Coverage & Equity


Everyone is protected by full immunization, regardless of location, age, socioeconomic status or gender-related barriers.


Extend immunization services to regularly reach “zero dose” and under-immunized children and communities.

Advance and sustain high and equitable immunization coverage nationally and in all districts.

Key areas of focus:

Disadvantaged populations: Identify and address low coverage throughout the life-course of the poorest and most disadvantaged individuals and communities.

Barriers to vaccination: Identify barriers to uptake of vaccination services due to age, location, social and cultural and gender-related factors, and use evidence-based approaches to overcome these barriers to achieving high, equitable coverage.

Gender-responsive strategies: Understand the role of gender in accessing vaccination services, and use gender-responsive strategies to overcome the barriers faced by recipients, caregivers, service providers and health workers.

Measles as a tracer: Use measles cases and outbreaks as a tracer to identify weaknesses in immunization programmes, and to guide programmatic planning in identifying and addressing these weaknesses.

Learning from disease-specific initiatives: Use the experience of disease eradication and elimination initiatives in reaching the most marginalized populations, and integrate successful strategies for delivery and accountability into immunization programmes, with the full integration of disease control perspectives into primary health care.

Context-specific interventions: Develop, evaluate and scale up innovative, locally tailored, evidence-based, people-centred approaches to reach poorly served populations.

Implementation research: Strengthen local capacity to conduct implementation research to identify factors that affect the equity of immunization coverage, interventions that enhance coverage and equity and promote use of the results to implement locally tailored, context-specific interventions and innovations to address inequities.

Application of the core principles:

People-centred. Gaps in coverage and equity will be addressed, especially among marginalized and disadvantaged groups such as mobile and displaced populations, by actively engaging representatives of local communities and local health providers in designing interventions for these groups.

Country-owned. To overcome barriers, national immunization programmes will use strategies based on proven, innovative approaches and local research on effective ways to deliver services to underserved groups.

Partnership-based. Partnerships will be built with local communities and representatives of marginalized groups to understand the obstacles to access to vaccination (including gender barriers faced by recipients, caregivers and health workers) and to address inequities.

Data-guided. Immunization data systems will be expanded subnationally to map and track “zero dose” and under-immunized populations and specific marginalized groups to ensure that they are covered by the immunization programme.