Georgia experienced a significant rise in Sex Ratio at Birth (SRB1) after its independence from the Soviet Union. Currently, it is among twelve countries worldwide where sex imbalances at birth have been observed. The other countries are Albania, Armenia, Azerbaijan, China, Hong Kong (SAR of China), India, the Republic of Korea, Montenegro, Taiwan (Province of China), Tunisia, and Vietnam.

Several studies (UNFPA 2015, 2017; Duthé at al. 2012) have provided a detailed analysis of reproductive behavior and birth masculinity in Georgia. These studies reveal that since 1992, deteriorating economic conditions coupled with strong son preference, low fertility rates, and access to affordable reproductive technologies have contributed to the increasing trend, one that lasted for almost 15 years, of an SRB imbalance in Georgia (via sex-selective abortions). SRB fluctuated around 114 from 1999-20042. Since 2004, SRB has been experiencing a reverse trend, reaching a normal level in 2016.

The study aims to investigate the various factors behind the changes in SRB and further explore to what extent social and economic policies and interventions have had an impact on decreasing GBSS through influencing family decisions regarding son preference and softening pressure on fertility choices. This study utilizes quantitative and qualitative analyses to explore the linkages between macroeconomic conditions and social protection schemes and variations in SRB:

• The qualitative analysis is based on focus group discussions (FGDs) with parents of school/preschool children and in-depth interviews (IDIs) with medical personnel and NGO representatives, conducted in four regions: Kakheti, Kvemo Kartli, Samtskhe-Javakheti, and Samegrelo-Zemo Svaneti. The first three were chosen because they have the highest SRB levels, while Samegrelo-Zemo Svaneti has shown the greatest improvement across Georgia since 2005.

• The quantitative analysis is based on quarterly panel data covering the period of 2005-2018 across nine Georgian regions.3 In the 1st stage, fixed and random-effect models were employed, using different specifications and combinations of explanatory variables, while the 2nd stage of the empirical analysis, included a spatial autoregressive model (SAR) and a spatial Durbin model (SDM) with a random effect and a clustered sandwich estimator (with the region used as a clustered variable).

Qualitative analysis reveals that, regardless of the downward trend in SRB, son preference is still prevalent in Georgian society. Awareness on GBSS in all surveyed regions is high. All participants acknowledge that while selective abortions were common in the past, they have since declined. Perceptions to recognize the phenomenon as a problem differ among the regions. While in Kvemo Kartli and Samtskhe-Javakheti, respondents did not problematize GBSS, in Kakheti and Samegrelo-Zemo Svaneti, the prevailing attitudes towards GBSS were quite negative.