Fifteen years of healthcare quality work revealed a pattern impossible to ignore: you cannot build a high-quality health system on a workforce without rights, fair wages, or occupational safety. GILS is the institution that Georgia built to close that gap — independent, evidence-based, and answerable to no one but the data.
The Public Health Institute of Georgia (PHIG) was established in 2011 to improve healthcare quality, patient safety, and accreditation in Georgia. Within the first year of operations, the same structural problem appeared at every hospital site visit, every quality assessment, and every standards consultation: the people delivering healthcare were working in conditions that no quality framework could ignore — low wages, undefined professional classifications, absent occupational safety protocols, and no independent body monitoring any of it.
"Every time we tried to improve healthcare quality, we hit the same wall. You cannot accredit a facility for patient safety when the nurses have no contract protections, the doctors have no professional classification, and the cleaners have no occupational health coverage. Labour is not a side issue in healthcare quality. It is the foundation."
— Prof. Giorgi Pkhakadze, Founder, GILS
Prof. Giorgi Pkhakadze founds PHIG in Tbilisi as an independent, non-commercial institution dedicated to healthcare quality, patient safety, and public health policy. From the outset, the human resources dimension of healthcare is central to PHIG's work: Georgia's nursing workforce is chronically understaffed relative to WHO benchmarks, and the legal classification of medical professions — the boundary between doctors, nurses, and technical support personnel — remains undefined in national law.
Prof. Pkhakadze serves as Deputy CEO of Evex Medical Corporation, Georgia's largest private healthcare provider with approximately 40 facilities nationwide. In this role, he leads the establishment of an in-house training centre and introduces a formal occupational health and safety advisory function — among the first such frameworks in Georgian private healthcare.
The experience is instructive precisely because of its limits. Even inside the country's largest healthcare group, wages are unlinked to skill classification or workload, labour protections are ad hoc rather than systemic, and no external monitoring mechanism exists. The exercise confirms that without independent, national-level data and standards, even well-resourced employers lack the benchmarks necessary to manage their workforces responsibly.
The UN Secretary-General's Independent Accountability Panel publishes its landmark assessment of private sector accountability in global health systems. The report documents — with evidence drawn from multiple countries — how commercialisation of healthcare has systematically eroded labour protections for health workers: suppressed wages, absent collective bargaining, unsafe working conditions, and the displacement of public-sector employment standards by unregulated private contracting.
"Private sector health care providers… frequently fail to meet basic labour standards for their own workforces, creating a fundamental contradiction in which the institutions charged with protecting population health undermine the occupational health of their own staff."Report of the Independent Accountability Panel for Every Woman, Every Child, Every Adolescent — UN Secretary-General, 2018
For PHIG, this report is a turning point. The conditions documented internationally — suppressed wages, undefined professional roles, absent occupational safety frameworks — match precisely what PHIG has observed across Georgian healthcare facilities since 2011. The gap is not a Georgian anomaly. It is a documented global failure with a known evidence base. And Georgia has no institution producing the country-specific data needed to address it.
Prof. Pkhakadze founds Accréditation Sans Frontières (ASF) — an independent international accreditation standards body, legally established in Paris — and PHIG begins working with ASF to bring a rigorous, internationally benchmarked accreditation framework to Georgian healthcare for the first time.
The result is historic: working together, PHIG and ASF engage over 50 Georgian healthcare facilities in a national accreditation programme. Four facilities achieve full accreditation — the first nationally-conducted healthcare facility accreditations in Georgian history. The ASF standards framework explicitly embeds patient safety, inclusive workplace culture, staff wellbeing, and occupational health as core accreditation domains — not optional additions.
The accreditation process surfaces the same structural problem across every participating facility: labour standards — wage levels, professional classification, occupational safety protocols — are the single most consistent area of non-compliance. No external data source exists against which facilities can benchmark themselves. The evidence for a dedicated labour intelligence institute is now overwhelming.
Simultaneously, COVID-19 strikes. Prof. Pkhakadze serves as principal public health adviser to the Prime Minister of Georgia and Cabinet of Ministers throughout the pandemic (2020–2022). The crisis exposes in real time what PHIG has documented for a decade: health workers are overworked, under-protected, uncompensated for occupational infection risk, and without adequate PPE standards. The pandemic makes the healthcare labour crisis impossible to ignore at the highest levels of government.
As ASF accreditation standards are extended across Georgian healthcare facilities, the process repeatedly surfaces the same structural gap: accreditation standards require documented human resource management, staff welfare protocols, and occupational health procedures — but there is no independent Georgian body that monitors whether facilities implement them, no public data on healthcare wages or working conditions, and no research platform producing the evidence base required for reform advocacy.
PHIG consults with international partners — ILO, WHO, academic institutions, labour law specialists, and Georgian civil society. The conclusion is unambiguous: a dedicated, independent labour studies institute is required. It must be grounded in ILO frameworks, operationally independent of all political and commercial interests, and committed to open-access dissemination in both English and Georgian.
In late 2023 and through 2024, PHIG formalises a collaboration with Accreditation Canada — one of the world's leading healthcare accreditation bodies — to bring Canadian international accreditation standards to Georgian healthcare facilities. PHIG serves as the in-country implementation partner, conducting assessments, supporting facility preparation, and guiding organisations through the full accreditation cycle.
The Accreditation Canada framework — unlike softer quality frameworks — embeds labour standards as substantive accreditation criteria. Qmentum International standards include dedicated requirements for:
The 2024 programme delivers a critical evidence contribution: across 23 Georgian healthcare facilities, OHS compliance and professional development documentation are among the most consistently under-developed domains. This is not a finding from a theoretical review — it is observed directly, at facility level, across a nationally representative sample of Georgian healthcare institutions.
The Georgian Medical Journal (GMJ) — of which Prof. Pkhakadze serves as Editor-in-Chief — formally establishes a dedicated occupational health and safety knowledge hub within its editorial structure. GMJ is Georgia's first open-access, internationally indexed medical journal. The OHS hub invites researchers, clinicians, policymakers, and labour specialists to submit peer-reviewed evidence on workforce conditions, occupational hazards, and labour rights in Georgian healthcare and the broader economy.
This is significant: for the first time, Georgia's leading open-access medical journal becomes an active platform for labour research — linking academic evidence production directly to the policy advocacy infrastructure being built through GILS.
GMJ Academy launches as a structured continuing professional development platform, offering certified online courses to Georgian and regional health professionals. A dedicated course on occupational health and safety — drawing on the GMJ knowledge hub evidence base and the policy frameworks developed through PHIG's accreditation work — is in active development.
The Academy completes the institutional architecture: peer-reviewed research (GMJ), professional education (Academy), and policy-grade data intelligence (GILS) now form an integrated platform.
The Georgian Institute of Labour Studies is formally established as an independent research initiative of the Public Health Institute of Georgia. After fifteen years of healthcare reform work, six years of accreditation standard development, and five years of deliberate evidence-base construction, GILS launches with a clear, bounded mandate.
GILS is the policy-intelligence layer of a deliberate, fifteen-year institutional architecture. Research, education, public communication, and data — each delivered through a dedicated platform, all connected.
Open-access, peer-reviewed journal. OHS knowledge hub active. English-language, internationally indexed.
gmj.ge →English-language news and analysis on Georgian labour, health workforce, and occupational safety policy.
news.gmj.ge →Georgian-language labour and health workforce news — reaching domestic audiences directly in their language.
sheniekimi.ge/ambebi →Certified continuing professional development. OHS course in development. Open to Georgian and regional professionals.
academy.gmj.ge →International accreditation standards body, legally established in Paris. Delivered Georgia's first national healthcare accreditation.
france-asf.fr →PHIG — founded 2011. The institutional home of GILS and the accreditation, research, and education ecosystem.
publichealth.ge →GILS has no government contracts, no employer affiliations, no trade union membership, and no political party relationships. Our analysis is funded through institutional sources and open grants. We follow the evidence wherever it leads — including when it is inconvenient for powerful actors.
Every figure we publish is sourced to Geostat, ILOSTAT, ILO databases, or peer-reviewed research. We document our methodology, we flag data gaps, and we do not inflate claims. If we are wrong, we correct publicly. Our credibility is our only asset — we protect it accordingly.
All GILS data tools, indices, law analyses, and research are freely available to anyone — in English and Georgian. Labour market intelligence should not be the private property of governments or well-funded organisations. It belongs in the public domain.
Fourteen interactive data tools. Twelve law analyses. Three independent indices. One mission: rigorous, independent, open-access labour intelligence.