In March 2025, the World Health Organization (WHO) published a report - "Using the package of interventions for rehabilitation in Georgia”. The document reflects the findings of a situational analysis conducted on the accessibility of rehabilitation services in 2023. This is the first time WHO has conducted an assessment of the availability of rehabilitation service in Georgia.

The 52-page report compiles the experiences and practices accumulated by Georgia in improving the availability of rehabilitation services. The document outlines the steps taken by the country to introduce the rehabilitation intervention packages of WHO and to develop the first national rehabilitation service package based on these global practices. Additionally, the report highlights how the rehabilitation intervention packages were utilized to identify priority target groups.

The WHO report states that Georgia serves as an example of how rehabilitation intervention packages can be effectively implemented for prioritizing beneficiaries, defining appropriate selection criteria and adopting a phased approach. A seperate section of the report discusses the specific steps taken by Georgia to develop priority-setting criteria for rehabilitation services. The World Health Organization emphasizes that Georgia remains committed to continuously adapting and refining its rehabilitation service packages, particularly in terms of improving accessibility to services.

The report states, nine months after the implementation of the rehabilitation service package in Georgia, the CIF conducted an evaluation. The goal of the assessment was to identify the impact of service delivery and the factors hindering its successful implementation. WHO acknowledges that the state-funded rehabilitation service package has demonstrated both its necessity and advantages in practice. The evaluation revealed that the rehabilitation intervention package has led to improved rehabilitation outcomes and higher patient satisfaction.

The WHO expressed gratitude to all those staff, who were involved in the development, implementation and integration of rehabilitation and service packages within Georgia’s Universal Healthcare Program, particularly in utilizing "Package of Interventions for Rehabilitation" (PIR) as a guiding framework.

(The WHO’s "Package of Interventions for Rehabilitation" (PIR) is a technical product developed as part of the WHO Rehabilitation 2030 initiative, aimed at enhancing access to rehabilitation services worldwide. The WHO first introduced the PIR in 2021.)

The report was developed with contributions from experts at the WHO, Ministry of Labor, Health and Social Defense of Georgia, Ken Walker Rehabilitation Clinic, the international foundation "Curatio," the Health Systems Strengthening Accelerator, and BAU International Hospital Rehabilitation Center.

The data informing the report was based on and was provided by professionals working in the rehabilitation field. Professor Irakli Natroshvili, Rector of Tbilisi State Medical University and Head of Ken Walker Rehabilitation Clinic is one of the professors, whose expertise and leadership have played a key role in the advancement of rehabilitation services in Georgia.

Professor Irakli Natroshvili, Rector of Tbilisi State Medical University and Director of the Ken Walker Rehabilitation Clinic in Tbilisi, emphasizes the significance of the WHO report in fostering the future development of rehabilitation services in Georgia:

"The WHO report serves as another strong impetus for the active advancement of rehabilitation services in Georgia. Today, the state already finances post-stroke rehabilitation as well as rehabilitation for conditions following traumatic brain and spinal cord injuries. However, it is equally crucial to expand rehabilitation treatment in other areas, such as post-hip replacement rehabilitation. A substantial number of surgeries are performed in this field, yet there remains a significant gap in post-surgical rehabilitation. This study is particularly significant because it marks the first instance in which a national adult rehabilitation program was introduced in Georgia. Although a pediatric rehabilitation program has been in place since 1996—delivered through various formats over the years, with an established network of service providers—the adult rehabilitation program did not exist before 2022. Until then, there were no state-funded rehabilitation services specifically designed for adults. 

In 2019, when WHO experts visited Georgia, the Ken Walker Rehabilitation Clinic was still under construction. The assessment involved numerous interviews, yet at the time, there was virtually no structured work on adult rehabilitation, apart from the efforts of my team. As a result, the focus of the WHO assessment was primarily on our work.

The clinic officially opened in June 2020, marking the first dedicated space for the development of a structured rehabilitation program. The Georgian government recognized the emerging potential for rehabilitation services and within less than two years, established the country’s first state-funded adult rehabilitation program.

Following the implementation of the state program, accessibility to rehabilitation services increased significantly. Patients now benefit from a fully structured, multidisciplinary rehabilitation approach, reducing financial burdens. One of the most significant achievements of this program is the substantial reduction in out-of-pocket expenses for patients. Some individuals receive rehabilitation fully covered by the state, while others benefit from 90%, 80%, or 70% coverage, with 70% being the minimum level of state co-financing. Rehabilitation is not an inexpensive service—it is a high-cost, resource-intensive medical intervention. Considering this, the fact that patients only need to cover 30% of the treatment costs, especially for such an intensive rehabilitation program, is a significant financial relief. As a result, there is currently high demand for all multidisciplinary rehabilitation services, ranging from physical rehabilitation to neuropsychological support.

One of the key factors contributing to this success was the synergistic collaboration between various stakeholders at the right time. A private investor provided funding to construct a state-of-the-art rehabilitation clinic, while USAID supported the education and training of specialists. This process involved the active participation of Tbilisi State Medical University, the Coalition for Independent Living, the Association “Partners for International Development” and Emory University in Atlanta. A crucial barrier to launching a state rehabilitation program was the lack of infrastructure and trained professionals. However, through this collaboration, we were able to fill these gaps—a clinic was built, infrastructure was developed, specialists were trained, and, as a result, the government promptly introduced the state rehabilitation program."