On July 16, 2020, the Public Defender presented a special report based on the monitoring of access of the population to primary health care within the framework of the state programme Rural Doctor.

Representatives of the Public Defender's Office studied the national legislation, analyzed international documents and complaints obtained during the working process or submitted by applicants. They also visited and inspected outpatient clinics in 70 villages in 16 municipalities across the country.

As a result of monitoring the municipalities and analyzing the regulatory acts, it was revealed that it is necessary to increase the accessibility and efficiency of rural primary health care. In particular:

• Construction/rehabilitation efforts should be carried out in the outpatient section as soon as possible; In order to comply with the sanitary-hygienic norms, the water supply system should be regulated and washbasins should be arranged; Adapted space should be arranged for persons with disabilities in accordance with standards; It is also necessary to arrange a separate space for vaccination according to appropriate standards.

• It is important to provide doctors with computers and the Internet (which we could find only in the Adjara outpatient clinics) so that to ensure that doctors have access to medical databases and patients’ medical files in order to enable them to timely upload information about scheduled and unscheduled vaccination of beneficiaries in the electronic immunization module.
• An important factor hampering thedevelopment of the primary health care system is the low salaries of the rural medical staff, which are not adequate for their efforts and costs. The fragmentary improvement in the working conditions of rural doctors and nurses should be described as a positive step, but their working environment, conditions, their right to take a leave or sick leave, status of a natural person, their transportation to villages, provision of computers, communication and other necessary technologies needs to be evaluated. The active involvement of the state and allocation of additional funds is important in this process
• There is an urgent need to introduce a mandatory system of continuous professional education to improve the qualifications of the medical staff involved in the Rural Doctor programme. It is also necessary to provide state funding for continuous medical education of family doctors, which will increase the motivation of doctors to take an active part in these activities.

For the purpose of solving the problems identified as a result of the monitoring, the Public Defender addressed the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs and the Emergency Situations Coordination and Urgent Assistance Center (LEPL) with relevant recommendations.