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Country Profiles

The Zero-Dose Learning Hub (ZDLH) provides technical and operational support to four Country Learning Hubs (CLHs) established in Bangladesh, Mali, Uganda, and Nigeria. The established CLHs represent a country- and community-driven approach to zero-dose (ZD) evidence generation, which is key to reaching the millions of children who are left behind. Together, the ZDLH and CLHs disseminate the learnings generated through their ZD work across immunization stakeholders at the community, national, regional and global levels.

The following country profiles describe the country’s immunization history, current ZD landscape, and successful interventions and lessons learned to date. More country-specific resources and materials will be developed over the lifespan of the ZDLH.

Photo of a woman holding an infant in the air. Source: Drik/USAID

Bangladesh Zero-Dose Landscape

Bangladesh has made tremendous progress over the last 20 years ensuring that children in the country are immunized against diseases that previously made up a large proportion of childhood illness and death, including diphtheria, tetanus, and measles. Despite high overall coverage of childhood vaccination, immunization gaps remain with some children missing doses or not receiving any vaccinations. Households that include children who have not received a single dose of the pentavalent vaccine series are estimated by a recent Gavi analysis of immunization coverage data to represent six percent of all deaths (6,046 total deaths) among children under five in the country. Learn more in this Bangladesh Zero-Dose Landscape.

Photo of four young girls

Mali Zero-Dose Landscape

Childhood vaccination rates in Mali have increased nearly 20 percent since 2001, paired with a nearly 50 percent decrease in the under-five mortality rate. Despite increases in vaccination coverage over time, gaps in immunization continue to contribute to under-five morbidity and mortality. One 2021 study found that 14 percent of pneumonia cases among Malian children in the study population were attributable to vaccine-preventable diseases, despite a pentavalent vaccine coverage rate of approximately 75 percent.9 ZD children are estimated by Gavi to represent 25 percent of all deaths (18,529 total deaths) among children under five in the country. Learn more in this Mali Zero-Dose Landscape.

Person holding a vaccine bottle

Nigeria Zero-Dose Landscape

Nigeria has made progress in improving vaccination coverage over the last two decades, with the percentage of children aged 12–23 months who have received their basic vaccination increasing from 23 percent in 2008 to 44 percent in 2021. Despite increases in vaccination coverage over time, gaps in immunization continue to contribute to under-five morbidity and mortality. Identifying approaches to tracking and reaching these children is critical to reaching full and equitable immunization coverage. Gavi estimates children who have not received a single dose of the pentavalent (Penta) vaccine series represent 39 percent of all deaths (336,925 total deaths) among children under five in the country. Learn more in this Nigeria Zero-Dose Landscape.

Photo of four infants

Uganda Zero-Dose Landscape

The delivery of vaccines that protect against preventable childhood diseases has been Uganda’s health system priority for several decades and has resulted in significant improvements in vaccination coverage and child mortality rates. Despite increases in vaccination coverage over time, gaps in immunization continue to contribute to under-five morbidity and mortality in Uganda. Households that include children who have not received a single dose of the pentavalent (penta) vaccine series are estimated by a recent Gavi analysis to represent 13 percent of the 10,847 deaths among children under five in the country. Learn more in this Uganda Zero-Dose Landscape.