PRIMARY HEALTH CARE IN TERRITORIAL COMMUNITIES OF THE KHARKIV REGION IN WAR CONDITIONS

Abstract

The purpose of the article is to identify the characteristics and problems of access to primary health care (PHC) in territorial communities of the Kharkiv region in conditions of war. The theoretical and methodological basis of the study was the concept of J. Levesque, which allowed for a comprehensive analysis of the characteristics of the primary health care system in the communities of the Kharkiv region and the capabilities of community residents. Methodology. The article is based on the materials of a study conducted in 2024 in the territorial communities of the Kharkiv region, which was exploratory in nature. An online survey using a Google form was used to collect data. The total number of respondents to the online survey was 371 patients of primary healthcare facilities in the territorial communities of the Kharkiv region. The survey covered indicators of healthcare accessibility from the perspective of the system (reachability, acceptability, availability and location, financial accessibility, suitability) and patients (awareness of needs, ability to find and access care, ability to pay, active participation in treatment). Scientific novelty. For the first time, the state of primary medical care accessibility has been comprehensively assessed in the frontline region of Ukraine, taking into account the impact of the war. Systemic barriers have been identified, including staff and technical shortages, insufficient digitization, and limited transport accessibility, as well as behavioral barriers, such as delayed seeking of help, psychological barriers, low digital literacy and limited understanding of medical documentation. Conclusions. Despite patients' high assessment of the accessibility, acceptability, and adequacy of primary health care, the consequences of the war – destruction of infrastructure, reduction of medical personnel, and economic instability – have a significant impact on its accessibility. Further development of PHC requires technological modernization, strengthening of human resources, improvement of transport accessibility, and increasing the medical and digital literacy of the population.