Georgia and Tajikistan share structural parallels in labour migration: both export large proportions of their working-age populations, both face health consequences of prolonged family separation, and both lack adequate health protection mechanisms for their citizens abroad.
“Georgia and Tajikistan are separated by geography, language and culture. They are united by the same economic logic: too many people, too few jobs at home, and a migration system that treats health as an afterthought.”
Pkhakadze G. Comparative Labour Migration Health Analysis. Tbilisi: PHIG; 2025.[1]
Introduction
Georgia and Tajikistan are both middle-income countries with active labour emigration to Russia, Europe, and the Gulf. In 2024, remittances accounted for 15.2% of Georgian GDP and 32.4% of Tajik GDP — placing both among the world’s most remittance-dependent economies.[2] For both countries, labour migration is simultaneously an economic survival mechanism and a public health challenge: the health of emigrants and their families is systematically overlooked by policy systems designed around sedentary populations.
This comparative analysis draws on PHIG’s Georgian data, ILO Central Asia programme data, WHO health statistics, and World Bank remittance data to identify shared patterns and differentiated responses.
| Indicator | Georgia | Tajikistan | Note |
|---|---|---|---|
| Population | 3.7M | 10.1M | |
| Estimated emigrants working abroad | ~650,000 | ~1,200,000 | Both high relative to labour force |
| Remittances (% GDP) | 15.2% | 32.4% | TJK = one of world’s highest |
| Primary destination | EU, Turkey, Russia | Russia (80%+) | GEO more diversified |
| Health insurance abroad | Variable by country | Minimal in Russia | Both have significant gaps |
| Pre-migration health screening | Not systematic | Not systematic | Gap in both |
| Post-return health follow-up | Absent | Absent | Gap in both |
| Occupational fatality rate abroad (est.) | 1.8/10,000 | 4.2/10,000 | TJK higher due to construction dominance |
Sources: World Bank Remittances Database 2024; IOM; ILO; PHIG analysis.[1,2,3,4]
Shared Health Consequences
Comparative analysis of available data identifies five health consequence patterns shared across Georgian and Tajik labour migration contexts: (i) mental health deterioration — depression rates among labour migrants in both populations estimated at 24–32%, significantly above sedentary population rates; (ii) disrupted NCD management — both populations show medication discontinuation rates exceeding 40% during migration periods; (iii) family health impact — children of absent labour migrant parents in both countries show higher rates of school non-attendance and psychological distress; (iv) occupational health gaps — both populations are concentrated in high-risk sectors (construction, domestic work, transport) with limited occupational safety coverage; and (v) return health burden — returning migrants from both countries show elevated rates of new morbidity not documented prior to emigration.[3,4,5]
Figure 1. Remittance Dependency: Georgia and Tajikistan vs. Global Comparators 2024 (% GDP)
Source: World Bank Remittances Database 2024.[2]
| Policy Measure | Georgia | Tajikistan | Model Country |
|---|---|---|---|
| Pre-departure health screening | Not systematic | Not systematic | Philippines (OFW programme) |
| Bilateral social security agreement with Russia | No | No | Ukraine (pre-2022) |
| Migrant health insurance fund | No | No | Sri Lanka (SLBFE) |
| Embassy health advisory services | Basic | Basic | Morocco |
| Post-return health assessment | No | No | Moldova (pilot) |
| Labour migration health strategy | No | Draft 2023 (not funded) | Philippines |
| Diaspora health network | Informal (PHIG work) | Informal | Armenia (formal network) |
Sources: PHIG policy review 2025; ILO 2024; IOM 2024.[1,3,4]
Figure 2. Depression Prevalence: Labour Migrants vs. Sedentary Population — Selected Studies (% affected)
Sources: Systematic review meta-analysis; ILO surveys; PHIG analysis.[3,4,5]
Conclusion
The structural parallels between Georgian and Tajik labour migration — high remittance dependency, absent health protection mechanisms, concentration in high-risk occupational sectors, and systematic under-measurement of migrant health — suggest that bilateral and multilateral policy learning between Georgia and Central Asian countries would generate mutual benefit. PHIG has proposed to IOM Geneva a joint technical working group on labour migration health for the EECA (Eastern Europe and Central Asia) region, to develop shared indicators, methodologies, and a regional policy toolkit building on the Philippines Overseas Employment Administration (POEA) model — the most comprehensive migrant health protection system currently in operation globally.
References
- Pkhakadze G. Comparative Labour Migration Health: Georgia and Tajikistan. Tbilisi: PHIG; 2025.
- World Bank. Migration and Remittances Database 2024. Washington DC: World Bank; 2024.
- ILO. Labour Migration and Health in Central Asia and Eastern Europe: A Comparative Assessment. Geneva: ILO; 2024.
- IOM. Health of Labour Migrants: Evidence Synthesis for the EECA Region. Geneva: IOM; 2024.
- Ratha D, Plaza S. Migration and Remittances Factbook 2024. Washington DC: World Bank; 2024.
Public Health Institute of Georgia
