Improving vaccination uptake through healthcare worker communication training

Background and aims

Healthcare workers (HCW) are the most influential actor in caregivers’ vaccination decisions, yet many lack structured training in effective communication. A WHO Europe training module introducing communication strategies, including motivational interviewing (MI), was implemented in Azerbaijan to strengthen HCW ability to engage hesitant caregivers. This evaluation aimed to assess the training’s acceptability, its impact on HCW confidence and communication practices, and its effect on vaccination uptake.

Methods

A mixed‑methods design compared HCW who received a one‑day, in‑person communication training with an untrained control group. Data included baseline, post‑training and three‑month follow‑up surveys; 56 observed consultations; interviews with 23 HCW and 22 caregivers; and clinic vaccination data from three months before and after training.

Results

The training was highly acceptable, with nearly all participants reporting its relevance and usefulness. Observations showed intervention group HCW were significantly more likely to employ key MI-consistent behaviours - including open‑ended questions, reflective listening, summarizing, and supporting caregivers to decide - across 7 of 13 assessed skills. Caregivers reported feeling more reassured, better informed and more trusting in trained pediatricians. HCW themselves described greater confidence, reduced conversational stress and improved ability to address misinformation. Importantly, vaccination rates increased significantly in the intervention group (from 67.0% to 87.5%, p = 0.03), while no significant change occurred in the control group.

Conclusions

A single day of structured communication training notably improved HCW communication practices and vaccination outcomes. These findings support the feasibility and value of scaling MI‑based communication training to improve the positive influence of HCW on caregivers’ vaccination decisions and strengthen immunization delivery.

Key messages

• WHO Europe communication training for pediatricians in Azerbaijan boosted vaccination rates from 67% to 87.5%. Motivational interviewing helped to effectively build trust with hesitant caregivers.

• A one-day training notably improved HCW communication skills and reduced stress. By using structured techniques, providers increased vaccine uptake and strengthened caregiver-doctor trust.