On May 28, 2025, Gavi’s Zero-Dose Learning Hub (ZDLH) hosted a global webinar titled “Unlocking Tailored Solutions: Understanding Root Causes and Barriers to Reaching Zero-Dose Children and Missed Communities.” The 90-minute session brought together public health experts, researchers, and frontline implementers from Bangladesh, Uganda, and Cambodia to explore what works, and what challenges remain, in identifying and reaching zero-dose (ZD) and under-immunised (UI) children.

With representation from the Bill & Melinda Gates Foundation’s Zero-Dose Learning Agenda (ZDLA), the webinar focused on translating insights into action—from policy-level coordination to community engagement and service delivery. A key highlight was the presentation by Dr. Md. Jasim Uddin from icddr,b, who shared findings from Bangladesh’s Country Learning Hub (CLH).

According to Bangladesh’s latest data, 1.9% of children remain zero-dose and 11.5% are under-immunised, despite high national coverage (80–84%). Using tools like IRMMA (Identify, Reach, Monitor, Measure, Advocate), the Country Hub examined barriers in hard-to-reach regions—such as wetlands, coastal zones, hill tracts, and urban slums. It found that barriers include limited service availability, lack of caregiver awareness, poor data tracking, and social factors like gender norms.

Tailored solutions piloted in Bangladesh include community-led education, modified service hours, e-tracking tools, and targeted outreach in slums, haor, and char areas. The CLH approach, aligned with Gavi’s Equity Accelerator Fund (EAF), combines real-time data and human-centered design to ensure vaccines like BCG, DPT, and Pentavalent reach every child, regardless of geography or background.

Speakers from Cambodia and Uganda shared complementary lessons, including outreach for migrant communities, extended clinic hours, and the impact of patriarchal norms on decision-making. The discussion emphasised the need for sustained political commitment, adequate financing, and cross-sector coordination.

As Gavi enters its next strategic phase (6.0), these cross-country learnings offer hope—and a roadmap—for stronger immunisation equity. By recognising local barriers and designing locally adapted solutions, the global immunisation community moves one step closer to a world where no child is left behind.   

Reference: 

Unlocking tailored solutions: Understanding root causes and barriers to reaching zero-dose children and missed communities [Internet]. Gavi.org. [cited 2025 Jul 16]. Available from: https://zdlh.gavi.org/events/unlocking-tailored-solutions-understanding-root-causes-and-barriers-reaching-zero-dose