Periodic Reporting for period 3 - RIVER-EU (Reducing Inequalities in Vaccine uptake in the European Region - Engaging Underserved communities)
Reporting period: 2024-06-01 to 2025-11-30
What is the problem/issue being addressed?
Vaccine uptake in most minority or ethnic communities in Europe is substantially and unacceptably lower compared to the general population. Members from these communities - in RIVER-EU: (1) the migrant community in Greece, (2) the Turkish females and (3) Moroccan females in the Netherlands, (4) the Ukrainian minority in Poland and (5) the Roma community in Slovakia - are likely to encounter health system barriers to accessing health care services. As a result, the vaccine uptake in these communities is low. To increase vaccine uptake and coverage in underserved communities, health system barriers must be removed.
Why is it important for society?
Removing health system barriers will on the one hand lead to a higher vaccine uptake in the underserved communities and will thereby improve protection against vaccine-preventable diseases at the national and European levels. On the other hand, barriers in vaccination services often indicate barriers in general health system functioning. So, with removing health system barriers in accessing vaccination services, RIVER-EU improves access to health services in general for all communities. A high vaccine uptake will decrease the burden of disease and therefore improve health and well-being for all children and adolescents in Europe. Equitable access to and use of vaccines will prevent infectious diseases in children and adolescents, thus allowing them to continue their development towards a healthy adulthood and preventing infection related cancers in later life.
What are the overall objectives?
The overall aim of the RIVER-EU project is to make access to MMR (Measles-Mumps-Rubella) and HPV (Human Papillomavirus) vaccination equitable, improving access to these vaccines among underserved communities in Greece, the Netherlands, Poland and Slovakia by identifying and removing health system barriers. We will do that by adjusting existing and/or developing new interventions tailored to underserved communities. To that purpose the project takes a co-creative and collaborative approach, where the underserved communities as well as the health care workers providing the health services are given a voice in all phases of the project. By doing so, we ensure that the perspectives and experiences of the communities and the vaccination services are acknowledged and that the current mismatch between health services and communities is repaired.
Vaccine uptake in most minority or ethnic communities in Europe is substantially and unacceptably lower compared to the general population. Members from these communities - in RIVER-EU: (1) the migrant community in Greece, (2) the Turkish females and (3) Moroccan females in the Netherlands, (4) the Ukrainian minority in Poland and (5) the Roma community in Slovakia - are likely to encounter health system barriers to accessing health care services. As a result, the vaccine uptake in these communities is low. To increase vaccine uptake and coverage in underserved communities, health system barriers must be removed.
Why is it important for society?
Removing health system barriers will on the one hand lead to a higher vaccine uptake in the underserved communities and will thereby improve protection against vaccine-preventable diseases at the national and European levels. On the other hand, barriers in vaccination services often indicate barriers in general health system functioning. So, with removing health system barriers in accessing vaccination services, RIVER-EU improves access to health services in general for all communities. A high vaccine uptake will decrease the burden of disease and therefore improve health and well-being for all children and adolescents in Europe. Equitable access to and use of vaccines will prevent infectious diseases in children and adolescents, thus allowing them to continue their development towards a healthy adulthood and preventing infection related cancers in later life.
What are the overall objectives?
The overall aim of the RIVER-EU project is to make access to MMR (Measles-Mumps-Rubella) and HPV (Human Papillomavirus) vaccination equitable, improving access to these vaccines among underserved communities in Greece, the Netherlands, Poland and Slovakia by identifying and removing health system barriers. We will do that by adjusting existing and/or developing new interventions tailored to underserved communities. To that purpose the project takes a co-creative and collaborative approach, where the underserved communities as well as the health care workers providing the health services are given a voice in all phases of the project. By doing so, we ensure that the perspectives and experiences of the communities and the vaccination services are acknowledged and that the current mismatch between health services and communities is repaired.
Over the past 36 months, we have focused on the implementation of the culturally tailored interventions which were implemented in communities with lower vaccination coverage, which are migrant populations in Greece, Turkish and Moroccan communities in The Netherlands, the Ukranian population in Poland, and the Roma population in Slovakia.
The culturally tailored interventions included health promoters led educational activities on MMR and HPV vaccinations to community members. As part of the intervention health promotors were identified and trained to deliver the trainings. In addition various stakeholders, including the health promotors were collaborating in the development of the educational materials to ensure cultural and linguistic appropriateness. The evaluation timeline encompasses three distinct phases: initial workshops with key stakeholders to collect baseline demographics and contextual information, ongoing monitoring meetings to document and discuss implementation progress and challenges, and a follow-up period for data collection including cost-effectiveness analysis.
Additionally, based on the lessons learned from the beginning of the project, a start has been made with the development of the guidelines. The guidelines provide principles, recommendations, and case study examples to guide the transfer of effective interventions for improving childhood immunisation in underserved communities across Europe. It outlines a practical, community-participatory approach to health system change that supports progress toward immunisation equity at local, regional, and national levels. The guidelines are aimed at a wide range of health and public health professionals.
The culturally tailored interventions included health promoters led educational activities on MMR and HPV vaccinations to community members. As part of the intervention health promotors were identified and trained to deliver the trainings. In addition various stakeholders, including the health promotors were collaborating in the development of the educational materials to ensure cultural and linguistic appropriateness. The evaluation timeline encompasses three distinct phases: initial workshops with key stakeholders to collect baseline demographics and contextual information, ongoing monitoring meetings to document and discuss implementation progress and challenges, and a follow-up period for data collection including cost-effectiveness analysis.
Additionally, based on the lessons learned from the beginning of the project, a start has been made with the development of the guidelines. The guidelines provide principles, recommendations, and case study examples to guide the transfer of effective interventions for improving childhood immunisation in underserved communities across Europe. It outlines a practical, community-participatory approach to health system change that supports progress toward immunisation equity at local, regional, and national levels. The guidelines are aimed at a wide range of health and public health professionals.
The project yielded already very rich outcomes. We have the results and materials of the implemented interventions that have been designed in collaboration with key stakeholders including policy makers, health professionals and community members. The interventions that have been implemented are culturally tailored educational sessions to the underserved communities and as such we contribute to make the vaccination programme more equitable.