Project overview
Vaccination uptake in most ethnic, religious and cultural minorities across Europe is substantially lower compared to the general population. We see these gaps in both routine immunization and COVID-19 vaccination. These vaccine inequalities are unacceptable.
Ethnic, religious or cultural minorities across Europe are likely to encounter health system barriers to accessing health care services, which are a major contributor to comparatively low vaccine uptake in these groups.
RIVER-EU (Reducing Inequalities in Vaccine uptake in the European Region – Engaging Underserved communities) will improve access to vaccination services for children and adolescents in selected underserved communities, specifically reducing inequity in measles, mumps, rubella (MMR) and human papillomavirus (HPV) vaccines.
RIVER-EU will work with eight target communities over the course of the 5-year project.
Three communities have been selected as “empowering examples”, due to their uncommonly high vaccination coverage rates against either MMR or HPV. These communities are:
- The Somali Community in Finland
- The Arab Israeli community in Israel
- The Bangladeshi community in the United Kingdom
The target communities where RIVER-EU aims to support increased vaccine uptake include:
- The migrant and refugee community in Greece (with a focus on MMR and HPV vaccines)
- Turkish adolescent females in the Netherlands (focus on HPV)
- Moroccan adolescent females in the Netherlands (focus on HPV)
- The Ukrainian migrant community in Poland (focus on MMR and HPV)
- The marginalized Roma community in Slovakia (focus on HPV)
Enablers to vaccination in the “empowering examples” groups will be identified, analysed, and, where appropriate and feasible, ‘translated’ to support the design and implementation of interventions to enable improved vaccine uptake in the five selected underserved communities.
Work Plan
A. SITUATIONAL ANALYSIS
WHERE WE ARE NOW
B. PLANNING PROCESS
WHERE DO WE WANT TO GO AND HOW WE GET THERE
Collecting evidence regarding underserved communities
- Description of underserved
communities. - Health system barriers and enablers to vaccination.
- Identification and selection of promising interventions.
- Collecting data for
transferability assessment.
B. PLANNING PROCESS
WHERE DO WE WANT TO GO AND HOW WE GET THERE
Transferability check, adjusting
and/or developing interventions
- Assessing transferability of promising interventions.
- Assessing necessary
adaptations for interventions. - Developing new interventions.
Implementing and evaluating interventions
- Agree upon outcomes questions and process and impact indicators.
- Agree upon required changes and adaptations of interventions.
- Evaluate implementation and scaling up.
- Barriers and facilitators for implementation of the
intervention. - Cost-efectiveness evaluation.
C. DISSEMINATION
Creating evidence-based guidelines
- Translating evidence into
guidelines. - Advising on transferability of promising interventions.
- Incorporate action framework to ensure guidelines are implementable
- Ensuring guidelines are
aligned with other existing and planned guidelines.
Integrate lessons
learned into trajectory
to change health
professional behaviour
- Reviewing suitable educational content on cultural sensitivity and health care delivery.
- Integration in Strenghthening Education and Knowledge Immunisation program (SEKI)
- Developing mechanism to make this educational content a requirement for health professionals in Europe.
- Dissemination of educacional content and tools.
Summary
A. SITUATIONAL ANALYSIS
Systematic and realistic review,
qualitative studies in selected
communities (underserved
communities with low uptake
and positive deviants).
B. PLANNING PROCESS
Qualitative studies to collect
in-depth information about
transferability, health system
barriers and enablers, intervention
content, continuous monitoring
and reflection process on the
implementation of interventions,
knowledge co-creation.
C. DISSEMINATION
Using evidence from A and B to
draft guidelines followeb by
iterative process of refinement
using expert panels.
