# Public Health Communication Challenges in Eastern Europe and Central Asia: A Scoping Review

## TL;DR

This study reviews public health communication in nine Eastern European and Central Asian countries, finding that outdated systems hinder transparency and worsen health inequalities during crises like the pandemic.

## Contribution

The paper provides a critical analysis of communication failures in post-Soviet healthcare systems and emphasizes the need for transparency and trust-building during health crises.

## Key findings

- Centralized communication systems in the region hinder timely information dissemination and increase health inequalities.
- Misinformation and disinformation often originate from government sources, undermining public trust.
- Effective crisis response requires transparency, evidence-based messaging, and collaboration with medical and civil society actors.

## Abstract

This scoping review examines public health communication across nine Eastern European and Central Asian states—Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, and Uzbekistan—highlighting how these systems have transitioned from Soviet-era legacies to contemporary practices. Eligibility criteria included the English- and Russian-language literature published from 1998 onwards, focusing on nine post-Soviet states. Sources of evidence comprised searches in Google Scholar, ScienceDirect, SSRN, Heliyon, MEDLINE/PubMed, and official government websites. Data were charted by three independent reviewers using a standardized form, with discrepancies resolved by senior reviewers. The review identifies persistent gaps in communication during health crises, with a particular focus on the COVID-19 pandemic, where centralized and hierarchical information flows often undermine transparency and responsiveness, as well as further increased health inequalities between rural and urban health outcomes. Despite ongoing reforms, the communication dimension of healthcare systems remains underdeveloped. Findings reveal that centralized and top-down communication remains a dominant feature across the region, hindering timely dissemination of information and limiting the capacity to counter misinformation, as both misinformation and disinformation sometimes emerge from the government. Ultimately, this review contributes a critical analysis of these systematic communication failures and underscores the need to strengthen public health communication and reduce health inequalities. To do it, governments must prioritize transparency, disclose decision-making processes, and rely on evidence-based messaging to build trust. Effective crisis response requires not only government leadership but also the active engagement of the medical and patient communities, supported by civil society and independent media. This review points out the need for more inclusive, transparent, and trust-oriented communication strategies to enhance public health preparedness and resilience in nine Eastern European and Central Asian contexts.