙКІСТЮ СИСТЕМИ ОХОРОНИ ЗДОРОВ’Я У СІЛЬСЬКИХ ТА ВІДДАЛЕНИХ ТЕРИТОРІЯХ

• Datum: 2026
• 1. Verfasser: Ilin, Igor
• Format: Artikel
• Sprache: Ukrainisch
• Veröffentlicht: Zhytomyr Ivan Franko State University 2026
• Schlagworte: утримання медичних кадрів; сільські та віддалені території; публічне управління охороною здоров'я; кадрова політика; інструменти утримання; багаторівневе врядування; кадровий дефіцит
• Online Zugang: https://eui.zu.edu.ua/article/view/362527
• Назва журналу: Economics. Management. Innovations

The article systematizes international experience in retaining healthcare workers in rural and remote areas within the context of contemporary challenges to the workforce sustainability of health systems. The purpose of the study is to summarize international approaches to addressing workforce attrition through the analysis of three interrelated dimensions: the factors that cause unstable retention of healthcare professionals; the instruments used to improve their retention; and the governance mechanisms through which these instruments are implemented at different levels of public administration. The study demonstrates that workforce instability in peripheral territories is multifactorial and is shaped by professional overload, poor working environments, professional isolation, limited career and professional development opportunities, unfavorable living conditions, and difficulties of social integration. On this basis, the paper identifies the main groups of retention instruments, including educational, financial, regulatory, professional support, organizational and labor-related, social and living-condition, community-oriented, and strategic workforce planning instruments. It is argued that none of these instruments can ensure sustainable results in isolation; their effectiveness depends on coherence, consistency of implementation, and adaptation to the specific characteristics of a given territory. The article shows that the most effective models are multilevel, partnership-based, and context-sensitive, in which the central government establishes the regulatory and financial framework, the regional level coordinates and adapts the instruments, and the local level creates the actual conditions for the professional and social embedding of healthcare workers. It is concluded that, for Ukraine, the practical value of this experience lies in the need to move from fragmented personnel decisions to a long-term, intersectorally coordinated retention policy aimed at strengthening the workforce sustainability of rural healthcare under conditions of demographic ageing, territorial disparities, and post-war health system recovery.