Geospatial approaches for mapping zero-dose prevalence and routine childhood immunisation coverage in low- and lower-middle-income countries: A scoping review

This peer-reviewed scoping review, published in Vaccine, examines how geospatial methods have been used to map routine childhood immunisation (RI) coverage and identify zero-dose (ZD) children across low- and lower-middle-income countries (LLMICs). The authors searched six databases for peer-reviewed studies published up to 2025 and reviewed study characteristics, data and covariates, spatial modelling methods, and methodological gaps.

Key findings

• The review identified 102 studies across 68 LLMICs, with 70% published between 2021 and 2024; however, 87% focused on Ethiopia, Nigeria and India.
• Only 20 studies (19.6%) assessed zero-dose prevalence, with substantial variation in how zero-dose was defined.
• Household surveys were the predominant data source, and the covariates used were largely demographic, which accounted for 49% of all covariates identified.
• Clustering/spatial autocorrelation (54%) and spatial interpolation (45%) were the most commonly used methods, while small-area estimation (13%) and machine learning (8%) were less common.
• Conflict-affected, informal-settlement, nomadic and mobile populations were underrepresented, alongside challenges related to missing covariates, data quality and sparse samples.

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