In a significant effort aimed at improving immunisation equity, the Country Learning Hub (CLH) for Immunisation Equity in Bangladesh orchestrated a crucial meeting to share findings from its Rapid Assessment on Zero-Dose. Collaboratively supported by Gavi, the Vaccine Alliance, in partnership with icddr,b, Jhpiego, and RedOrange Communications, the CLH’s exploration holds the potential to reshape immunisation strategies in the country. 

The meeting brought together a diverse assembly of health professionals, policymakers, and program managers, with the focal point of discussion centred around the Rapid Assessment’s core objectives. These objectives encompassed the comprehensive identification of immunisation gaps, shedding light on areas where children had yet to receive vaccines, thereby exposing critical vulnerabilities within the immunisation landscape. 

Additionally, the assessment aimed to unearth the underlying barriers and determinants contributing to the zero-dose phenomenon, while also spotlighting socioeconomic disparities that warranted precise and targeted interventions. By offering a lucid portrayal of immunisation gaps, the assessment served as a foundational framework for the formulation of effective strategies aimed at bridging these disparities and challenges.

The Rapid Assessment’s methodology entailed a meticulous sequence of steps, commencing with collaborative discussions with EPI stakeholders and an in-depth analysis of secondary data sources, including CES 2019 and DHIS2-2022, laying the groundwork for pinpointing regions with zero-dose children. This was followed by on-ground validation through field visits to ensure data accuracy and corroborate monthly EPI reports. A process of reanalysis and rigorous assessment, employing Lot Quality Assurance Sampling (LQAS), facilitated the precise refinement of data, ultimately revealing high-risk areas. LQAS further unveiled communities with significant concentrations of zero-dose or under-immunised children, shedding light on critical pockets that demanded attention. 

The assessment’s comprehensive findings illuminated various facets of Bangladesh’s immunisation landscape. Specific upazillas and city corporation zones were identified as vulnerable areas with pronounced zero-dose vulnerabilities. A notable connection was revealed between maternal education, antenatal care, and the prevalence of zero-dose children. Additionally, heightened risks in regions like Sylhet underscored the importance of tailored geographic interventions. The role of local government representatives and community leaders emerged as pivotal in empowering efforts to address the immunisation gap. 

Drawing from these insights, a series of actionable recommendations have emerged: prioritising Data Precision by enhancing the quality of DHIS2 data stands out as a crucial step; fostering Community Engagement through collaboration with local leaders and communities emerges as an effective strategy to bridge immunisation gaps; embracing Innovative Approaches, such as digital interventions and mobile-based reminders, is advised to counter the impact of lost vaccine cards; and recognising the importance of Focused Strategies, including tailored interventions like evening sessions and specialised strategies for urban communities. 

In essence, the Rapid Assessment on Zero Dose undertaken by the Country Learning Hub serves as a compass guiding Bangladesh’s journey toward immunisation equity, paving the way for targeted interventions that underscore the nation’s commitment to ensuring every child receives the protective shield of immunisation, irrespective of their geographic or socioeconomic circumstances.