Designup

Category: Health Systems Strengthening

  • Poster Presentation at Copenhagen 2012 Conference on HIV

    Curatio International Foundation presented two posters at Copenhagen 2012 Conference- HIV in Europe.

    One of the posters presented results of Bio-Behavioural surveys among Injecting Drug Users in five cities of Georgia in 2008-2009 and specifically explored Low testing uptake and their determinants among this high risk group in Georgia. Authors: Ivdity Chikovani, Ketevan Goguadze, Natia Rukhadze, George Gotsadze

    The poster was presented in the session – Lessons learned in the implementation of HIV testing strategies for IDUs.

    Another poster addressed issues around late diagnoses for HIV care. The National HIV/AIDS database for 2000-2010 was analysed and characteristics of high risk groups for late diagnosis in Georgia were identified. Authors: Ketevan Goguadze, Ivdity Chikovani, Natia Rukhadze, George Gotsadze

    The posters can be seen at the HIV in Europe web site:

    Low testing uptake and their determinants among IDUs in Georgia

    High risk groups for late HIV diagnosis in Georgia

  • 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.

  • New web guide for using qualitative approaches to health systems research

    By the end of summer 2011 Curatio International Foundation and London School of Hygiene and Tropical Medicine (LSHTM) developed the web resource which serves as a guideline for qualitative approaches in researching the health systems.

    Information of the web site is based on the experience of the study “Exploring providers’ and patients’ perspectives on barriers to quality of care for chronic heart failure (CHF) “. The study, in its turn, is a part of a project that explores transferability of qualitative principles (those for group and individual interviews) to low income former Soviet countries by conducting qualitative studies in Uzbekistan and Georgia. In the framework of the project CIF has conducted and analyzed findings of the qualitative research focusing on patients with heart chronic diseases and primary health care providers.

    In the framework of the project CIF has conducted and analyzed findings of the qualitative research focusing on patients with heart chronic diseases and primary health care providers.

    The project aims to develop understanding of how qualitative methodologies can be developed for use in low/middle income countries, and how they can be developed for use in comparative health systems research. The proposed study therefore includes two countries in a comparative case study design. Each case study will use qualitative methods (individual interviews and group discussions) to explore a topic in quality of care that is of interest to both health care systems. The interviews will be used to explore physician and patient perspectives on barriers for quality care in the treatment of chronic heart failure in primary care settings.

    Web-based learning modules on qualitative methods of data collection for health services research in central Asia and the former Soviet Union have been developed as a part of the project. The learning outcomes for the module are designed around the specific elements of this study. The module is planned to be incorporated into teaching at the School of Public Health in Uzbekistan, LSHTM and is openly accessible on the web to interested parties.

    The project is funded by the Alliance for Health Policy and Systems Research (AHPSR).

     

    Follow the link to view the web site.

  • Customer Satisfaction Research Report on Corporate Health Insurance Released

    Curatio International Foundation releases report on Customer Satisfaction Research on Corporate Health Insurance. The report was supported by International Health Budget Monitoring Initiative of the Open Society Institute. The research prepared by the three experts of CIF (Marine Egutia, Natia Rukhadze, Tamar Gotsadze) looks at trends of insurance market, shares of insurance types and customer satisfaction. Georgian insurance market is young, though the rapid growth is apparent. Data prompted by the National Bank of Georgia proved 33 percent growth in 2009 compared with the year 2008. The Health insurance is the most popular and occupies 68.6 percent of market structure.

    The share of the insurance companies has increased since 2007 following the health financing reform launched by the Government of Georgia. The private insurance companies succeeded to attract substantial amount of state finances. Insurance of state program beneficiaries by insurance companies is being implemented in the framework of state assignments. According to 2008 year data, 18 percent of Georgian population is insured by the state. Along with this, there is a slow pace of corporate insurance development which is used by employees of public, private and non-governmental sectors. Retail insurance comprises 1 percent of market. 76 percent of the population is exposed to health risks.

    The study aims to explore satisfaction of corporate clients of insurance companies and develops recommendations for further polishing and improvement of corporate insurance services. The research revealed that there is a high share/percent of not insured employees in corporate insurance schemes. Financial accessibility is one of the most noteworthy barriers for joining the insurance scheme. Not all citizens having the will to use insurance have a guaranteed opportunity to get corporate insurance.

    Insurance product seems less attractive for those having the will to get insured. Insurance contracts are imperfect that often becomes the reason for customer dissatisfaction and finally leads to changes of services and vendors. Procedures for contract extension and update are complicated and have a negative impact on insured. Variety and multitude of insurance packages further complicates the process of vendor choice and decision making.

    At the end the report prompts possible ways for problem solving and offers valuable recommendations on how to make corporate health insurance better and raise customer satisfaction.

    Follow the link to view the full version of the report, policy brief and presentation.

  • Regulation of Health Professionals-Comparative Analysis of Georgia and Western Countries

    The report presents the Comparative Analysis of Georgia and Western Countries. This publication was produced for review by the United States Agency for International Development in the framework of the CoReform. The publication highlights factors deremining approaches to the regulation of health professionals, instruments used for regulating professional resources, factors influencing rules of licensing and authorization at national and international levels. Published in April 2008, Author: Vakhtang Megrelishvili. Read the full version.

  • Effects of GFATM on Georgia’s Health System Development, 2008

    Global health initiatives like Global Fund to fight HIV/AIDS, TB and Malaria (GFATM), Global Alliance for Vaccines Initiative (GAVI), Roll Back Malaria and Stop TB etc. are intended to support developing countries to effectively deal with specific diseases/conditions. In practice, the vertical nature of such financing is likely to have a variety of direct and indirect effects upon health care systems, both positive and negative. The size and the components of the grant, makes Global Fund the most significant player, at least for now. But evidence shows that experience with disbursement of GFATM grants has caused considerable frustration in recipient countries. In some countries, these new financing sources are providing larger sources of funding than the entire annual public health budget. Depending on how these resources are used, they have the potential to overstretch already weakened systems, or they may serve to support to the broader health care system with potentially positive effects on other health priorities as well. In Georgia, our study looked at the possible system wide impact of Global Fund on Georgia’s health care system. Therefore, the aim of the study was to look at the actual effects of GFATM on the policy environment, public-private interaction, human resources and access to specific services by clients. The findings are based on a base-line survey implemented in 2004 with financial support received from EU and an end-line survey financially supported by Alliance for Health Policy and Systems Research (AHPSR), within the frames of research network for Global HIV/AIDS Initiative. Authors: Ketevan Chkhatarashvili; George Gotsadze, Natia Rukhadze. View the document.

  • 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.

  • Cooperation in Health Care System Transformation in Georgia-CoReform Project, 2004-2009

    In 2004 with the financial aid of the U.S. Agency for International Development (USAID) Mission in the Caucasus, the project “Cooperation in Heath System Transformation Project” commenced. The project was completed in September 2009. The project provided technical assistance to the Government of Georgia (GoG) to strengthen its capacity to transform the health system of the country into a more efficient, accountable, and transparent one. With the cooperation of the Ministry of Labor, Health, and Social Affairs (MoLHSA), Abt Associates (Abt), Care International (CARE), Emerging Markets Group (EMG), and Curatio International Foundation (CIF), the project was designed to assist the government of Georgia to improve its health care financing system, reproductive health support, family planning (RH/FP), and strengthen health institutions at the national level.

    Activities were designed to position the GoG to adopt an innovative and comprehensive approach towards formulating solutions that address significant equity and affordability gaps in the health system, high abortion rates, and the limited donor coordination.

    The project consisted of the following major components:

    Health Financing and Policy Development;
    National Health Accounts;
    Family Planning and Reproductive Health;
    Organizational Development and Donor Harmonization.
    National Health Accounts was implemented by CIF in close cooperation with MoLHSA and an intersectoral working group represented by following agencies: Public Health Department, Ministry of Economy, State Statistic Department, Insurance State Supervision Board, Insurance Association, SUSIF, Ministry of Finances, Statistic and Disease Control Centre, and National Institute of Health and Social Issues. The main goal of the project was to implement and institutionalize National Health Accounts (NHA) as a policy tool and integrate it within broader health system reforms. This component took place in the period of September 2004 -September 2007.

    Family Planning and Reproductive Health has been implemented by Care International, which has specific responsibility to implement this component in close partnership with CIF. The main goal of the reproductive health (RH) and family planning (FP) policy component of the project was to achieve an improved legislative, regulatory, and policy framework to provide an adequate supply to the increased demand for quality reproductive health services. The RH/FP policy team strategy was to assist the MoLHSA by supporting the policy working group at national level. The activities of the reproductive Health Policy Working Group were designed to achieve objectives related to the improvement of access to RH/FP services. Target outputs of the policy working group included: a comprehensive review and analysis of the current policy and regulatory framework governing the provision of and access to family planning and reproductive health information and services; a National RH/FP Policy to enhance access to and delivery of quality RH services; the National RH Strategy for the purpose of providing guidance for activating the RH policy; and drafting legislation in support of the Georgian RH Policy, in order to provide the MoLHSA and the government with a legislative platform to implement the Policy (in progress). This second component of the project took place between October 2004 and September 2008.

    Organizational Development and Donor Harmonization. The main goal of this component of the project was to achieve a “better functioning of the MoLHSA through improvement of the functioning of organizations within the health sector, establishment of coordinated linkage between policy planning, project design, and project implementation.” Since 2004, the CoReform OD Team has been providing significant assistance to the MoLHSA and its affiliated agencies to define their core functions, to put in place functional structures with clear roles and responsibilities, establish a health policy process that is more transparent and systematic, institutionalize donor harmonization and coordination as a routine function of the MoLHSA, and build the capacity of the Ministry staff to enable them to effectively carry our their newly defined roles and responsibilities. The key implementer of this component during the optional period (October 2006 – September 2009) is CIFs in close partnership with Abt Associates, which had been performing specific responsibilities in the Project Base Period (October 2004 – September 2006). The major strategies of the component are: the MoLHSA System Reorganization, Performance Improvement, Policy Cycle Management, and Capacity Building.

  • Regional Workshop on Rotavirus and Diarrheal Disease

    On January 23-24, 2008 a Regional Workshop entitled “Rotavirus and Diarrheal Disease Control” was held in Tbilisi, Georgia. The workshop with 50 participants was sponsored by PATH and hosted by Curatio International Foundation.

    The workshop brought together representatives from Eastern Europe and Central Asia (EE/CA) countries, WHO, UNICEF, GAVI experts with aim to share the current evidence, and determine the level of interest, main needs/key priorities and concerns of the stakeholders. Several countries in EE/CA struggle with high rates of diarrheal disease (DD) morbidity and mortality.
    among young children. The new interventions such as rotavirus vaccines, zinc treatment, and lowosmolarity oral rehydration solution (ORS), complement existing approaches and contribute significantly to meaningful reductions in morbidity and mortality in many countries. Introduction of these new interventions is hampered by a lack of awareness and diminished prioritization for diarrheal disease. Participants from the following eight countries of EE/CA region attended the workshop: Tajikistan, Uzbekistan, Kyrgyz Republic, Moldova, Ukraine, Armenia, Azerbaijan and Georgia.Participants included leaders, representatives of various sectors involved in child health care, infectious disease surveillance and control, and immunization, including: officials from the Ministries of Health, public health officials, academicians in the fields of pediatrics and infectious diseases, local pharmaceutical companies, experts from donor organizations.

    Konstantine (Koka) Pruidze, Deputy Minister, (MoLHSA Georgia) Dr. John Wecker (PATH), and Dr. Ketevan Chkhatarashvili (CIF). The key presentations on an integrated strategy of DD control, child morbidity/mortality situation in the region with focus on DD, the current evidences regarding new control interventions including rotavirus vaccines, the rotavirus surveillance findings in the region and updates in the GAVI application process were made by Dr. John Wecker (PATH), Dr. Sanjiv Kumar (UNICEF), Dr. Liudmila Mosina (WHO), Dr. Robin Biellik (PATH), Dr. Ivone Rizzo (GAVI Alliance).
    Representatives from each participating country presented information on the burden of DD in their countries, discussed existing control strategies and needs for their strengthening.

    Georgia in addition presented key messages of the National Strategic Plan developed by the experts group under the leadership of PATH and CIF. Priority areas, needs for improvement were identified during the workshop.

  • Primary Health Care Strengthening Project in Azerbaijan

    Primary Health Care Strengthening Project was implemented during the period of September 2005- September 2007 by a consortium of organizations led by International Medical Corps (IMC) in cooperation with Abt Associates Inc., Curatio International Foundation, and the John Hopkins University Bloomberg School of Public Health’s Center for Communication Programs. The PHC Strengthening Project provided technical assistance to the Government of Azerbaijan (GoAZ) in a collaborative effort to strengthen the country’s primary healthcare system.

    The project consisted of four components:

    Creating a policy and legal framework that defines primary healthcare and the primary health delivery system;
    Increasing public expenditures for the improved health allocation for primary healthcare;
    Improving quality of primary healthcare services;
    Promoting the idea of personal responsibility for one’s health among individuals and families.
    The general objectives of the project were:

    Establishing current referral and utilization patterns for the most common health conditions in the population;
    Estimating household health expenditures to adjust the findings of quarterly Household Budget Survey (HBS) that was implemented by the State Committee on Statistics (SCS);
    Obtaining baseline and impact indicators to monitor and evaluate reforms implemented in PHC (in pilot regions) and in Health Care Financing;
    Developing instruments and obtaining primary data (at least for one pilot district) for mapping health utilization and elaborating health system Master Plan in pilot districts;
    Providing Government of Azerbaijan with the critical information about population’s self-reported health status and health care utilization, with the purpose of helping the government to formulate or adjust state policies.
    The Project concentrated on assisting the GoAZ in the development of major changes in nationwide health policy and financing. Simultaneously, the Project tested critical interventions at the level of individual facilities and communities in selected districts that served as pilot demonstration sites. The Project activities, both on national and district levels, were closely coordinated with the World Bank Project in Health Sector (Health II). Agreement was reached on focusing the Project’s pilot efforts to demonstrate the new PHC financing and organizational models in those pilot districts that were targeted by the World Bank Project. The latter envisions the rationalization of health infrastructure and optimization of human resources in pilot districts as a necessary precondition for significant investments required for modernizing health care delivery system in these districts. Respectively, the Baseline Study envisioned under the Project served as (a) baseline for anticipated World Bank Project interventions and (b) primary data source for health care delivery system rationalization planning (master planning) exercise.