In Bangladesh, ensuring that every child receives life-saving vaccines is a challenge, particularly for zero-dose (ZD) and under-immunised (UI) children. The Country Learning Hub-Bangladesh (CLH-Bangladesh) has developed targeted field-level interventions to address these gaps, with a clear focus on reaching the hardest-to-reach populations, including those in remote areas and urban slums. These interventions are essential to achieve immunisation equity in Bangladesh, which remains a critical health priority.

One of the key strategies introduced by CLH-Bangladesh is the E-Tracker system, a digital tool designed to monitor the immunization status of children under 24 months. Health assistants, paramedics, and vaccinators are equipped with tablets and smartphones to electronically register newborns and track their vaccination progress. By streamlining this process, the E-Tracker system helps identify ZD and UI children, significantly reducing dropout rates and ensuring that no child is left behind.

E-Messaging is another vital component of the intervention. Through this system, parents receive timely reminders about their child’s upcoming vaccination via mobile messages. This simple yet effective communication method ensures that parents are informed and encouraged to bring their children to vaccination sessions, thereby improving vaccine uptake.

To further strengthen these efforts, CLH-Bangladesh has introduced E-Monitoring. This web-based system allows program managers, policymakers, and stakeholders to track the progress of vaccination sessions in real-time. From the national level down to the union level, stakeholders can view how many children have been vaccinated and identify those who missed their doses. This data-driven approach makes it easier to take corrective actions swiftly and maintain high coverage rates.

Community involvement is another cornerstone of CLH-Bangladesh’s approach. Advocacy meetings with local leaders—such as union council chairpersons, religious figures, and social workers—help generate grassroots support for vaccination programs. These meetings address challenges, raise awareness about the benefits of vaccines, and highlight the status of ZD and UI children. Local leaders are encouraged to play a more active role in urging parents to vaccinate their children.

The use of Behavior Change Communication (BCC) materials has also been integrated into the project. These materials are designed to visually communicate the importance of vaccinations to communities. They are utilised during interpersonal communications, group discussions, and meetings, providing a more engaging way to promote immunisation.

For mothers with busy work schedules, particularly in urban areas, evening EPI sessions have been introduced. These sessions, organised in collaboration with the City Corporation and partner NGOs, allow working parents to access vaccination services outside regular hours, ensuring that their children don’t miss out on critical doses. To reach remote communities, CLH-Bangladesh has also proposed a modified EPI session schedule, including crash programs and increasing the frequency of sessions. By accommodating the unique needs of each region, these interventions aim to reach ZD and UI children in areas that are often overlooked.

In addition, the support of NGO workers has been enlisted to amplify the efforts of health assistants. NGO field workers assist in identifying newborns, motivating parents, and supporting health workers during vaccination sessions. Their involvement has been key in extending the reach of immunisation programs to communities that would otherwise remain underserved.

Finally, community engagement meetings and yard meetings have been vital in sensitising parents and caregivers to the importance of vaccines. These gatherings provide a platform for open discussions about vaccination schedules, benefits, and post-vaccination care, ensuring that community members are fully informed and engaged in protecting their children’s health.

By combining technology, community engagement, and flexible service delivery, CLH-Bangladesh’s interventions are creating a more inclusive and equitable immunisation landscape. These efforts are a step forward in reducing the number of ZD and UI children, ultimately contributing to a healthier and more protected future for all children in Bangladesh.