PHIG’s Health and Migration Observatory tracks population movement and its health consequences across the South Caucasus and Eastern Europe. After its first full year of operation, this review examines what the data show.
“Migration is the defining social phenomenon of our era. Its health consequences are the defining challenge for health systems that were designed for static populations. The Observatory exists because ignoring this challenge does not make it smaller.”
Pkhakadze G. H&M Observatory Launch Statement. Tbilisi: PHIG; 2024.[1]
Introduction
PHIG’s Health and Migration Observatory (H&M Observatory) was launched in January 2024 as a structured data collection, monitoring, and analysis platform covering the health dimensions of migration flows in and through the South Caucasus. It monitors four migration streams: labour migration from Georgia to Europe and the Gulf; Ukrainian displacement through and into Georgia; Central Asian migration in transit through the Caucasus; and internal displacement within Georgia related to the unresolved conflicts of the 1990s.[1,2]
This first-year review presents the Observatory’s key data products, methodological development, and emerging findings from 12 months of operation.
| Migration Stream | Data Sources | Population Monitored | Update Frequency | Key Partners |
|---|---|---|---|---|
| Georgian labour emigration | Geostat, MoI border data, IOM surveys | ~180,000 active labour migrants | Quarterly | Geostat, IOM, MoLHSA |
| Ukrainian displacement | UNHCR, border agency, PHIG survey | ~28,000 Ukrainians in Georgia 2024 | Monthly | UNHCR, Red Cross |
| Central Asian transit migrants | IOM, border data, key informant interviews | ~12,000–18,000/yr estimated | Quarterly | IOM, ICMPD |
| Georgian IDPs | MoLHSA, Social Services Agency | ~280,000 registered IDPs | Annual | Social Services Agency |
| Syrian/Afghan refugees | UNHCR | ~8,200 registered refugees | Monthly | UNHCR |
Sources: H&M Observatory Database 2024; PHIG.[1,2,3]
Year-One Key Findings
The Observatory’s most significant first-year finding concerns the health profile of Ukrainians resident in Georgia. A PHIG survey of 480 Ukrainian adults in Georgia (conducted April–June 2024) found that 38% reported at least one unmet health need in the previous three months, most commonly medication access (29%), mental health support (22%), and specialist consultation (18%).[4] Health insurance coverage among non-registered Ukrainians was 12% — far below the near-universal coverage available to registered Ukrainians and Georgian nationals under the UHC programme.
Figure 1. Ukrainian Displacement to Georgia: Monthly Arrivals and Cumulative Stock 2022–2024
Sources: Georgian Border Police data; UNHCR Georgia; PHIG H&M Observatory.[1,3,4]
| Health Indicator | Ukrainians in Georgia (n=480 survey) | Georgian national avg | Gap/Comment |
|---|---|---|---|
| Health insurance coverage | 41% (registered); 12% (not registered) | 99.8% (UHC) | Critical coverage gap for non-registered |
| Unmet health need (3 months) | 38% | 12% | 3x higher gap |
| Mental health need not met | 22% | 14% | Displacement-related stress |
| Chronic disease management continuity | 54% reporting treatment gap | N/A | Medication supply interruption |
| Maternal care access (pregnant women) | 82% | 99% | Access gaps for unregistered |
| Child vaccination (0-5 yrs) | 71% | 94% | Catch-up programme needed |
Sources: PHIG Ukrainian Displacement Health Survey 2024; MoLHSA UHC monitoring data.[4]
Figure 2. H&M Observatory: Migration Health Risk Dashboard — South Caucasus 2024
Conclusion
The H&M Observatory’s first year has produced original data on Ukrainian displacement health needs, established monitoring frameworks for four migration streams, and generated policy-relevant evidence for the MoLHSA, UNHCR, and IOM. The second-year priorities are: expanding the Ukrainian cohort follow-up to 1,000 persons with a longitudinal design; establishing a data-sharing protocol with IOM Georgia for Central Asian transit migrant data; and publishing the Observatory’s first annual State of Health and Migration report to serve as the authoritative evidence base for regional migration health policy.
References
- Pkhakadze G, Tsuladze L. PHIG Health and Migration Observatory: Year One Report 2024. Tbilisi: PHIG; 2024.
- IOM. World Migration Report 2024. Geneva: IOM; 2024.
- UNHCR. Georgia Country Operations Report 2024. Tbilisi: UNHCR; 2024.
- Pkhakadze G, Tsuladze L, Goguadze K. Health status and access to care among Ukrainians residing in Georgia: a cross-sectional survey. J Migration Health. 2025;10:100228. doi:10.1016/j.jmh.2025.100228
- Rechel B, Mladovsky P, Ingleby D, et al. Migration and health in an increasingly diverse Europe. Lancet. 2013;381(9873):1235–45.
Public Health Institute of Georgia
