Country Learning Hubs

The ZDLH helps generate, synthesize, and share ZD data and evidence at both the global and country levels. The structure is a hub-and-spoke model: JSI, the global learning partner manages learning and evidence at the global level, and four country learning hubs in Bangladesh, Mali, Nigeria, and Uganda, comprised of local partners/consortiums, capture and use country-level programmatic data and evidence to provide insights on how the ZD strategy is being translated at the subnational level through improved monitoring and evidence generation.

The four Learning Hubs include:

• Bangladesh: Led by the International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b) with partners Jhpiego and RedOrange Communications.
• Mali: Led by GaneshAID with the Center for Vaccine Development-Mali (CDV-Mali) and the University of Science, Technique and Technologies of Bamako (USTTB).
• Nigeria: Led by the African Field Epidemiology Network (AFENET) with the African Health Budget Network (AHBN).
• Uganda: Led by Infectious Diseases Research Collaboration (IDRC) with partners PATH and Makerere University School of Public Health.

The Learning Hub countries were selected to ensure variation by region and context, including rural, urban, conflict, or refugee, and based on a relatively high number and proportion of ZD children. Other considerations included feasibility and risk mitigation.

ZDLH Global Consortium

In addition to the four country learning hubs, the ZDLH mechanism includes a global consortium led by JSI Research & Training Institute, Inc., in partnership with the International Institute of Health Management Research, New Delhi and The Geneva Learning Foundation. The global consortium provides technical and operational support to the Learning Hubs and disseminates learnings at the community, regional, national, and global levels.

Technical Assistance

During the first half of 2025, JSI, as the ZDLH global learning partner, continued to deliver targeted technical assistance, fill knowledge gaps, and accelerate evidence-to-action efforts across the four Learning Hub countries while also advancing global knowledge resources that support reaching ZD and UI children, including the Theory-Based Evaluation Toolkit and the forthcoming Lot Quality Assurance Sampling (LQAS) Toolkit. During this reporting period:

• In Bangladesh, JSI provided technical feedback on the draft Forcibly Displaced Myanmar Nationals household survey report, offering recommendations on population comparisons and use of the wealth index in refugee contexts. JSI also collaborated with IIHMR to finalize and submit the Bangladesh Political Economy Analysis report to Gavi, incorporating Gavi’s feedback to prepare the report for dissemination.
• JSI provided several rounds of feedback on the Mali Learning Hub’s implementation research (IR) report and reviewed their new protocol for an approach to improve vaccine equity through better data use. JSI also provided technical input to refine the IR theory of change, clarifying causal pathways and intermediate outcomes, and reviewed qualitative tools for alignment with the revised framework. Additionally, JSI continued to advise on research related to the rollout of the Coach2PEV and MEDEXIS digital applications.
• In Nigeria, JSI supported the Learning Hub to finalize and publish the Decentralized Immunization Monitoring (DIM) manuscript in Vaccines and strengthened the IR baseline report through detailed feedback on sampling methods, gender frameworks, data analysis, and costing approaches. JSI developed a customized Excel tool and provided handson support for calculating sampling LQAS frames for upcoming DIM data collection in other states. Additional support included refining the Learning Hub’s quarterly report structure, enhancing the clarity and strategic alignment of the draft learning agenda manuscript, and collaborating with Gavi and the Learning Hub on strategic planning to align timelines, integrate DIM and IR activities, and update the project theory of change and monitoring plans.
• JSI supported the Uganda Learning Hub by reviewing and refining data collection tools linked to their ongoing IR including the Health Facility Assessment, ZD follow-up surveys, and qualitative research. JSI also contributed to developing an intervention mapping tool for activities in Mubende district and helped create a presentation using contribution analysis and outcome harvesting to illustrate Uganda’s progress. Additional support included feedback on the Learning Hub’s costing concept paper and subsequent costing study of targeted immunization strategies as well as support for their knowledge translation plan and draft publications. JSI further reviewed the endline quantitative survey tool and revised the IR theory of change to guide measurement and storytelling.

Facilitating Learning and Sharing

Bridging the Know-Do Gap: Ongoing Knowledge Translation Activities

During this reporting period, the ZDLH expanded its knowledge translation (KT) agenda. New KT resources were launched, including a KT Measurement Brief and a multi-part blog series guiding public health professionals on moving research into policy and program action. ZDLH also hosted two global webinars focused on tailored solutions to ZD identification and monitoring challenges, along with methods to strengthen collaboration, data sharing, and feedback loops that drive immunization improvements. The webinars, with simultaneous interpretation in English and French, reached over 337 participants during the live streaming from global health organizations, civil society, and national immunization programs, including WHO, the Gates Foundation, and CHAI. Recordings and slides are accessible on the ZDLH website for on-demand learning.

Zero-Dose Resource Library

The ZDLH resource library features a curated repository of evidence-based monitoring, monitoring, and learning resources; tools; guidance; and approaches, as well as existing evidence from each country and resources generated by the ZDLH.

During this period, the ZDLH website welcomed 5,821 visitors who downloaded 169 unique resources/files a total of 2,583 times. The most downloaded resources included:

1. Knowledge Translation for Zero-Dose Immunization Research
2. Nigeria Zero-Dose Landscape
3. Closing The Immunization Gap: Enhancing Routine Immunization in Nigeria by Reaching Zero-Dose and Under-Immunized Children in Marginalized Communities: Report of a Rapid Assessment
4. Assessment of the Political Economy Context Surrounding Evidence Use for Zero-Dose Programming and Policies in Nigeria
5. Utility of Data Capture Platforms for Identifying Zero-Dose Children in Uganda

The Bangladesh dashboard has not been updated at this time, as recent EPI data are not yet available through the national DHIS2 system. According to the Learning Hub, data submission from the field has been temporarily delayed due to ongoing administrative challenges affecting reporting processes which have affected the availability of data from the Learning Hub study subdistricts (upazilas). In addition, national-level data through the electronic Joint Reporting Form (eJRF) have not been available since August 2024, preventing updates to the national trend figures. While EPI sessions and activities have continued, the corresponding data have not yet been transmitted to the national level.

Access the full report: Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Bangladesh (October 2025)

The following section presents data on key immunization indicators in Mali. An explanation of the data sources and interpretation of the figures is presented in the text that follows.

Coming soon

The following section presents data on key immunization indicators in Nigeria. An explanation of the data sources and interpretation of the figures is presented in the text that follows.

Coming soon

The following section presents data on key immunization indicators in Uganda. An explanation of the data sources and interpretation of the figures is presented in the text that follows.

These figures present the number of children immunized with DTP1 and DTP1 coverage in Uganda from October 2019 to March 2025, with trends at the national level, Gavi-supported districts, and Learning Hub study districts largely mirroring one another. Coverage remained relatively stable over most of the period, with a noticeable dip in late 2022–early 2023, followed by steady recovery with reported coverage rates exceeding 100 percent across all levels. In the October 2024–March 2025 period, more than one million children were immunized nationally, the highest level recorded. These gains point to a strong rebound in immunization delivery, likely reflecting intensified efforts such as the national BCU campaign.

DTP1 Trends in Uganda, 2019–2025

Learning Hub Study Subdistricts in Uganda: Trends in DTP1 Coverage from Q4 2022 to Q2 2025

Source: Uganda DHIS2 reported in Uganda Learning Hub Quarterly Progress Report

This figure displays subnational data from the Uganda DHIS2 on DTP1 coverage from quarter four (Q4) 2022 to quarter two (Q2) 2025. While immunization rates remain variable across the six Learning Hub subdistricts, the 2025 data largely highlight a continuation of previous trends. In Kasese, coverage has largely stabilized: Karambi has remained steady in the 80 percent range since mid-2024, while Isango showed the strongest improvement, rebounding in 2025 to reach a new peak of 99 percent. In Mubende, the two subdistricts followed diverging paths. Kiruuma, which had spiked dramatically in late 2023, saw only a temporary recovery in late 2024 before declining again in 2025, while Butoloogo showed renewed momentum with a sharp rebound in Q2 2025 (107%). In Wakiso, both Bussi and Namugongo displayed similar dynamics: low and stagnant coverage through 2024, a sharp rise likely due to the national BCU campaign in late 2024, and subsequent declines in 2025.