Impediments to Effective Decentralization in Azerbaijan: The Problem of Competencies and Resources in Local Self-Government

This study explores the role of two institutional impediments, namely a lack of power and resources, which slow the development of Azerbaijan\u27s local self-government. In spite of the fact that the last two Azerbaijani governments have accepted the rationale for and have taken steps towards democratic decentralization, local self-government has remained a weak component of the country\u27s political and administrative system. The study argues that limited municipal powers, combined with a scant and unsustainable revenue stream, are one of, if not the most important, barrier to the institutionalization of Azerbaijan\u27s local self-government. The study employs a descriptive mixed methods case research method to analyze the current state of municipal powers and finances. The end of the paper briefly discusses the changing structure of incentives, which may compel the government to reexamine its previously passive approach towards the problems and suggests a number of areas from which improvements should begin

Barriers and drivers of positive COVID-19 vaccination behaviours among healthcare workers in Europe and Central Asia: a qualitative cross-country synthesis

Abstract Vaccination uptake is essential to controlling the ongoing COVID-19 pandemic. Healthcare workers (HCWs) play a critical role in receiving, recommending and delivering COVID-19 vaccination. Understanding the specific influences on each behaviour enables the development of targeted and tailored interventions to improve vaccination uptake. This paper presents a qualitative synthesis of HCWs’ individual and context barriers and drivers to these three vaccination behaviours across 10 countries in Europe and Central Asia. Qualitative data from interviews and focus group discussions with 378 HCWs between December 2020 and March 2022 were synthesised and organised by four COM (capability, physical and social opportunity, motivation) factors. Differences by stage of COVID-19 vaccine roll-out (in preparation, early and late delivery) were explored. Receiving vaccination related to all four factors. Recommending vaccination mostly related to capability and motivation. HCWs were generally well-informed by official sources and viewed vaccination as the way to end the pandemic, acknowledging their important role in this. Colleagues, family and friends were positive influences on personal vaccination decisions. However, knowledge gaps were evident, particularly amongst nurses who relied on (social) media. Concerns about safety and effectiveness, often connected to knowledge gaps, were heightened by the accelerated timeline for COVID-19 vaccine development and approval. This impeded some HCWs’ motivation to receive and recommend vaccination even in the later roll-out countries. Delivering vaccination was facilitated by support from public health organisations, teamwork and service re-organisation, more evident amongst later roll-out countries. Ongoing high workloads, stress and burnout hindered delivery. Complex and inter-related factors affecting HCWs’ vaccination behaviours were identified. These insights should inform the design of multifaceted interventions (e.g., communication skills training, management support for HCWs’ mental health, and engaging them in decision-making for service redesign); not only for COVID-19 vaccination as it is integrated into routine services but for routine immunization as a whole