Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #101272

Anton Luchitsky, MD, PATH, Partners for Health Reform Project, 4800 Mongomery Lane, Suite 600, Bethesda, MD 20814, 301-347-5319, anton_luchitsky@abtassoc.com, David Hotchkiss, PhD, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70012, and Mamuka Djibuti, MD, PhD, Curatio International Foundation, 37D Chavchavadze Ave, Tbilisi, 0179, Georgia.

The USAID-funded Partners for Health Reformplus Project provides assistance to the Government of Georgia to improve the Immunization MIS and Infectious Disease Surveillance.

A reform package was developed by the National Expert Group and project advisors on the basis of the system assessment findings. It includes new technical guidelines, job aids, software applications, district-level training, and continuous supervision and support. The reforms were initially introduced in one pilot region. After a one-year pilot period, both the new immunization MIS and surveillance reforms were successively implemented in the rest of the country in 2003-2005. The effectiveness of the intervention package was assessed through an operations research study based on quantitative and qualitative data collected at the district- and facility-levels. The study utilized a quasi-experimental research design with both intervention and control groups.

The study results provide evidence that the reforms led to improvements in data quality, analysis and response, and contributed to an increase in national immunization coverage rates and the reduction of vaccine wastage. However, not all immunization targets were reached, and, often, outbreak control measures were inadequate. The results from the study suggest that the response was limited due to a number of health system constraints beyond the scope of the intervention package such as inadequate public financial resources for the health sector and lack of legal and administrative power for centers of public health to carry out effective program management. Having realized the importance of these constraints, in 2004, the Government initiated measures aimed at optimization of the program funding, and became determined to revise and enact legislation that would regulate the structure and functioning of the public health services.

Learning Objectives:

1) to identify key determinants of a functioning infectious disease prevention and control program;
• to recognize that, in order to make a sustainable improvement, all health system factors that may affect the functioning of surveillance, need to be studied and addressed

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.