Georgia
Georgia is a country in the Caucasus region between Eastern Europe and Western Asia. Its population of 3.7 million people has a life expectancy at birth of 69 years (male) and 77 years (female). Georgia maintained Soviet-style healthcare after the fall of the Soviet Union until 1995 but saw a dramatic decline in quality of care and facilities. To increase access and quality of care, in 2013 the government launched the ‘State Universal Health Care Programme’, a minimum service package for all citizens with no state or private insurance. Yet out-of-pocket expenditure remains a barrier to accessing health services. The Georgian Healthcare System State Concept 2014-2020 serves as a national health plan, with heavy emphasis on health in all policies. The UHC Partnership will support the review and operationalization of the primary care strategy 2016-2023 as well as build capacity around strategic purchasing, with the goal of enhancing efficiency in the organization and delivery of publicly financed health services. You can access important country documents by clicking here.
Technical Areas
Completed/Cancelled
| Product/Service | Deliverables | Status |
|---|---|---|
| Establish a National Working Group to prepare an action plan for strategic purchasing and steer its implementation | Action plan developed, reviewed and agreed | Completed |
| TA to review and operationalise the primary care strategy 2016-2023 | Recommendations for improving quality mechanisms in primary care and strengthening coordination between primary and hospital care | Completed |
| Capacity building in health financing | Training in health financing delivered to appropriate people | Completed |
| TA to explore ways of using SSA invoicing data to support strategic purchasing | Action plan for data systems improvement and provider payment refor | Completed |
| TA to assess the SSA’s administrative capacity and capacity-building needs | Action plan for organisational strengthening and capacity development | Completed |
| TA to develop best practice patient pathways for priority health outcomes and develop tools to support their implementation | Pathways developed spanning all levels of care and supporting purchasing instruments identified (contracting, payment, performance monitoring) | Completed |
| Designing best practice patient pathways for selected priority clinical areas and developing tools to support their implementation. | Best practice patient pathway for diabetes type 2 is developed and validated in local context and increased MOLHSA’s and SSA’s capacity to use different policy instruments to support best practice patient pathway’s implementation | Completed |
| Strengthening regulatory capacity and regulation to improve access to quality medicines by introducing Good Manufacturing Practice and Good Distribution Practice. | Establishment of the National GMP/GDP Inspectorate, incl. Recruitment and Training of GMP Inspectors and introduction of Quality Management System and Standard Operating Procedures. | Completed |
| Preparing a strategy for strategic purchasing and providing support to advance the Social Services Agency’s capacity to implement the strategy. | A strategy for strategic purchasing based on international evidence and the Georgian health system context and increased capacity of the SSA to effectively implement the strategy for strategic purchasing | Completed |
| Revising and introducing new payment systems (Diagnosis-Related Group – DRG) and strengthening strategic purchasing to increase efficiency. | DRG-based payment system introduced in 2019/2020 and integrated to the overall strategic purchasing framework. | Completed |
| Assist drafting and endorsing the new Law on Medicines and related regulations to improve access to quality medicines | Law on Medicines to be submitted to Parliament. Improved capacity in regulating the pharmaceutical market (marketing authorization and related areas) as well as initial work in the area of pricing | Completed |
| Assist implementation of selective contracting mechanisms, incl. optional policy dialogue | Assist reshaping/establishing New health division’s structure of the Social Services Agency (SSA) to better incorporate strategic purchasing functions Capacity building for new and existing SSA staff, to effectively implement the strategy for strategic purchasing | Completed |
| Support DRG implementation and enhancement of other elements of strategic purchasing to increase the value for public funds | Policy advice and oversight of process of implementation of hospital payment system. Foster hands-on capacity building of the SSA staff, incl. knowledge exchange / study visit to comparable institution with strong capacity in the area of DRG-hospital payment system. Assist procedures for quality improvements of claims data. Assist piloting DRG as a “shadow” payment system, including advocacy and communication | Completed |
| PHC Strategy/Roadmap updated/revised in line with the changing priorities and policy environment and vertical programmes integrated into PHC | PHC Strategy/Roadmap timely updated and stakeholders' consensus reached Integrating vertical programmes into PHC (including CDs, public health, mental health, etc.) and scaling up of prevention activities | Completed |
| Strengthening Human Resources for Health in Georgia | COVID delayed Human resources for Health (HRH) assessment . Support HRH planning capacity and capability Support new nursing strategy and strengthening of nursing competencies in PHC. | Completed |
| Comprehensive policy guidance on health financing under UHC-P project and BAR course for capacity building | Improving health services financing Comprehensive policy guidance on health financing under UHC-P project and BAR course for capacity building Barcelona course for capacity building | Completed |
| Support in developing and implementation of financial protection policies and improving health accounts | Support to improve national health accounts Report on financial protection with policy recommendations | Completed |
| Strengthening HRH policies to ensure proper supply and retention | HRH assessment report and recommendations, HWD/Governance assessment report and recommendations, HRH policy and HWD roadmap | Completed |
Details
| Product/Service | Deliverables | Status |
|---|---|---|
| Regulatory system strengthening including laboratories and inspection | COVID delayed Assistance in strengthening assessment function and capacity building of the Pharmaceutical Inspectorate, including implementation of GMP and GDP | On track |
| Support to improve access to medicines through systems development including HTA, pricing, strategic procurement, supply chain systems, and reimbursement including out of pocket payments | Assist in improving the national legal framework on medicinal products and the institutional development plan Assist in updating and operationalizing the national Essential Medicines List Assist in improving price regulation and pricing policies | On track |
| Improving health financing equity and distribution of health system's resources | System-wide analysis of health financing equity and distribution of health system's resources Mobilization of technical expertise for intervention through national implementation of Strategy and action plan for refugee and migrant health in the WHO European Region Defining the basic health package, including designing the system and process of revision and renewal | On track |
| HIS & surveillance | Map of HIS system and recommendations on streamlined data collection | On track |
| Strengthening health system through digital health/digitalization | COVID delayed Support introduction of electronic medical records Strengthening Governance for digital health, including telemedicine | On track |
| Health system strengthening to achieve UHC | all deliverables support this | On track |
| Support digitalization of the health sector | Assessment report and recommendations, feasibility study, training courses | On track |
| Strengthening health financing policies to support UHC | Review of the DRG implementation status; PHC payment system design adjustments are waiting adoption of the PHC Roadmap; Health Financing Progress Matrix assessment | On track |
| WHO leadership in strengthening coordination in support of national efforts to accelerate progress toward the health-related SDGs among government, multilateral organizations and other development partners | Leadership on WHO-led EU-funded joint activities (reporting) Steering committee meetings with Ministry and UN Partners (exchange of information) | On track |
| Support to develop of pharmaceutical policies aiming at improving access to and quality of medicines | Draft law on medicines | On track |
| NCD control and addressing risk factors | Roadmap on the integration of NCDs into PHC and training of PHC providers Health workforce assessment and health workforce strategy | On track |
| Governance & regulatory framework | Governance structure for Medical Holding to manage Rural Doctors' Program and PHC reform, regulatory framework for digital health/telemedicine | On track |
| Strengthening national capacities in data gathering, analytics and health information systems to better inform policies | Training in data collection and analysis | On track |
| Technical support to attaining cervical cancer elimination | Roadmap for accelerating the elimination of cervical cancer as a public health problem in Georgia | Not started |
| Support National Cancer Control Plan /strategies: development or prioritization or expert review or costing, or all the above. | Costing of NCCP with HQ | Not started |
Stories from the field
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