Challenges of Primary Health Care Reforms in Georgia (1995-2018)

Verulava, Tengiz (2019) Challenges of Primary Health Care Reforms in Georgia (1995-2018). In: Politics Around the Caucasus, IV International Scientific Conferenсe, 2019, Ivane Javakhishvili Tbilisi State University.

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Primary Health Care (PHC) reforms have been an integral part of health sector reforms in Georgia. These reforms can be divided into four distinct periods: 1994–1999, 2000–2006, 2007–2012 and from 2013 to the present. In 1994/1995, the government issued policies that led to the decentralization of the health system, introduced new payment mechanisms for services, removed health personnel from the State payroll and opened up space to privatize health facilities. In 1997 the government defined a basic benefits package that included a range of primary care services. Due to economic reasons, the majority of local municipalities, which were responsible for financing primary care services for the local population, were unable to allocate adequate funding. A new period in PHC reform began in 2000. Responding to inadequate access to PHC services primarily for rural residents the Rural Health Programme was launched in 2001. Family medicine training programmes were started with the support of the United Kingdom Department for International Development. After the Rose Revolution in 2007, the government launched an ambitious health financing reform with the overall goal of improving equity and financial access to essential services for the poor. The government contracted out the delivery of benefits to private insurance companies, which assumed responsibility for programme administration. In March 2007, the government introduced a revised vision for PHC reform, which differentiated between urban and rural models of PHC provision. The government intended to sell PHC buildings to rural doctors for a nominal price. All rural doctors were given the basic medical equipment that was necessary for their practice. Rural primary care doctors acquired a new legal status as individual entrepreneurs and were authorized to manage their own PHC budgets. The next phase of PHC reforms started in 2013. The newly elected government initiated the Universal Health Coverage Programme for the whole population. The administration of all State-funded programmes became the responsibility of the Social Service Agency. In mid-2017 the government introduced a differentiated approach for Universal Health Coverage Programme benefits, including improved drug benefits for chronic disease management among the poor population.

Item Type: Conference or Workshop Item (Paper)
Uncontrolled Keywords: Primary Health Care
Subjects: H Social Sciences > HL Healthcare Policy and Management
H Social Sciences > HO Public Health
Divisions: Centres > Insurance and Public Health Center
Depositing User: Professor Tengiz Verulava
Date Deposited: 26 Jul 2019 15:04
Last Modified: 26 Jul 2019 15:04

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