Keywords
rehabilitation
disability
traumatology
martial law
barrier-free access
How to Cite
Abstract
In press
Background. The prosthetics system in Ukraine is in a deep crisis due to the full-scale war, which has shifted the priority to mass complex combat injuries, while exacerbating pre-war structural problems: the lack of national standards, a critical shortage of qualified personnel, and fragmented infrastructure. The emergence of high-tech charitable centers has created a precedent for a "two-speed" system, highlighting the need not for improvements but for a structural overhaul of the entire management system.
Aim. To determine the key determinants and effectiveness of public prosthetics policy in Ukraine under martial law, and to substantiate conceptual directions for systemic transformation aimed at creating a stable, fair, and quality model integrated into the national policy of barrier-free access.
Materials and Methods. The study employed a systemic approach, bibliosemantic, regulatory-legal, comparative, quantitative, and qualitative analysis. International (ISO, ISPO) and national standards for prosthetics and orthotics, national legislation, official statistical data, scientific publications, and reports were analyzed. The article provides a comparative analysis of the public policy on prosthetics in Ukraine and the institutionally stable model of the Republic of Lithuania.
Research Ethics. The work was conducted in compliance with the principles of academic integrity. All conclusions are based on the analysis of publicly available data and scientific publications with appropriate references. Since the research did not involve direct work with human subjects or the collection of personal data, approval from a bioethics committee was not required.
Results. A dynamic but contradictory model was identified: despite increased funding and the "money follows the patient" model, there is a concentration of funds among a limited number of centers. A "two-speed" system has formed with a critical technological gap between innovative charitable and technologically outdated state centers. A critical shortage of qualified personnel (approximately 220 specialists) and a significant wage gap between sectors were revealed. The monitoring system is limited to aggregated indicators, making it impossible to assess real quality.
Conclusions. Public prosthetics policy requires a transition from fragmented improvements to comprehensive reform. Its future effectiveness depends on ensuring financial sustainability through flexible multi-source planning, overcoming personnel shortages by creating a national system of education and certification according to international standards, and full integration into the National Barrier-Free Strategy until 2030. This will transform prosthetics from a medical service into a component of continuous medical-social rehabilitation and inclusion.
Keywords: healthcare organization, rehabilitation, disability, traumatology, martial law, barrier-free access.
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