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

Area of Science:

• Public Health
• Health Services Research
• Health Policy

Background:

• Georgia's post-1991 health care reforms decentralized the system, overlooking human resource management (HRM).
• These oversights negatively impacted the Georgian national immunization program's effectiveness.
• This study assesses HRM practices within the national immunization program in late 2004.

Purpose of the Study:

• To evaluate the state of human resource management practices in Georgia's national immunization program.
• To identify key challenges and barriers affecting the program's performance.
• To provide recommendations for improving immunization program effectiveness through better HRM.

Main Methods:

• A mixed-methods approach was employed, surveying 392 providers and 30 managers across 30 districts.
• Data collection included face-to-face interviews, mail surveys, and four focus groups.
• Quantitative data were analyzed using ANOVA and Chi-square tests; qualitative data underwent content analysis.

Main Results:

• Significant findings include weak administrative links between public health centers and primary care facilities.
• A lack of clear management guidelines and written job descriptions (49.6%) was prevalent.
• Inadequate salaries, lack of managerial authority, poor HRM knowledge/skills, and resource limitations were major barriers.

Conclusions:

• The National Immunization Program suffers from a weak organizational structure, processes, and insufficient management/supervision skills, particularly at peripheral levels.
• Developing workforce skills and processes is a vital investment for improving immunization rates and health care reform.
• Systemic financial and health system constraints require strategic policy and cross-sectoral reforms to enhance program performance.