Reaching Zero-Dose Children: Resources from MOMENTUM

A key marker of immunization coverage is the proportion of children who receive the third dose of the diphtheria, tetanus, and pertussis-containing (DTP) vaccine. The term “zero-dose” is used to describe children who have not received even a first dose of DTP-containing vaccines. It is increasingly recognized that zero-dose children are less likely to receive other primary health care services — so reaching them with immunization can be of further benefit by serving as an entry point to other health, nutrition, and social services.

MOMENTUM is working to understand the unique challenges faced by zero-dose children and their communities, and the interventions that can effectively reach them. The project is also fostering innovation to map private health care providers and examining the intersections between provider footprints and the likely locations of zero-dose children. Collectively, these efforts seek to support advocacy and drive strategic decision-making on zero-dose policies and programs by global, regional, and country-level immunization stakeholders.

MOMENTUM is committed to immunizing zero-dose children and has produced the following resources to expand the evidence base on immunization and child health. If you consult or download any of these resources, we welcome your feedback on their value and/or suggestions for future work.

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Research/Analysis

Addressing Insufficient Operational Funding to Reach Zero-Dose Children and Missed Communities (Brief)

Explores entrenched obstacles to reaching zero-dose children and missed communities with routine immunization services, and strategies to reach specific hard-to-reach and vulnerable populations.

Effects of Faith Actor Engagement on the Uptake and Coverage of Immunization in Low- and Middle-Income Countries

Summarizes evidence about vaccine hesitancy trends for both COVID and non-COVID immunizations in a special investigation into the role of faith actors on immunization uptake in USAID priority countries for maternal, newborn, and child health and family planning/reproductive health.

How Data Systems Can Help Reach Zero-dose and Under-immunized Children

This brief, intended for government decision-makers, funders, and partners, highlights findings and recommendations from the Landscape Analysis of Health Information Systems and Data Tools for Identifying, Reaching, and Monitoring Zero-Dose and Under-immunized Children.

Frank Kimaro/Jhpiego

Impact of the Sars-Cov-2 Pandemic on Routine Immunization Services: Evidence of Disruption and Recovery from 170 Countries and Territories (Article)

This study, published in The Lancet Global Health journal, synthesizes data from 170 countries and territories, finding declines among vaccination doses administered and other indications of significant and widespread disruptions in immunization systems during 2020.

Des Syafrizal/USAID

Landscape Analysis of Health Information Systems and Data Tools for Identifying, Reaching, and Monitoring Zero-Dose and Under-Immunized Children (Report)

Describes information systems and tools that can help identify, reach, and monitor zero-dose and under-immunized children in the Democratic Republic of the Congo, Kenya, Mozambique, and Nigeria.

Karen Kasmauski/MCSP and Jhpiego

Now Is the Time to Recognize and Reduce Gender-Related Barriers to Immunization (Blog)

Discover the impact of gender-related barriers on routine immunization and how we can address them so that all children are protected from vaccine-preventable diseases.

Seeing Old Problems Through a New Lens: Recognizing and Addressing Gender Barriers to Equitable Immunization (Webinar Recording)

Key learnings about gender barriers and how they obstruct equitable access to immunization services throughout a person’s life.

Reaching Zero-Dose Children: Evidence for Engaging the Private Sector

Summarizes the key findings and recommendations of a longer literature review synthesizing information on the private sector’s role in delivering immunization services to zero-dose children.

Multi-Country District Health Survey/Multiple Indicator Cluster Survey Analysis of Zero Dose Status (Report, Forthcoming)

Quantifies and qualitatively describes the sociodemographic profile of zero-dose children in 82 low- and middle-income countries and proposes a conceptual framework to describe the multilevel barriers specific to zero-dose children.

Interventions for Reaching Zero-Dose Children

Frank Kimaro/Jhpiego

Reaching Zero-Dose Children: Insights from MOMENTUM

Focused on generating learning to inform action, engaging new partners, and addressing needs in fragile settings, this program brief provides insights from four MOMENTUM projects on identifying and reaching zero-dose children.

Commitment to Immunizing Zero-Dose Children

Download this document to learn about MOMENTUM's commitment to immunizing zero-dose children.

Kate Holt/MCSP

Engaging Faith Actors to Boost Vaccine Uptake and Combat Vaccine Hesitancy (Brief)

Highlights evidence-based approaches for engaging local faith actors in immunization as well as identifying current evidence gaps.

Kate Holt/MCSP

Promising Practices for Engaging Local Faith Actors to Promote Uptake of COVID-19 Vaccination: Lessons Learned from Ghana, Indonesia, Sierra Leone, and Uganda

Explores 15 promising practices for increasing vaccine uptake through strategic engagement of faith actors.

Karen Kasmauski/MCSP

Experiences and Lessons Learned in Engaging with the Private Sector for Immunization (Webinar Recording)

MarketLinks, USAID, MOMENTUM Private Healthcare Delivery, and other partners hosted a webinar in November 2021 to share lessons from the field on engaging the private sector to deliver immunizations.

Leave No One Behind: How Can We Reach Every Child With Life-saving Vaccines

Learn how MOMENTUM is making sure routine immunizations remain a priority so that children don’t miss out on getting the vital vaccines they need.

Rabiul Hasan/icddr,b

Private Sector Engagement for Immunization Programs in Low-and Middle-Income Countries

Comprehensive brief outlining best practices and evidence around private sector engagement in immunization programming.

Private Sector Engagement to Boost Reach of Immunization Programs (Brief)

Introduces key issues on private sector engagement for immunization service delivery in the context of COVID-19 vaccine rollout.

Reaching Zero-Dose Children: Immunization in Fragile/Conflict-Affected Settings

Builds understanding of how to reach key populations missed by immunization services, including those living in poor urban or remote-rural areas, and those affected by conflict and displacement.

Recap: All Things Zero-Dose 2.0

On Friday, April 29, 2022, immunization experts from across the MOMENTUM suite of awards participated in a “fireside chat” on Facebook, LinkedIn, and YouTube LIVE to discuss how to identify and reach zero-dose children. Watch the full recording here.

This November, Marketlinks Explores the Potential of the Private Sector in Expanding the Reach of and Access to National Immunization Programs (Blog)

Suggestions on how the private sector can be leveraged to reach more people with routine immunizations and COVID-19 vaccines.

Webinar Series | Identifying Zero-Dose Children

Ongoing webinar series from MOMENTUM Routine Immunization Transformation and Equity approaches, methodologies, and other topics related to estimating and identifying zero-dose children.

Matt Hackworth/IMA World Health

MOMENTUM Integrated Health Resilience: Reaching Zero-Dose Children in Fragile Settings (Forthcoming)

Outlines the steps MOMENTUM is taking to leverage and adapt the Reaching Every District/Reaching Every Child approach in fragile settings to build health resilience at the humanitarian-development nexus.

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