Health Research for a Responsive Healthcare System in Georgia

The project was funded by the Rockefeller Foundation and implemented by Curatio International Foundation (CIF) in collaboration with National Health Management Center of Georgia (NHMC), Tbilisi State Medical University, Department of Public Health and Management of Georgia (DPHM), London School of Hygiene and Tropical Medicine (LSHTM), United Kingdom. The project started in December 2000 and lasted for 30 months.

In summer 2000, CIF responded to the Call for Proposals announced by the Rockefeller Foundation under the worldwide initiative entitled “Stimulating Health Research in Developing Countries by Improving the Enabling Environment.” The Award Selection Committee received 542 proposals from 83 countries. After a lengthy and comprehensive selection process, only 10 proposals were selected and awarded grants. One of them was a proposal submitted by CIF. CIF became the only organization from Europe to receive an award. This proposal was ranked the highest among 54 proposals from 20 European countries.

The project titled “Health Research for a Responsive Healthcare System in Georgia” was designed in accordance with the National Health Policy document of Georgia, which was adopted by the government in 1999 and presented at the donor coordination meeting held at WHO EURO in Copenhagen later in the same year. Article 4.12.3 of National Health Policy emphasizes the need for developing and strengthening health research in the country, in order to provide scientific evidence for making appropriate policy choices.

The project was the first step toward implementing this part of the National Health Policy and stood in accordance with the strategic plan for implementation of the new health policy. In order to establish and develop the Healthcare System in the country, which was responsive to the Georgian population’s needs and assure equity to every citizen, it became imperative for Georgia to base policy decisions on evidence obtained through quality research. The goal of the project was to strengthen the link between research and policy choices through collaboration among different institutions and governmental agencies. The guiding principle in achieving this goal was equity-oriented health research, which provided necessary evidence and advocated for the policy choices aimed at achieving equity for the
population and helped alleviate the widening gap between the rich and the poor of the country.

The approach of the project directly related to the spirit of the award. It helped Georgia to develop a national research agenda, institutionalized NHRC, strengthened the national research capacity through diverse collaboration with different institutions in the country and with outside expertise. This approach not only created the opportunity for government and nongovernmental institutions to help solve the pending problems in the national health sector, but also to develop the capacity for future.

The National Health Research Agenda (NHRA) became the guiding document in the coming years not only for the proposed project implementation, but also for the country itself, and formed a part of the National Health Policy implementation process. NHRA concentrated on research topics that addressed the following areas:

Assuring equity of access to healthcare, including evaluating access to health services by different income groups in the country and considering geographical, financial, and cultural aspects;
Responsiveness of the existing health system to population’s needs, including studying health systems, population’s health needs, knowledge, attitude, practice, etc.
The project carried out a number of research projects covering priority topics identified in the NHRA. Results were made available for policy-making and policy-advocating purposes. The project issued Request for Proposals (RFP) and awarded up to 10 small grants to researchers. Research topics were concurrent to the spirit of the Awards and were NOT aimed at supporting research projects in specific areas of health (e.g. biomedical, clinical, operational, epidemiological etc). It was expected that each small grant should concentrate on a specific topic (e.g. equity in access; responsiveness of system to population’s need; priority health needs, etc.). As a result of this activity, diverse aspects of the Georgian Health Sector were researched. It allowed the project to advocate various policy issues with the government during the completion stage and contributed to constructive dialogue between the government and scientific community based on the evidence derived through research.

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