IA2030 Case Study 10. Development of zero dose situational analyses and action plans

This report is part of series aiming to capture the perspectives of a diverse group of health practitioners working to deliver or manage immunization services in low- and middle-income countries. Contributing to consultative engagement between international and local levels, each report offers a unique opportunity to discover unfiltered experiences and insights from thousands of people whose daily lives revolve around delivering immunization services.

Potential participants on the Movement for IA2030 programme organized by the Geneva Learning Foundation (TGLF) in 2022 (“Scholars”) completed an application form that included a section on zero-dose and under-immunized populations. Those providing detailed information on zero-dose challenges were invited to complete a further mini-survey designed to find out more about Scholars zero-dose challenges and how they are addressing them.

The mini-survey was completed by 110 participants from 25 countries, representing all levels of national immunization programmes. The mini-survey provided an opportunity to explore the processes and guidance used by respondents to understand their zero-dose challenge and to develop action plans to address them.

Key findings 

Analysis of vaccine coverage data, discussions with colleagues, and consultations or dialogue with communities were the most commonly used approaches to understand zero-dose challenges. Analysis of vaccine coverage data and dialogue with communities were felt to be most useful.

Global guidance was widely used, particularly that on situational analysis and data triangulation (referred to by 44.5% and 42.7% of respondents, respectively). Action plan development drew primarily on Reaching Every District/Community guidance and local knowledge (both referred to by 70% of respondents)

A high proportion of respondents in the group reported undertaking consultations with communities during situational analyses (86.4%) and in planning of activities (83.6%).

Most respondents (82.7%) reported planning actions in collaboration with other services, particularly maternal health and nutrition.

The mini-survey has provided insight into how immunization workers at different levels of immunization systems are aiming to understand and respond to zero-dose challenges and the global guidance they are using. Although widely used by respondents, there is significant scope to increase the use of global guidance – particularly as this group is known to be highly motivated and may therefore be particularly likely to seek out global guidance.

In addition, there are opportunities to use engagement through the TGLF platform to gain a deeper understanding of the guidance needs of frontline workers and to involve them in the co-design and assessment of future guidance. 

This Immunization Agenda 2030 (IA2030) case study is part of the IA2030 Movement’s Knowledge-to-Action Hub. Learn more about the Hub… Learn more about the Movement…