THE ROLE OF PUBLIC POLICY IN ENSURING PUBLIC HEALTH

population, preventing diseases, improving the quality and increasing life expectancy, ensuring the sanitary and epidemic well-being of the population; development of regulatory documents on priority areas for the development of the healthcare sector for the period up to 2025.


Introduction
The state receives existence and significant prospects only if there is a healthy human potential.Maintaining health, improving the quality and life expectancy, strengthening the reproductive potential, forming a responsible attitude to one's health should become one of the main strategies and policies of each state.
In a broad sense, politics is a certain part, program or direction of such activity, a set of means (tools) and methods for realizing certain strategic interests in order to achieve certain goals in a certain social environment.Public health policy is a set of management decisions and activities aimed at creating conditions for maintaining health and increasing the quality of life of citizens.An adequate and effective public health policy -Public Health Policy -is crucial because it transfers the theory and research of public health into the practical world, the practice of health care, thereby ensuring the preservation of the health of the population (WHO, 2022).
Therefore, the purpose of this study was to determine the role, influence and instruments of public policy for the preservation and promotion of public health.

Materials and methods
During the study, a retrospective analysis of the literature data, as well as the legal framework of Ukraine in the field of maintaining the health of the population, was performed.

Results and discussion
Government policies can have a significant impact on the quality of life and health of citizens.It combines not only management decisions and activities in the field of the health care system, but also other political decisions that are also important and have an effect on maintaining the health of the country's population.Some of the effects that public health policies can have include: 1. Access to health care: Public policy may determine the accessibility of health care to the population.This may include financing the healthcare system, organizing and distributing medical services and medicines, developing prevention programs, etc.An effective government policy in this area can provide comprehensive and equal access to quality healthcare, which contributes to improving the quality of life and improving the health of all segments of population (Alston, Nichols, Allender, 2019;Chung, Muntaner., 2006;Navarro, Shi., 2001).
2. Social protection: Public social protection policies such as social security programs, unemployment benefits, child care benefits and others can have a direct impact on the quality of life of citizens.Such programs provide social support and protection from economic hardship, which contributes to the stability, well-being and improvement of the general health of the population (Navarro, Shi, 2001).
3. Education: Government policy in the field of education can affect the accessibility and quality of education.Education is a fundamental element for human development and empowerment.The right policies to improve the accessibility, equity and quality of education can significantly improve the quality of life and contribute to better health.Educated people have more opportunities to get a job, make better money, access health information and better manage their health (Gopinathan, Buse, 2022;Zajacova, Lawrence, 2018;Karas Montez, Hayward, Zajacova, 2019).
4. Economic development: Government policies can influence the economic development of a country, which in turn affects the quality of life and health of citizens.Economic growth, job creation, and the reduction of poverty and inequality contribute to better living conditions.In addition, economic growth provides funding for the development of health care, social protection and other areas that directly affect the health and well-being of the population (McCartney, Hearty, Arnot et al, 2019; Ndumbe-Eyoh, Muzumdar, Betker, 2021).
6. Social justice: Public policies aimed at achieving social justice also play an important role in improving the quality of life and health of citizens.Equality, regardless of racial differences, age, gender, etc., is the basis for the implementation of all the above opportunities to improve the health of the entire population (MON Ukraine, 2020; Schram, Schuring et al, 2019).
To understand the mechanism for the implementation of state policy to ensure public health or health care policies, it is important to single out such components and their functions as institution and institutional.
Institution is the primary element of a system/industry, these are organizations and institutions that determine the policy and interaction of all structures in a particular area.In healthcare, institutions regulate the provision and organization of medical services for various categories of the population in accordance with state policy in the field of health protection.
Institutional -unites all legislative documents and normative legal acts through which the implementation of state policy, decisions of institutions in the field of health care actually takes place.
Different countries have their own institution structures and organizations that interact with public authorities, funding bodies and the provision of health services.The role of these institutions is to develop and regulate political decisions, determine the standards and quality of health care.
As examples of health care institutions in highly developed countries are the following.
In the US healthcare system, institutions such as the Centers for Disease Control and Prevention (CDC) and the Federal Office for Health Quality play an important role in defining and monitoring national strategies to prevent or manage disease, and in regulating and paying for healthcare services (CDC, USA, 2023); In the UK, the National Health Service (NHS) is the key institution responsible for providing health care to the entire population.The NHS governs the financing, organization and provision of health care in the country, ensuring the availability and equity of health care (National Health Service, UK, 2023); In Norway, institutions such as the Norwegian Directorate for Health and Social Services regulate and oversee health care.They develop policies and quality standards, and provide funding and resources for health services (Norwegian Directorate of Health, 2023); In the Japanese health care system, institutions such as the Ministry of Health, Labor and Welfare (MHLW) regulate and coordinate health care.Japan is known for its universal health insurance system, which ensures the availability and coverage of health care for all citizens (Ministry of Health, Labor and Welfare of Japan, 2023).The institutional mechanisms of the Japanese system also include the National Health Council, which develops strategies and recommendations in the field of public health, and municipal health authorities, which implement policies at the local level; In the German health care system, the role of institutions includes the Federal Ministry of Health (FMH), (Federal Ministry of Health, German, 2023), which develops laws and regulations in the field of health care, as well as the Federal Agency for Quality in Medicine, which monitors and evaluates the quality of medical care.In addition, there are compulsory health insurance funds in Germany, which play an important role in the financing and organization of health care; In the Canadian health system, the role of institutions is played by the Canadian Health Council, which develops strategies and recommendations in the field of health (Canadian Federal Commissions on Health Care, 2023), and the Canadian Institute for Health Information, Canadian College of Health Information Management (CCHIM, 2023), which collects and analyzes population health data.A feature of the Canadian system is the provincial responsibility for providing health care, which means that each province has its own institutional structure for managing and financing health care.
In Ukraine, institution is represented by the following structures: The Ministry of Health of Ukraine is the main executive body responsible for the development and implementation of state health policy.It coordinates the work of other state bodies and organizations, makes recommendations and develops regulations (Ministry of Health of Ukraine, 2023); The National Health Service of Ukraine (Natsionalʹna sluzhba zdoroviya Ukrainy, 2022) is the central executive body that implements the state policy in the field of state financial guarantees of medical support for the population under the program of medical guarantees; Regional and local health authorities are responsible for the organization and management of the health system at the regional and local levels.They develop regional health strategies and programs and allocate resources to provide health care in their territories; Medical institutions, including hospitals, polyclinics and dispensaries, also play an important role in decision-making and the allocation of resources in the healthcare sector.They determine what medical services will be provided, how resources will be used, including medical personnel, equipment and medicines.Medical institutions also interact with government agencies and structures, as well as with patients and public organizations to provide effective and affordable medical care.
The institutional components through which the implementation of the state policy in the field of health care are laws and regulations that regulate relations in the health care system; regulations governing norms and quality standards in medicine, as well as the volume, conditions and algorithms for the provision of medical services (Ministerstvo ohorony zdoroviya Ukrainy, 2022).
Thus, laws and regulations play a key role in defining duties and responsibilities in the healthcare sector.For example, the existence of laws requiring compulsory insurance or guaranteed access to certain medical services has a significant impact on the organization of the healthcare system and the provision of medical care to the population.Established norms and quality standards play an important role in ensuring the safety and effectiveness of medical care.Various organizations, such as the World Health Organization (WHO) and the National Institutes of Health, develop and regulate health care quality standards (Uryadoviy portal Ukrayiny, 2022).
An adequate state policy to ensure public health is especially important today for Ukraine, which is at a difficult stage of existence.The level of health of the population of Ukraine today is characterized as unsatisfactory, since over the past decade there has been an increase in the level of general mortality of the population within 4%, while in Europe, on the contrary, it has decreased by 4%, and the average life expectancy in Ukraine by 5%.-10 years less than in economically developed European countries (WHO, 2018).For the period 2007-2017 the level of prevalence of diseases increased by 10.6%, the incidence of diseases -by 38.9%, natural population growth is negative and ranges from 5.8 to 7.8 per 1000, the total population decreased by 7.7%, which threatens national security of the state (Tsentr medychnoyi statystyky Ministerstvа ohorony zdoroviya Ukrainy, 2019).
Today, Ukraine, despite the current political situation, actively takes care of maintaining and strengthening the health of the population, implementing a policy aimed at preventing the occurrence or increase in the level of non-communicable diseases.By implementing this strategy, Ukraine, like other UN member countries, has joined the global process of achieving the Sustainable Development Goals, since 2016 an inclusive process of achieving them in Ukraine has been launched.Each global goal was considered taking into account the specifics of national development, resulting in a national system consisting of 86 tasks (United Nations Development Programme, 2017).These national development goals, indicators for monitoring their implementation and targets for achievement by 2030 were reflected in the National Report "Sustainable Development Goals: Ukraine".In fact, this system is the basis for further comprehensive monitoring of indicators in the country.
Also, the Law of Ukraine "On the public health system" (09.2022) was adopted, which is aimed at protecting and strengthening the health of the population, preventing diseases, improving the quality and increasing life expectancy, and ensuring the sanitary and epidemic well-being of the population.It clearly presents the main tasks and operational functions of the public health system, and identifies their performers (Law of Ukraine, 2022).
Among the relevant documents aimed at strengthening population health is the order of the Ministry of Health "On approval of priority areas for the development of the healthcare sector for 2023-2025" (Decree of the Ministry of Health of Ukraine, 2022), which includes measures to prevent health-destructive behavior (smoking, alcohol, unhealthy eating, etc.), strengthening the educational component of medical personnel in matters of infection control, standardizing the provision of medical care and creating an effective system for monitoring the quality of medical services, and developing e-health.
The expansion of the package of guaranteed medical services for the population under the program of medical guarantees has also become a key one.In 2023, the program of medical guarantees was expanded with six packages of medical care services, including rehabilitation assistance, which is relevant for all countries and Ukraine especially, taking into account the realities (Natsionalʹna sluzhba zdoroviya Ukrainy, 2022).

Conclusions
Adequate and effective policies have a great influence on the health of the country's population, and not only in the field of the health care system.To understand the mechanism for implementing policies to ensure public health, institutions and institutional are distinguished, which cover both institutions and organizations that form the policy and interaction of all participants to implement policies, and regulatory and legal documents through which the implementation and implementation of these initiatives actually take place.
Despite the difficult period of Ukraine's existence, the country supports the policy, strategy of preserving and strengthening the health of the population.At the present stage, legislative acts are being adopted, such as expanding the programs of medical guarantees for the population, developing the public health system, implementing the strategies of the UN global plan to achieve the Sustainable Development Goals, which will help improve the level of public health and integrate Ukraine into the European community.