Health Reforms and Public Health in Georgia

BACKGROUND: Starting from 90‘th, the Government of Georgia (GoG) made several attempts to transform Georgian health care system into one with improved efficiency, accessibility, and quality services. Mandatory social health insurance which was introduced in the 1990s was abolished and private health insurance has been promoted as its replacement. The main principle of health care reform since 2006 was the transition towards complete marketization of the health care sector: private provision, private purchasing, liberal regulation, and minimum supervision.This paper aims to analyze an impact of ongoing reforms on public health and population health status.MATERIALS AND METHODS: A systematic review of the available literature was conducted through national and international organization reports; key informant interviews were conducted with major stakeholders. RESULTS: The country has attained critical achievements in relation to improved maternal and child health, national responses to HIV, TB and Malaria. Life expectancy has increased from 70.3 years in 1995 to 75.1 years in 2010. Under-5 mortality indicator has improved from 45.3 to 16.4 per 1000 live birth in 2005-2010 meaning a 64% decrease. However, Georgia is still facing a number of critical challenges securing better health for the population. Cardiovascular diseases are by far the largest cause of mortality, respiratory diseases are the leading cause of morbidity and have doubled during last decade. Georgia has one of the highest rates of male smoking in the world (over 50%).CONCLUSION: Governmental efforts in health promotion and disease prevention can have significant impact on health status by preventing chronic diseases and detecting health problems at a treatable stage. Government should consider increasing funding for public health and prevention programmes with the focus on prevention of the main risk factors affecting the population’s health: tobacco and drug use and unsafe sexual behaviour.