CC BY
11
Section 6. Economics and managementy
https://doi.org/10.29013/ESR-22-5.6-59-64
Vanishvili Merab, PhD in Economics, Professor, Georgian Technical University Kokashvili Nanuli, PhD in Economics, Associate Professor Gori State Teaching University Sosanidze Maka, PhD in Economics, Associate Professor Gori State Teaching University
GENDER BUDGETING IN THE FIELD OF GEORGIAN HEALTH AND SOCIAL PROTECTION: ANALYSIS AND EVALUATION
Abstract. Based on the latest literary sources and rich factual material, the scientific article consistently discusses topical issues of financial theory and practice, gender budgeting in the healthcare and social protection of Georgia.
It has been established that the spheres of health care and social orientation have a high gender significance. At the same time, the study shows that the state budget programs of Georgia do not contain gender sensitivity.
It is substantiated that the goals set in the health and social protection programs of the state budget of Georgia, and the indicators of intermediate and final results require more specification in accordance with the principles of the program budgeting methodology in general, as well as taking into account additional gender aspects.
Keywords: gender budgeting, program budgeting, gender sensitivity, gender gap, gender impact, gender analysis.
1. Introduction
Gender plays an important role in the origin and spreading of certain diseases/pathologies, as well as in their treatment and well-being. This is due to biological differences between the sexes, as well as socio-economic and cultural factors that influence the behavior of women and men and their use of health services (Shanava & Vanishvili [2]; Shanava
& Vanishvili [3]; Vanishvili, Lemonjava et al. [8]; Gechbaia et al. [7]).
In general, it can be said that women are better than men, aware ofthe state oftheir health and are more active in using health services. There are several reasons for this: a) a reproductive role; b) their "caring" role; c) their large proportion in the entire older population; D) Gender stereotypes (Vanishvili Merab et al. [10]).
In Europe, the health sector is predominantly male. Women occupy lower positions in the sector (eg nurses and midwives) and are a minority among senior professionals (doctors, dentists). Women are also underrepresented in leadership positions in the sector. In addition, due to the high involvement of women in the health sector, special attention should be paid to gender-sensitive education.
Gender analysis is of particular importance in the social sphere. It is believed that the integration of gender issues in social areas such as health and social care is associated with the availability ofrelevant skills and therefore, gender is more pronounced than, for example, in the private sector and agriculture, which are more related to opportunities. An analysis of government subsidies or other social spending shows that when, for example, spending on health and social welfare is cut, it makes a gender difference - the increased burden falls on households and mainly on women. This issue is closely related to gender budgeting (Vanishvili & Sreseli [9]).
Gender budgeting involves incorporating gender equality considerations into a country's budget process and reallocating budgetary resources to facilitate gender mainstreaming in all areas or sectors. Due to the complexity of gender budgeting, there is no universal approach to it. The approach used and the institutional structure are usually based on the characteristics of a particular country.
Due to the urgency of the problem, the purpose of our study is to analyze and evaluate gender budgeting in the field ofhealthcare and social security in Georgia.
2. Materials and Methods
Well-known methods have been developed to assess the value of gender equality in health and social care, such as: 1) One Health tool developed under the International Health Partnership, It also includes analysis, evaluation and financing of the health nutrition system with the use of different scenarios; 2) "Cost of social protection" ("Calculation of the minimum cost of social protection"), which evaluates the closure of different social programs, checks
their similarity and validity in case of increasing the social program; 3) Reproductive Contraceptive Instrument (UNFPA).
The Beijing Platform for Action emphasized the importance of gender budgeting in the social sector. In particular, interested developing and developed countries have agreed that, on average, 20% of the official development assistance budget and 20% of the social programs of the state budget should take into account a gender vision (Nathalie Holvoet [11]).
When evaluating capital projects, the following five main stages of gender budgeting are distinguished: 1) Analysis of the situation of women, men, girls and boys in the relevant infrastructure sector; 2) Assessing the gender sensitivity of programs, legislation and past projects; 3) Evaluation of the implementation of gender-sensitive activities and project proposals at the expense of budget allocations; 4) Monitoring the distribution of allocated funds, as well as services provided to the relevant target groups; 5) Assess the impact of the respective infrastructure project and the changed situation compared to the first phase.
The following two methods for analyzing gender budgeting of infrastructure projects are known: 1) Gender-Disaggregated Beneficiary Assessment: data for this estimator can be obtained through relevant surveys, household interviews, focus group discussions, direct observation, case studies and other methods. The main questions to be explored should be divided into gender, geographic region, level of education, status of opportunity, and other relevant categories; 2) Gender Expenditure Analysis: This method involves evaluating relevant budgets and policies in a gender-responsive manner to assess the allocation of resources to boys/men and girls/women. The main point of this method is to understand what gender influences the funded project has.
3. Results and discussion
According to the National Statistical Office of Georgia, as of January 1, 2022, the population of Georgia is 3688.6 thousand people (48% men, 52% women) and has been increasing by an average of
0.04% annually over the past 5 years. Over the past decade, on average, more boys are born each year than girls, and therefore the sex ratio at birth (male/ female) is 1.08, while at the same time, the average annual sex ratio at death (male/female) is 1.05. This means that the number of men both in terms of fertility and mortality during this period is higher than that of women (http://gender.geostat.ge/gender/ index.php?action= Demography).
The coefficient of natural increase (per 1000 population) is -3.8 as ofJanuary 1, 2022, this indicator has been decreasing by an average of 20% annually since 2014, more precisely, the difference between births and deaths is decreasing and the ratio of this difference to the total population decreases with the number (natural increase rate). If we consider this indicator by regions of the country, then during 2021 in all regions, except for the municipality of Tbilisi, the Autonomous Republic ofAdjara, Samtskhe-Javakheti and Kvemo Kartli, there was a negative difference between births and deaths (https://www.geostat.ge/ ka/modules/categories/321/ bunebrivi-mateba).
The average age of the population increased in 2022 compared to 2002 for both men (from 33.9 to 36.1 years) and women (from 37.9 to 40.4 years), which led to an increase in the average the age of the population during this period for both sexes (from 36 to 38.3 years). In terms oflife expectancy (life expectancy at birth (year) disaggregated by sex), at the end of2021 this figure is 71.4 years for both sexes, of which 75.4 years for women and 67.5 years for men. However, this indicator for both sexes has slightly decreased over the past 5 years (for comparison: 72.7 years in 2016 and 71.4 years in 2021).
One of the most important gender indicators in the field of health and social protection is the level of infant mortality. According to the State Statistics Service, compared with 2016, infant mortality will decrease by a total of 94 units in 2021 (from 507 to 413) (http://gender.geostat.ge/gender/index. php?action=Demography). And the mortality rate for children under 5 years old (per 1000 live births)
for both sexes is slightly reduced (from 10.7 to 10.0) (https://www.geostat.ge/ka/modules/catego-ries/320/gardatsvaleba).
Gender-relevant are age coefficients that measure the population aged 0-14 years and 65 years and older for every 15-64 years, or show the number of children and elderly dependents of the working-age population, which reached 54.1 as ofJanuary 1, 2022. Among them, 31.2 is the load factor by the age of young people, 22.9 is the load factor by the age of the elderly. This number has been growing over the years. In general, both in the case of the elderly and children, the load rate in women is higher than in men. With individual children, the load factor is higher for men, and for older children, for women (https://www.geostat.ge/ka/modules/catego-ries/41/mosakhleoba).
It is also important to observe a country's household statistics for gender analysis of a country's social background. According to the 2014 census, there are about 1.109.130 households in the country, the average household size (number of people living in it) is 3.3, and this figure is approximately equal for urban (3.3) and rural (3.4) settlements. At the same time, the number of single-member households in the country is quite large (193.874 for both sexes), of which 63% are single women and 37% are single men (http://census.ge/ge/results /census1/households).
In terms of employment and economic activity in general, the economically active population (activity rate) for women is significantly lower than for men (for example, 56% and 74%, respectively, in 2021). This is why women have lower unemployment and employment rates than men.
In this regard, it is also interesting to consider the average monthly nominal wages of employees by type of activity and gender. The average salary ofboth sexes in 2015 was 900.4 lari, and in 2020-1191.0 lari. The salary of men is on average 1.5 times higher than that of women (in 2020, 1.407.7 lari and 952.2 lari, respectively (https://www.geostat.ge/ka/modules/ categories/683/dasakmeba-umushevroba).
In this regard, it is also interesting to consider the average monthly nominal wages of employees by type of activity and gender. The average salary of both sexes in 2015 was 900.4 lari, and in 2020-1191.0 lari. The salary of men is on average 1.5 times higher than that of women (1.407.7 lari and 952.2 lari, respectively, in 2020). The difference between salaries has slightly decreased compared to 2015. In areas such as "financial and insurance activities", "health and social services", "professional, scientific and technical activities", "public administration and defense; Mandatory social protection "The gender wage gap has widened over this period and is still significantly higher. These differences are narrowing in areas such as wholesale and retail trade, as well as real estate, administrative and support services, education, and more. For many years only in one sector "Electricity, gas, steam and air conditioning" women's wages were higher (by an average of 1.1 times) than men's (https://www.geostat.ge/ka/ modules/categories/39/khelfasebi).
As of 2021, the total number of pension and social package recipients is 971.648, of whom 65% are women and 35% are men. The share of women and men is different between pensioners and recipients of social packages. 71% of the 745.001 people receiving the pension are women, while 63% of the 226.647 people receiving the social package are men.
It should also be noted that according to the Social Services Agency, for example, in 2019, on average, more than 70.000 people receive a monthly state pension supplement due to their permanent residence status in a high-mountainous settlement. There are approxi-mately twice as many women among these persons as men; And in the same mountain village, the number of recipients of additional payments to the social package with permanent residence status exceeds 13 thousand every month, of which about 60% are men and 40% are women (http://ssa.gov. ge/ index.php?lang_id=&sec_id=1444).
According to the Social Services Agency, on average, 56% of the recipients of the planned component of outpatient services are women and 44% are
men. In total, in 2019, 588.551 patients and 685.182 cases of illness were registered as beneficiaries of the universal health program, and the amount of compensation amounted to about 132 million lari. Thus, the cost of one case of treatment will be on average 198 GEL for both sexes, and the cost of one patient will be 224 GEL. Although the number of female and male patients eligible for the program is roughly evenly distributed, during this period, the amount reimbursed per unit in the case of men is approximately 8-9% higher than the amount reimbursed for women in the department (http://ssa.gov.ge/index. php?lang_id=&sec_id=1454).
An analysis of the current health and social situation in Georgia shows that these areas are of gender importance. Therefore, when planning and budgeting government programs, it is necessary to take into account the current situation and current gender needs, as well as analysis of international experience and research for the implementation of effective and adapted policies for relevant population groups (Vanishvili, Katsadze et al. [5]).
Regarding the gender analysis of medical and social programs provided for by the state budget, it should be noted that the priority "Affordable, high-quality healthcare and social security" includes nine budget programs according to the state budgets for 2019 and 2020 and the attached materials. For this priority, due to the magnitude of the priority, we find a very small entry in terms of gender relevance in the priority description part, also only in the 2019 budget and the attached country key data and directions document for 2019-2022 (Vanishvili & Katsadze [8]).
As world experience shows, due to the high gender significance of the healthcare and social protection sphere, the information available on the priority should include a gender vision and make it understandable (Vanishvili & Lemonjava [6]; Vanishvili & Lemonjava [7]).
4. Conclusion
In summary, it can be noted that the healthcare and social services sectors are of great gender importance,
however, the analysis of the submitted budget laws mostly presented in the form of statistics and do not shows that the state budget programs of Georgia do adequately reflect gender needs. The goals, milestones not disclose gender sensitivity. Most programs and and outcomes set in the program need to be more spe-sub-programmes are not gender sensitive, several pro- cific, both in accordance with the principles of the programs differ in their gender relevance, There are also gram budgeting methodology in general, and taking some targets set in terms of gender, however these are into account additional gender aspects.
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