Designup

Category: Project

  • 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.

  • CIF Calls for participation in internship program for 2011-2012

    Curatio International Foundation launches its internship program for 2011-2012 years and invites interns from around the world who are studying at masters or Ph.D. level and who are interested to have first-hand experience in the real-life setting and to contribute to the research projects implemented by the organization.

    Since 2002 CIF has hosted number of students from world’s leading universities such as Johns Hopkins, London School of Hygiene and Tropical Medicine, Yale etc.

    Timing of the Internships

    – Winter interns (December through February) from 2 to 6 weeks
    – Summer interns (June through September) from 1 to 4 month

    Terms of the Internships

    This is non-paid internship although CIF provides following to the interns:

    – Office space and access to internet communication and office equipment;
    – Access to on-line library with more than 8,000 information resources and in 30 different languages

    For interns outside Georgia:
    – Internship coordinator, who provides continuous guidance around the research topic and support to an intern during their stay in Georgia and after their departure, during scientific paper preparation;
    – Logistical support prior to arrival to Georgia and during their stay, which includes following but not limited to: acceptance letter to facilitate obtaining travel grants from different donors, support for accommodation in Tbilisi-Georgia, guidance for travel, etc.
    – Block grant in the amount of 500 USD.

    The Benefits to Interns are:
    – Ability to apply knowledge and research skills on practice and satisfy project requirements at their school;
    – Contribute to and be one of the authors of a scientific paper published in a peer reviewed journal with high impact factor;
    – Interact with the professionals continuously involved/contributing to policy making process;

    Read the full description of announcement to obtain full information on application process and research topics for 2011-2012 years.

  • Prices, Availability and Affordability of Medicines

    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 6 month in 2010. 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.  Though the study has not covered all therapeutic categories, these do not detract from the importance of the above results as basis for action and as baseline for future studies. Authors: Tamar Gotsadze, Natia Rukhadze, Tinatin Turdzeladze; 2010. The full version of the report in available in Georgian.

  • 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.

  • Exploring providers' and patients' perspectives on barriers to quality of care for chronic heart failure (CHF) in Uzbekistan and Georgia

    Exploring providers’ and patients’ perspectives on barriers to quality of care for chronic heart failure (CHF) in Uzbekistan and Georgia
    In the framework of the project the qualitative study will be undertaken aiming at exploring barriers to quality of care for heart failure in two FSU states: Uzbekistan and Georgia. The project is funded by the Alliance for Health Policy and Systems Research (AHPSR).
    Lead investigators are: Dr. Judith Green, London School of Hygiene and Tropical Medicine, Dr. Mohir Ahmedov, Tashkent Medical Academy, School of Public Health, Dr. George Gotsadze, Curatio International Foundation (CIF).

    The study 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. The aim of the larger project is 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.

    The choice of topic for this project is based on a number of factors. First, the share of non-communicable conditions in the burden of diseases in developing countries is continuously increasing. According to WHO data, in 2001, non-communicable conditions accounted for 46% of the disease burden, the number that is expected to grow to 56% by 2020. [2]

    Secondly, a significant shift in health policy making centering on quality care has taken place in the West over the last two decades. A noticeable translation of the policy shift in the developing country settings followed suit. The increasing interest in quality of care in developing countries is timely, as improved quality of care benefits patients by reducing medical errors and unnecessary care, increasing utilization of effective medications and procedures, as well as leading to significant system-wise improved efficiencies.
    Heart failure (HF) is a major contributor to morbidity and health care costs, with an estimated population prevalence of 3-4%. Two threats to quality of care are the poor utilization of evidence based treatment protocols and inadequate patient adherence. To explore physician and patient perspectives on the barriers to quality of care for heart failure, researchers will first interview physicians from a purposively selected sample of urban and rural clinics to identify factors that impede compliance at the physician and patient level in Uzbekistan and Georgia. Prescription of ACE-inhibitors and beta-blockers will be used as markers of quality of care. The physicians (N = 10-15 in each country) will be interviewed to identify their current treatment approaches to patients with HF, their knowledge of existing guidelines, and their perspectives on what factors limit the use of ACE-inhibitors and beta-blockers in their practice. To explore patient level factors, CIF will invite 5-6 HF patients from each clinic (N= 4 groups in each country) to a group discussion to identify their perspectives on managing HF, treatment regimes, accessing health care for HF and their views on medications prescribed. All interviews and discussions will be audio recorded, transcribed and qualitatively analysed. The outputs from the project will be peer reviewed publications on barriers to quality of care for HF in the two countries and information for policy makers on potential areas for improvement. This study is part of a larger study on the transferability of qualitative methodology, and additional outputs will be: learning about the development of qualitative methods suitable for comparative health systems research and the development of web based materials to help training for health systems researchers.

  • Tracking global HIV/AIDs initiatives and their impact on health systems: effects on the roles of civil society organisations in Ukraine, Kyrgyzstan and Georgia

    The aim of the study is to explore the effects of Global Fund HIV programmes on the roles of civil society organisations (CSOs) in Georgia, Kyrgyzstan and Ukraine. The study represents a follow-up to the Global HIV/AIDS Initiatives Network (GHIN) studies that examined the effects of Global HIV/AIDS initiatives on country health systems. Specifically the study will assess the effects of Global Fund programmes on the focus, aims and roles of CSOs; seek to understand how Global Fund HIV programmes have influenced the relationships between CSOs and government; and build an understanding of the effects of Global Fund HIV programmes on relationships between CSOs. The study will primarily be based on semi-structured interviews with country stakeholders and CSOs. Duration: January-July 2010.

    Country studies are supported by the Open Society Institute. Network Funders are DFID, Irish Aid and Danida.

    In Georgia the study with be implemented by Ketevan Chkhatarashvili and Natia Rukhadze from Curatio International Foundation.

    The country researchers will provide inputs into the development of the Research Protocol (methodology) at other appropriate stages in the study including: design of interview tools, sampling strategy, identification of appropriate secondary data sources and relevant literature plus conducting the fieldwork.

    As a result of the study articles in peer reviewed publications will be posted.

  • Tajikistan Child Health Care Services and Data Quality Assignment

    Aim of the project was to identify deficiencies in children birth and death registration system and identify quality of child health care rendered by family medicine practitioners at primary health care level; The project was funded by the World Bank. Duration: May 2010 – May 2011.

    Project encompassed the following two components:

    Part I: Qualitative research to identify attitude, practice and barriers to effective collection of data related to child births and deaths registration. The data were collected in selected regions from health officials and staff responsible for health data reporting at the different administrative levels (health facilities, local government, rayons, oblasts and central levels) and different groups in the community (women and men) to identify the factors that prevent them from registering child birth and death cases. Analytical report provided specific policy and operational recommendations for the government and donor community.
    Part II: Primary Health Care (PHC) facilities survey in selected regions using the IMCI Health Facility Survey methodology. The survey covered 70 PHC centers stratified by centers with and without personnel trained in Family Medicine. The study report along with main findings provided specific policy and operational recommendations to improve child health care services at the primary care level;
    The findings of both surveys were disseminated at the workshop in Dushanbe in May 2011.

  • 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.

  • HIV/AIDS Surveillance Plan, 2010

    The National HIV/AIDS Surveillance Plan in Georgia was developed by the national working group in the frame of the project funded by The Global Fund- “Establishment of evidence-base for national HIV/AIDS program by strengthening the HIV/AIDS surveillance system in the country”.

    Download the document here.