The disease burden of COVID-19 infection, morbidity, and mortality is unevenly distributed across different population subgroups. A one-size-fits-all approach may not reach all groups. Identifying barriers and drivers that influence people’s behaviour towards COVID-19 public health and social measures (PHSM), such as vaccination, testing, and other protective behaviours, is a crucial step when designing tailored interventions.
The first phase of the study on Underserved Groups consisted of a national situation analysis following the WHO Tailoring Health Programmes (THP) approach. Through a literature scan, expert interviews, and an expert meeting, barriers and drivers towards COVID-19 PHSM were mapped across different population subgroups in the Netherlands. Older migrants emerged as a priority group: they face a disproportionate disease burden, show lower uptake of protective measures, and are confronted with a combination of individual and contextual barriers, including language difficulties, limited health literacy, distance to services, and reduced trust in government and healthcare institutions.
Effective preparedness must be designed around real lives, not abstract populations, in order to inform effective interventions.
Tom Oreel
PDPC, Erasmus University Rotterdam
Postdoctoral Researcher
Building on these findings, the second phase of the study focused specifically on older migrants (60+) of Turkish, Moroccan, and Surinamese origin living in Rotterdam. The aim was to gain in-depth insight into the individual and contextual factors shaping their support for and adherence to public health and social measures during a pandemic, using COVID-19 as a case study.
In close collaboration with the Afrikaanderwijk Coöperatie (a community-based organisation based in Rotterdam-Zuid), key figures from Turkish, Surinamese and Moroccan (Berber and Arabic-speaking) communities were recruited. These key figures recruited participants from their own communities and conducted the research in their own language and with a shared cultural background, ensuring trust and accessibility within the target group. During the summer of 2025, semi-structured interviews were conducted with 36 participants in total: 12 from the Turkish community, 12 from the Surinamese community, and 12 from the Moroccan community (6 Berber and 6 Arabic-speaking). All participants who were interviewed also took part in focus group sessions: one for Turkish participants, two for Surinamese participants, and two for Moroccan participants. Audio recordings were transcribed and translated, after which qualitative analysis followed. The findings will be used to formulate evidence-based policy recommendations for tailored pandemic preparedness interventions.
Read more about the barriers and drivers influencing people’s behaviour towards COVID-19 public health and social measures in the Netherlands in the report ‘One size does not fit all‘:
