Barriers to and drivers of vaccination – insight and recommended actions: targeting vaccination inequities in Azerbaijan

Overview

Despite overall high national coverage for measles-mumps-rubella and diphtheria-tetanus-pertussis vaccinations in Azerbaijan, suboptimal coverage is found at the subnational level. A qualitative study gathering behavioural insights was conducted in low-coverage districts of Azerbaijan between January and March 2023, aiming to identify barriers to and drivers of childhood vaccination uptake. Findings revealed knowledge gaps and concerns among both health workers and caregivers. Rural areas in these districts also face significant barriers, including a lack of health-care workers and limited outreach. Caregivers demonstrate knowledge of vaccination but have mixed views on safety and effectiveness, and are often influenced by the negative opinions of family and friends. The results of this study were used to inform an action plan with activities tailored to the barriers identified in these districts. It included a focus on health worker capacity-building, community engagement and communication strategies to improve vaccination coverage. The overall aim is to achieve over 95% immunization coverage and reduce refusals by 50%. Key messages emphasize the safety and importance of vaccines, timely vaccination and evidence-based decision-making for caregivers.