Georgia’s healthcare system: a journey of reform, investment and progress

Purpose This study analyzes Georgia’s healthcare transformation from 1991 through both historical policy evolution and the WHO Health Systems Framework, evaluating how reforms prioritized or neglected system components while projecting 2030 outcomes. Design/methodology/approach We analyzed 26 peer-reviewed studies, WHO reports and Georgian government records, categorizing reforms by WHO component and assessing their cumulative impact on equity and efficiency. Findings Georgia’s journey reveals three distinct phases: post-Soviet collapse (1991–2006), market-driven reforms (2007–2012) and universal coverage expansion (2013–present). While financing and service delivery improved (OOP payments reduced from 74.7 to 57%), chronic workforce shortages (1:1 nurse–doctor ratio) and governance gaps persist. The 2030 strategy represents the first holistic attempt to address all WHO components simultaneously. Practical implications Policymakers must balance historical lessons (e.g. corruption risks in decentralization) with WHO-aligned investments, particularly in workforce training and digital infrastructure, to achieve 2030 goals. Originality/value This is the first study to combine historical policy analysis with WHO framework application for Georgia, revealing how reform sequencing explains current strengths (90% coverage) and weaknesses (rural disparities).