Human resource management in the Georgian National Immunization Program: a baseline assessment

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IDL-49664.pdf (139.9 KB)

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2007-07

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Abstract

Background: Georgia's health care system underwent dramatic reform after gaining independence in 1991. The decentralization of the health care system was one of the core elements of health care reform but reports suggest that human resource management issues were overlooked. The Georgian national immunization program was affected by these reforms and is not functioning at optimum levels. This paper describes the state of human resource management practices within the Georgian national immunization program in late 2004. Methods: Thirty districts were selected for the study. Within these districts, 392 providers and thirty immunization managers participated in the study. Survey questionnaires were administered through face-to-face interviews to immunization managers and a mail survey was administered to immunization providers. Qualitative data collection involved four focus groups. Analysis of variance (ANOVA) and Chi-square tests were used to test for differences between groups for continuous and categorical variables. Content analysis identified main themes within the focus groups. Results: Weak administrative links exist between the Centres of Public Health (CPH) and Primary Health Care (PHC) health facilities. There is a lack of clear management guidelines and only 49.6% of all health providers had written job descriptions. A common concern among all respondents was the extremely inadequate salary. Managers cited lack of authority and poor knowledge and skills in human resource management. Lack of resources and infrastructure were identified as major barriers to improving immunization. Conclusion: Our study found that the National Immunization Program in Georgia was characterized by weak organizational structure and processes and a lack of knowledge and skills in management and supervision, especially at peripheral levels. The development of the skills and processes of a well-managed workforce may help improve immunization rates, facilitate successful implementation of remaining health care reforms and is an overall, wise investment. However, reforms at strategic policy levels and across sectors will be necessary to address the systemic financial and health system constraints impeding the performance of the immunization program and the health care system as a whole.

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GEORGIA, IMMUNIZATION, PERSONNEL MANAGEMENT, HEALTH HUMAN RESOURCES, HEALTH SYSTEM

Citation

Esmail, L. C., Cohen-Kohler, J. C., & Djibuti, M. (2007). Human resource management in the Georgian National Immunization Program: a baseline assessment. Human Resources for Health, 5 (20). doi:10.1186/1478-4491-5-20

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http://hdl.handle.net/10625/49664

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IDRC Research Results / Résultats de recherches du CRDI
2000-2009 / Années 2000-2009
Canadian International Immunization Initiative (CIII2) / l’initiative canadienne d’immunisation internationale
Health Systems Research / recherche sur les systèmes de santé
Maternal, Newborn, and Child Health (MNCH) / la santé de la mère, du nouveau-né, et de l’enfant
Research Results (GHRI) / Résultats de recherches (IRSM)