Implementation of effective, self-sustaining headache services in the Republic of Georgia: Evaluation of their impact on headache-related disability and quality of life of people with headache.

Background Headache disorders are widespread and disabling. They are common in Georgia, especially headache on ≥15 days/month (HA ≥ 15), but there are no headache services. Objective We established headache services meeting local needs, investigating feasibility, consumer uptake and satisfaction, and cost, with an exit strategy bequeathing effective, self-sustaining services that could be rolled out nationwide.

Will (or can) people pay for headache care in a poor country?

We asked whether attempts to introduce headache services in poor countries would be futile on grounds of cost and unsustainability. Using data from a population-based survey in the Republic of Georgia, an exemplary poor country with limited health care, and against the background of headache-attributed burden, we report on willingness to pay (WTP) for effective headache treatment. Consecutive households were visited in areas of Tbilisi (urban) and Kakheti (rural), together representative of Georgian habitation.

Validation of a Georgian language headache questionnaire in a population-based sample.

In a pilot phase of a survey of the prevalence of primary headache disorders in the Republic of Georgia, we validated a Georgian language questionnaire for migraine (MIG), tension-type headache (TTH), MIG+TTH and trigeminal autonomic cephalalgias (TAC). A population-based sample of 186 people with headache completed the questionnaire and were blindly examined by one of two headache experts. The questionnaire diagnoses were: MIG 49, TTH 76, MIG+TTH 45 and TAC 16.

A pilot methodological validation study for a population-based survey of the prevalences of migraine, tension-type headache and chronic daily headache in the country of Georgia.

We report the methodology of an epidemiological survey of the prevalences of migraine, tension-type headache and chronic daily headache in Georgia. Medical residents visited adjacent households in Tbilisi to interview a pre-defined target of 100 biologically unrelated subjects. All respondents reporting headache in the previous year, as well as random 20 non-headache controls, were examined by a neurologist.