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This report was prepared by:
Dr Zurab Klimiashvili, MDDirector of the Cardiology Clinic LTD “Cardionet Pineo”, Tbilisi, GeorgiaNational CVD Prevention Coordinator for Georgia
with the assistance and advice from:• Georgian Society of Cardiology • National Center for Disease Control and Public Health
Georgia is since 1991 a parliamentary republic with 3.717 million inhabitants. Its area of 70.000 km2 can be compared to Austria.
The country has a life expectancy at birth of 72.9 years. It has a young population with only 14.3% above the age of 65. The population is mainly Orthodox Christian Georgian. The annual growth in economy is around 3%.
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The health sector is one of the priority sectors for the government of Georgia. Medical care is provided both at state owned health facilities and at private institutions. After 2003-2004 the healthcare system was reformed into a heavily privatised model. The state retained control over a few medical facilities dealing with mental illness and infectious diseases, while all other hospitals and clinics were privatised. Primary care is delivered by general practitioners.
The Georgian government provides financial coverage through a state agency, the Social Service Agency, though patients must share the cost of some services through co-pays. While the state finances healthcare, the delivery of healthcare is largely reliant on private medical facilities and personnel
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In Georgia, like in the most of the countries over the World, non-communicable diseases has the largest share in the mortality structure. Diseases of the circulatory system constitute 15.5% of all registered cases of diseases in the country, and 8.6% of all new cases. High morbidity and mortality rates are specific for such diseases as hypertension, ischaemic heart diseases and cerebrovascular diseases. According to WHO 2014 Health Report, non-communicable diseases account for nearly 94% of all deaths, among them 69% due to CVDs, 14% to cancer, 1% to diabetes and 4% to chronic respiratory diseases.
In 2000 - 2015, prevalence of diseases of the circulatory system in Georgia has followed the upward trend.
The main actors in cardiovascular prevention in Georgia are:
Based on the information provided by the STEPS surveys the multi-sectorial State Council on NCD Prevention and Control was established in 2015. The National Strategy of NCD Prevention and Control and a 4-year action plan has been endorsed in January 2017.
Based on the STEPS and other survey data and according to the strategy and action plan the essential drugs for major NCDs (IHD and stroke, asthma and COPD, Diabetes type 2 and thyroid gland dysfunction) for the most vulnerable populations are now provided through the Universal Healthcare Program. This has been operational during the past four years and covers basic benefit package services and some medications at the primary care level.
The National Centre for Disease Control and Public Health is implementing the State Program on Health Promotion, the largest component of which is tobacco control, which includes a media campaign, training of the quit-smoking line staff and primary health care centres monitoring of enforcement of smoke-free legislation in public premises, developing tobacco cessation mobile application and school educational materials. The other components are among others alcohol, nutrition, physical activity, mental health.
Cardiovascular rehabilitation unfortunately is not well disseminated at present in Georgia due to insufficient financing. There are no dedicated programmes or specialised cardiac rehabilitation centers in Georgia, merely a few centers in the private sector which operate programs for which patients pay out of pocket. Expanding cardiac rehabilitative centers across the country would assist in reduction of CV disability.
The key actions for the next five years:
Finally, we need to study the experience of other countries which have witnessed a similar transition like in our country.
Note: The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.
Our mission: To reduce the burden of cardiovascular disease
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