Reaching Zero-Dose Children through Stronger Primary Care in Southern Madagascar
Situation:
Vaccination is one of the most effective ways to protect children from preventable diseases and death. Yet in southern Madagascar, many children still grow up without this protection. In remote communities, long distances, poverty and weak health structures make access to care even harder. During the first SOAMEVA phase, more than 213,000 zero-dose children under five were identified across 16 districts, showing the urgent need to strengthen local immunisation and primary care systems.
Objectives:
The project aims to reach zero-dose and under-vaccinated children in southern Madagascar and connect them sustainably to primary care. It integrates immunisation with maternal and child health, TB and HIV services, brings mobile clinics to remote communities, strengthens health workers and local facilities, and improves data and follow-up systems. The project aims to vaccinate at least 150,000 children.
- ≥8,000 integrated mobile vaccination sessions delivered
- ≥150,000 children vaccinated
- ≥3,500 CHWs receiving a structured CHW support package
- ≥10 CHW groups/associations established and operational
- ≥150 primary care facilities receiving structured, continuous support
- ≥95% of partnering facilities with fully functional cold chain
The project strengthens Community Health Workers, primary care facilities and cold chains, delivers mobile vaccination services in remote communities, and improves data and follow-up systems. Immunisation is integrated with maternal and child health, TB and HIV services.
The project strengthens existing public health structures and is closely aligned with the Ministry of Health. Trained local teams, digital systems and CHW support are embedded into routine care, ensuring that successful approaches are locally anchored, transferable and usable in the long term.
A key feature is the strong data basis from the completed first project phase: vaccination status was recorded for children under five across 16 districts, identifying more than 213,000 zero-dose children. This shows where unvaccinated children live and enables mobile vaccination services to be planned in a targeted way.
Further information: https://www.doctorsformadagascar.com/
