Making motherhood safer is a human rights imperative, and it is at the core of UNFPA’s mandate.

Although Georgia made remarkable progress over the past 20 years, many challenges remain to fully implement the outcomes of the Cairo and Beijing meetings and their review conferences. Millennium Development Goal 5 “Improve maternal health” have still not been attained in Georgia. Despite the recent decline, the reported maternal mortality in Georgia continues to be four times as high as the EU average and almost twice as high as the European region average. Although the immediate medical causes of maternal deaths differ, the underlying causes of these deaths are preventable and result in complications for the mother during pregnancy, delivery, and after delivery.

UNFPA/Georgia country programme advocates and supports integration of maternal health service delivery across the continuum of care by forging strong, collaborative and sustainable partnerships within and beyond the health sector. UNFPA works with government, professional associations and academia to take all measures to secure women’s rights of access to necessary and quality health care and support services that allow them to go safely through pregnancy and childbirth, and that provide them with the best chance of delivering a healthy infant.

In pursuit of this objective the major interventions focus on:

• Supporting the Ministry of Labour, Health and Social Affairs in elaboration of the National Maternal & Newborn Health and RH Strategy for the period of 2017-2030, accompanied by a 3-year costed Action Plan, which will be the highest achievable standard of reproductive health for all individuals in Georgia. Development of this strategic documents are inspired by the WHO “Action plan for sexual and reproductive health: towards achieving the 2030 Agenda for Sustainable Development in Europe – leaving no one behind”, and are based on the government policy, which envisages financial support of maternal and child health medical service full cycle including antenatal, obstetric and neonatal services;
• Supporting National flagship initiative - Perinatal Care Regionalization project, which is an important step towards strengthening maternal and newborn health care system in Georgia. This process is planned to be concluded by 2018, with assigning relevant levels of patronage of pregnancy, obstetric and neonatal services to Perinatal clinics to ensure pregnant women at risk receive care in facilities able to provide the required level of specialized care;
• Improving obstetric and perinatal care by working towards evidence-based knowledge and practice through development/adaptation of evidence-based policies, guidelines and standards for increased quality of maternal health care for all;
• Ensuring availability of quality of services for emergency obstetric care and newborn care by establishing analysis of severe maternal morbidity cases (“near-miss” events) at the health-facility levels;

Family Planning

Access to safe, voluntary family planning is a human right. Family planning is central to gender equality and women’s empowerment, and it is a key factor in reducing poverty. Efficient family planning reduces the number of unwanted pregnancies and unsafe abortions, prevents pregnancy-induced mortality and morbidity, reduces the incidence of sexually transmitted infections, including the HIV/AIDS infection, protects the teenagers’ health and it is one of the most cost-efficient means of improving the health and well-being of women, men, young people and the entire community. For all these reasons, investing in modern FP is one of the most effective strategies for improving maternal, infant and child health.

Although the Georgia Reproductive Health Surveys between 1999 and 2010 have indicated some progress, Georgia is still characterised by high levels of unintended pregnancy, a substantial unmet need for modern effective FP method use, and a still high incidence of induced abortion. The latter is still used as a main method of FP, and its incidence can only be reduced by increasing the use of effective FP methods. Provision of FP counselling and services in Georgia are still limited at the Primary Health Care (PHC) level. It is also worth noting that recent recovery of fertility in Georgia (current TFR in Georgia is approximately 2.1) has taken place in the context of increasing prevalence of contraception; the diffusion of contraception fostered a strong decline of abortion and enabled an increase of fertility at the same time. The real trade-off that the country faces in this area is not so much one of fertility vs. family planning, but of family planning vs. abortion.

Within those lines, UNFPA work in Georgia supports family planning by: (a) evidence-based advocacy for increased access of vulnerable populations, including youth, to integrated and rights-based family planning services at the primary healthcare level; (b) advocacy for discouraging abortion and promotion of modern methods of family planning; (c) generating evidence on women’s reproductive health for policy advocacy; (d) disseminating evidence-based guidelines and tools and assisting country with their national adaptation.

More specifically our interventions entail:

• Revision of the relevant existing national public health policies and programmes to determine their linkages to global and regional strategies on sexual and reproductive health and rights to ensure coordinated and cost-effective implementation;
• Ensuring that Family Planning is an integral part of the National Maternal & Newborn Health Strategy to develop more people-centred, integrated health services;
• Revision and adaptation of the WHO guideline - Medical eligibility criteria for contraceptive use (MEC), 5th edition. Twelve different protocols were adapted, approved by the MoLHSA Guidelines’ Board in 2017.
• Adaption and nationwide roll-out of the Virtual Contraceptive Consultation (ViC) online learning platform for evidence-based family planning to strengthen the capacities of service providers. ViC has been institutionalized by the Medical University’s academic council and accredited as part of the University’s blended learning strategy;
• Supporting implementation MICS survey in partnership with UNICEF, to generate reliable and disaggregated data on a number of indicators related to SRH, including Family Planning;
• Tackling, including through use of the media, existing and newly emerging myths and misconceptions about methods of contraception.