Monitoring of Georgian Healthcare Budget for Population under the Poverty Line

1. Monitoring of Georgian Healthcare Budget for Population under the Poverty Line Project time period: November 2006 — November 2006 Project financial requirements: approx. 35.000 USD Key Researchers: Economic Policy Research Centre (EPRC) Partners: Open Society Georgia Foundation and the Coalition “for Transparency of Public Finances” Contact details: George Khodeli gkhodeli@eprc.ge, Irina Lashkhi: irina@osgf.ge Nina Kiknadze: nkiknadze@osgf.ge

2. Project Goal • Impact the budget process by raising public awareness of problems in medical care component for people below the poverty line • Cost-expenditure adequacy and actual delivery of promised services to the beneficiaries.

3. Background and Rationale • Medical care component for people below the poverty line being the priority health program with a timeline of 3 years, initiated by the President of Georgia, launched in July 2006 has a budget of 180.000 000 GEL (approx. 103.000 000 USD).

4. Study Aim and Objectives • What funds are planned in the state budget for delivering healthcare services per capita annually -- How much was allocated, how much was spent and how much was needed? • To inform the beneficiaries about the privileges granted to them by the State and teaching them about the steps they need to take in order to receive these benefits.

5. Problems • Realistic data of people below the poverty line does not exist: even though according to the department of statistics the indicator is 15% officials of Georgian health institutions admit it to be significantly higher (approx. 25%) • Government definition of “under the poverty line” is unclear, inadequate and unrealistic (owners of Frig, TV are excluded). • Potential beneficiaries are not sufficiently informed regarding their rights and healthcare services promised by the State.

6. Study Aim and Objectives • Cost-expenditure adequacy and actual delivery of promised services to the beneficiaries; • Controlling programs against decrease of identified state financing, and monitoring to make sure there is no overflow of funds in attempt by the state to cover other expenses • Resource tracking: source-agent-provider-beneficiary (controlling against corruption and unaccounted expenditure)

7. The Scope of the Research • State allocation for healthcare of poor population (Source: MoLHSA — Agent: SUSIF) • Monitoring contracting procedures between agent and provider (providers are contracted despite of unsatisfactory international standards) • Monitoring provider expenditures (actual delivery of promised services to targeted population). • Measuring adequacy of allocated funds in regard with actual cost of healthcare services. • Years to be covered: 2002-2006 • Framework of analysis: scrotal

8. Methodology A) Design -- Quantitative and qualitative analysis -- Economic analysis -- Comparative analysis (What funds are being planned for 2007 in regard to the 2006 indicators?) B) Key respondents -- Parliament, MoF, MoLHSA, SUSIF (Mr. Surguladze, Mr. Sopromadze), Providers

9. Methodology C)Tools -- Budget analysis, literature review, stakeholder meetings D) Source of Data -- Budget document, audit reports, MoLHSA budget and annual reports. E) Data collection -- Collection of all background materials, to contribute accurate data

10. Methodology F)Data analysis method -- Manual analysis using EXCEL G) Review process -- Meetings with stakeholders to present preliminary findings to discuss and influence using report recommendations • Source of data: MoLHSA, SUSIF, Provider

11. Advocacy Strategies AIMS: • To illustrate lack of transparency, corruption • To influence public policies • To impact on the decision making process of the government

12. Advocacy Strategies ACTIVITY: • To turn data into information accessible and understandable to the public • To raise public awareness (e.g. Mass media, workshops, awareness campaigns etc.) AUDIENCE: • Parliament committees, officials of MoLHSA, Civil Society

13. Dissemination • Produce monthly, quarterly and annual reports • Publishing brochures • Posting them on websites of EPRC, OSGF, and the coalition TPF • Organizing presentations and discussion roundtables, conference • Distribute the findings amongst the government bodies, local governments and self-governing bodies, mass media, civil society, local and international NGO-s.

14. Monitoring and evaluation • The monitoring and evaluation of project will be conducted by the board of the Coalition for Transparency of Public Finances, by the OSGF and OSI NY • We will also carry out monitoring of reactions and feedback regarding our project on TV and other sources of mass media and conduct their conclusive analysis.

15. Expected Results • The project implementation will promote maximal transparency of the planned proccesses of the above mentioned program. • By providing transparency the risk of improper and/or non cost-effective spending will decrease • The government will be advised on a regular bases regarding the process of execution of the program.

16. Thank you!