A story of our involvement in Romania

The measles outbreak in Romania that started in 2016 and resulted in dozens of victims has accelerated not only the need for administrative and legislative measures on vaccination, but has also raised the question: why 10 years ago we had good vaccination coverage at national level, around 95% (the level recommended by the World Health Organization to ensure good individual and collective protection) and, over time, things have deteriorated? One of the potential answers is increasing hesitancy towards vaccination over time as an effect of anti-vaccination movements, the effects of which have not been effectively addressed, including through improved counselling by vaccination health professionals.

Based on the assumption of the Centers for Disease Control in Atlanta (USA) and UNICEF according to which improving interpersonal communication between health care providers and the population can lead to increased vaccination coverage, CHPS, with the support of the two organizations, conducted training sessions between 2019 and 2022 from the perspective and practices of motivational interviewing used in routine vaccination.

These were followed by a mentoring programme for training graduates who wanted support in implementing the new practices. The intervention was carried out for health professionals involved in vaccination in 4 counties: Brasov, Mures, Neamt and Vrancea.


The results and the interest in the new approach led us, with the support of UNICEF Romania, to carry out an extensive nationwide programme in partnership with the National Society of Family Medicine Association (SNMF). Professionals involved in vaccination received updated knowledge, skills and guided practice on interpersonal communication and motivational interviewing approach. The intervention supports open counselling given to each individual on the topic of vaccination (both routine immunisation and COVID-19 vaccines), tailored to each individual's level of hesitancy, which may prove beneficial, both to the health professionals concerned, to their colleagues who may then benefit from cascade trainings, and to the patients they serve, as it decreases resistance, improves relationships and confidence levels, and may ultimately support an increase in vaccination coverage.

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