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Tailored and context-specific interventions are needed to ensure that people and communities value, actively support, and seek out immunization services. This starts by gathering local data to understand local drivers of vaccine uptake, and then responding with targeted strategies to sustainably increase confidence and demand for vaccination. Strategies should include communications, community engagement, monitoring for misinformation, behaviorally-informed strategies, and enhancements to service quality and support for health workers.
• Numerator: Number of WHO Member States which reported implementing at least one behavioural or social strategies (i.e., community engagement, digital or social listening, behaviourally informed interventions, public communications, service quality intervention, interventions to build capacity among healthcare workers, other strategies) to address under-vaccination.
• Denominator: Total number of WHO Member States.
• Baseline year: 2021
Supplemental analysis:
1) Proportion of countries that conducted any assessment of the demand-related reasons for under-vaccination
• Numerator: Number of WHO Member States which reported conducting an assessment of the demand-related reasons for under-vaccination.
• Denominator: Total number of WHO Member States
2) Proportion of countries that conducted any assessment of the demand-related reasons for under-vaccination and the assessment included a survey of Behavioural and Social Drivers (BeSD) of vaccination using the globally validated tools
• Numerator: Number of WHO Member States which reported conducting an assessment of the demand-related reasons for under-vaccination and included a survey of BeSD of vaccination using the globally validated tools.
• Denominator: Number of WHO Member States which reported conducting an assessment of the demand-related reasons for under-vaccination.
Behavioral and social drivers: Vaccination-specific beliefs and experiences that programmes may be able to modify to boost vaccine uptake.
Community engagement: Processes of working collaboratively with community representatives and other local organizations and leaders to understand their perspectives towards vaccination, and co-design local interventions to address barriers to vaccination uptake.
Digital or social listening: Strategic monitoring or tracking of conversations or content on social media, traditional media, or in the public space about vaccination, primarily to detect and assess rumours and misinformation, as well as public sentiment about vaccines.
Behaviourally informed interventions: Interventions that are designed to directly shape vaccination behaviours, without changing thoughts of feelings about vaccination. Examples of behaviourally informed interventions includes requirements, default appointments, or an SMS that vaccination is due (reminder) or late (recall).
Public Communication: Communications to inform and educate the public, to respond to misinformation based on findings from digital or social listening activities. May include a mix of mass media, social media campaigns and interpersonal communications.
Service quality intervention: Variety of interventions to improve the overall experience of vaccination, i.e., health worker training to convey key information on expected side effects and ability to respond to questions or concerns, changes to the timing and location of services to better meet local community needs and improve access, or other enhancements to service delivery to reduce waiting times and improve the overall experience of vaccination.
Interventions to build capacity among healthcare workers: Activities intended to increase the knowledge and awareness of healthcare workers (including a broad spectrum of physicians, nurses, vaccinators) about vaccines, to increase their own confidence and demand for vaccines, as well as their ability to engage with their local community and convey messages about vaccination to their target population.
Terms associated with supplemental analysis:
Assessment: Includes any surveys, studies, or formative research at a national or sub-national level to generate data (quantitative or qualitative) to explain reasons for under-vaccination (low uptake).
Demand-related: This includes beliefs, social norms/processes, intentions, and practical issues related to vaccination.
Count the number of WHO Member States which reported that they have implemented behavioural or social strategies to address under-vaccination.
• Calculation for 2021: This is calculated as the number of WHO Member States which reported that they implemented a community engagement strategy, public communications strategy, service quality intervention strategy, interventions to build capacity among healthcare workers, or other strategy to address under-vaccination. This equals the number of WHO Member States which responded ‘Yes’ to at least one of the relevant questions in JRF 2021.
• Calculation for 2022 and on: This is calculated as the number of WHO Member States that meet one of the two conditions -
1) Reported that they implemented strategies to address under-vaccination which was informed by results of demand-related assessments.
2) Did not report whether they implemented strategies to address under-vaccination which was informed by results of demand-related assessments, but reported that they implemented a community engagement strategy, digital or social listening strategy, behaviourally informed interventions strategy, public communications strategy, service quality intervention strategy, interventions to build capacity among healthcare workers, or other strategy to address under-vaccination which was informed by results of demand-related assessments.
Step 2: Divide the indicator numerator by the total number of WHO Member States (denominator equals 194 WHO Member States).
JRF Questions for indicator calculation:
• JRF 2021
• In {Year}, did the country implement any strategies to address under-vaccination?
Community engagement (Yes/No/ND/NR)
Digital or social listening (Yes/No/ND/NR)
Behaviourally informed interventions (Yes/No/ND/NR)
Public communications (Yes/No/ND/NR)
Service quality intervention (Yes/No/ND/NR)
Interventions to build capacity among healthcare workers (Yes/No/ND/NR)
Other (Yes/No/ND/NR)
• JRF 2022
• In {Year}, did the country implement any strategies to address under-vaccination which was informed by results of demand-related assessments? (Yes/No/ND/NR)
• If yes, select one or more of the options below:
o Community engagement (Yes/No/ND/NR)
o Digital or social listening (Yes/No/ND/NR)
o Behaviourally informed interventions (Yes/No/ND/NR)
o Public communications (Yes/No/ND/NR)
o Service quality intervention (Yes/No/ND/NR)
o Interventions to build capacity among healthcare workers (Yes/No/ND/NR)
o Other (Yes/No/ND/NR)
JRF Questions for supplemental analysis:
• In {Year}, did the country conduct any assessment of the demand-related reasons for under-vaccination?
• Did the assessment(s) include any survey of Behavioural and Social Drivers (BeSD) of Vaccination using the globally validated tools, including priority indicators?