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Fiscal sustainability and transition - Georgia


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This presentation on Georgia was made by Tamar Gabunia, Lithuania, at the 3rd Health Systems Joint Network meeting for Central, Eastern and South-eastern European Countries held in Vilnius, Lithuania, on 25-26 April 2019

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Fiscal sustainability and transition - Georgia

  1. 1. Georgia Experience and the perspective on TB, HIV and Hep C Elimination in the context of anticipated transition Tamar Gabunia Deputy Minister of Internally Displaced Persons from Occupied Territories, Labor, Health, and Social Affairs Vilnius, April 26, 2019
  2. 2. Demographic and Socio-Economic Situation Government expenditure on health per capita – 104 $US Government expenditure on health as % of GDP – 2.8% Government expenditure on health as % of State Budget – 8% Maternal Mortality (per 100000 live birth) – 13.1 Infant mortality (per 1000 live birth) – 9.6 Under 5 mortality rate (per 1000 live birth) – 11.1 GDP per capita (at current prices), (2017) – 4067 $US GDP growth – 5% Government expenditure on health as % of GDP – 3.1% General Government expenditure on health per capita (USD) – 117 Population – 3 728 300 (2017) Birth rate (per thousand population) – 14.3 Mortality rate (per thousand population) – 12.8 Life expectancy at birth – 73.5
  3. 3. Access to Health Services: Universal Health Care Program • Substantial increase of State Health Care Budget: 2012 365 million Gel  2018 1.111 million Gel • Key Outcomes since 2013 (HUES 2017) – Reduced out of pocket payments among most poor – Increased utilization of hospital services – Relatively slow increase in utilization of outpatient services – Reduced financial payments on drugs • 23 vertical programs including HIV/AIDs, Tuberculosis and Hepatitis C • Global Fund support to HIV/AIDs and TB since 2004
  4. 4. The way towards Sustainable Development Goals Better access to care Better user experience Better financial protection WHO Barcelona Office for Health Systems Strengthening Decentralization & Integration in Primary care and Community Base Services (e.g. Georgia Harm Reduction Network) Focus on Quality and Performance Measurement Improved efficiency, Strategic Purchasing of Health Services, payment mechanisms
  5. 5. Some examples of ongoing efforts for improving quality and access to essential health services currently supported by the Global Fund and other partners • International partnership with Gilead to ensure access to free Hep C drugs for Hep C elimination by 2020 – 90% of the population tested-95% of confirmed enrolled on treatment-95% of enrolled cured – Substantial progress made since the project launch – In 2019 the International Liver Foundation recognized Georgia as the Center for Excellence in Hep C elimination • Integration of TB, HIV and Hepatitis C Services and greater decentralization at Primary care level and within harm reduction services – One window principle – Shared use of GeneXpert capacity for TB and Hep C testing • Results –based financing for TB care : Multidisciplinary approach to better case management at outpatient level
  6. 6. Interventions to address Challenges of the Transitional Period Service Standards approved by the Ministry Services delivered by Civil Society Actors costed and mechanisms for output based financing introduced Budget impact analysis undertaken for harm reduction and other interventions supported by the GF Build capacity of Social Service Agency and create enabling environment for CSO contracting for health service delivery Mechanisms to verify outputs and outcomes Key performance indicators for quality monitoring and Results Based Financing
  7. 7. Thanks for your attention!