TRANSFORMATIONAL CHANGES IN THE LOGISTICAL SUPPORT OF HEALTH CARE FACILITIES IN UKRAINE UNDER MARTIAL LAW

Abstract

The article examines the complex transformational processes in the system of material and technical support (MTS) of healthcare facilities in Ukraine under the challenges of full-scale martial law. 1 The relevance of the study is driven by unprecedented infrastructural losses and the necessity of forming a new model of healthcare resilience. 1 The author analyzes the transition from a strategy of planned resource renewal to the implementation of autonomous life-support systems based on the decentralization of energy supply and satellite communication technologies. 1 Drawing on methodological approaches, the role of adaptive management and digital logistics in minimizing the risks of critical resource shortages is substantiated. 1 Structural changes in the nomenclature of medical equipment are identified, with an emphasis on tactical medicine and high-tech rehabilitation. 1 Proposals for the modernization of MTS based on the “Build Back Better” concept are formulated, involving the creation of an energy-efficient and mobile network of medical institutions. 2 Furthermore, the study introduces an integrated model of adaptive resilience evaluated through an original mathematical index of infrastructure adaptability, which links technological innovation, energy decentralization, and logistical flexibility. Statistical analysis based on Rapid Damage and Needs Assessment (RDNA) reports demonstrates a massive gap between direct physical damage and indirect economic losses, highlighting the high efficiency of autonomous resources. Practical case studies, including the green restoration of Horenka clinic with a heat pump and a hybrid solar power station, as well as solar integration in Zviahel Hospital, confirm the economic feasibility of decentralized solutions.