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Category: 2011

  • EPIC Studies – Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010–11

    Journal Health Affairs publishes a new Article EPIC Studies: Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010–11 coauthored by CIF team member Keti Goguadze.

    Abstract: Governments in resource-poor settings have traditionally relied on external donor support for immunization. Under the Global Vaccine Action Plan, adopted in 2014, countries have committed to mobilizing additional domestic resources for immunization. Data gaps make it difficult to map how well countries have done in spending government resources on immunization to demonstrate greater ownership of programs. This article presents findings of an innovative approach for financial mapping of routine immunization applied in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. This approach uses modified System of Health Accounts coding to evaluate data collected from national and subnational levels and from donor agencies. We found that government sources accounted for 27–95 percent of routine immunization financing in 2011, with countries that have higher gross national product per capita better able to finance requirements. Most financing is channeled through government agencies and used at the primary care level. Sustainable immunization programs will depend upon whether governments have the fiscal space to allocate additional resources. Ongoing robust analysis of routine immunization should be instituted within the context of total health expenditure tracking.

    The online version of the Article is available here.

  • An investigation on community-level influences on mental health amongst internally displaced persons in Georgia, 2011-2012

    The project was implemented by CIF in collaboration with London School of Hygiene and Tropical Medicine (LSHTM) (Dr. Bayard Roberts, Professor Martin McKee, Professor Vikram Patel and Dr. Nino Makhashvili). The project was funded by Wellcome Trust (United Kingdom).

    Aim of this research study is to deepen understanding of the extent to which community-based influences may help promote mental health (including alcohol use) amongst IDPs and returnees in Georgia. The study would provide rigorous evidence on the burden of depression, psychological distress, harmful alcohol use, and also coping strategies amongst IDPs and returnees in Georgia. This information could be used to help inform appropriate responses from governmental and nongovernmental agencies. This would be one of the first studies globally to specifically explore the way in which community factors may help promote the mental health of IDP and returnees.

  • Assessing the Health Insurance for the Poor in Georgia

    During the last two decades Government of Georgia initiated series of reforms introducing major changes in health financing policy and restructuring the health system to reverse the negative trends observed in equity, affordability and quality of essential health service for significant part of the country population and particularly for the poor.

    Addressing problems in equity and financial protection against health care costs through re attainment of universal coverage for essential health care services for the entire population was one of the longstanding and explicitly stated national health policy goals.

    Affordability of health care services is one of the most critical issues for Georgia’s health sector. The matter is among top five most important national issues for a large part of the Georgian population. Medical Insurance for the Poor (MIP), a public program initiated in 2007, provides private insurance coverage to one fifth of the Georgian population and is aimed to protect its beneficiaries from financial hardship and impoverishment that may be caused by health care expenditures.

    The study implemented by the Curatio International Foundation with the support from the Alliance for Health Policy and Systems Research/World Health Organization assesses the impact of Medical Health Insurance (MIP) for the Poor on equity in access to essential health care services and financial protection against health care costs for the poor and general population.

    The first phase of the study was published in May 2011. The document briefly describes identified accomplishments and shortcomings of the public private partnership in realization of medical insurance for the poor and discusses emerging policy options and policy recommendations on the future of MIP.

    The second part of the study aimed to assess the overall impact of medical insurance for the poor. The resulting document also reviews steps undertaken by the government in the design and implementation of the insurance program: the way the benefit package was designed, institutional and purchasing arrangements. It also describes the role of high level actors in MIP formulation and implementation, their influence, nature of interest and perceived position on possible future MIP expansion.

    View full documents:

    Policy Brief-Medical Insurance for the Poor: impact on access and affordability of health services in Georgia

    Policy Brief- Health Insurance for the Poor in Georgia, Content, Process and Actors

    Full Study Report- Health Insurance for Poor: Georgia’s Path to Universal Coverage

     

  • Fourth Wave Results of Pharmaceutical Study Published

    Curatio International Foundation has completed a study exploring ‘Price, Affordability and Availability of Medicines in Georgia’. The study was divided into three stages and carried out in 2009-2001.

    The key aim of the study is to improve affordability and availability of medicines for the population.

    Based on a three-year observation of pharmacies and different medicines in Georgia, Curatio International Foundation studied the practice in the pharmaceutical sector and came up with recommendations based on research findings. The recommendations will be presented to the broad audience of the health sector – the Health Care Committee of Parliament, the Ministry of Health, the insurance sector and other interested parties.

    The study was conducted using the methodology of the World Health Organization (WHO). The survey looked at prices and mark-ups of 52 medicines (brand-name medicines and their cheap generic equivalents) over the period of three years in licensed pharmacies nationwide.

    Findings and recommendations of three stages were unveiled in December 2011.

    Read more on study methodology, findings and recommendations- Presentation (available in English) and Brief (available in Georgian).

  • National Center for Biotechnology Information published CIF’s scientific paper on Unsafe injection and sexual risk behavior among injecting drug users in Georgia

    In August 2011, National Center for Biotechnology Information published CIF’s scientific paper on Unsafe injection and sexual risk behavior among injecting drug users in Georgia.

    The paper describes the prevalence and correlates of unsafe drug injecting and sexual behaviors among IDUs recruited across five cities in Georgia in 2009. IDUs were administered a questionnaire collecting information on demographics, drug use, sexual behaviors, and HIV testing behaviors. Correlates of risky injecting and sexual behaviors were determined using logistic regression. Of 1,127 IDUs, the majority (98.7%) were men, and the median duration of injecting drugs was 7 years. Unsafe injecting behavior at last injection was reported by 51.9% of IDUs, while 16.8% reported both unsafe injecting behavior and not using condoms with last occasional and/or commercial partner.

    Read the article at PubMed, National Center for Biotechnology Information’s web site

  • Price, availability and affordability of medicines in Georgia-2009-2011

    The present report unveils the findings of the study “Price, availability and affordability of medicines in Georgia” implemented over the course of three years- 2009-2011 in the capital Tbilisi and regional cities. The study was supported by the World Bank and the Open Society Institute.

    The survey looked at availability and price of Innovative Brands and their equivalent low price generics, analyzed collected data by type of medicine, regional differences as well as by type of pharmacy. The survey also looks at medicine mark-ups and compares with mark-ups in European countries, measures affordability of standard treatments as percent of average subsistence monthly allowance and provides comparison of the standard treatments by innovative brands and equivalent low price generics.

    The present report “Price, availability and affordability of medicines in Georgia” attempted to obtain reliable data on these aspects and documents tendencies of change over the course of three years. Over the course of three years the study covered almost all licensed pharmacies and 52 types of medications in the capital Tbilisi and regional cities.

    The power point presentation document and brief study report can be viewed here (yet avaialble only in Georgian).

  • Findings of the pharmaceutical market study in 2009-2011 years

    The key aim of the study is to improve affordability and availability of medicines for the population.

    Based on a three-year observation of pharmacies and different medicines in Georgia, Curatio International Foundation studied the practice in the pharmaceutical sector and came up with recommendations based on research findings. The recommendations will be presented to the broad audience of the health sector – the Health Care Committee of Parliament, the Ministry of Health, the insurance sector and other interested parties.

    Giorgi Gotsadze, the Curatio International Foundation Director: “Through the study we provide strong evidence to decision and policy makers on the current condition of the pharmaceutical market. We hope that this study will foster debates between the interested parties”.

    The study was conducted using the methodology of the World Health Organization (WHO). The survey looked at prices and mark-ups of 52 medicines (brand-name medicines and their cheap generic equivalents) over the period of three years in licensed pharmacies nationwide.

    The survey measures the quality of access to medicines in both pharmacy chains and independent pharmacies. In 2011, Pharmadepo and Parmacenter added to the pharmacy chains involved in the survey (PSP, Aversi, GPC) in 2009-2010.
    The survey looks at the access to medicines by years as well. It analysis the impact of amendments made in 2009 to the Law on Drugs on the access to medicines and medicine prices in Georgia. The survey analysis how the changes influence the patients’ treatment costs in patients with different diagnosis.

    The survey has found that:

    • The market has witnesses a tougher rivalry since 2009, which has likely led to the reduction of markups of brand-name products. Markups decreased most in 2001;
    • The year 2011 witnessed an increase in access to both brand-name products and their cheap generic equivalents;
    • Despite improved affordability the market is experiencing a lack of generic products;
    • Access to medicines varies by regions. Access, especially the access to generic medicines, in some regions is still low;
    • The level of access is highest in the Pharmadepo/Pharmacenter pharmacy chain and lowest in independent pharmacies, which is likely to be the result of unequal competition among pharmacies;
    • Even though there is a decreasing trend in medicine markups, the markups in Georgia are higher than in European states, which means that Georgian importers add more funds to medicine prices than European ones (which should respectively lead to higher profits). Consequently, the share of pharmaceutical costs in the national healthcare spending in Georgia is much higher compared to European states.
    Impact on Standard Treatment Costs:
    • There has been a decreasing trend in the standard treatment price for the past three years;
    • In 2011 standard treatment costs decreased more in case of treatment by brand-name medicines compared to treatment by generic products, however the treatment by generic medicines requires less spending because of low retail price of such medicines.
    The survey of prices and availability of medicines was divided into three phases and conducted in Georgia in 2009-2011. The first and third stags were financed by the World Bank, while the second one – by the Open Society Institute.CIF presents the results of the study exploring “Price, availability and affordability of medicines in Georgia”.

    Study presentation and small study report (available in Georgian).

  • Main findings of Catastrophic Health Expenditure Analysis in Georgia

    The researcher of the Curatio International Foundation Natia Rukhadze presented the findings of Catastrophic Health Expenditure Analysis in Georgia at the “Seminar on Health Financing Reforms in Georgia” held in MoLHSA on October 26, 2011.

    The study was funded by the World Health Organization (WHO) and uses the data from nationally representative Integrated Household Survey (HIS) conducted by National Statistical Office (GEOSTAT) on an annual basis; Study looked at trends in household catastrophic health spending during 2006-2010 among different population groups. The purpose of the study was to look at population level impact of the Government’s health financing reforms initiated in 2006/07 and aimed at providing state subsidized health insurance to extremely poor.

    See the full report of the study.

  • Contribution to the development of National Health Care Strategy 2011-2015

    Curatio International Foundation has contributed to the development of National Health Care Strategy 2011-2015: “Affordable and Quality Health Care”. Under the current strategy, the government intends to improve population health through a reduction of disease burden and mortality by 2015. In order to achieve these goals, the government of Georgia has drawn up five strategic objectives and defined 26 strategic initiatives which are expected to be implemented over the course of coming five year period.

    Over the past several months the Foundation experts have worked extensively with the GoG and offered analytical support as well as strategic inputs in the process of strategy formulation.

    To review the document please follow the link.

  • Catastrophic Health Expenditure Analysis in Georgia

    On October 26, 2011 the researcher of the Curatio International Foundation Natia Rukhadze presented the findings of Catastrophic Health Expenditure Analysis in Georgia at the “Seminar on Health Financing Reforms in Georgia” held in MoLHSA.

    The study was funded by the World Health Organization (WHO) and uses the data from nationally representative Integrated Household Survey (HIS) conducted by National Statistical Office (GEOSTAT) on an annual basis; Study looked at trends in household catastrophic health spending during 2006-2010 among different population groups. The purpose of the study was to look at population level impact of the Government’s health financing reforms initiated in 2006/07 and aimed at providing state subsidized health insurance to extremely poor.

    See the full report of the study.