Designup

Category: Article

  • Article: Barriers to mental health care utilization among internally displaced persons in the republic of Georgia: a rapid appraisal study

    The new paper identifies the health system barriers leading to low rates of utilization of mental health services among internally displaced people (IDP) with mental disorders. The paper was published in BMC Health Services Research authored by Adrianna Murphy, Ivdity Chikovani, Maia Uchaneishvili, Nino Makhashvili and Bayard Roberts.

    Rapid appraisal methods were used to investigate barriers to accessing mental health care services among adult IDPs in Georgia. Inadequate coverage of mental disorders and poor identification and referral systems, underfunding, shortage of human resources, poor information systems, patient out-of-pocket payments, and stigmatization – these factors emerged as important barriers affecting access.

    Download the full article.

  • Article: Barriers to delivering mental health services in Georgia with an economic and financial focus: informing policy and acting on evidence

    A new paper discusses the economic and financial barriers to delivering mental health services in Georgia and assessing the opportunities for reform that can support the development of strategies for change.

    The article was published in BMC Health Services Research, authored by researchers from Curatio International Foundation – Lela Sulaberidze, Ivdity Chikovani, Maia Uchaneishvili, George Gotsadze and researcher from Imperial College London – Stuart Green.

    The analysis identified a variety of local economic barriers, including: the inhibition of the diversification of the mental health workforce and services due to inflexible resources; the variable and limited provision of services across the country; and the absence of mechanisms to assess the delivery and quality of existing services. The main financial barriers identified were related to out of pocket payments for purchasing high quality medications and transportation to access mental health services.

    Whilst scarcity of financial resources exists in Georgia, there are clear opportunities to improve the effectiveness of the current mental health program. Addressing system-wide barriers could enable the delivery of services that aim to meet the needs of patients. The use of existing data to assess the implementation of the mental health program offers opportunities to benchmark and improve services and to support the appropriate commissioning and reconfiguration of services.

    The article has open access and it is downloadable here.

    Also check our ResearchGate profile to access this and other interesting papers authored by CIF researchers.

  • Article: Human immunodeficiency virus prevalence and risk determinants among people who inject drugs in the Republic of Georgia

    [vc_row][vc_column][vc_column_text]A new paper discusses HIV prevalence and risk factors among people who inject drugs in Georgia. The article was just published in The Journal of Infection in the Developimg Countries and is authored by Natia Shengelia, Ivdity Chikovani and Lela Sulaberidze.

    In Georgia as in most Eastern European countries, injecting drug use still remains one of the leading transmission modes of HIV infection. A cross -sectional, anonymous bio-behavioral survey of PWID was conducted in seven cities of Georgia in 2014-2015. Overall 2,022 PWID were investigated. Bivariate and multivariate regression analyses were performed to identify association of HIV positivity with other factors.

    Significant associations were found between HIV positivity and history of drug injection, older age at first drug injection, safe sex behavior last year and preventive program coverage. HIV prevalence among PWID is stable and remains at low level. Our study shows that preventive interventions influence the sexual behavior of HIV positive PWID, however, the majority of injecting drug users are still not reached with these interventions. A changing environment may present additional challenges for harm reduction and current safe practices may change unless continuously supported by innovative HIV prevention programming.

    Download the full paper here.

    The article is also available on ResearchGate platform.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/1″][ultimate_spacer height=”30″][/vc_column][/vc_row]

  • 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”]

     

  • Article: Privilege and inclusivity in shaping Global Health agendas

    Health Policy and Planning published an article Privilege and inclusivity in shaping Global Health agendas.  CIF director George Gotsadze co-authors the paper together with Kabir Sheikh, Sara Bennett and Fadi el Jardali.

    The article discusses lack of inclusivity in Global Health and possible actions to promote inclusivity and diversity in the field.

    “Northern voices dominate Global Health discussions. Of recent Lancet Commissions, excluding representatives from international organizations, 70% of commissioners on the Women and Health commission came from the global North, and likewise, 71% of the Health and Climate Change commission, 72% of the Global Surgery commission and 73% of the Global Health commission (Lancet 2016). Only two out of the 16-member Board of Directors of the Consortium of Universities of Global Health come from the global South (CUGH 2016). No current or past president and only one current member of the World Health Summit’s scientific committee is from the global South (WHS 2016). Only one of the 17 advisory board members of the journal Global Health Governance is based in a low/middle income country (LMIC) institution (GHG 2016).

    Only 15% of the world’s population lives in high-income countries. Yet Global Health conferences continue to be dominated by invited Northern speakers and important committees on Global Health composed mainly of Northerners. The words of a few from the global North wield a disproportionate power that carries …”

    The full text is downloadable here.

  • 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.

  • 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.

  • Costs of routine immunization services in Moldova: Findings of a facility-based costing study

    An International peer reviewed Journal Vaccine, published an article Costs of routine immunization services in Moldova: Findings of a facility-based costing study. Authored by experts from the Curatio International Foundation.

    The study evaluates the total economic and unit costs of the immunization program in the Republic of Moldova as part of a multi-country study supported by the Bill and Melinda Gates Foundation.

    The study shows that the cost of fully immunizing a child in a middle-income country is much higher than previous estimates. The study findings could contribute to building a new evidence-base that will provide valuable inputs into the development of national and global policies, as well as contribute to better planning and management of the national immunization program in Moldova.

    Visit ResearchGate to read and download the article.

  • Health Service Utilization for Mental, Behavioural and Emotional Problems among Conflict-Affected Population in Georgia

    An International peer reviewed Journal PLOS One has published an article Health Service Utilization for Mental, Behavioral and Emotional Problems among Conflict-Affected Population in Georgia: A Cross-Sectional Study, authored by experts from the Curatio International Foundation, and the London School of Hygiene and Tropical Medicine and GIP-Tbilisi.

    The article presents health care utilization patterns for mental, behavioral and emotional problems among the adult population in Georgia affected by 1990s and 2008 armed conflicts.

    The study suggests that there is limited use of formal health services for mental health problems among this population. The factors identified by the study that prevent from use of services are financial access barriers, especially for drugs, self treatment, poor referral pathways between primary and specialized care, lack of perception about mental health problems among the population. The paper discusses possible ways to improve mental health services in Georgia.

    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.