Optimizing Georgia's public health workforce: a study on demographics, engagement, and capacity building

A well-functioning public health system relies on a robust workforce. Comprehensive data on the workforce, such as number, distribution, and key characteristics, are crucial for evidence-based workforce planning and development. However, 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.

A survey of the core public health workforce, including employees at central and regional units of the National Center for Disease Control and Public Health (NCDC) and Municipal Public Health Centers (MPHC), 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, along with questions on career progression, job satisfaction, and motivation.

The response rate was 81.3%. Findings showed that the median age was 48 for NCDC and 56 for MPHC employees. Over 80% of NCDC and 90% of MPHC employees are women. More than 50% of the workforce hold a master's degrees or higher, and over half of degree-holders specialized in public health or medicine. Mean years of service are 14.9 (NCDC) and 18.0 (MPHC), but career mobility is limited, only 33.3% of NCDC and 10.5% of MPHC staff have ever been promoted. NCDC employees spend most time on administration and surveillance/response, while MPHC staff focus on communicable disease management, administration, and immunization. Training participation is limited, with employees in key positions having better access. Despite limited advancement and relatively low pay, the workforce reported high job satisfaction and strong intrinsic motivation.

These findings are pivotal in identifying workforce planning and development bottlenecks and developing targeted strategies. Key interventions include addressing an aging workforce through targeted recruitment and succession planning, 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.