Strengthening Immunization Services Where Children Need Them Most

With the support of the Government of the Republic of Korea, UNICEF Georgia is helping municipalities strengthen immunization systems and ensure that every child has access to life-saving vaccines. Through a comprehensive initiative implemented in 2025 in Rustavi, Marneuli and Gori, UNICEF and its implementing partner, Caritas Czech Republic, worked to address both systemic and behavioral barriers to immunization, strengthening local immunization systems, improving health worker capacity, addressing caregiver concerns and laying the groundwork for sustained improvements in vaccine coverage and equity.

Georgia has made important progress in routine immunization at national level, but disparities remain across municipalities. Evidence from the 2023 Root Cause Analysis and Coverage & Equity Assessment showed that the three municipalities had concerning levels of zero-dose children: 19.3 per cent in Rustavi, 12.8 per cent in Marneuli and 5.6 per cent in Gori. The analysis also identified key barriers, including missed opportunities, weak follow-up mechanisms, inconsistent application of contraindication guidance, caregiver hesitancy, misinformation and limited use of reminder systems. 

The programme was designed to respond to these challenges not only by increasing demand for vaccination, but also by improving the systems that help families access services and receive trusted information.

A major focus was strengthening municipal immunization systems. Standard operating procedures were developed and rolled out across 63 primary healthcare facilities, while digital tools were introduced to support monitoring, performance feedback, follow-up and reporting. An electronic reminder system using SMS and email was also established in alignment with national platforms, helping facilities better track children who may have missed or delayed vaccination.

The initiative also invested in health workers, recognizing that trusted, confident and well-informed providers are central to improving immunization uptake. Healthcare providers received training and mentorship on true and false contraindications, adverse events following immunization, catch-up vaccination and interpersonal communication for immunization. Accredited continuing medical education training reached 273 providers, strengthening their ability to communicate clearly with parents and caregivers. 

At the same time, the project addressed caregiver concerns and misinformation through behaviorally informed information, education and communication videos, expert-led parent education sessions with trusted pediatricians, social media monitoring and rapid response to misinformation. Behavioral insights were continuously used to update communication tools, including briefs and FAQ materials, so that messages remained relevant to the real questions parents were asking. 

By the end of the project, all 63 primary healthcare facilities had access to updated digital tools for tracking coverage, follow-up and reporting. Post-training assessments showed near-universal improvement in health workers’ knowledge of contraindications, adverse events following immunization and counselling. Project-supported videos reached hundreds of thousands of caregivers through digital, television and facility-based dissemination, while social listening helped ensure that communication materials responded to changing caregiver concerns.

Although municipal rankings are lagging indicators and cannot usually be shifted within a short project cycle, the initiative established important foundations for continued progress. By the end of 2025, Rustavi and Marneuli had functional reminder systems, trained and supervised providers, active mechanisms to respond to misinformation and clear pathways for scale-up through the National Center for Disease Control and Public Health.

The experience showed that improving immunization performance requires more than short-term awareness raising. System readiness, consistent supervision, provider confidence, caregiver trust and reliable follow-up mechanisms all need to work together. The project also demonstrated the value of trusted messengers and dynamic behavioral insights in addressing misinformation and supporting families to make informed decisions about vaccination.

From strengthening 63 primary healthcare facilities and training hundreds of health professionals to improving access to trusted immunization information for families, the support of the Republic of Korea is helping build stronger, more resilient immunization services in Georgia. This investment is not only protecting children today but also creating sustainable systems that will help ensure every child has the best possible start in life.