- Aha! Moment
What behavioural changes could restore immunization uptake in Suriname?
Emiliano Díaz, Luciano Doest
- September 14, 2026
- 3:18 pm
SECTOR
PROJECT TYPE
Location
BEHAVIORAL THEME
OVERVIEW
This Aha! Moment examines how behavioral and systems-level barriers contribute to declining routine immunization uptake in Suriname. Conducted by Busara in partnership with the Inter-American Development Bank (IDB), the study finds that misinformation, caregiver uncertainty, weak follow-up systems, and service friction interact with operational constraints to create missed opportunities for vaccination, particularly for HPV and multi-dose schedules. The research identifies practical, behaviorally informed strategies that can strengthen both vaccine confidence and the efficiency of immunization services nationwide.
Research Questions
- What behavioral and systems-level barriers are contributing to declining routine immunization uptake in Suriname?
- How do caregiver uncertainty, misinformation, service friction, and operational constraints interact across the vaccination journey?
- What practical behavioral changes could strengthen immunization delivery and improve vaccine uptake?
- Which interventions could improve vaccine completion while reducing caregiver burden and pressure on frontline health workers?
Methods
The study used a behavioral systems diagnostic combining a review of national reports and survey data with stakeholder interviews and contextual observations. Researchers interviewed Ministry of Health officials, national immunization program staff, regional health services, and Medical Mission representatives, and observed school-based and clinic-based vaccination sessions to document caregiver journeys, service delivery processes, operational bottlenecks, and behavioral dynamics shaping vaccine uptake. Findings were synthesized into a prioritized implementation roadmap for future interventions.
THEMATIC AREAS
Key Findings
- Missed vaccinations are increasingly explained by misinformation, uncertainty, weak follow-up systems, and service friction that accumulate across the caregiver journey.
- Field observations showed that clear communication, pre-booked appointments, reminders, privacy during school vaccination sessions, and simple anxiety-reduction techniques can improve the vaccination experience while reducing caregiver burden and staff workload.
- Healthcare workers remain the most trusted source of vaccine information, making them important actors for strengthening vaccine confidence.
- The highest-priority recommendations combine trusted local messengers, transparent vaccine communication, reminder systems, lightweight data tools (DHIS2-light), and standardized behavioral practices that can work within existing service delivery systems.
- Small behavioral improvements, when combined with operational improvements, can strengthen immunization systems and reduce missed opportunities for vaccination.
Implications for Policy or Development
- For policymakers: Strengthening immunization requires investment not only in vaccine supply and infrastructure, but also in communication systems, trusted messengers, reminder systems, and practical behavioral improvements throughout the vaccination journey.
- For immunization program managers: Behaviorally informed service redesign, including appointment reminders, standardized communication materials, privacy improvements, and rapid misinformation response protocols, can improve vaccine completion while reducing pressure on frontline health workers.
- For healthcare workers: Providing standardized communication tools, simple behavioral scripts, and practical service improvements can strengthen caregiver trust and improve vaccination experiences.
- Future work should pilot and rigorously evaluate these interventions under real implementation conditions, including reminder systems, misinformation response mechanisms, trusted messenger strategies, and behavioral service redesign across urban and remote settings.
How to cite: Busara. 2026. What behavioural changes could restore immunization uptake in Suriname? (The aha! moment No. 34). Nairobi: Busara. DOI: doi.org/10.62372/KGKN8598.