Work with communities and CSOs to understand and address root issues behind hesitancy [MALI, Male, Region, MoH staff]

Work with religious leaders in supporting vaccines as halal [INDONESIA, Province, MoH staff]

Use local storytellers and community dramas in ZD communities to give pro-vaccine messages

Use male peer educators to talk to men

Use CHVs to build trust

Use COVID vx campaigns to line list RI ZD [NIGERIA, Female, National, retired MoH/NPHCDA staff]

Use MNCH weeks to line list RI ZD [MALI, Male, Ségou Region, WHO staff]

Check RI vx status in EPI registers during SIAs; if not in register and ZD, line list for follow up [PHILIPPINES]

Frequently revise ZD analysis in urban areas due to movement/migration of population [BANGLADESH, Male, National, NGO staff]

Use monthly/quarterly meetings to review DHIS2 data and triangulate with community feedback [MALI, Male, District in Sikasso Region, WHO staff]

Use weekly/monthly reviews to compare tally sheets/register with settlements in catchment area to see where session sizes are smaller than they should be, or caretakers aren’t coming; this can indicate likely buildup of ZDs [HF]

Same method, focusing on urban HFs with ZD clusters [MALI, Male, Sikasso Region, UNICEF staff]

Put all known newborn names (with and without vaccination) into EPI register and tickler box/file to keep track of ZD, under-immunized, and who is on schedule

Use influential women to help search for ZD children [MALI, Female, Region, MoH staff]

Community volunteers (VHTs) register all newborns for HF to follow up [UGANDA, Female, District, MoH staff]

Work with coaches to give quick health talks during local sporting events

Work with traditional leaders, barbers and traditional birth attendants to help line-list all newborns to follow up on – especially around traditional naming ceremonies [NIGERIA]

Form health committees in churches and mosques, with regular discussions around vaccination 

Reinforcing messages about immunization & schedules given by leaders at community events [UGANDA, Female, HF, MoH staff]

Work with communities to respond to their requests for vaccination due to frequent outbreaks such as measles in IDP sites [MALI, Male, Gao Region, UNICEF staff]

Challenge: A focus just on increasing coverage may not correct neglect of ZD communities [MALI, Male, HF, MoH staff]

Microplanning revisions (at least once a year) that address root causes and are co-developed with communities

Form RI committee with catchment area communities to ensure all contribute to identifying root causes [NIGERIA, Male, Sokoto State, MoH/SPHCDA staff]

Redesign outreach, including a focus on good mobilizers at each site [UGANDA, Male, HF, MoH staff]

Create microplans with daily implementation plan [NIGERIA, Male, Kano State, MoH/SPHCDA staff]

Revise plans mid year to adjust outreach for new/emerging settlements in urban or remote areas [TANZANIA]