Pilot testing of behaviour-based immunization toolkit enters second phase in Bulgaria

WHO/Europe has developed an innovative toolkit that aims to support countries in understanding the environmental (supply-side), supportive and motivational determinants that influence vaccination behaviours of populations at risk of vaccine-preventable diseases. The toolkit is being pilot-tested as part of a new project in Bulgaria, in collaboration with the Ministry of Health, the National Centre for Infectious and Parasitic Diseases (NICPD) and local civil society organizations.

During a first mission to Bulgaria in May, a WHO/Europe team met national counterparts and key stakeholders, and began to identify pockets in marginalized and Roma communities that were at risk of vaccine-preventable diseases.

The second phase of the project took place in Sofia, Bulgaria, on 10–14 September 2012.  This second mission was dedicated to testing the formative phase of the toolkit. The specific objectives of the mission were as follows:

• to confirm the assessment of the immunization situation in Bulgaria;
• to present segmentation data used to identify susceptible populations and their characteristics;
• to understand caregivers’ vaccination behaviours;
• to write a research protocol and develop instruments to carry out primary research with identified target groups; and
• to schedule the remaining activities to be achieved prior to the third mission.

Activities that took place over the course of the mission included:

• a workshop with national and provincial level government and nongovernment organization stakeholders;
• a second one-day workshop with health mediators; 
• clarification of research needs;
• meetings with research agencies to request proposals for conducting research on vaccination-seeking behaviours among vulnerable communities.

The mission ended with a debrief with Ministry of Health representatives.

Further project activities

Next steps include research and the development of a concept note with strategic recommendations on how to increase uptake of infant and child immunization among marginalized, including Roma, communities in Bulgaria. It is expected that this will be shared with the Ministry of Health representatives in December 2012.

Overall, this pilot will result in a toolkit to be made available to all WHO European Region Member States.