Stakeholder engagement to assess the transferability of vaccination interventions in Greece

BACKGROUND: Due to political instability, poverty and war Greece has been witness, over the last decade, to continuous migrant and refugee flows which enter the country mainly on their way to Northern Europe. Through the RIVER-EU project in Greece we aim to identify and tailor successful interventions that can address health system barriers to MMR/HPV vaccination for this group. METHODS: RIVER-EU adopts participatory action research (PAR) in order to give voice to all involved groups. The main aim of the focus groups (FGs) and the interviews was to explore transferability. We aimed to discuss how promising interventions could be transferred to the Greek reality and discussed barriers and facilitators. RESULTS: FGs were conducted with migrant/refugee parents (mainly mothers), adolescents (boys and girls) and other stakeholders such as health professionals and policy makers. The main challenge in Greece is the diversity of the target group (migrants/refugees), as people who arrive to Greece come from different countries have different cultural and religious backgrounds and have fled their countries for different reasons (war, poverty, financial problems). Possible solutions were discussed such as schools as an intervention site. An additional problem identified was access to vaccination services (for HPV/MMR) and the need to create synergies with local health organizations. Finally, it was evident that adolescents as a group, although from different cultural backgrounds, share common values and norms. CONCLUSIONS: The RIVER-EU project has implemented an innovative approach to explore barriers and facilitators of transferability and tailor the intervention to the specific circumstances of the situation in Greece. Through the PAR the target groups were able to voice their beliefs about what should be implemented in which way and able to discuss possible solutions. Agreement about the importance of HPV/MMR vaccination for migrants/refugees in Greece was established.