Pakistan continues to face significant immunization challenges, with nearly 400,000 zero-dose children reported in 2024 and ongoing polio endemicity. To address this, the Government of Pakistan has rolled out several targeted initiatives to identify and reach zero-dose children, but their relative cost and effectiveness have remained unclear.
A new study by PHC Global and ThinkWell provides a comprehensive on the cost of zero-dose interventions and routine immunization delivery across Punjab and Sindh. Using a bottom-up costing approach across 56 sites, the study compared financial and economic costs for three zero-dose interventions—polio house-to-house campaigns, Clinics on Wheels, and integrated outreach activities—against routine delivery through fixed sites and regular outreach.
Results show that integrating zero-dose identification into polio campaigns is among the most cost-efficient approaches, requiring no additional financial outlay. Meanwhile, integrated outreach performed best in rural areas with weak health infrastructure. Clinics on Wheels are costly and should be leveraged as a highly targeted intervention in areas where zero-dose children are concentrated in informal settlements. Overall, the effectiveness and cost-efficiency of each delivery strategy depended on its ability to address the specific barriers in reaching zero-dose children.
Any organization or individual working in the field of immunization economics can submit findings, opportunities, calls to action, or other relevant work below to be shared with our community.