Abstract

Abstract Resilient and equitable health systems should respond to the needs of their populations and remove barriers specific to cultural, religious, or ethnic minorities. Vaccination should be accessible to all in order to prevent infectious diseases. The EU funded project ‘Reducing Inequalities in Vaccine uptake in the European region - Engaging Underserved communities’ (RIVER-EU) aims to improve access to childhood vaccination in the migrant community in Greece (focus on MMR and HPV), the Turkish females and Moroccan females in the Netherlands (focus on HPV), the Ukrainian minority in Poland (focus on MMR and HPV), and marginalized Roma communities in Slovakia (focus on HPV). Considerable health system barriers to vaccination were identified in all underserved communities, such as a lack of culturally and linguistically appropriate information, insufficient capacities, coordination and delivery of health care, and financial costs. Based on a realist review, 36 publications on evidence-based interventions that aim at increasing vaccination coverage of MMR and HPV in underserved communities were considered in RIVER-EU. In order to identify useful and transferable interventions that tackle the health system barriers perceived by underserved communities, an in-depth understanding of context is needed. Moreover, it is of essential importance to involve various stakeholders of the underserved communities to investigate which interventions have the potential for sustainable improvement of access to vaccination. RIVER-EU relies on the Participatory Action Research (PAR) approach to identify and develop interventions in partnership with underserved communities. The building of trustful collaboration with stakeholders for intervention identification and decision-making often remains a black box in the literature. This is, however, a prerequisite for overcoming health system barriers to vaccination. For participatory transferability analysis, we conducted an assessment of evidence-based interventions, interviews and focus groups with various stakeholders. The aim of this workshop is to open the black box on developing trustful relationships with stakeholders from underserved migrant communities and ethnic minorities to identify potentially transferable interventions. We aim to discuss strategies on how to involve underserved communities, barriers and enablers to the involvement of the different stakeholders and lessons learned. The workshop will be structured into 5 presentations of 10 minutes, including moderated questions and answers sessions involving the audience to share their experiences. After all presentations, there will be a moderated concluding discussion on common elements of relationship building in the different contexts, and on contextual particularities when co-creating knowledge with the underserved communities. Key messages • Trustful knowledge co-creation with underserved communities for identification, selection and adaptation of interventions is crucial to tackle health system barriers to vaccination. • Participatory transferability analysis is a structured approach to face complexity of context and guide a decision-making process on interventions. It builds a basis for successful implementation.

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