5.64physicians per 1,000 (2023) — highest in the region; EU 4.15
5.97nurses and midwives per 1,000 (2023) — EU 8.98
1.06nurses per physician — EU 2.16
12countries in the RHWCO region for comparison
Georgia is the home country of RHWCO and its first full case. The numbers above come from the WHO National Health Workforce Accounts as published by the World Bank, and they make the observatory’s central point in one line: Georgia does not lack doctors — it has more per head than the European Union — but its nursing workforce and its skill mix are far from European norms, and nothing in the headcount says what any of these professionals can actually do. That is a competency question, and it is the question Georgia’s regulatory system, built around attendance-based attestation, has not been designed to answer.
Regulation of competence in Georgia
| Instrument | What it governs | Competency relevance | Source |
|---|---|---|---|
| Law of Georgia on Medical Activity (1997, as amended) | Right to practise, state certification of physicians, continuing professional development, professional responsibility | Certification is examination-based at entry; maintenance relies on CPD credits rather than demonstrated competence | Legislative Herald of Georgia (matsne.gov.ge) |
| Law of Georgia on Health Care (1997, as amended) | Rights of patients, duties of providers, licensing of facilities, medical education and research | Frames quality obligations of facilities, not of individuals | matsne.gov.ge |
| Rules of state certification and the unified post-diploma (residency) programmes | Specialty training, examinations, certificates | The main competency gate; written examination, limited practical assessment | Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs |
| Law of Georgia on Higher Education; NCEQE authorisation and accreditation standards | Medical and public health degree programmes | Programme-level outcomes required; WFME-aligned standards for medicine since 2019 | NCEQE |
| Law of Georgia on Occupational Safety (2019); Labour Code | Safety and health at work, including for health workers | Competency of safety personnel defined; health-worker specific competencies absent | matsne.gov.ge; GILS |
| EU–Georgia Association Agreement (2014; in force 2016), Title VI Chapter 22 (Public Health) and DCFTA approximation annexes | Approximation to EU public-health acquis; cooperation on health workforce | Creates the legal expectation of alignment with EU professional-qualification and patient-safety frameworks | EUR-Lex 22014A0830(02) |
| WHO Global Strategy on Human Resources for Health: Workforce 2030; WHO Europe Framework for Action on the Health and Care Workforce 2023–2030 | Member-State commitments on planning, education, regulation, retention | Both call for competency-based education and regulation and for National Health Workforce Accounts — the data used above | WHO 2016; WHO Europe 2023 |
| WHO Global Competency Standards for Health Workers providing refugee and migrant health services (2021) | Competency standards and curriculum guide | Delivered in Georgia’s region by PHIG under WHO contract (Riga 2024; Kenya 2025–26); the only competency standard Georgia has piloted end-to-end | WHO 2021 |
What this means for competency policy
- Supply is not the constraint. With physician density above the EU average, further expansion of medical school intake does not address outcomes; the questions are distribution, skill mix and what graduates can do.
- The nursing gap is structural. A ratio of one nurse per physician cannot support task-sharing, chronic-disease management or safe hospital care at European standards; competency frameworks for nursing, with career pathways, are the single largest lever.
- Attestation measures attendance. Georgia’s CPD-credit model records hours, not performance; RHWCO’s central argument — that attendance is not competence — is drawn directly from this system.
- The EU and WHO anchors already exist. The Association Agreement and the two WHO frameworks give the legal and normative basis for a competency-based system; what is missing is a national competency architecture and the data to run it.
- Georgia can lead the region. Having piloted a WHO competency standard end-to-end, Georgia is placed to host the regional observatory and to offer its typology and gap analysis to the other eleven countries.
Data notes and limitations
Densities are WHO NHWA figures as published in the World Bank WDI; definitions of “nurse and midwife” vary between countries, and latest years differ (2020–2023). Georgian administrative data (NCDC statistical yearbook; Geostat) may differ from NHWA submissions; RHWCO uses the international series for comparability and cites national figures where they are discussed. Updated figures are pulled each year; the retrieval date is stated on each chart.
Cite this page: Public Health Institute of Georgia, Regional Health Workforce Competency Observatory. Georgia: the evidence. Version 5.1, 6 October 2026. https://publichealth.ge/rhwco/georgia/ (accessed: add date). Licence CC BY 4.0. Data from WHO NHWA/World Bank WDI are CC BY 4.0 and cited at source.