Georgia’s health system performance: significant steps taken but challenges remain

From the Editorial

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.