20 Years Anniversary brochure describes reforms that have significantly altered the landscape of health care in Georgia after collapse of the Soviet Union. The contents draw on important publications and oral narratives by those who have been initiators, implementers and witnesses to all major changes in the history of Georgia’s health system over the last two decades.
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[vc_row][vc_column][vc_column_text]In 2014 Curatio International Foundation conducted a study on financial barriers of the mental health system. The study employed qualitative research methods, as well as literature review and secondary data analysis.
CIF prepared a policy brief document, which presents main barriers existing at the different levels of the system creating access problems to adequate and quality services for the population.
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Curatio International Foundation together with Center for Information and Counseling on Reproductive Health TANADGOMA is implementing the research project which aims to generate reliable information to plan preventive interventions targeting key populations at riks of HIV/AIDS.
Currently Georgia belongs to the groups of countries with concentrated HIV epidemics. According to the National Center for Disease Control and Public Health 4,131 People living with HIV (PLWH) were officially registered by the end of 2013. The number of newly registered cases is about 500 per year. According to the national HIV surveillance system among newly registered HIV cases heterosexual transmission is the main mode of transmission (49%), followed by injecting drug use (35%) and homosexual intercourse (13%). The findings of the last Bio-BSS conducted in 2012 among female sex workers (FSWs) in Tbilisi and Batumi showed that, HIV prevalence among FSWs is 1.3% in Tbilisi and 0.8% in Batumi. The current study represents a further round of Bio-BSS in Tbilisi and Batumi, with the additional survey of population size estimation, which is important for the planning and implementation of adequate preventive interventions.
The current study is supported by Global Fund to fight HIV/AIDS, tuberculosis, and malaria. International experts are invited to participate in the survey design development and results analysis.
To view full reports please follow the links below:
Georgia is among the countries with low HIV/AIDS prevalence but high potential for developing a widespread epidemic. From the early stage of HIV epidemic in Georgia injecting drug use was the major mode of transmission. However, for the last two years heterosexual transmission became prevailing route for HIV spread.
Current study represent the subsequent wave of Bio-Behavioral Surveys (Bio-BSS) undertaken in Georgia among People Who Inject Drugs (PWIDs) since 2002. Objective of Bio-BSS was to measure prevalence of HIV among PWIDs, provide measurements of key HIV risk behaviors and generate evidence for advocacy and policy-making. The study was implemented within the GFATM-funded project “Generate evidence base on progress in behavior modification among MARPs andeffectiveness of preventive interventions, to inform policies and practice” by Curatio International Foundation (CIF), Public Union Bemoni and the National Center for Disease Control and Public Health.
See full version of the study report.
HIV testing is an important preventive measure to avoid the HIV epidemics spread. Along with other measures implemented with the Government and donor organizations support in Georgia HIV testing is offered to the representatives of high-risk groups, including PWIDs. Although the level of awareness of this risk-group about the availability of counseling and testing services is satisfactory, the utilization of these services is low. This survey aimed at investigating factors promoting or hampering utilization of HIV testing services among PWIDs.
The qualitative survey among PWIDs was conducted in 2012 in six big cities of Georgia (Tbilisi, Batumi, Kutaisi, Zugdidi, Telavi, Gori) in parallel with the Bio-Behavioral Surveillance Survey. The survey applied in-depth interviews technique. In total, 56 respondents participated in the qualitative survey, 12 of which were females. Anonymity was ensured for the study participants. The study protocol and the questionnaire were approved by the Ethics Committee of the HIV/AIDS Patients Support Foundation. The fear of diagnosis is one of the leading barriers to HIV testing. This psychological barrier is supported by a deeply rooted stereotype that a positive HIV test result means a death sentence for the patient and that HIV infection is a disease which is dangerous for the patient’s social contacts. The fear of diagnosis is closely connected with stigma that exists in the society in relation with HIV positive / AIDS affected individuals. The survey revealed that stigma associated with drug users, especially female drug users, is a major impeding factor for undertaking HIV testing. By avoiding HIV testing drug users are, in fact, trying to keep themselves away from acquiring the double label of an “AIDS patient” and a “drug addict” (double stigma).
Read the full report.
Georgia is among the countries with low HIV/AIDS prevalence but with a high potential for the development of a widespread epidemic. From the early years of epidemic injecting drug use was the main route for HIV transmission, however, for the last two years heterosexual transmission is prevailing. According to the national HIV surveillance system, infections acquired through heterosexual contact account for 44.3% of all new HIV cases registered in 2012.
This study represents the subsequent wave of Bio-BSS surveys undertaken among FSWs since 2002. Current study was conducted in 2012 using the Time-Location Sampling (TLS) sampling technique and managed to recruit 280 FSWs in total – 160 in Tbilisi and 120 – in Batumi. The objective of the 2012 Bio-BSS was to measure the prevalence of HIV and syphilis among FSWs, to provide measurements of key HIV risk behaviours and to generate evidence for advocacy and policy-making. The study was implemented within the GFATM-funded project “Generate evidence base on progress in behavior modification among MARPs and effectiveness of preventive interventions, to inform policies and practice” by Curatio International Foundation (CIF), Center for Information and Counseling on Reproductive Health – Tanadgoma and the National Center for Disease Control and Public Health.
Published in 2013.
See the full version of the report.
Curatio International Foundation developed the methodological guideline for conducting bio behavioral surveillance surveys. The document presents standarts of undertaking studies and includes sections such as general definition of terms, indicators, analytical tables etc.
The document is available in Georgian.
15 years anniversary publication spotlights some of the Curatio International Fondation’s (CIF) achievements in health system reform since 1994, thus shedding some light on the impact of CIF’s contributions, and to address the organization’s future aspirations. Published in December, 2009.
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- 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
In February 15, 2011 the Journal of International Aids Society Published the paper by CIF on Prevalence of HIV among injection drug users in Georgia.
Georgia is categorized as a low-HIV-prevalence country. According to the national HIV registry data, there has been a sharp increase in newly diagnosed cases since 2004, with a steady increase since 2008. Annually, almost half of the newly diagnosed cases are revealed at the AIDS stage of disease. There is regional heterogeneity in HIV prevalence with higher rates in the capital (Tbilisi), regions bordering Turkey, and in the conflict zone of Abkhazia. Injection drug use remains a major risk factor for HIV transmission. In 2009, more than 70% of new HIV infections were attributed to injection drug use or sexual contact with an injection drug user.
Drug abuse and its related health and social consequences are critical challenges facing Georgia. As a bridge between Europe and Asia, Georgia and other south Caucasian countries serve as a drug trafficking route into Russia and Europe. The conflict regions may also have conditions that support drug trafficking. No reliable estimates on the extent of drug use in Georgia currently exist
Since the Injection drug use remains a major risk factor for HIV transmission in Georgia authors of the study aimed to characterize the prevalence of HIV among injection drug users locally.
To assess the knowledge and behavior in injection drug users a cross-sectional, anonymous bio-behavioral survey in combination with laboratory testing on HIV status was conducted in five Georgian cities in 2009. A snowball sample of 1127 eligible injection drug user participants was investigated.
Read the full paper at Journal of International Aids Society web site.