Designup

Category: Europe & Eurasia

  • Contributing to publishing the paper: Circus monkeys or change agents? Civil society advocacy for HIV/AIDS in adverse policy environments

    Curatio International Foundation has contributed to publishing the paper that explores the factors enabling and undermining civil society efforts to advocate for policy reforms relating to HIV/AIDS and illicit drugs in three countries in Eastern Europe and Central Asia: Georgia, Kyrgyzstan and Ukraine. The paper was published on the world’s leading scientific papers’ source Sciencedirect.com in the rubrics: Social Science and Medicine.

    The paper looks at political contexts and explores how the civil society actors’ strengths and weaknesses inhibit or enable advocacy for policy change – issues that are not well understood in relation to specific policy areas such as HIV/AIDS, or particular regions of the world where national policies are believed to be major drivers of the HIV/AIDS epidemic. The study is based on in-depth interviews with representatives of civil society organizations (CSOs) (n = 49) and national level informants including government and development partners (n = 22).

    Development partners and government tend to construct CSOs as service providers rather than advocates. While some advocacy was tolerated by governments, CSO participation in the policy process was, ultimately, perceived to be tokenistic. This was because there are financial interests in maintaining prohibitionist legislation: efforts to change punitive laws directed at the behaviors of minority groups such as injecting drug users have had limited impact.

    Read the full paper online or download PDF.

  • Paper on Prevalence of HIV among injection drug users in Georgia published on Journal of International Aids Society, 2011

    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.

  • 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

  • Bio Behavioral Surveillance Survey with biomarker component among HIV/AIDS risk groups, identifying the number of injective drug users (IDU), operations survey, 2012

    The project was implemented with financial support from Global Projects Implementation Center.

    The project “Behavioral Surveillance Survey with biomarker component on HIV/AIDS in high risk groups, identifying the number of injective drug users, operations survey” aimed at creating credible/valuable source of information which will serve as the evidence for planning national programs on HIV/AIDS and assessing national response.

    In terms of targeting HIV/AIDS risk groups the objectives of the project was as following: a) Conducting bio-behavioral surveillance surveys among high risk groups, b) defining the number of injective drug users and c) conducting operations survey. All these objectives served the goal of identifying barriers that impede injective drug users to receive counselling and testing services.
    Behavioral surveys with bio-marker component among high risk groups took place within the time frame set by the HIV/AIDS National Plan among IDUs, prisoners, commercial sex workers and men who have sex with men (MSM).

    The following serways were implemented:

    The project was implemented by the Curatio International Foundation, National Center for Desease Control and Public Heatlh, public union “Bemoni” and Medical-Psychological Association “Tanadgoma”.

  • 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.

  • 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.