Cooperation in Health Care System Transformation in Georgia-CoReform Project, 2004-2009

In 2004 with the financial aid of the U.S. Agency for International Development (USAID) Mission in the Caucasus, the project “Cooperation in Heath System Transformation Project” commenced. The project was completed in September 2009. The project provided technical assistance to the Government of Georgia (GoG) to strengthen its capacity to transform the health system of the country into a more efficient, accountable, and transparent one. With the cooperation of the Ministry of Labor, Health, and Social Affairs (MoLHSA), Abt Associates (Abt), Care International (CARE), Emerging Markets Group (EMG), and Curatio International Foundation (CIF), the project was designed to assist the government of Georgia to improve its health care financing system, reproductive health support, family planning (RH/FP), and strengthen health institutions at the national level.

Activities were designed to position the GoG to adopt an innovative and comprehensive approach towards formulating solutions that address significant equity and affordability gaps in the health system, high abortion rates, and the limited donor coordination.

The project consisted of the following major components:

Health Financing and Policy Development;
National Health Accounts;
Family Planning and Reproductive Health;
Organizational Development and Donor Harmonization.
National Health Accounts was implemented by CIF in close cooperation with MoLHSA and an intersectoral working group represented by following agencies: Public Health Department, Ministry of Economy, State Statistic Department, Insurance State Supervision Board, Insurance Association, SUSIF, Ministry of Finances, Statistic and Disease Control Centre, and National Institute of Health and Social Issues. The main goal of the project was to implement and institutionalize National Health Accounts (NHA) as a policy tool and integrate it within broader health system reforms. This component took place in the period of September 2004 -September 2007.

Family Planning and Reproductive Health has been implemented by Care International, which has specific responsibility to implement this component in close partnership with CIF. The main goal of the reproductive health (RH) and family planning (FP) policy component of the project was to achieve an improved legislative, regulatory, and policy framework to provide an adequate supply to the increased demand for quality reproductive health services. The RH/FP policy team strategy was to assist the MoLHSA by supporting the policy working group at national level. The activities of the reproductive Health Policy Working Group were designed to achieve objectives related to the improvement of access to RH/FP services. Target outputs of the policy working group included: a comprehensive review and analysis of the current policy and regulatory framework governing the provision of and access to family planning and reproductive health information and services; a National RH/FP Policy to enhance access to and delivery of quality RH services; the National RH Strategy for the purpose of providing guidance for activating the RH policy; and drafting legislation in support of the Georgian RH Policy, in order to provide the MoLHSA and the government with a legislative platform to implement the Policy (in progress). This second component of the project took place between October 2004 and September 2008.

Organizational Development and Donor Harmonization. The main goal of this component of the project was to achieve a “better functioning of the MoLHSA through improvement of the functioning of organizations within the health sector, establishment of coordinated linkage between policy planning, project design, and project implementation.” Since 2004, the CoReform OD Team has been providing significant assistance to the MoLHSA and its affiliated agencies to define their core functions, to put in place functional structures with clear roles and responsibilities, establish a health policy process that is more transparent and systematic, institutionalize donor harmonization and coordination as a routine function of the MoLHSA, and build the capacity of the Ministry staff to enable them to effectively carry our their newly defined roles and responsibilities. The key implementer of this component during the optional period (October 2006 – September 2009) is CIFs in close partnership with Abt Associates, which had been performing specific responsibilities in the Project Base Period (October 2004 – September 2006). The major strategies of the component are: the MoLHSA System Reorganization, Performance Improvement, Policy Cycle Management, and Capacity Building.