Dissertation Title: National Public Health Institutes and Health Communications: A Rapid Assessment of the Health Communication System at the National Center for Disease Control and Public Health in the Country of Georgia

Dissertation Chair: Dr. Harry Heiman

Dissertation Abstract:

Background: Effective health communication is a core public health capacity, yet existing assessment frameworks often emphasize emergency messaging outputs rather than the organizational structures required to sustain high-quality communication during both routine and crisis conditions. This dissertation examines how national public health agencies can assess and strengthen organizational capacity for health communication, using the National Center for Disease Control and Public Health of Georgia as a case study. The study responds to gaps identified in global standards and tools, including the Joint External Evaluation, States Parties Self-Assessment Annual Reporting tool, International Health Regulations benchmarks, Public Health Accreditation Board standards, SBCC Capacity Assessment Tool, and the Crisis and Emergency Risk Communication framework. Together, these frameworks provide strong guidance on risk communication, community engagement, and emergency messaging, but give less explicit attention to internal governance, staffing, budgets, workflows, infodemic management infrastructure, and cross-unit coordination.

Methods: The study used a rapid mixed-method organizational assessment design. An a-priori codebook was developed from five health communication domains: health communication program; guidelines and standard operating procedures; infrastructure, materials, and supplies; health communication practices; and health communication coordination. Data were collected through key informant interviews and document review at Georgia’s NCDC and coded using a 0–3 maturity ladder, where 0 indicated no evidence or absent capacity, 1 indicated emerging or ad hoc capacity, 2 indicated documented and operational capacity, and 3 indicated institutionalized and routinely reviewed capacity.

Results: Findings indicate that Georgia has important health communication assets, including experienced spokespersons, emergency communication structures linked to incident management, partner relationships, program-level communication activities, and evidence of multichannel dissemination during major responses. However, the assessment also identified persistent structural gaps. Overall maturity was low, with most coded items scoring at level 0 or 1. The strongest areas were partner and NGO liaison, spokesperson capacity, and some emergency communication procedures. The weakest areas were dedicated strategy and budget, social listening and infodemic management tools, systematic message-development procedures, communication evaluation, and internal coordination across NCDC units.

Conclusion: The dissertation concludes that sustainable health communication capacity depends on institutionalized structures, not only skilled individuals or crisis-specific practices. A structure-focused assessment module can complement existing global tools by identifying actionable organizational gaps and supporting investment in governance, workforce, coordination, and infodemic management systems.