RESUMO
This review is part of a series of country-based studies generating new evidence on financial protection in European health systems. Financial protection is central to universal health coverage and a core dimension of health system performance. Georgia has a relatively high incidence of impoverishing and catastrophic health spending compared to other countries in Europe. Catastrophic spending is driven mainly by out-of-pocket payments for outpatient medicines, but also for inpatient and outpatient care. It is heavily concentrated among the poorest households. Although reforms introduced since 2013 have improved access to health care and reduced the health system’s reliance on out-of-pocket payments, public spending on health remains low and gaps in coverage persist. To strengthen financial protection, increased public investment in health – especially in primary health care – is necessary but not enough. The government should also address gaps in coverage by prioritizing better protection for poor households and people with chronic conditions; introduce stronger regulation of service volumes and prices (including medicine prices) to ensure resources are used efficiently; and improve the quality of primary health care.
Assuntos
Financiamento da Assistência à Saúde , Gastos em Saúde , Acessibilidade aos Serviços de Saúde , Financiamento Pessoal , Pobreza , Assistência de Saúde Universal , GeorgiaRESUMO
A phylogenetic analysis of samples taken from reported outbreaks of peste des petits ruminants virus (PPRV) in Georgia revealed a closer relationship to viruses from northern and eastern Africa than to viruses from countries closer to Georgia. This finding has crucial implications for the control of PPRV in the region.
Assuntos
Surtos de Doenças , Doenças das Cabras/epidemiologia , Peste dos Pequenos Ruminantes/epidemiologia , Vírus da Peste dos Pequenos Ruminantes/genética , RNA Viral/genética , Doenças dos Ovinos/epidemiologia , África/epidemiologia , Animais , Antígenos Virais/genética , República da Geórgia/epidemiologia , Doenças das Cabras/transmissão , Doenças das Cabras/virologia , Cabras , Peste dos Pequenos Ruminantes/transmissão , Peste dos Pequenos Ruminantes/virologia , Vírus da Peste dos Pequenos Ruminantes/classificação , Vírus da Peste dos Pequenos Ruminantes/isolamento & purificação , Filogenia , Filogeografia , Ovinos , Doenças dos Ovinos/transmissão , Doenças dos Ovinos/virologiaRESUMO
Brucellosis is the one of most common livestock zoonoses in Georgia, resulting in significant economic losses. Livestock were sampled in three regions of Georgia (Kakheti, Kvemo Kartli, Imereti). Districts that historically reported high numbers of brucellosis related morbidity were selected for serological, bacteriological and molecular surveys. Surveying efforts yielded samples from 10,819 large and small ruminants. In total, 735 serological tests were positive on Rose Bengal and 33 bacterial isolates were recovered and identified as Brucella melitensis or Brucella abortus by microbiology and AMOS-PCR. A Bayesian framework was implemented to estimate the true prevalence of the disease given an imperfect diagnostic test. Regional posterior median true prevalence estimates ranged from 2.7% (95% CI: 1.4, 7.2) in Kvemo Kartli, 0.8% (95% CI: 0.0, 3.6) in Kakheti, to an estimate of 0.6% (95% CI: 0.0, 2.9) in Imereti. Accurate and efficient surveillance of brucellosis is not only of economic value, but also informs efforts to reduce the disease impact on the human population.