Public Health Administration, Management and Policy: Country Research Paper-Georgia

1.Introduction and overview Deterioration of health of population in recent years is acknowledged as one of the biggest problems of Georgia. Poverty, meager social protection provided by the state to extremely limited segment of population, environmental conditions, improper diet and food insecurity, exposure to high level of stress, ineffective health policy and improper management of health care facilities, low accessibility of health care- all these contribute to the decline in health. Dissolution of the Soviet Union caused the disruption of the existing system of health care. Answering the need of establishing different from centralized system of health care in 1995 health care reform was launched. New laws set ground for the launching of the health care reform in 1996. The main focus of the reform was on privatization of health care facilities and transition to the coverage of population by the state insurance system. Reform also entailed reorganization of medical education, creation of licensing system and accreditation of courses, continuing medical education. Reform aimed also on reducing the number of medical facilities and decrease of the number of people occupied in health care. Today thirty two, two state and thirty private, medical Universities grant degrees in medicine. Two of them offer degree course in public health care and management. Students of half of the medical universities have from 18 to 96 hour course in public health care and management. Head doctors of all clinics are physicians by education, but since last years a certificate in public health care, management and organization is required from them. The certificate is obtained through passing exam. The system of continuing education which was launched in full in May and 2003 targets at ensuring that medical staff is upgrading its theoretical knowledge and skills. Initially certification and in consequent every five years re-certification through collection of credits and/or exams is required for getting license to practice medicine. The courses in public health care and management for medical personnel are available at the National Health Management Center and State Medical Academy. 2.Country profile 2.1.Health care system before the Independence Georgia is situated to the South of the Caucasian mountains, bordering Russia in the North, Turkey and Armenia in the South, Azerbaijan in the East. Its Western part is washed by the Black sea, while the northern is dominated by high mountains of the Great Caucasus range with some of the highest peaks above 5,000 meters. The climate ranges from subtropical Mediterranean to continental. The location and difference in altitude contributes to the diversity of relief, climate and soils, which on their part determine the diversity of agriculture, way of living and traditions. After more than a century of Russian occupation and seventy years of being a part of Soviet Union, Georgia declared its independence in 1991. The population of Georgia is about 4,600,000, 57.8% of which is urban. The majority are ethnic Georgians (70.1%), while the large minorities are Armenians (8.1%), Russians (6.3%) and