Duration: 1 November 2024 – 31 October 2028

Introduction and Overview

ChangePHC Georgia — “Embedding System Change for People with Long-Term Conditions: Learning from Primary Health Care Reform in Georgia” — is a four-year (2024–2028) research and capacity-strengthening programme that supports Georgia’s national efforts to modernise its primary health care (PHC) system and address the growing burden of chronic diseases. Funded by the National Institute for Health and Care Research (NIHR) and the UK Department of Health and Social Care, the project aims to generate actionable evidence for policymakers, practitioners, and global health partners.

Implemented by the Curatio International Foundation, London School of Hygiene and Tropical Medicine and Ilia State University, in partnership with WHO European Centre for Primary Health Care. ChangePHC uses a mixed method, participatory approach to assess how PHC reform affects patients, providers, facility managers, and decision-makers across Georgia. Through surveys, interviews, and national data analysis, the project explores issues of access, equity, and financial protection in PHC.

Project aim is to (i) understand the performance and consequences of Georgia’s planned

PHC reform across different regions and health system levels, and the likelihood of any changes being sustained; and, (ii) significantly strengthen Health Policy and Systems Research (HPSR) capacity in Georgia and the wider eastern European region. We will focus on three key NCDs targeted by the reforms (hypertension, diabetes and COPD).

Project will conduct six interlinked work packages (WPs) examining:

1. How service users experience and respond to the changing PHC service offering in relation to utilisation, continuity of care, and treatment burden;
2. How providers (PHC and specialists) experience the changing PHC service model, how they adopt new practices and how they respond to the changed incentives embedded in new provider payment modes;
3. How decision-makers at the different system tiers understand the PHC reform, their readiness for and commitment to implementing change;
4. How the wider political and economic context affects reform implementation at system level;
5. How major indicators of equity and access to PHC change for people with NCDs at population level, and how this varies across different regional contexts.
6. Synthesis work package will bring insights from WPs 1-5 together.

Community perspectives are central to the initiative. Through Community Engagement and Involvement (CEI) meetings held in Tbilisi, Kvemo Kartli, and Samegrelo, the team works directly with patients, doctors, and facility managers to identify PHC challenges and ensure local priorities inform research design and validate study outcomes.

Beyond research, ChangePHC emphasises capacity strengthening and regional knowledge exchange, building research and policy capacity at individual, organisational, and regional levels. These efforts will contribute to stronger, more equitable, and evidence-driven PHC systems in Georgia and across the WHO European Region.

Organizations Involved:

• Curatio International Foundation
• London School of Hygiene and Tropical Medicine
• Ilia State University
• WHO European Centre for Primary Health Care

Project Outcome

The ChangePHC Georgia project is expected to generate robust, policy-relevant evidence that will strengthen the design and implementation of Georgia’s Primary Health Care (PHC) reform. By combining quantitative, qualitative, and policy analysis methods, the project will provide a comprehensive understanding of how PHC reforms influence access to care, equity, and financial protection. Its findings will inform national health policy decisions and contribute to broader regional learning within the WHO European Region. Beyond research, ChangePHC will leave a lasting legacy by building sustainable research capacity, fostering equitable international partnerships, and empowering local researchers, practitioners, and policymakers to use evidence for system improvement.