GTA

Support: Pfizer Foundation/ Global Health Innovation Grant (GHIG) program, USA

Collaboration: Bhanu Municipality

Status: Completed (April 2024-March 2025)

Objective: The project aimed to enhance immunization coverage and reduce vaccine- preventable diseases in the Bhanu Municipality of Tanahun district, Nepal by identifying the target population, developing a community vaccine delivery model, and assessing the feasibility and sustainability of the program.

Methodology/Activities: The project employed a community-based approach using Female Community Health Volunteers (FCHVs), household surveys, mobile applications, and local government collaboration. It integrated real-time tracking, targeted interventions, and capacity- building initiatives for health workers. Data management was enhanced through a digital immunization register to improve tracking and service delivery​.

The project significantly strengthened primary health care delivery in Bhanu municipality by developing comprehensive training materials including manuals, IEC materials, and diaries for FCHVs and HWs to record the project's necessary data. Also, the existing software eHMIS has been enhanced in its functionality to support project objectives, enabling real-time data tracking of immunization coverage targeting zero-dose children. 60 FCHVs were trained to develop their skills on completing diary for tracking zero-dose children and to encourage them to constantly report collected data into health facilities. Also, training for 68 HCWs were conducted to enhance their skills of using eHMIS for proper data management. Microplanning was conducted with stakeholders, FCHVs and health workers to identify SWOT in the current immunization efforts to incorporate the findings into the project design and implementation plan. Automated SMS system was also set up for parents of target children and pregnant women in order to send them reminders for timely vaccination. Furthermore, FCHVs and HCWs has been actively mobilized for effective community mobilization and data collection, which are critical for identifying and reaching zero-dose children. Additionally, mobile units were also deployed to remote wards in order to reach hard-to-reach populations. 11,194 households were surveyed where 2 zero-dose and 12 under-immunized children were identified and the parents of these children were motivated to get their children vaccinated and all of the children now are getting vaccinated.

Conclusion: The Zero-Dose Project in Bhanu Municipality proved to be a highly effective model for increasing immunization coverage. Through integrated community mobilization, digital tracking, and stakeholder engagement, the project significantly reduced the number of unvaccinated children and improved public health outcomes.