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Category: Primary Healthcare

  • Primary Health Care Systems: Georgia case study

    Curatio International Foundation publishes Georgia case study of primary health care system (PRIMASYS). The PRIMASYS case study covers key aspects of primary health care system, including policy development and implementation, financing, integration of primary health care into comprehensive health systems, scope, quality and coverage of care, governance and organization, and monitoring and evaluation of system performance.

    The PRIMASYS case study applied a framework looking at how the primary health care system works and what factors (both contextual and related to policy changes) have influenced access to and performance of primary health care in Georgia since 1994. Documents review and in-depth interviews with key stakeholders were conducted in 2017 in order to understand barriers and facilitators of the system reforms in Georgia.

    Georgia PRIMASYS case study emphasizes that Georgia’s health care system has undergone radical reforms over the last two decades, significantly influenced by external drivers such as political dynamics, macroeconomic factors, international partners’ involvement and internal processes.

    The current PHC system in Georgia offers accessible and affordable services to the population, with differentiated benefits to those in greater need. However, the system still requires significant improvements to achieve its ultimate goal of delivering comprehensive, continuous and people-centered care.

    Georgia PRIMASYS case study was part of the series of 20 PRIMASYS case studies globally developed with the support of the Alliance for Health Policy and Systems Research in collaboration with the Bill & Melinda Gates Foundation. The case studies will serve as the basis for a multi-country analysis of primary health care systems, to understand the systems-level determinants of primary health care performance, and to draw cross-cutting lessons learned in the implementation of primary health care policies and systems reforms and interventions.

    Download the full report.

  • Article: Determinants analysis of outpatient service utilization in Georgia: can the approach help inform benefit package design?

    Curatio International Foundation conducted secondary data analyses of Health Service Utilization and Expenditure survey (2 waves), conducted by Ministry of Labor Health and Social Affairs of Georgia, supported by WHO and The World Bank.

    We studied factors that impact utilization of outpatient health services in Georgia. Several important findings have been revealed, that can be successfully used to update existing outpatient service package and make it more relevant to the needs of Georgian population.

    1. Household income is linked to service consumption – Families with high and middle income are more likely to use outpatient services than those who have low income;
    2. Out of the pocket payment is one of the important barriers for service usage, in particular increase of service costs by one Georgian Lari reduces the use of outpatient services by 2%;
    3. Patients with chronic illness are less likely to use outpatient services, compared to patients with acute health problems – frequency of outpatient service utilization is 2 times less;
    4. Utilization of outpatient services is affected by the age factor – people from 45 to 64 are less likely to use outpatient services and often seek self-treatment.

    To respond to the above listed challenges, it is important to fit outpatient service packages to the population needs.

    The recent changes in the Universal Health Care Program, initiated by Georgian government and launched in May, 2017 will be a step forward to improve population financial protection. The changes respond to the research findings and recommendations in regard of outpatient services, that are fully represented in the article.

    [vc_button url=”http://curatiofoundation.org/wp-content/uploads/2017/05/12961_2017_Article_197.pdf” text=”Download full article” size=”” align=”left” type=”primary” outlined=”0″ icon=”” target=”_blank”]

     

  • The drivers of facility-based immunization performance and costs. An application to Moldova


    The drivers of facility-based immunization performance and costs.     An application to Moldova. This is the article an International peer reviewed Journal Vaccine published, Co-authored by experts from the Curatio International Foundation.

    The study was a part of a multi-country coting and financing study of routine immunization program, supported by the Bill and Melinda Gates Foundation.

    Few costing studies of primary health care services in developing countries evaluate the drivers of immunization program performance and cost. This exercise attempted to fill this knowledge gap and helped to identify organizational and managerial factors at a primary care, district and national level that affect the cost and performance of the routine immunization program in Moldova

    Visit ResearchGate to read and download the article.

  • Healthcare Utilization and Expenditures for Chronic and Acute Conditions in Georgia: Does benefit package design matter?

    An International peer reviewed journal BMC Health Services Research publishes an article Healthcare utilization and expenditures for chronic and acute conditions in Georgia: Does benefit package design matter?, authored by experts from the Curatio International Foundation and London School of Hygiene and Tropical Medicine.

    The article presents study results, evaluating health care utilization and expenditures within the program: Medical Insurance for Poor in Georgia (MIP).

    The study assesses how the program effect varied for patients with different health conditions and identifies areas for improvement. The study documented that MIP had a more positive impact for patients with acute illnesses, while for beneficiaries with chronic illnesses, the positive impact was observed just during exacerbations.

    Increasing MIP benefits, particularly for patients with chronic illnesses, should receive priority attention if universal coverage objectives are to be achieved.

    Visit ResearchGate to read and download the article.

  • An Impact Evaluation of Medical Insurance for Poor in Georgia: Preliminary Results and Policy Implications

    An International peer reviewed journal Health Policy and Planning has published an article An impact evaluation of medical insurance for poor in Georgia: preliminary results and policy implications, authored by Curatio International Foundation experts.

    The authors evaluated the impact of Medical Insurance for Poor in Georgia (MIP), the Government program that delivered state-subsidized health benefits to the poorest groups of the Georgian population through contracts with private insurance companies.

    This study documented that after 3 years of the MIP implementation the program successfully managed to reduce financial access barriers for the MIP covered individuals by delivering greater financial benefits to the poorest. Although the MIP did not facilitate growth in health care utilization for all beneficiaries, positive trends were observed among capital city residents.

    The equity impact of the MIP and improved financial protection, especially for the poor, are benefits to be considered by the government for the Universal Health Coverage.

    Visit ResearchGate to read and download the article.

  • Health Insurance for Poor: Georgia's Path to Universal Coverage

    The study 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 document briefly describes identified accomplishments and shortcomings of the public private partnership in realization of MIP and discusses emerging policy options and policy recommendations on the future of MIP.

    The study was financially and technically supported by the Alliance for Health Policy and Systems Research/World Health Organization and carried out by Curatio International Foundation.

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

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

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

     

  • 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.

  • Premium Estimates for the 2009 State Health Care Benefit Program for the Poor

    It is estimated that during 2009 up to 900 000 poor individual will be covered by the Program. Monthly Premium estimations done by CoReform/CIF hired actuaries in September 2008 have already submitted to the MoLHSA to inform 2009 State Budget allocations, namely: a) average premium 12.64 Gel per month per person that makes 151.68 Gel per person per annum; b) different premium coefficients estimated for the following scenarios: i) age and sex; ii) different age groups (age 0-49; age 50-74; age 75 and above); iii) age, sex and family size; iv) age, sex and region; The premium estimations informed GoG Decree #32 dated February 19, 2009, where average premium exceeds 12.64 GEL and equals 15 Gel per month, largely because of Government’s policy decision to further expand insurance package for the Poor.

    Premium Estimates for the 2009 State Health Care Benefit Program for the Poor (ENG)
    Premium Estimates for the 2009 State Health Care Benefit Program for the Poor (GEO)

  • Georgia Health Utilization and Expenditure Survey

    The Health Utilisation and Expenditure Survey (HUES) was conducted in May/June 2007 and consisted of a nationally representative sample of 3,218 households.

    The objectives of the survey were: to estimate household health expenditure and compare this with the Integrated Household Survey (IHS) estimates to provide adjustment factors; to provide information on reported health status, use of services and user satisfaction; and to provide a baseline for reforms in primary health care and sector financing, both nationally and for specific ‘pilot’ regions where additional support is being provided. A second round of the HUES is planned for 2009 and will provide follow-up information in each area.

    Get the full version of the survey.

  • Introductory Workshop on National Health Accounts in Azerbaijan

    Dr. George Gotsadze, Director of Curatio International Foundation, traveled to Baku, Azerbaijan during May 16-18, 2007. Dr. Gotsadze was invited within the frame of Primary Health Care (PHC) Strengthening Project in Azerbaijan to contribute to the introductory workshop on National Health Accounts (NHA) organized for the national team in Azerbaijan.

    Dr. Gotsadze gave presentation on using NHA data for informing the national policy making process and presented the Georgian experience on introduction and institutionalization of NHA.

    See the presentation 1.
    See the presentation 2.