| At the time of its independence from the Soviet Union, Georgia appeared to have been a relatively well-off republic with the potential for rapid economic growth and social development. Since independence, however, Georgia has suffered from intense civil conflicts. A large influx of Internally Displaced People (IDPs) from the civil conflict areas (Abkhazia and South Ossetia) to the major cities placed a heavy burden on the local areas' and the country's infrastructure and available resources, already weakened by a general post-Soviet era economic collapse. In order to address the worsening health of the population as a result of deteriorating socio-economic conditions and health infrastructure, the government initiated health sector reform, which included a change from centrally-planned and financed health services to program-based financing and payroll-based social insurance. No longer protected by a centralized health sector that provided free universal access to healthcare services, large segments of the population found themselves denied basic medical services. Among the most affected groups were internally displaced people, the disabled, and the elderly. This study evaluated the complex factors that affect the ability of internally displaced women living in public facilities in Tbilisi (the capital of Georgia) to access healthcare services as a result of health reforms. The research demonstrated that the displaced women's perceived access is poor and that most of them regard themselves as having a significant problem in accessing healthcare services, mainly due to their inability to pay the high cost of care. |
