In May 2006, the USAID/Caucasus Mission awarded PATH $400,000 to strengthen surveillance, information, education, communication (IEC) activities, and procurement planning to address avian influenza (AI) in Georgia. As specified in the proposal, PATH has established a partnership with a Georgian nongovernmental organization, Curatio International Foundation (CIF), to implement this activity. View the document.
Category: 2006
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Policy Implications of the first Systematic Tracking of Financial Flows for HIV/AIDS in Ukraine, 2006
Policy Implications of the first Systematic Tracking of Financial Flows for HIV/AIDS in Ukraine is presentation delivered by the nine health care experts in Toronto in August 2006.The presentation looks at background information of HIV/AIDS like prevalance, HIV/Aids statistics, HIV/AIDS spending, finances sources, expenditures by functions, comparison with other countries in the scope of expenditures by functions etc. Authors of the presentation: Yuriy Chechulin, George Gotsadze,Catherine Chanfreau, Liudmila Husak,Vinay Saldanha, Anastasiya Nitsoy, Viktor Galayda,Manjiri Bhawalkar, Tania Dmytraczenko. View the full version of the presentation.
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Health Systems 20/20, 2006-2011
Health Systems 20/20 (HS 20/20), was a five-year (2006-2011) cooperative agreement, funded by the U.S. Agency for International Development (USAID). It offered help to the USAID-supported countries in solving problems in health governance, finance, operations, and capacity building. By working on these dimensions of strengthening health systems, the project helped people in developing countries, to gain access to the population, health, and nutrition (PHN) services.
Health financing, governance and operations initiatives were integrated in Health System 20/20. This integrated approach was focused on building capacity for long-term sustainability of system strengthening efforts. The project acted through global leadership, technical assistance, brokering and grant making, research, professional networking, and information dissemination.
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Effects of GFATM on Georgia's Health System Development
The project funded by the Alliance for Health Policy and System Research (HPSR) was implemented in February 2006- 2008 by Curatio International Foundation. The proposed study is a continuation of the baseline research carried out in Georgia during 2004 in accordance with SWEF study protocol on GFATM impact on a national health system.
The proposed study applied to the already developed study protocol and instruments. It helped evaluate GFATM impact on Georgia’s health system by looking at:
Policy processes;
Human resources;
Pharmaceutical and commodity supply system;
Public-private mix; and
Access to services by HIV/AIDS high risk groups and TB patients.
Results of the study inform the primary health care reform policies of the country about the aim to integrate services for focal diseases on a PHC level. In addition, results also contribute to global evidence on GFATM possible impact on a broader health system. The research findings have following policy relevance: they inform national, as well as international policy makers about where GFATM contributes to the strengthening of health care system in Georgia and what can be done to address weaknesses; it also informs policy makers about where national health care system has degree of similarity with the Georgian one and contribute to the body of evidence being generated by the SWEF research network. -
Strengthening surveillance, IEC and procurement planning to address Avian Influenza in Georgia
The project was funded by USAID/Caucasus and implemented by Curatio International Foundation (CIF) and Program for Appropriate Technology in Health (PATH) in June 2006-April 2007. The key partners were: Ministry of Labour, Health and Social Affairs, DPH, NCDC, WHO, UNICEF, World Bank, DTRA, HHS/CDC, MoA, AgVantage. The aim of the project was to assist the Government of Georgia with well-coordinated approach on surveillance, IEC and procurement that would strengthen early warning systems, outbreak investigation, and effective response to a possible pandemic.
The objective of the project was to strengthen surveillance/early warning system, procurement planning, and procurement of commodities to address the immediate need, information, education, communication. One of the major components of the project, surveillance, included following activities: assessment of current practices, needs and system design, development of surveillance standards and protocols, development of guidelines, training of public health workers and medical professionals, provision of ongoing on-the-job technical assistance, dissemination of methods, results and lessons learned. The second component for the project, procurement, it combined the need of immediate assessment in consultation with the Government and major donors/partners and in procurement such as the World Bank and DTRA; procurement and delivery of required commodities; development of a master inventory of all commodities required to support surveillance of pandemic influenza. The third component IEC was implemented through provision of input to the development of the National Communications Strategy; development of essential talking points for spokespersons; workshops with media representatives; roundtables with national and regional officials; development of guidelines for health workers on communication with the public.
Over the project period of June 2006 to April 2007, PATH and CIF closely collaborated with the Government of Georgia and other stakeholders.
Key partners included:
Ministry of Labor, Health and Social Affairs (MoLHSA)
Department of Public Health (DPH) and a network of regional and rayon Centers of (????????)
Public Health (CPH)
National Center for Disease Control and Medical Statistics (NCDC)
World Health Organization/European Region (WHO/EURO) and WHO/Georgia office
United Nations Children’s Fund (UNICEF)
World Bank (WB)
US Defense Threat Reduction Agency (DTRA)
Department of Health and Human Services/US Centers for Disease Prevention and Control (HHS/CDC)
Ministry of Agriculture (MoA)
AgVantage Project
The following activities were undertaken within the frame of the project:Training of public health personnel and health care professionals in the new surveillance procedures and measures to control AI infection in humans;
Development of AI communication guidelines (“talking points” and “message maps”), followed by training for spokespersons and media representatives;
Procurement and delivery of surveillance and laboratory supplies;
Development of an inventory and forecasting tool to strengthen laboratory preparedness and ensure coordination of laboratory supplies and personal protective equipment (PPE). -
Ukraine Mission Report
CIF consultant George Gotsadze was invited by the country office of UNAIDS Ukraine to support the reconstruction of the management component of the Tuberculosis and HIV/AIDS Control Project, financed with the loan proceeds from the World Bank. The project has been suspended by the World Bank since April 2006 due to the slow implementation of the project. Three conditions were recommended by the World Bank to the Government for the continuation of the project. The Government had met required conditions and the suspension placed on the project was effectively lifted. Restructuring the project management and developing detailed implementation plan for the period December 2006-June 2007 were two conditions out of three for the Government of Ukraine to tackle with the help of the consultant.
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Feasibility Assessment for Introduction of the Community Based Health Financing in Egypt
The project of Feasibility Assessment for Introduction of the Community Based Health Financing (CBHF) was funded by Egyptian Social Fund for Development (SFD) and implemented by Curatio International Foundation during the period of September 2005- May 2006. The objective of this mission was to provide technical assistance to the SFD in evaluation of feasibility of CBHF in the selected Egyptian communities and, if CBHF proved feasible, cooperate with the government authorities in developing an action plan for CBHF implementation.
Consultants conducted following activities:
Visited Egypt during November 5 – 22, 2005 and discussed with SFD the methodology of and the approach to the assignment, agreeing on the final methodology to be used in feasibility assessment;
Conducted meetings with the Egyptian government, technical counterparts/experts in the area of health sector financing, and the donors active in health sector reform area;
Identified main risks associated with the implementation of a CBHF scheme in Egypt;
Reviewed the documented evidence about CBHF in Egypt;
With the help of SFD staff and based on the proposed methodology, they identified the sites/communities and institutions in which to conduct visits;
Analyzed the available information relevant to the household health care needs, health service utilization patterns, health care access barriers, socio-cultural factors determining health care seeking behavior, and considered these factors in determining the feasibility of CBHF;
Prepared the feasibility study report and discussed the findings with the client;
Conducted a workshop with the stakeholders to discuss feasibility study findings as well as to propose options and to agree on those conceptual models that were found acceptable by the stakeholders for the pilot project. -
Georgia Health Information and Disease Surveillance Reform
Georgia Health Information and Disease Surveillance Reform project was funded by the U.S. Agency for International Aid/ Caucasus (USAID) and was implemented in partnership with Partners for Health Reform Plus (PHRplus) Project and Curatio International Foundation. The objective of the project was to strengthen Immunization Management Information System (MIS) and Vaccine Preventable Disease (VPD) Surveillance. The project ran from January 2002 until September 2006.
The project was designed and implemented in coordination with principal stakeholders from the Interagency Coordinating Committee (ICC) of Georgia. ICC members were invited from the Department of Public Health, Ministry of Labour, Health, and Social Affairs (MoLHSA), the National Centre for Disease Control and Medical Statistics (NCDC), and international organizations, such as USAID and UN Agencies (UNICEF, WHO). The project aimed to provide assistance to the Government of Georgia to improve the Immunization Information System and the Surveillance of Vaccine Preventable Diseases to provide public health managers, providers of health services, and other stakeholders with appropriate information for making correct strategic, tactical, and operative decisions to keep the VPD epidemiological situation under control. The project also aimed to reduce the morbidity and mortality burden of these diseases on the population and to determine how to use the available vaccines and other programme resources more efficiently.
Immunization MIS:
The improved MIS model is based on an accurate census of the child population, performed by every health facility in its catchments area on an annual basis. The model enables the Health workers to more accurately determine target population, project vaccine needs, compute immunization coverage, and evaluate performance of individual facilities. The reformed MIS model also includes a number of innovations that allow better immunization program management and more rational use of resources at all levels. Countrywide implementation of the reformed MIS was supported by the Decree of the MoLHSA.
The reform package included:
Immunization MIS guidelines for health care providers and public health workers
Job aids for public health and facility workers
Software application “GEOVAC” for the district, regional and National levels. The application improves the process of data unification, enables to determine poorly performing administrative units, and identifies underlying reasons causing the deficiencies. -
Healthy Women in Georgia
Healthy Women in Georgia (HWG) project was funded by U.S. Agency for International Aid (USAID) and implemented by JSI Research & Training Institute Inc. in collaboration with Curatio International Foundation, Save the Children, Orthos. The duration of the project was September 2003 – July 2006.
The objective of the project was to improve women’s health in Georgia. The HWG Program targeted selected facilities in the Imereti region at regional and district levels, and ten ambulatories at the primary health care level. The program developed “Women- Friendly” health care information, counseling and services in facilities and communities. District and ambulatory health providers, pharmacists, and “sakrebulo” (village council) leadership were engaged in the program.
“Parents’ Schools” for patients and clients were established in three district-level health care facilities, to provide information and counseling in formal courses. The HWG Program established a peer education system for adolescents in schools and community gathering places, and reached out to women in communities who did not attend health facilities.
Georgia has one of the highest abortion rates in the world. The HWG Program strengthened access to and availability and quality of modern methods of contraception for family planning, as safe and effective alternatives to abortion.
The objectives of the project:
Establish sustainable, accessible, and high quality “Women-Friendly” services in “combined” facilities (which respectively include a Maternity Hospital, Women’s Consultation Center, and Reproductive Health Cabinet) at regional and district levels in Kutaisi, Zestaphoni and Chiatura;.
Strengthen provision of women’s health information, counseling, and services, including antenatal care, contraception, and family planning at primary health care level in ten “ambulatories”, located in the coverage areas of the two facilities in Zestaphoni and Chiatura, develop referral procedures from primary to secondary level facilities, and encourage health providers to reach out to the village-based;.
Target women, men, and adolescents (patients/clients, service “drop-outs,” and those who have never attended health facilities) living in the coverage areas of the regional, district, and primary care facilities, increase their knowledge, and affect their practices and behaviors to improve healthy life styles and women’s health status;.
Increase availability and use of modern contraceptives as an alternative to present high rates of abortion, and to prevent sexually-transmitted infections (STIs) and contribute to the health of mothers and infants;
Update and improve women’s health care knowledge and skills among health care providers, with reference to WHO standards and international research-based medical and program evidence. -
Effectiveness of Supportive Supervision in Improving the Performance of National Immunization Program in Georgia
The project was funded by Cida/IDRC (Canadian International Development Centre; The International Development Research Centre) and implemented by Curatio International Foundation in collaboration with Toronto University. The duration of the project was July 2004 – March 2006.
The study objective was to document the effects of “supportive supervision” on the performance of the immunization program at the district level in Georgia.
The intervention package included: development of supervisory guidelines, district-level training, continuous supervision and support, monitoring and evaluation, and funding for Centers of Public Health to carry out the package of interventions (travel and communication costs). Supportive supervision, which was the focal point of the package of interventions, was based on introducing updated job descriptions with documented lines of supervision; improving communication lines and skills; introducing guidelines and tools for supervision, performance review and monitoring, and evidence-based action planning, all of which help health workers to improve immunization service delivery.
The effectiveness of the intervention package was assessed with a pre/post-experimental research design. The package of interventions was uniformly implemented in 15 districts selected randomly out of the nation’s 67 districts. Another 15 districts were selected to serve as controls. Measurements were assessed at the baseline and end of the one-year intervention. Quantitative, qualitative and postal surveys were used to collect the information and derive conclusions. Study revealed that significant improvements in the performance of immunization program occurred after implementation of the intervention. In contrast to control districts, intervention districts experienced a significant increase in DPT-3 coverage, decrease in contraindications rate, decrease in refusals rate, and decrease in vaccine wastage between baseline and follow-up stages. The intervention did not appear to have independently contributed to the relative change in service delivery outcome indicators.