A new literature review published in Tropical Medicine and Infectious Disease examines how gender-related factors contribute to the occurrence and prevalence of zero-dose children in Sub-Saharan Africa. The authors screened nearly 3,700 records and included 24 relevant studies from 2015 to 2025, identifying four major thematic barriers: women’s empowerment and autonomy, male involvement and entrenched gender norms, socioeconomic and structural constraints, and gaps in education, awareness, and health system responsiveness.
Their synthesis highlights how limited maternal decision-making power, unequal financial access, patriarchal norms excluding male engagement, and health services that do not accommodate gendered realities together perpetuate immunisation inequities.
For immunization policy and program planners, this review underscores the need for gender-responsive strategies to reach zero-dose and under-immunised children. It argues that boosting maternal autonomy, integrating men into child health messaging, tailoring service delivery to women’s mobility and schedules, and routinely collecting sex-disaggregated data can all help close immunisation gaps.
As countries strive to achieve equitable vaccine coverage, these insights emphasize that addressing gender norms is not peripheral, but central, to reaching every child.
Thumbnail image credit: Gavi/2024/Mohamed Abdihakim Ali
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