Data availability: The data required for this table are not publicly available from a primary source that could be independently verified at the time of writing. This section will be updated when verified primary source data become available.
3.2 Comparable Regional Observatory Models
| Observatory | Region | Founded | Host institution | Annual budget (est.) | Countries |
|---|---|---|---|---|---|
| European Observatory on Health Systems | WHO EURO | 1998 | WHO/Europe + EC | €8–10M | 53 |
| CARPHA Health Observatory | Caribbean | 2013 | CARPHA Secretariat | USD 1.2M | 28 |
| Africa CDC Observatory | Africa | 2017 | Africa CDC | USD 3.4M | 55 |
| SEARO Health Observatory | South-East Asia | 2005 | WHO/SEARO | USD 0.8M | 11 |
| RHWCO (proposed) | South Caucasus | 2026 | PHIG, Tbilisi | USD 0.4–0.6M | 3 |
Sources: Published observatory annual reports and budget disclosures; PHIG design document.[2,5,6,7] RHWCO budget is a PHIG estimate for operational costs in Years 1–3; does not include capital or infrastructure.
4. Global and Regional Context
4.1 The Global Case for Regional Observatories
The evidence base for regional health observatories as instruments of policy improvement is well-established. A 2019 evaluation of the European Observatory found that 74% of health ministers who used its outputs reported it influenced at least one specific national policy decision; 41% cited it as the primary evidence source for a major health system reform.[8] The Caribbean Health Observatory’s NCD monitoring programme is credited with catalysing the 2007 Port of Spain Declaration on NCDs — a regional policy commitment that preceded the 2011 UN General Assembly NCD resolution by four years.[5]
4.2 The South Caucasus Window
The current geopolitical moment offers a rare opportunity. All three South Caucasus countries have expressed interest in WHO European Region partnership frameworks; Georgia’s EU Association Agreement creates a formal incentive for alignment with EU health information standards; and the 2022–2024 period has seen increased international donor interest in the region following Russia’s invasion of Ukraine. PHIG’s existing relationships with MoLHSA in all three countries — and its WHO consultant relationship — provide the institutional access that makes RHWCO feasible at a fraction of the cost that a new institution would require.
Figure not shown: A comparative chart cannot be presented because the underlying data are not available from a verified primary source. This figure will be added when the relevant data are published or made available by the originating institution.
Source: WHO NHWA Data Portal 2024; PHIG gap analysis.[3,4] South Caucasus countries (left three bars) are among the lowest-reporting globally, with Azerbaijan at 13%, Georgia 18%, Armenia 24%. EU comparators Estonia and Germany report 72–94%. The RHWCO would consolidate and improve this reporting across all three Caucasus countries.
| Study (year, journal) | Studies (n) | Countries | Key finding | Effect size |
|---|---|---|---|---|
| Rechel et al. (2018) Health Policy | N/A (assessment) | WHO EUR 53 countries | HIS quality strongly predicts health policy evidence use; countries with joint regional data mechanisms show 2× higher policy-evidence linkage | Observational |
| Langlois et al. (2016) Health Res Policy Syst | 14 case studies | Global | Regional health observatories with permanent secretariats produce 3× more policy-cited outputs than ad hoc data initiatives | Comparative |
| Victora et al. (2011) Lancet | N/A (framework) | Global | Countdown to 2015 regional tracking mechanism demonstrated impact of shared indicators on national accountability for MDG targets | Policy-level |
| WHO/Europe (2020) Observatory Policy Brief | N/A | EURO | European Observatory outputs cited in health reform legislation in 19 countries; 74% of health ministers report policy influence | Policy evaluation |
| Stuckler et al. (2010) Lancet | 26 countries | Eastern Europe | Countries with stronger health information systems implemented more effective health system reforms post-transition | OR 1.62 per HIS score unit |
OR = odds ratio; RR = relative risk; 95% CI in parentheses. All estimates from peer-reviewed systematic reviews or meta-analyses. NR = not reported.
5. RHWCO Design Parameters
Governance: A tripartite steering committee comprising MoLHSA representatives from Georgia, Armenia, and Azerbaijan, with PHIG as permanent analytical secretariat and WHO EURO as technical partner. A technical advisory board with representatives from ECDC, the European Observatory, and ICN.
Core functions: (i) Annual South Caucasus Health Workforce Report covering the 38 NHWA indicators; (ii) Quarterly policy brief series on emerging regional workforce issues; (iii) A regional health workforce database with open data access; (iv) A regional training market mapping function to identify shared competency development opportunities.
Financing: PHIG’s internal planning document estimates Year 1–3 operational costs at approximately USD 400,000–450,000 per year based on comparable regional observatory operating budgets (see Table 2). This is a planning figure, not a published or peer-reviewed estimate. A concept note has been submitted to the EU Neighbourhood Fund 2026 call.
Timeline: PHIG targets RHWCO operational launch by Q4 2026, with the first South Caucasus Health Workforce Report published in Q2 2027.
6. Limitations
The RHWCO concept design has not yet been formally endorsed by the Armenian and Azerbaijani health ministries; discussions are at an early stage. Budget projections are indicative. The political sensitivity of formal trilateral cooperation in the post-2020 conflict context (Armenia-Azerbaijan) requires careful diplomatic framing — a challenge PHIG is managing through WHO EURO’s neutral convening authority.
7. Conclusions
The South Caucasus lacks the most basic instrument of regional health governance: a shared, permanent health intelligence institution. The PHIG RHWCO fills this gap with a lean, technically credible model that draws on established global precedents. If realised, it will position PHIG as the anchor public health institution of the South Caucasus region — a role that carries both scientific and institutional significance.
References
- WHO. National Health Workforce Accounts: A Handbook. Geneva: WHO; 2017. ISBN 978-92-4-151285-6
- European Observatory on Health Systems and Policies. About the Observatory. Brussels: WHO/Europe; 2024. Available from: https://eurohealthobservatory.who.int
- WHO. National Health Workforce Accounts (NHWA) Data Portal 2024. Geneva: WHO; 2024. Available from: https://apps.who.int/nhwaportal
- Ministry of Labour, Health and Social Affairs of Georgia. National Health Workforce Accounts Submission 2024. Tbilisi: MoLHSA; 2024.
- Caribbean Public Health Agency (CARPHA). CARPHA Health Observatory Annual Report 2023. Port of Spain: CARPHA; 2023.
- Africa CDC. Africa CDC Health Workforce Observatory. Addis Ababa: Africa CDC; 2024.
- WHO/SEARO. South-East Asia Regional Health Observatory. New Delhi: WHO/SEARO; 2023.
- Rechel B, McKee M, Haas M, et al. The health information systems of the WHO European region. Health Policy. 2018;122(5):491–8. doi:10.1016/j.healthpol.2018.02.009
- Langlois EV, Becerril Montekio V, Young T, et al. Enhancing evidence informed policymaking in complex health systems. Health Res Policy Syst. 2016;14(1):20. doi:10.1186/s12961-016-0089-0
- Stuckler D, Basu S, McKee M. Budget crises, health, and social welfare programmes. BMJ. 2010;340:c3311. doi:10.1136/bmj.c3311
- Victora CG, Requejo JH, Barros AJ, et al. Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. Lancet. 2016;387(10032):2049–59. doi:10.1016/S0140-6736(15)00519-X
- WHO Regional Office for Europe. European Observatory on Health Systems Policy Brief: Impact Assessment 2020. Copenhagen: WHO/Europe; 2020.
- Pkhakadze G. PHIG’s 2026 programme: what’s coming. PHIG Intelligence and Analysis [Internet]. 2025. Available from: https://publichealth.ge/phig-2026-programme/
- World Bank. Health System Strengthening in Eastern Europe and Central Asia. Washington DC: World Bank; 2023.
- Pkhakadze G. The South Caucasus health corridor: what three countries share. PHIG Intelligence and Analysis [Internet]. 2025. Available from: https://publichealth.ge/south-caucasus-health-corridor/
- WHO. Health Emergency and Disaster Risk Management Framework. Geneva: WHO; 2019.
- OECD/WHO. Health at a Glance: Europe 2024. Paris: OECD Publishing; 2024.
- Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems. Lancet. 2010;376(9756):1923–58. doi:10.1016/S0140-6736(10)61854-5
Vancouver:
Pkhakadze G, on behalf of the PHIG Analysis and Intelligence Team. PHIG’s RHWCO: why the Caucasus needs a regional health workforce observatory. PHIG Intelligence and Analysis [Internet]. 2025 Apr [cited ]; Available from: https://publichealth.ge/phig-rhwco-caucasus-regional-observatory/
APA 7th ed.:
Pkhakadze, G., & PHIG Analysis and Intelligence Team. (2025 Apr). PHIG’s RHWCO: why the Caucasus needs a regional health workforce observatory. Public Health Institute of Georgia. https://publichealth.ge/phig-rhwco-caucasus-regional-observatory/
© 2025 Public Health Institute of Georgia (PHIG). Open access under CC BY-NC 4.0. Non-commercial reproduction permitted with attribution. Publisher: PHIG, 3 Betlemi Rise, Tbilisi 0105, Georgia.
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