Joint external evaluation of the International Health Regulations (2005) core capacities of Georgia

Over the past decade, Georgia has shown considerable progress in terms of economic development and poverty reduction on its way from a lower-middle to upper-middle income country. Despite positive indicators, challenges persist, such as an aging population. One of the major priorities of the Georgian Government is to ensure universal access to quality and effective health care services for the population. Although the public spending on health care has increased significantly over the years, the percentage of the gross domestic product (3.1% in 2022) is still considerably lower compared to countries in the European Union.   

The National Healthcare Strategy establishes a roadmap for the development of the country's health care system until 2030 and defines the strategic directions required for its implementation. It should be commended that the country has made considerable progress in reducing the burden of communicable diseases. The launch of the Universal Health Care Programme in 2013 with improved communicable disease surveillance, immunization, and more effective disease prevention and control programmes contributed to a stable downward trend in the incidence rates of many communicable diseases. Despite the progress, pre-existing and newly emerging communicable diseases continue to pose challenges to the country's health care system. In addition, it remains particularly important to improve the emergency response capacity of primary health care facilities and hospitals. It should be noted that hospital beds are distributed unevenly across the country and more than 80% of the total number of beds are in private ownership. which could have implications on service delivery and compliance with national standards and regulations.  

During the Joint External Evaluation (JEE) mission to Georgia, capacities in 19 technical areas were evaluated through a peer-to-peer collaborative process that brought subject matter experts together with members of the external assessment team. The team was composed of representatives from several Member States, international organizations, or academic institutions, engaged in week-long technical discussions and field visits. 

 

The objective of the assessment was to compile a comprehensive evidence base, including other previously conducted reviews and evaluations, and provide the Georgian authorities with actionable information to improve the implementation of the International Health Regulations (IHR). However, the evaluation itself does not build capacities and therefore, it remains crucial that the identified priority recommendations should be captured in a National Action Plan for Health Security (NAPHS), which in turn drives translation of priorities into concrete technical activities. The NAPHS should, where applicable, be aligned with the overall National Healthcare Strategy. 

The external team deeply appreciates the significant efforts made by the national IHR focal point (NFP) team at the National Centre for Disease Control and Public Health (NCDC) in coordinating the self-evaluation phase ahead of the external mission. However, for the effective NAPHS development and implementation, it would be especially important to get a corresponding level of engagement and awareness from the highest political levels of government and from several ministries (echoing the recommendation made in the previous JEE mission in 2019). 

 

The external team also acknowledges that several recommendations deal with establishing committees, and revising action plans and strategies, all of which may be important steps to developing capacities, but nevertheless should be streamlined given constraints on human resource capacity. Furthermore, various technical area-specific action plans should fall under the umbrella of NAPHS as specific priority activities.