Regulatory framework of family medicine implementation in Ukraine

BACKGROUND: Primary health care (PHC) is the most important element of health system. The development of PHC based on family medicine will allow to significantly improve the demographic situation, to achieve equitable distribution and efficient use of budget funds. However, implementation of general clinical practice/family medicine (GPFM) is constrained by lacking resources and imperfect system of training health professionals, incompleteness of legal and financial frameworks, information support, and mechanisms of interaction between general practice and other health services. The aim of this study was to analyze the legal aspects of the implementation of the family medical practice in Ukraine.METHODS: Thirty four regulatory documents directly related to PHC in Ukraine on the basis of family medicine for the period from 1995 to 2007 were found and analyzed. Among these four decrees of the Cabinet of Ministers of Ukraine and 30 orders of the Ministry of Health of Ukraine were found.RESULTS: Regulatory framework for introduction of family medicine is being enhanced actively. However, it still lacks regulations of relationship between doctors of GPFM and other specialists defining their responsibilities; issues of differential allocation of funds across the levels of health care with the focus on the PHC financing; providing adequate financing, remuneration for labour and motivation to professionals working in "general practice/family medicine"; providing the necessary powers for private family doctors; facilitating the participation of NGOs in the processes of the sector administration; ensuring proper assessment and quality control of PHC based on family medicine.CONCLUSION: Further development and improvement of the legal framework is needed to speed up the PHC reform based on family medicine and continued implementation of general practice/family medicine.