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Improving Immunization Uptake Among Zero-Dose Children in Somalia
- Cheikh
- Somalia
- GAVI REACH and IRC
- February 1, 2026
Situation
In Somalia’s South West State—Bay, Bakool and Lower Shabelle—conflict, displacement, seasonal migration and limited public services have left thousands of children unvaccinated. Strong oral traditions shape information flow, yet misinformation and distrust toward government-linked actors hinder health uptake. Multiple partners, including GAVI REACH, International Rescue Committee and ThinkPlace, collaborate with local organisations to access these hard-to-reach communities.
Assignment
The task was to uncover why so many children remain zero-dose and identify behavioural, structural and informational barriers. The challenge: co-design strategies that enable caregivers in inaccessible or partially accessible areas to be identified, reached and engaged despite security, social and cultural constraints.
Approach
A five-phase human-centred process guided the work: immersion and desk review; ethnographic research and surveys; synthesis using the WHO BeSD framework; participatory prototyping; and development of a community engagement strategy. Methods included storytelling, decision games, gender-segmented focus groups, immersive observations and co-creation with community leaders and CHWs.
Result
Outputs included an insights report and a 2023–2026 Community Engagement Strategy featuring four interventions: gamified education tools, story-based communication, standardized M&E and strengthened partnerships with community and religious leaders. These approaches are expected to shift norms, increase vaccination uptake among zero-dose children and embed positive health behaviours within Somalia’s oral culture.