Evidence synthesis brief: the economics of reaching zero-dose children

Health Systems Insight (formerly ThinkWell Institute) released a new evidence synthesis, “What do we know about the economics of reaching zero-dose children?”, summarizing the latest findings from 13 studies across five countries. This brief brings together preliminary results presented during the Immunization Economics Pre-Congress 2025, held in Bali in July ahead of the IHEA World Congress, where researchers and practitioners shared early findings from a growing body of economic studies on zero-dose strategies.

Key takeaways

The report highlights emerging insights on the economics of reaching zero-dose children:

• Trade-offs between cost and timeliness: Delivery strategies that reach more zero-dose children per session—like campaign-style approaches—tend to be more cost-efficient but may leave children off-schedule longer.
• Integrated strategies deliver broader value: Approaches combining immunization with nutrition and other health services can reach more children while providing greater overall health benefits.
• Costs vary widely across contexts: What is cost-efficient in one location may not be in another, underscoring the need for context-specific design.
• Design-intensive interventions remain costly: Human-centered design interventions can effectively address persistent demand-side barriers, but their costs do not necessarily decrease when scaled to different context.
• Targeted financial incentives show promise: Conditional cash transfers can reduce financial barriers for caregivers, especially when integrated into existing social protection systems.

Read the full brief: What do we know about the economics of reaching zero-dose children? 

Thumbnail image credit: Gavi/2023/Nipah Dennis