Subject: Re: Association Implementation Report on Georgia (2019)
From: Ketevan Goginashvili <[email-masked]>
To: Maia Nikoleishvili <[email-masked]>, Ekaterine Adamia <[email-masked]>, Natia Nogaideli <[email-masked]>, Lika Klimiashvili <[email-masked]>, Irma Gelashvili <[email-masked]>, Grigol Chkadua <[email-masked]>, Nino Jinjolava <[email-masked]>, Tea Gvaramadze <[email-masked]>
Cc: Mariam Darakhvelidze <[email-masked]>, Beka Peradze <[email-masked]>, Nino Odisharia <[email-masked]>, Paata Jorjoliani <[email-masked]>, Sopo Belkania <[email-masked]>, Mariana Mkurnali <[email-masked]>
Date: Tue, 26 Feb 2019 05:33:16 +0000

With regard to children's rights, infant (and maternal) mortality rates remain high as compared to European rates, due to low quality ante, perinatal and post-partum services amongst other factors. Child poverty remains high.

Comment: By World bank classification Georgia is low-middle income country (DGP per capita US$4047). Government expenditure on Health is USD120. Population 3.7 Million.

Georgia has achieved remarkable progress in reducing under–five and neonatal mortality rates to 10.2 and 6.1 per 1000 live births respectively by 2015 thus accomplishing the Millennium Development Goal #4 (MDG) set at the 2000 Millennium Summit: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate. Infant mortality rate has decrease dramatically since 2000-2017 from 27.3 to 9.6 per 1000 live birth.

National MNH Strategy 2017-2030 with related short term Action Plan (2017-2019) is developed and approved by the government with the aim to provide long-term guidance and coherent plan of action for the improvement of maternal and new born health in Georgia.

The initiative of starting the perinatal care regionalization process from May 2015 is a significant step forward in strengthening the maternal and newborn health care system, which considers defining the levels of perinatal service providers and their role and responsibilities in order to provide the correct   timing of the correct patient to a correct medical institution and, if necessary, effective referral. Regionalization was be completed in 2017.

105 facilities assessed, 82 facilities have designated level of care. All 82 facilities strengthened their capacity for infrastructure/equipment and competencies of service providers according to the level requirements.

In 2016, MoLHSA in alliance with NCDC launched the nationwide electronic registry “Mother’s and neonate’s health surveillance system”, so called “Georgian Birth Registry” (GBR). The system tracks information on all cases of pregnancy, delivery, postpartum, neonatal care and abortion.

The GBR provides an opportunity: to get comprehensive knowledge on a wide array of indicators, related to the maternal and newborn health, morbidity and mortality along with the quality of antenatal, obstetric and neonatal care; to make evidence-based policy decisions. The coverage of pregnancy and childbirth by GBR increased from 47% in 2016 to 96 % in 2017.

In March, 2017 MoLHSA initiated a selective contracting of facilities providing perinatal care services. Social Service Agency contracts only facilities which demonstrate required compliance with pre-defined quality criteria. Currently 30 facilities, providing perinatal care services from three largest cities of Georgia (Tbilisi, Kutaisi and Batumi) are involved in selective contracting process. The existed contract includes 10 quality indicators, covering the critical issues related to obstetric and neonatal care in Georgia.

The routine clinical audit of cases of stillbirth and maternal and neonatal mortality has been introduced by the MoLSHA in 2017 with aim to advance practice of obstetrics and neonatal care and improve the quality of services through detailed clinical analysis of selected mortality cases. The comprehensive audit process allows identification of root causes of gaps and deficiencies in existing practices and in the health system and planning the corrective policy and practice measures at the local and national level.

From: Maia Nikoleishvili <[email-masked]>
Date: Monday, February 25, 2019 at 4:44 PM
To: Ketevan Goginashvili <[email-masked]>, Ekaterine Adamia <[email-masked]>, Natia Nogaideli <[email-masked]>, Lika Klimiashvili <[email-masked]>, Irma Gelashvili <[email-masked]>, Grigol Chkadua <[email-masked]>, Nino Jinjolava <[email-masked]>, Tea Gvaramadze <[email-masked]>
Cc: "[email-masked]" <[email-masked]>, Beka Peradze <[email-masked]>, nutsi odisharia <[email-masked]>, Paata Jorjoliani <[email-masked]>, Sopo Belkania <[email-masked]>, Mariana Mkurnali <[email-masked]>
Subject: FW: Association Implementation Report on Georgia (2019)

მოგესალმებით,

გიგზავნით საქართველოს საგარეო საქმეთა სამინისტროდან მიღებულ მეილს, რომელსაც თან ახლავს ევროკომისიის მიერ გამოქვეყნებული ანგარიში ასოცირების შესახებ შეთანხმებისა

და ასოცირების დღის წესირიგით გათვალისწინებული ღონისძებების შესრულების თაობაზე.

დოკუმენტიდან ამოკრეფილია (იხ. ქვემოთ მიმოწერა) ის საკითხები, რაზეც ევროკავშირს მეტ-ნაკლებად უარყოფითი შეფასება აქვს.

გთხოვთ, ხვალ 26 თებერვლის დღის პირველ ნახევარში მოგვაწოდოთ თქვენი პოზიცია (ინგლისურ ენაზე) ევროკავშირის კომენტარებთან დაკავშირებით.

პატივისცემით,

მაია ნიკოლეიშვილი

From: Tamar Chokoraia [mailto:[email-masked]]
Sent: Monday, February 25, 2019 3:05 PM
To: Maia Nikoleishvili <[email-masked]>
Subject: FW: Association Implementation Report on Georgia (2019)

გამარჯობა მაია,

გიგზავნი ევროკომისიის მიერ გამოქვეყნებულ დოკუმენტს „Association Implementation Report on Georgia (2019)“.

გთხოვ, პრემიერ-მინისტრის ინფორმირებისთვის ოთხშაბათს დღის პირველი ნახევრისთვის მოგვაწოდო  პოზიციები (ინგლისურად, მაქსიმუმ ნახევარი გვერდი თითო კომენტარი) ქვემოთ მოყვანილ საკითხებთან დაკავშირებით:

Ø With regard to children's rights, infant (and maternal) mortality rates remain high as compared to European rates, due to low quality ante, perinatal and post-partum services amongst other factors. Child poverty remains high.

Comment: … Since 2018, registered socially vulnerable families, whose rating score is equal to or less than 100 001 with a child/children under 16 years, receive 50 GEL as the child's benefit, instead of 10 GEL previously. (info on countering mortality)

Ø Child-care has still not been fully deinstitutionalised and two large institutions for children with disabilities remain operational. A number of unregulated institutions financed and run by local municipalities, the Georgian Orthodox Church and Muslim communities continue to operate without proper monitoring.

Comment: …

Ø Georgia set up the  , though it is not yet fully functional

Comment: …

Ø The Tripartite Social Partnership Commission continues to meet at its annual plenary session as well as at working group level; however the former continues to be held with irregular frequency

Comment: Tripartite Social Partnership Commission held 2 meetings in 2018, on April 19 and September 7; it discussed occupational health and safety related issues. The TSPC also held a strategic planning meeting with the support of the International Labour Organization. To develop social partnership at a regional level, based on the decision made at the TSPC meeting of February 10, 2017, the TSPC of the Autonomous Republic of Adjara was established in April 2018. (check with Min Labour)

Ø The current system of labour inspections requires further adjustments to be an effective mechanism for implementation of the ILO fundamental conventions on labour rights

Comment: The number of labour Inspectors was increased to 40. In addition, two divisions were established: Inspecting Division and Monitoring and Supervising Division. In order to effectively enforce the OSH law across all the sectors, GoG is committed to increase the number of labour inspectors to 80 (80 labour inspectors would be needed based on the ILO standard, 1 labour inspector per 20,000 workers in transition economies). Labour officials are being constantly trained and retrained while the institution is being gradually developed. Recently, international certificates in OSH have been granted to the inspectors. (check with Min Labour)

Ø The Law on Occupational Health and Safety entered into force in August 2018 allowing the labour inspectorate to perform unannounced checks and apply fines. However, its application is restricted to economic activities defined by the Government which involve increased risk, heavy, hazardous and dangerous working conditions

Comment: The Parliament of Georgia approved a legislative package on February 19, 2019, according to which the law on Occupational Health and Safety applies to all spheres of economic activity. In addition, the current OSH law will acquire the status of an organic law, in order to make it more protected from political leverage, fluctuations and guarantee establishment of effective labour rights protection system. Organic law of Georgia on Occupational Safety will enter into force by September 2019. The law strengthens the labor inspection and gives monitoring service representatives right to unconditional access to workplaces. It expands the power of labor inspectors: they will be able to enter the enterprise without the permission of the judge, while according to the law, adopted in March 2018, the labor inspectors were not able to do it unless there was an accident or a planned inspection. (check with Min Labour)

Ø There was no progress towards approval of the Employment Service Law, while the piloting of a new model of public employment services continues slowly in the selected regions.

Comment:

Ø A new pension system raised a lot of criticism from domestic and international experts.

Comment:

Sincerely,

Tamar Chokoraia

Department of  European Integration

Ministry of Foreign Affairs of Georgia

0118 Georgia, Tbilisi, Sh.Chitadze str.4

Cell: (+995) 591 010820

E-mail: [email-masked]

Web: http://www.mfa.gov.ge/