Report | Reaching Zero-Dose and Under-Immunized Children in Remote and Underserved Settings of Ethiopia: Evaluation

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Polio Report – November 2022

BACKGROUND

Ethiopia has recently made substantial gains in increasing coverage of childhood vaccination. Between 2000 and 2019, proportion of children who received all the routine antigens increased from 15 to 44%, and that of measles-containing vaccine 1 (MCV-1) doubled from 32 to 59%. Proportions of zero-dose (missing DPT-1 containing vaccine) and under-immunized (missing DPT-3 containing vaccine) have been also reduced by 32 and 40 percentage points, respectively. Yet, important challenges remain unaddressed. In 2019, 23% of children 12-23 months of age were zero-dose and 39% under-immunized. Among GAVI-supported countries, Ethiopia is ranked fifth based on burden of zero-dose immunization. Other outstanding challenges include high dropout, and geographic and social inequality. The recent political unrest and Covid-19 pandemic have also threatened to revert the hard-fought gains.

PURPOSE

With the financial support from Bill and Melinda Gates Foundation, Project HOPE in partnership with AMREF Health Africa and three local implementing partners, conducted an evaluation project – Reaching zero-dose and under-immunized children in remote and underserved settings of Ethiopia. The objectives of the research were to identify and map clusters of missed communities and zero-dose children in Ethiopia, to explore demand and supply barriers, including gender and socio-cultural constraints, and; to generate evidence to inform policy and practice towards reaching zero-dose and under-immunized children in Ethiopia. This document summarizes the overarching findings of the four main sub-components of the study: situational assessment, vaccination coverage survey, barrier and enabler (B&E) analysis and formative assessment for developing key strategies.