Child receives vaccine in GokweBy Michael GwarisaZimbabwe is falling behind in its efforts to fully immunise every child, with approximately 34,000 children going without basic vaccinations each year. This alarming statistic, contained in the latest World Health Organization (WHO) and UNICEF Estimates of National Immunization Coverage (WUENIC) report released on July 15, 2025, highlights the persistent vulnerability of Zimbabwe’s youngest citizens, many of whom remain completely unprotected from life-threatening vaccine-preventable diseases.The WUENIC report revealed that across Southern Africa, the number of “zero-dose” children, those who have not received even the first dose of the diphtheria, tetanus, and pertussis (DTP1) vaccine, has soared to 948,000, a sharp rise from the previous year. Zimbabwe, though showing strong coverage in some areas, remains among the countries struggling with zero-dose clusters.In 2024, Zimbabwe recorded a 93% DTP1 coverage rate.
However, that 7% gap translates into tens of thousands of children, about 34,000, who receive no vaccines at all. These children are not only susceptible to diphtheria, tetanus, and pertussis but also to a wide array of other preventable diseases such as measles and polio.Why Children Are Being MissedAccording to Dr. Rudo Chikodzore, UNICEF Zimbabwe’s Health Specialist for Immunization and Public Health Emergencies, the major drivers of this crisis include geographic inaccessibility, vaccine hesitancy, and transient lifestyles.She cited hard-to-reach areas such as Binga, Gokwe North, and Mbire Districts, which face challenges like poor road networks, flood-prone terrain, and long travel distances to health facilities.
Informal settlements and border communities are also disproportionately affected.Vaccine hesitancy, fueled by misinformation, religious objections, and a low perceived risk of disease, adds to the problem. While traditionally more prevalent among low-income populations, Dr. Chikodzore warned of a growing trend of vaccine resistance among affluent urban communities.She added that mobile populations such as artisanal miners, contract farmers, and informal traders often miss key vaccination appointments, resulting in many children falling through the cracks of the healthcare system.Sister Caritas Mbombe, District Nursing Officer for Gokwe, said: “On the issue of zero doses, as a district we have realised that because of the vastness of the district versus the number of facilities that are in the district, most of our communities are not able to come to the facilities to seek services including vaccinations.
We also realised that as a district, we reach more communities through outreach activities with the effort of saving lives and livelihoods. We hope that the zero doses are going to reduce because the facilities are now conducting more outreach activities.”Zimbabwe’s Immunisation Gaps in NumbersAccording to the WUENIC report, only 84% of Zimbabwean children completed the full DTP3 series, while 90% received the first dose of the measles vaccine. This leaves around 48,000 children at risk of contracting measles, one of the world’s most contagious diseases.None of the countries in Southern Africa reached the 90% coverage target for all core childhood vaccines, making the region particularly vulnerable to disease outbreaks.Despite the challenges, Zimbabwe ranked among the top performers in DTP1 coverage in the region, behind only Botswana (98%) and Malawi (94%).What’s Working: Success Factors for High DTP1 CoverageZimbabwe’s relatively high DTP1 coverage has been attributed to strong political commitment, the prioritisation of the Expanded Programme on Immunisation (EPI) within national health strategies, and the use of village health worker networks and school-based platforms.Other contributors include the integration of immunisation into primary healthcare and maternal-child health services, consistent support from partners such as UNICEF, Gavi, and WHO, as well as community trust and awareness built through years of effective outreach.Government Response to Zero-Dose CrisisIn response to the ongoing immunisation challenges, the Ministry of Health and Child Care (MoHCC), through the EPI department, has implemented several measures.
These include conducting a gender barrier assessment in 2024 in districts with high zero-dose and under-immunised children, supporting 33 high-burden districts to run community and facility-based outreach, and introducing a performance-based demand creation model engaging local gatekeepers. The ministry is also rolling out the “My Village, My Home” model, which helps village heads and health workers track missed children and ensure they receive vaccines.Women queue to have their children vaccinated in GokweAdditionally, the government is procuring tricycles, all-terrain vehicles, and mobile vans to reach remote areas, while constructing health posts closer to communities. Cold chain equipment, including solar-powered vaccine refrigerators, is being deployed across rural facilities to maintain vaccine potency.
Communication strategies are being guided by human-centered design and behavioural and social drivers data collected in the 19 priority districts.UNICEF’s Complementary EffortsUNICEF, working closely with MoHCC and partners, is implementing several complementary strategies. These include bundling routine vaccines with vitamin A supplementation, deworming, and other health services during child health days, and deploying mobile outreach teams supported by community health workers to reach remote communities. There is also continued support for data-driven microplanning and zero-dose mapping using DHIS2 and local surveys.Demand generation and community engagement are driven by social behaviour change (SBC) strategies, including dialogues with caregivers, and the involvement of traditional and religious leaders.
UNICEF continues to invest in strengthening the EPI supply chain, including the procurement of solar-powered refrigerators and cold chain maintenance support.Dr. Chikodzore noted: “Yes, several innovations are currently being implemented. The ‘My Village, My Home’ tracking tool is used by VHWs to monitor vaccination defaulters and mobilize caregivers.
To improve vaccine storage and delivery in off-grid and hard-to-reach communities UNICEF has supported the procurement of solar powered refrigerators and tricycles as part of Health Systems Strengthening. Bundling services like HPV vaccine, Tetanus/Diphtheria booster, nutrition services, sexual reproductive health, and SBC during integrated outreach days ensures a comprehensive package is given for the zero dose children as they are children who are also deprived of other health services.”Support to End Zero-DoseUNICEF, Gavi, and WHO are applying the Gavi IRMMA framework (Identify, Reach, Monitor, Measure and Advocate) to structure zero-dose strategies and improve coordination to reach underserved children. UNICEF has supported zero-dose mapping and data-driven microplanning using DHIS2 and administrative data to identify under-served zones, track defaulters, and schedule outreach.To reach children beyond static facilities, MoHCC with financial support from partners conducts integrated catch-up campaigns and mobile outreach, bundling routine vaccines with other child health services, especially in rural, border, and informal settlement areas.
Social and behaviour change initiatives include community dialogues to address misinformation, engagement of local leaders, and training of healthcare workers in interpersonal communication, data use, and outreach microplanning.UNICEF has also made major investments in cold chain infrastructure and logistical support to ensure vaccine availability and storage. Through funding from Gavi and other partners, Zimbabwe continues to benefit from vaccine procurement, operational planning, and technical assistance for zero-dose reduction strategies.Opportunities and ChallengesDr. Chikodzore highlighted several opportunities to build on existing success.
These include adapting the HPV Plus and school-based outreach models for routine immunisation, leveraging county-level leadership under Zimbabwe’s devolution agenda, and utilising funding from the Pandemic Fund and Gavi health system strengthening grants.However, challenges remain. These include the decline in overseas development assistance as Zimbabwe transitions toward middle-income status, increasing immunisation inequity in informal urban settlements, and health worker shortages that threaten service continuity.As the global Immunization Agenda 2030 calls for halving the number of zero-dose children from 2019 levels by the end of the decade, Zimbabwe faces a pivotal moment. Urgent action, sustained investment, and deepened community engagement will be essential to ensure no child is left behind.Post Views:250Tweet
Source: HealthTimes
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