WHO Regional Office for Europe - Sabin€¦ · Bulgaria •No interventions yet ” the success of...
Transcript of WHO Regional Office for Europe - Sabin€¦ · Bulgaria •No interventions yet ” the success of...
WHO Regional Office for Europe
Demand and acceptance activities
IAIM Joint Regional Meeting for the Americas & Europe
Madrid, 1-2 February 2017
Presenter: Katrine Bach Habersaat, WHO Regional Office for Europe
Acceptance and demand
Vaccine confidence-building and crisis response
Intersectoral health education
Technical support to Member States
Responding to vaccine deniers
HPV
Introduction Crisis response
Regional advocacy platform to promote vaccination • Web • New online forum • Reports • Social media • Immunization
Highlights • WHO EPI Brief
Annual advocacy event
Acceptance and demand
MR symposium event
Advocacy for sustainable funding
Presenters: Julie Leask and Katrine Bach Habersaat
Evaluation committee members: Victor Balaban, Eve Dubé, Benjamin Hickler,
Everold Hosein, Julie Leask, Brent Wolff
Evaluation of the Tailoring Immunization
Programmes (TIP) methodology and
implementation in Member States
IAIM Joint Regional Meeting for the Americas & Europe
Madrid, 1-2 February 2017
Challenges of reaching the last 5 – 10 – 15 %
%
%
Susceptible groups
Need for tailored strategies to reach susceptible population groups
Tailoring Immunization Programmes (TIP)
A structured process
informed by behavioural
science and theory
undertaken to understand
enablers and barriers
with a view to defining
evidence-informed
interventions to increase
vaccination coverage
A people-centered approach:
Subjective experience is valuable.
Behaviours are complex.
TIP process
Situation analysis
Research
Tailored strategies
Segmentation
Evaluation
Evaluation activities
Detailed review of regional and national TIP
documents
Regional online survey with 46 Member States
Missions to four Member States
Regular telephone meetings and evaluation committee workshop
Evaluation committee
• Victor Balaban, behavioural scientist, US CDC
• Eve Dubé, anthropologist, researcher at the Research Center of the CHU-Québec,
Adjoint Professor, Université Laval
• Benjamin Hickler, medical anthropologist, Communication for Development Specialist
– Health Section, UNICEF Programme Division
• Everold Hosein, Communication Advisor/Consultant, Adjunct Professor, New York
University
• Julie Leask, behavioural scientist, Associate Professor, University of Sydney, School
of Public Health
• Brent Wolff, team lead for Demand, Policy and Communication team, Global
Immunization Division, US CDC
Leading global experts in social science research in immunization and
in vaccine hesitancy, immunization communication and immunization
programme delivery
Evaluation insights
National TIP projects explored
Bulgaria Lithuania Sweden United
Kingdom Low childhood
vaccination
coverage, esp.
among vulnerable
(Roma)
populations
causing large
measles outbreak
in 2009-2011
Very low uptake of
seasonal influenza
vaccination among
pregnant women
Suboptimal
childhood
vaccination
coverage among
three communities:
• anthroposophic
community;
• Somali
migrants;
• undocumented
migrants
Suboptimal
childhood
vaccination
coverage in
ultraorthodox
Charedi Jewish
community in
North London
resulting in
recurrent disease
outbreaks
Interventions
designed; not
implemented
Interventions
implemented,
evaluated,
expanded
Interventions
designed;
implemented for
Somali community
Recommendations
in advocacy report;
now with
implementers
Examples of insights gained
Bulgaria: Doctors perceived
vulnerable groups had low
health culture, leading to
misunderstandings and false
assumptions re. their
information needs.
Sweden: Parents were worried
about high incidence of autism in
their community, however, health
workers felt inadequate to answer
questions and were hesitant to
mention autism in relation to
vaccination.
UK: No resistance to
vaccination, however, also no
community support. This was
key as social norms are
critical for behaviour in the
community.
Lithuania: Flu vaccination for
pregnant women was not
integrated in routine care,
nor recommended or
supported by health workers.
TIP challenges
• Ensuring translation of diagnostics into long-term
change – and increased vaccination uptake
• Reducing resource requirements – human,
financial, time
• Ensuring local ownership and leadership, avoiding
dependence on WHO
• Ensuring clarity and a good understanding of the
method
TIP strengths
• Informative: insights from a structured process for
deep listening
• Inclusive and participatory: listening to, and
understanding, community perspectives
• Interdisciplinary: using the collective knowledge of
many stakeholders – “This is where the magic
happens” (national vaccination program manager)
• Engaging: leading to new relations and partnerships
• Comprehensive: focusing broader than
communications
• Supported: value of WHO engagement and support
Impacts
Lithuania
• Flu vaccination coverage in the district increased to 107 pregnant women in 2015-16 compared to only 6 in the season before
Sweden
• Plan to evaluate impact in 2017
• Plan for ongoing surveys of attitudes and demographics of sub-optimal vaccination
UK
• Monitoring/ evaluation of interventions recommended in advocacy report
Bulgaria
• No interventions yet
” the success of TIP ultimately must be an increase in vaccination uptake (…) the experience from the first round of TIP shows that implementation, i.e. changing immunization systems and service delivery culture is a long and difficult process
”
Recommendations
Recommendations
• Keep the research methodologies and participatory approach
• Local ownership of process
• Accelerate to the change phase
• WHO support, engagement and branding
• New materials
• Promote TIP
Conclusion