Liberia’s expanded programme on immunisation: A critical and interpretative review of immunisation social behavioural change communication challenges and opportunities

This desk review presents a critical, interpretative assessment of Liberia’s Expanded Programme on Immunisation (EPI), focusing on identifying behavioural, systemic, and governance determinants that shape vaccine uptake and delivery. The analysis draws from government strategies, peer-reviewed literature, and grey reports to map the evolution of EPI within Liberia’s fragile post-conflict health context. Using the Walt and Gilson Health Policy Triangle and the Critical Interpretive Synthesis, the study highlights fragmented coordination, limited use of behavioural evidence, weak integration of Social and Behaviour Change (SBC) frameworks, and persistent inequities in access. Findings underscore the need for a shift from campaign-driven outreach to institutionalised, evidence-based SBC systems embedded within national and county health structures. Policy implications emphasise strengthening behavioural data systems, investing in cross-sector SBC capacity, and formalising governance mechanisms linking EPI, the Health Promotion Division, and local actors. The paper proposes an actionable roadmap for integrating behavioural science into Liberia’s immunisation system to improve coverage, resilience, and public trust.