Gavi, the Vaccine Alliance launched its first-ever inter-country Zero Dose Learning Hub eXchange on May 31. This global webinar on identifying and reaching zero-dose children to improve immunisation coverage became an instant success.

Nearly two thousand participants from 84 countries logged in, mainly frontline practitioners, all eager to listen, learn and share their experiences. Zero Dose was their common ground, ZD the buzzword. Bangladesh and Mali received the honour to kick off the premiere session by presenting case studies to explain the challenges they are facing in identifying and reaching zero-dose children and the strategies they developed to overcome the hurdles.

Gavi has invited Bangladesh and Mali to set up the first Country Learning Hubs (CLH), along with Nigeria and Uganda. While the countries work in different immunisation settings, they all struggle with immunisation inequity, with groups of unimmunised and under-immunised children in smaller or bigger numbers. The CLH project provides a national platform to study and analyse data to identify missed communities, find out which interventions do or don’t work, and share as well as learn. ZDLH-X webinar facilitates the CLH to take it to an inter-country level, a global exchange.

“Slum-dwellers, fishermen, snake charmers, garment workers, indigenous communities, Bihari’s and migrants.’ Md Sarwar Alam, a surveillance officer at WHO, sums up the left-out communities of the Chattogram City Corporation in South Bangladesh. These people live within the city borders, close to immunisation centres, but were still hard to reach. A measles outbreak in 2019 signalled the problem.

Fieldworkers found many children were not vaccinated. The city corporation learned valuable lessons from the neighbouring remote indigenous areas. ‘Indigenous peoples speak a different language, which creates a communication gap with healthcare workers,” notes Md Sarwar Alam. Language, however, is not the only hurdle, he clarified when probed by a peer participant. Microplanning turned out to be a copy-paste exercise without any involvement of the left-out communities. That has changed now. Health workers now visit local groups, consult cultural and religious leaders and discuss strategies. Rapid Convenience Monitoring data show it works: no more unimmunised children and no measles outbreak.

Mali’s frontline practitioners face a totally different scenario, working in a conflict zone challenging to access given the security issues. Fusseiny Dembele and his colleagues successfully used a weeklong festival to create a safe zone where they set up a vaccination site with the support of community leaders, women groups and festival organisers.  It took a lot of preparation but created a window to build a network of local volunteers.

Peer participants respond enthusiastically to the ZDLH-eXchange. Although there was not enough time to present all the planned case studies, everybody was inspired.

ZDLH-X webinar is recorded and can be viewed here.