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Health and Social Development

Objective
Current Situation
Successes
Program Activities
Assessments and Other Publications

Objective

Increase the use of health, education, and social services and change behavior

Current Situation

Improving reproductive health: USAID’s Healthy Women in Georgia project works to improve women-friendly, client-focused health services, counseling, and education in selected communities.

Georgia’s health and social services sectors are struggling to overcome the ill-effects of low government spending in these areas since independence in 1991.  Not surprisingly, schools and health facilities have not been well-maintained, maternal and child mortality rates are high, and secondary school attendance rates are dropping.  In spite of this, Georgia has managed to keep its life expectancy rate stable and keep vaccine preventable diseases in check.  In addition, due to its improved ability to collect tax and other revenues, the government has increased the health budget by more than 20% for 2006.

Successes

• Youth-related projects benefited 55,000 youth
• HIV-prevention interventions reached over 12,000 people at high risk for HIV, and use of shared injecting equipmentdecreased from 79.2% (2002) to 42.9% (2005)
• Nine newly established “DOT (direct observation therapy) Spots” in Tbilisi have increased patient compliance with TB treatment therapy from 28% to 91%; the TB treatment success rate in Tbilisi reached 71% in 2005 versus 60% in 2003
• Mobile outreach services for street children provide 1,300 children with food, shelter, clothing, and medical assistance
• USAID helped the Ministry of Health produce the first set of National Health Accounts (NHA), which enabled the Ministry to justify a more than 20 percent increase in the 2006 government health budget.
• The new immunization Management Information and Vaccine Preventable Disease Surveillance Systems developed under a USAID-supported project were institutionalized throughout the country via ministerial decree in 2003.  As a result, for the first time in the last decade, the Georgian immunization information system accurately estimated actual coverage rates (80.9%) and improved overall immunization management in the country.
• The Ministry of Labor, Health, and Social Affairs approved the integration of family planning services at the primary health care level in 44 USAID-supported health clinics
• Client exit interviews conducted at the USAID-supported health clinics show that 84% of postpartum women and 90% of women coming for prenatal care received family planning counseling – as compared with 7% nationwide.

Program Activities

Education Sector

Building Trust: USAID supported annual summer camp brings together more than 400 youth from many regions of Georgia.

USAID partner Academy for Educational Development (www.aed.org) is helping the Ministry of Education decentralize the education sector and develop a national accreditation system for general, higher, and vocational education.  The project will establish 100 regional education “resource centers,” which will be responsible for implementing education reforms countrywide.  The project also will help set national standards for quality education and will assist schools in meeting the quality standards.  Many rectors, faculty, quality assurance personnel, and other education sector stakeholders will participate in regional workshops and trainings on accreditation and quality assurance issues.  

Georgia's territorial conflicts and ethnic diversity make it imperative to bring youth from different backgrounds together to promote trust and confidence building.   Encouraging positive interaction and education will promote a wide variety of skills and improved psychosocial attitudes among youth.  USAID partner United Nations Association of Georgia (www.civil.ge) created a network of extracurricular, school-based youth clubs offering educational (including vocational training) and recreational activities.  The youth club network organizes many nationwide opportunities to come together and engages youth in various outreach activities to benefit their communities.  So far, nineteen clubs have been opened in schools benefiting 800 youth.  An annual summer camp brings together more than 400 youth from many regions of Georgia.

Social Sector

USAID partner Save the Children (www.assistancegeorgia.org.ge), through several sub-partner local NGOs, is implementing a project that helps street and other vulnerable and at-risk children.  The project provides shelter, food, clothing, healthcare, non-formal education, and psychological services to children and their families.  Since the project began in 2004, over 1,300 children and their families have benefited from the above services.  In 2005, the Government of Georgia took steps to create a comprehensive child and family protection reform program to replace the former Soviet-oriented model that emphasized institutionalization.  Save the Children and its local partner organizations are playing a key role in this process.

Health Sector

Prevent and Control Infectious Disease

Increasing Immunizations: With help from USAID, overall child immunization levels have reached 80.5% in Georgia

USAID is working to prevent and control the incidence of vaccine preventable diseases, tuberculosis, HIV, and sexually transmitted infections.  Medical Service Corporation International, (www.mscionline.com) Abt Associates (www.abtassociates.com), and UNICEF (www.unicef.org) are USAID partners whose activities are providing expert advice, limited equipment, vaccines for the government's national immunization program, a health information management and infectious disease surveillance system, and help with improving the diagnosis and treatment of tuberculosis in the capital and, eventually, nationwide.  In 2005, overall child immunization rate reached an all time high of 80.9%.

Reproductive Health

Georgia leads the Caucasus region with its high rate of abortion, and maternal and child mortality rates are high.  In order to slow and reverse these trends, USAID activities are designed to increase access and education to improved quality healthcare for women.  Our partner, John Snow Inc. (www.jsi.com), is implementing a project to improve women and family-friendly, client-focused health services, counseling, and education in several communities.  The project covers reproductive health, pre-natal care, safe motherhood, and other reproductive health issues.

Strengthen Health Systems

With less than 1% of GDP spent on public health expenditures, hospitals and clinics, health care delivery and standards, and health policy are all in need of urgent attention and reform.  The new political climate in Georgia represents a rare window of opportunity for health system reform.  USAID partner Abt Associates (www.abtassociates.com) helps the Georgian government improve its health care financing system, support reproductive health and family planning policy development, strengthen its health institutions at the national level, and institutionalize National Health Accounts (NHA) as a policy tool.
Our partner American International Health Alliance (www.aiha.com) focuses on the development of model systems of primary health care in two regions of Georgia.  Special emphasis is placed on training the staff of our two partner hospitals to address the learning needs of nurses, healthcare administrators, and physicians.

Assessments and Other Publications

Socio-Economic Inventory Assessment

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