To ensure universal health coverage, Georgia has implemented reforms of its health care system. A market based approach and privatization of public facilities were the major characteristics of the reform process. In this paper a systematic review was carried out to analyze the outcomes of the reforms in terms of sustainability in health care financing, equity, efficiency, quality and cost control. The evidence shows that because of a lack of strategic policy making capacity, the reforms were not successful. Subsequent changes in the reforms have undermined the sustainability in health financing, efficiency, equity and quality of healthcare. Massive privatization of the health sector without effective regulatory mechanisms has led to an impending risk of market failure. To improve efficiency and effectiveness in the health care sector in terms of improving universal health coverage, healthcare quality, financial protection of the general population and sustainability in health financing, improvement in the regulatory framework and a public- private mix regulatory system is a priority.
Lela Sehngelia,Milena Pavlova,Wim Groot