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Results-Based Financing for immunization demand promotion, as part of the HSS2 Grant Project (EPI RBF)

Crown Agents Zimbabwe > Results-Based Financing for immunization demand promotion, as part of the HSS2 Grant Project (EPI RBF)

Project Overview

Project Title: Results-Based Financing for Immunization Demand Promotion, as part of the HSS2 Grant Project (EPI RBF) / RBF For Reduction of Zero Dose and Under-Immunized Children Project as part of HSS3 FPP Grant In Zimbabwe
Legal Entity: Crown Agents Zimbabwe (CAZim)
Project Location: 20 Low EPI Performing Districts in Zimbabwe
Client: Ministry of Health and Child Care (MoHCC)
Funding Partners: GAVI, the Vaccine Alliance
Project Duration: 2021 – 2024 / 2025-2029 

Project Background

The EPI RBF project is designed to address the challenges of under-immunization and vaccine hesitancy in Zimbabwe’s 20 low EPI performing districts. Funded by GAVI, this initiative aims to reduce morbidity and mortality from vaccine-preventable diseases (VPDs) by enhancing demand promotion/creation for immunization services through robust community engagement strategies.

The project aligns with GAVI’s 5.0 Vision for 2030, which is inspired by the SDGs and Immunization Agenda 2030 (IA2030). It focuses on improving immunization coverage by overcoming barriers to access and addressing vaccine hesitancy through community sensitization and awareness raising about the importance of immunization.

Project Goal

Goal is to reduce morbidity and mortality from Vaccine Preventable Diseases (VPDs) through demand creation/promotion in 20 low EPI performing districts of Zimbabwe, with an objective to increase demand and utilisation of immunization services through robust community engagement of CBOs/VHWs to address religious and other hindrances to EPI service utilization by involving Pro- vaccine/pro-health religious leaders in health care management through community engagement/dialogue.

Project Approach

1. Community Engagement

CAZim, alongside MoHCC, engages communities to implement the human-centred design(HCD) where we focus on  specific communities and co-create tailored interventions to address the challenges based on the local community insights, and capabilities.  The HCD has ensured an organized process for working directly with users – families, religious leaders, gatekeepers, communities, health centers, and agree on tailored solutions to effectively address challenges related to vaccine uptake,  response and demand for vaccination. The primary goal is to reach zero-dose children, under-immunized and leaving no one behind.

2. Demand Creation & Promotion

The project includes community sensitization activities such as:

  • Door-to-door meetings
  • Drama groups and role plays
  • Public gatherings at dip tanks, clinics, and rallies
  • Storytelling and interactive sessions
  • Question and Answer session

  • Community sensitization with kraal heads, village heads, and health center committees.

  • CBOs/CHWs follow up defaulters and refer for immunization to boost herd immunity.
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Services Provided

  • Community Sensitization:
    Community sensitization and awareness raising about the importance of immunization.
  • Follow-up on Defaulters:
    CBOs and CHWs follow up on defaulters and refer them to nearby clinics or outreach points for vaccination.
  • Targeted Vaccination Campaigns:
    Engaging communities in ensuring the vaccination of children and adults to improve herd immunity.
  • Door-to-Door Meetings:
    One-on-one engagement with community members to discuss immunization benefits and dispel myths surrounding vaccinations.
  • Drama Groups and Role Plays:
    Interactive drama performances to illustrate the importance of immunization in an entertaining yet educational manner.
  • Storytelling, Question and Answer Sessions:
    Sharing stories about vaccination and providing opportunities for community members to ask questions and engage in quizzes to improve their understanding of immunization.

Key Achievements

DTP3 Coverage Compared to Baseline Data (2021)

  • 18 districts (90%) surpassed baseline coverage target during the period Jan – Aug 2024. Engagement with vaccine-hesitant groups strengthened through recruitment of CBOs/CHWs from all sectors, including white garment Apostolic churches.

DTP3 - % Coverage Compared to District Targets

  • 18 districts (90%) surpassed the target of ≥ 80% coverage during Jan – Aug 2024, indicating good utilization of services by the community as this is a proxy measure for immunization uptake.

MR2 Coverage Compared to Baseline Data (2021)

  • Achieved 80% increase in MR2 vaccination coverage when compared to baseline data, with improvements across the targeted districts.

Impact Charts and Maps

Below are the charts and maps illustrating the effectiveness of the EPI RBF project and the resulting improvements in immunization coverage in the low-performing districts.

EPI-RBF Project Operational Districts
DTP3 - % Coverage Compared to District Targets
MR2 Compared to District Targets

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