Optimizing Georgia’s Public Health Workforce: A Study on Demographics, Engagement, and Capacity Building

Abstract Background: A well-functioning public health system relies on a robust public health workforce. Comprehensive data on the workforce, such as number, distribution, and key characteristics, is crucial for evidence-based workforce planning and development. However, very few comprehensive public health workforce assessments exist, especially in low- and middle-income countries. Public health reforms over the years and needs identified during the COVID-19 pandemic prompted this assessment in Georgia. Methods: A survey of the core public health workforce, including employees at central and regional units of the National Center for Disease Control and municipal public health centers, was conducted online between June and September 2023. The survey collected data on workforce demographics, education, on-the-job training, and time spent across different program areas and job functions. The survey also included questions on career progression within the organization, job satisfaction, and motivation. Results: The response rate to the survey was 81.3%. Findings showed that the median age is 48 for the NCDC workforce and 56 for the MPHCs. Over 80% of NCDC and 90% of MPHC employees are women. Employees have robust pre-service education, with more than half specializing in the public health domain. The mean years of service are 14.9 for NCDC employees and 18.0 for MPHC employees, but career mobility is limited, and salary structures vary by region. Despite long tenures, only 33.3% of NCDC and 10.5% of MPHC staff have ever been promoted. At NCDC, the largest share of employee time is spent on administrative program areas, and surveillance and response, while MPHC employees primarily focus on communicable disease management, administration, and immunization. Participation in training is limited, with employees in key positions having better access to training. The workforce reports reasonable satisfaction and finds substantial intrinsic motivation in their work. Conclusions: The insights gained from this study are pivotal in identifying workforce planning and development bottlenecks in Georgia and developing targeted strategies. Key areas for intervention include recruiting workers to meet emerging public health needs, providing competitive salaries to attract a younger workforce, and strengthening training offerings. This effort to profile the public health workforce could guide similar assessments in the future and in other countries to prevent, detect, and respond to public health threats.