This Order of the Ministry of Health of Ukraine No. 599 dated May 8, 2026, establishes new rules for the organization of perinatal and neonatal care in Ukraine. The document implements a three-tier model of medical care, which clearly categorizes healthcare facilities based on their capacity to provide care depending on the complexity of the clinical case. The primary objective is to ensure safe pregnancy management, childbirth, and newborn care through effective patient routing. The Order also repeals obsolete 2011 regulations, updating approaches to medical care in accordance with modern standards.
**Structure and Key Provisions:**
The document consists of a regulatory section and the Procedure itself, which includes:
1. **General Provisions:** definitions of terms (perinatal period, neonatal care, risk degree) and criteria for forming the perinatal network.
2. **Levels of Care:** a detailed description of the three levels (from physiological pregnancy to highest-risk cases).
3. **Risk Classification:** criteria for assigning patients to risk categories (low, medium, high).
4. **Annexes:** lists of medical indications for referral to the second and third levels of care.
Compared to the previous version, the Order details the mechanisms of interaction between facilities, the use of telemedicine, and more clearly defines the competencies of facilities depending on the condition of the mother and child.
**Important Provisions for Implementation:**
* **Three-Tier System:**
* *First Level:* physiological pregnancy and healthy newborns (gestational age > 36 weeks).
* *Second Level:* pathologies of moderate severity, newborns weighing > 1500 g with a gestational age of ≥ 34 weeks.
* *Third Level:* high risk, preterm infants (< 1500 g, < 32 weeks), complex congenital malformations, and cases requiring intensive care or surgery.
* **Routing:** A key instrument is the assessment of the degree of perinatal risk, based on which it is determined exactly where the patient should receive care.
* **Coordination:** Each facility is obligated to appoint a responsible person for coordination and patient transfer, which minimizes risks during transportation.
* **Evidence-based Approach:** All actions of medical personnel must be based on the Ministry of Health sector standards, and data must be mandatorily entered into the Electronic Health System (eHealth).
