Health reforms and Public Health in Georgia

УДК 614.2(479.22)BACKGROUND: Starting from 90‘th, the Govern -ment of Georgia made several attempts to trans -form Georgian health care system into one withimproved efficiency, accessibility, and quality ofthe services. Mandatory social health insurance,which was introduced in the 1990s, was abolishedand private health insurance has been promotedas its replacement. The main principle of healthcare reform since 2006 was the transition towardscomplete marketization of the health care sector:private provision, private purchasing, liberal regu -lation, and minimum supervision.This paper aims to analyze an impact of ongoingreforms on public health and population healthstatus.MATERIALS AND METHODS: A systematic reviewof the available literature was conducted throughnational and international organization reports;key informant interviews were conducted withmajor stakeholders. RESULTS: The country has attained criticalachievements in relation to improved maternal andchild health, national responses to HIV, TB andMalaria. Life expectancy has increased from 70.3years in 1995 to 75.1 years in 2010. Under-5 mor-tality indicator has improved from 45.3 to 16.4 per1000 live births in 2005-2010 meaning a 64% de -crease. However, Georgia is still facing a numberof critical challenges securing better health for thepopulation. Cardiovascular diseases are the largestcause of mortality, respiratory diseases are theleading cause of morbidity and have doubled dur-ing last decade. Georgia has one of the highestrates of male smoking in the world (over 50%).CONCLUSION: Governmental efforts in health pro -motion and disease prevention can have signifi-cant impact on health status by means ofpreventing chronic diseases and detecting healthproblems at a treatable stage. Government shouldconsider increasing funding for public health andprevention programmes with the focus on preven -tion of the main risk factors affecting the popula -tion’s health: tobacco and drug use and unsafesexual behaviour.KEY WORDS: health care reform, public healthAll the authors are with the Tbilisi State MedicalUniversity, Tbilisi, Georgia This paper was received 01.03.2012, accepted05.05.2012, published 10.07.2012.