Georgia’s health system performance: significant steps taken but challenges remain
At a time when Georgia faces not only the effects of the global economic crisis but also significant health challenges, it is crucial for the Government to continue to consolidate and further advance its ambitious health system reforms to protect the poor and the most vulnerable. These are the conclusions of a new report prepared by the Georgian Ministry of Labour, Health and Social Affairs with the support of the World Health Organization (WHO) and World Bank experts.
The report, entitled Georgia health system performance assessment, issued on 17 November 2009, shows that the overall health status of the population has improved since 2000. In some areas, specifically health insurance coverage and primary health care, the country is in the midst of implementing significant reforms to achieve national objectives. The report documents the measures adopted by the Government in recent years to ensure coverage and access by the poorest Georgians to essential health care services through its Medical Insurance Programme. A positive finding highlighted in the report is the extension of health insurance coverage to some 750 000 people living below the poverty line in 2008 – a 12% increase compared to 2007.
Nevertheless, in spite of these initial positive strides, the report indicates that significant challenges remain. “While we are striving to improve the performance of the health system, and the health system is indeed performing better, this report provides critical information to help us take further action to make our system better,” says Alexander Kvitashvili, Georgian Minister of Labour, Health and Social Affairs.
The report shows that a significant challenge remaining is the high burden of out-of-pocket payments for a significant number of people. This creates barriers to access to care when people need it, and also explains why the number of visits to doctors in 2007 was as low as 1.8 per person. The report advises that an increase in public health expenditure, which is still significantly lower than in other countries in Europe and central Asia, coupled with well-targeted investments in the health sector, will have a major impact on improving health and equity in the country.
The international community has a role to play in supporting the Georgian Government in addressing the challenges in the health system over the medium term. Indeed, as noted by Nata Menabde, Deputy Regional Director of the WHO Regional Office for Europe, “the report gives sufficient background to better assist Georgia in building a stronger and more efficient health system and public health programmes. This objective is defined by our mandate and we will do our best to fulfil it.”
Asad Alam, World Bank Director for the Caucasus Region, echoed this view by reiterating the Bank’s commitment, working with other partners such as WHO, USAID, the European Commission and other specialized agencies of the United Nations to support ongoing and additional health reform efforts in Georgia over the medium term “to help create conditions for the operation of a high-performance health care system, with quality services, safe, efficient and accessible to all, building upon the evidence presented in the report”.