Immunization is one of the most effective public health interventions with most children in the world receiving vaccinations. The COVID-19 pandemic showed the value of vaccination for global health security but caused routine vaccinations to backslide with nearly 67 million children missing out (according to UNICEF). Despite the scientific evidence on the benefits for children, adolescents and adults, some communities remain hesitant or do not have sufficient knowledge to seek vaccination.

Identifying the root cause of barriers to vaccine uptake is critical to ensure that young people understand the importance of routine immunization. Girl Effect, through a new partnership with Gavi, the Vaccine Alliance, delivers youth-centered behavior change communications that address the gender barriers and create demand for vaccination amongst young people.

Building on the success of our work to date to drive demand for the HPV vaccine amongst girls in Africa, we are designing our program in Ethiopia and Tanzania to focus on the urgent challenge of how to reach missed communities and work to reverse the decline in uptake of vaccines caused by the pandemic. Our content bust-myths, fights misinformation and inspires conversation about the importance of vaccination programmes, speaking up about health concerns and accessing health services.

Identifying missed communities

The Gavi 5.0 strategy and the Immunization Agenda 2030 (IA2030) focus on reaching zero-dose children that have missed doses of the most widely available immunizations. We have worked with the Ministries of Health in Tanzania and Ethiopia to identify the communities most in need of support to build demand for immunization and understand the benefits to vaccination to overcome myths and misconceptions.

Our focus is two audiences: young caregivers to improve routine immunization for children; and adolescent girls and their families to improve coverage for the cervical cancer vaccine.

Using national immunization data on zero dose communities, we selected regions to prioritize for the program in pastoral, rural and peri-urban settings where we can tailor and test the best messages for specific audiences. This included factors like regional and district vaccination data; teenage pregnancy rates; infant and child mortality rates; social cultural trends; and persistent gender norms.


The nature of the HPV vaccine roll out in most countries (in schools) has meant there are girls that miss out as a result of not being enrolled in schools. In pastoral areas where school enrollment is low, clan leaders and religious leaders are very influential, and we must engage the community first to find out-of-school girls and encourage them to be vaccinated against cervical cancer.

Designing with youth at the centre

As part of our design work, the Girl Effect team traveled to the regions to speak to communities, research the barriers to vaccination and map out the behaviors that we need to influence to drive uptake of routine immunization and the HPV vaccine. Using human-centered methods in each region, we convened development experts, tech innovators and youth advisers to meet young people, parents and community leaders to co-design solutions around a problem statement.

From these co-creation workshops and focus group sessions we rapidly designed behavior change communications approaches to drive uptake of both routine immunization and the HPV vaccine.

To reach out-of-school girls and zero-dose communities as well as large numbers of adolescent girls eligible for the HPV vaccine, we are piloting community-level, digital and mass-media campaigns in select districts to measure the behavior change impact. Immunization doesn’t exist in a silo, so we are designing our programme holistically to address barriers to vaccination alongside issues like sexual and reproductive health, education and nutrition.

The co-design process is robust, allowing us to test our approaches and ensure the messaging used stay relevant to our audiences’ needs and address the gender barriers that limit vaccine uptake to have a lasting impact.


Ensuring every girl understands the value of life-saving vaccines

Due to the decline in coverage for the cervical cancer vaccine worldwide, Girl Effect has stepped in to support catch-up plans by the Ministries of Health in Ethiopia and Tanzania to drive uptake of the HPV vaccine. To mark Africa Vaccination Week, we are launching campaigns to reach the large number of girls that missed out on the vaccine during the pandemic. Girl Effect’s youth brands in Tanzania and Ethiopia will support on-ground mobilization activities – reaching millions of young people via TV, social media, radio, print and club networks.

Our work to date with Gavi, the Vaccine Alliance, has shown that girls are powerful change makers for themselves and for those around them. Ensuring every girl understands the value of life-saving vaccines is essential to protect the health of girls, young women and children so that no-one gets left behind.