Subject: RE: Association Implementation Report on Georgia (2019)
From: Tamar Chokoraia <[email-masked]>
To: Maia Nikoleishvili <[email-masked]>
Date: Wed, 27 Feb 2019 06:48:32 +0000

დიდი მადლობა მაიკო!

სს,

თამუნა

From: Maia Nikoleishvili [mailto:[email-masked]]

Sent: Wednesday, February 27, 2019 10:47

To: Tamar Chokoraia

Subject: RE: Association Implementation Report on Georgia (2019)

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

Comment: According to
the World Bank classification Georgia is a low-middle income country (GDP per capita USD 4047). Government expenditure on Health is USD 120. 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 decreased
dramatically since 2000-2017 from 27.3 to 9.6 per 1000 live birth.

In 2017, the Georgian government developed a comprehensive long-term (2017-2030) Maternal and
Newborn Health Care Strategy and short-term Action Plan (2017-2019) with the aim to provide long-term guidance and coherent plan of action for the improvement of maternal and new born health in Georgia.

Significant step toward improvement of maternal and newborn health outcomes was initiation of perinatal care regionalization in 2015. Regionalization
of the perinatal care system is recognized as an ideal model of health care delivery to improve health outcomes and decrease maternal and infant morbidity and mortality through provision of risk-appropriate care. Through regionalized system Georgia ensures
that each mother and newborn is delivered and cared in a facility appropriate for his or her healthcare needs and to facilitate the achievement of optimal outcomes.
Regionalization process was completed in 2017. Within the regionalization of the perinatal care
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, the Ministry of Labour, Health and Social Affairs of Georgia (MoLHSA)
in collaboration with LEPL National Centre for Diseases Control and Public Health 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 caesarean section.

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. LEPL 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.

The Governmental policy is directed to create a social protection system that will reduce social risks caused
by poverty. Targeted social assistance is a special cash assistance programme aimed at reducing levels of poverty of the most vulnerable households in the country.  The programme is operational since 2006 and is based on the assessment of households using
special methodology that uses Proxy Means Testing formula and assesses households with “wellbeing score”. Since 2015 with the support of World Bank UNICEF, revised methodology of assessment and assistance scheme was introduced. New methodology is oriented
on family income (or property bringing income), consequently, beneficiary can become a family having no income or income bringing property.

Assistance is provided based to the gradation system - families, having lower scores receive more financial
support. Additionally, a new child cash benefit (CB) was introduced for families having children under 16 years of age.

Social transfers, especially Target Social Assistance (TSA) have a great impact on poverty reduction. According
to the Welfare Monitoring Survey 2017[1]
of UNICEF, TSA income was removed from household consumption, extreme poverty among children would have increased from 6.8% to 13.1%. These findings demonstrate that TSA+CB has the highest impact on children. TSA also better targets households with children.
By 2017 15.4 % of households with children received TSA +CB and 12.6% of them received TSA only vs 7.3% of households without”. Since 2019, socially vulnerable families with a child/children under 16
years, whose rating score is equal to or less than 100 001, receive 50 GEL as the CB, instead of 10 GEL previously.

Ø
Child-care has still not been fully deinstitutionalized 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: Deinstitutionalization of two remaining state institutions for children
with disabilities is progressing. Two small family type homes for children with severe disabilities and health problems have been opened in 2016-2018. In order to better support children with disabilities in foster families, payment for foster families has
increased in 2019, whereas cash benefit in support of children with disabilities reintegrating with their biological families has also increased.  Number of children placed in the foster families instead of institution increases annually. Number of Children
in foster care in 2017 – 216, number of children in foster care 2018 – 235.

As for institutions run by the local municipalities and faith based organization: regulatory framework has become stricter. Based on the Georgian law on licensing child care institutions, as of September
2018 no institution can provide care to children (24 hour residential care) without license unless it is an educational facility and falls under the order of the Minister of Education and Sciences of Georgia N 448 dated on 15th September of 2005 “on the Establishing
General Education Institutions as a Legal Entity of Public Law and Approving the Statute of Public School".

By the amendment on 26th of November of 2018 to the order N 448 on 15th of September of 2005 of the Minister of Education and Sciences of Georgia
on the "Establishing General Education Institutions as Legal Entities of Public Law and Approving the Statute of Public School" - 3 schools of Dusheti municipality (Barisakho, Magaroskari, Shatili) were added to the list of public schools subordinated by the
Dusheti Educational Resource Center.

Based on the above mentioned law, providing such services without license is punishable and will lead to fines.

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 (TSPC) held 2 meetings in 2018, on April 19 and September 7; At the meetings were 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).

Development/strengthening of social dialogue and regular meetings of the Tripartite Social Partnership Commission are on the agenda of the Government of Georgia. The
TSPC is working within Action Plan 2018-2019, covering the issues of significant importance in labour sphere.  Development of social dialogue at regional level is also a part of the action plans and on the agenda of GoG. The very first step was creation of
TSPC in Adjara. The GoG will be working throughout 2019 to guarantee that the commission in Adjara is running and functioning.

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.

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.

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:
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. New employment model was implemented in 4 regions covering 15 offices overall. Implementation of the new model in 7 regions is planned in 2019. In addition,
it is foreseen to it is foreseen to empower and institutionally develop State Employment Services with the aim to ensure access to employment services, improve employability of local population, providing new employment/vocational training services, etc. The
Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia together with stakeholders (State bodies, social partners) is working on the National Labour and Employment Strategy and Strategy Realization
Action Plan 2019-2023.   The process is being finalized and strategy will be adopted in March.

The draft Employment Service Act is being under discussion among line ministries and social partners and part of the National Labour and Employment Policy Strategy.

From: Tamar Chokoraia [mailto:[email-masked]]

Sent: Tuesday, February 26, 2019 7:57 PM

To: Maia Nikoleishvili <[email-masked]>

Subject: FW: Association Implementation Report on Georgia (2019)

მაიკო, სამწუხაროდ, ვერ ვხსნით ფაილს, რაღაც ტექნიკური ხარვეზია როგორც ჩანს.

თუ არ შეწუხდები, თავიდან რომ გამოგვიგზავნო სხვა ფორმით, მაგალითად პირდაპირ მეილში რომ ჩააკოპირო.

მადლობა წინასწარ!

სს,

თამუნა

From: Maia Nikoleishvili [mailto:[email-masked]]

Sent: Tuesday, February 26, 2019 19:22

To: Tamar Chokoraia <[email-masked]>

Cc: Mariana Mkurnali <[email-masked]>; Sopo Belkania <[email-masked]>

Subject: RE: Association Implementation Report on Georgia (2019)

თამუნა,

გიგზავნით სამინისტროს კომენტარებს ევროკავშირის ანგარიშთან დაკავშირებით, საქართველოს ოკუპირებული ტერიტორიებიდან დევნილთა, შრომის, ჯანმრთელობისა და სოციალური დაცვის სამინისტროს
კომპეტენციის ფარგლებში.

პატივისცემით,

მაიკო

Maia Nikoleishvili MPA

Chief Specialist of International Relations Division

Analytics, HR Management and International Relations Department

Ministry of IDPs from the Occupied Territories, Labour, Health and Social Affairs of Georgia

144 Tsereteli ave., 0159 Tbilisi, Georgia

Tel.: +995 32 2510034 (0803)

Cell phone: +995 577272713

E-mail:
[email-masked]

[1]
http://unicef.ge/uploads/WMS_brochure_unicef_eng_web.pdf