New curriculum key to strengthening immunization services in Azerbaijan

A new immunization curriculum, developed with guidance from WHO, has been adopted by medical and nursing education institutions in Azerbaijan. This is part of a comprehensive collaboration between WHO and the Ministry of Health, with financial support from the European Union (EU), which has led to sustainable improvements in the quality of immunization services in Azerbaijan.

The new curriculum follows a revision of the existing curriculum and is based on identified competencies needed to provide quality immunization services. It Incorporates the latest innovations and best practices in the immunization field and stands out as a fundamental investment in health-care providers and, by implication, the quality of immunization services they can provide.

Ensuring high and equitable vaccination coverage to protect entire communities from vaccine-preventable diseases requires detailed planning, safe vaccine handling and storage, high-quality immunization services and a well-informed public. In Azerbaijan, as part of a 3-year EU-WHO/Europe joint project on immunization, all pieces of this complex puzzle have been addressed and strengthened to create lasting improvements and impact on public health.

Improving education

Four-day training-of-trainers sessions were conducted in both in-service and pre-service institutions, namely the Azerbaijan Medical University, Baku Nursing College No 2 and the State Advanced Training Institute for Doctors. The Department of Medical and Science Education at the Medical University also established a vaccination simulation room, which it has incorporated into the education programme. Here students are trained in safe vaccination techniques, including vaccine administration, vaccine cold-chain management and communicating about vaccination, based on a new training module developed by WHO.

As well as filling identified gaps in educational programmes and updating information provided, the new immunization curriculum also addresses local challenges, such as missed opportunities to vaccinate caused by gaps in health-care providers' knowledge of actual contraindications.

Dr Alakbarova Mehriban, a paediatrician who attended an in-service course, noted, "The new course provided valuable updates on vaccines, including innovative changes in vaccination planning. A key takeaway was the guidance on vaccinating premature infants. While this was previously avoided, we now understand that babies born as early as 32 weeks can safely receive vaccines".

Enhancing communication skills

By improving their communication skills, the new immunization curriculum empowers health-care providers to dispel myths and misconceptions that can potentially reduce demand for vaccinations. "The communication module will help us build trust by teaching health workers to understand parents' perspectives," noted in-service course facilitator, Matanat Garakhanova.

Course participant, Rustambeyli Ilhama, added: "This knowledge enables us to address parents' concerns about vaccinations with accurate and reliable information. For instance, using what I learned, I was able to reassure several parents that vaccine ingredients pose no harm to their babies".

To evaluate the impact of the new curriculum in medical and nursing schools, a survey was conducted among students who completed the course in the previous academic year. The same survey will be conducted at the end of the 2025 academic year to allow for a comparison of course outcomes before and after the curriculum change. This assessment is crucial for understanding the curriculum's effectiveness and identifying areas for further improvement.

Updated guidance

The Ministry of Health, with technical assistance from WHO and in partnership with the United Nations Children's Fund (UNICEF), has approved a newly developed national immunization guideline that gives primary health care providers the most up-to-date, evidence-based information about immunization. The content addresses gaps in knowledge and barriers to vaccination identified through research on routine immunization among health-care providers and caregivers, implemented with WHO support.

"The immunization guideline has become our go-to reference. It helps us address both our own uncertainties and those of parents. I consider this an important step forward," noted immunologist, Dr Gunay Ibrahimova.

Key improvements to the guideline include a revised table on actual contraindications to vaccination, a schedule for delayed vaccinations, updated information on management of the cold chain and vaccine administration in exceptional cases, such as for babies with low birth weight or children with unknown vaccination status. The new guideline is used as reference material by both in-service and pre-service educational institutions.

The holistic approach of Azerbaijan health authorities, in collaboration with WHO, to strengthen immunization services and improve equity will lead to sustainable changes in the attitudes and knowledge of immunization service providers and the broader medical community. This partnership is expected to have a significant impact on achieving the goals and targets of the European Immunization Agenda 2030 in Azerbaijan.