Indicator selected for global monitoring for Immunization Agenda 2030 Impact Goal Indicator 2.1
Zero-dose children are defined as those that lack access to or are never reached by routine immunization services. They are operationally measured as those who did not receive their first dose of DTP, a vaccine containing diphtheria-tetanus-pertussis.
At the global and regional level, the number of zero-dose children by region and country will lead to a prioritization of efforts, and can be used to create accountability for countries that do not reach targets, or backslide from previously attained targets. Furthermore, it can be used to communicate about immunization gaps that exist in the world, and advocate for concerted efforts to bridge them.
At the country and subnational level, identifying zero-dose children and underserved communities should facilitate a root-cause analysis of the reasons for under-vaccination, and identification of the barriers that exist for certain communities and geographies. From a communication perspective, the importance of this indicator will highlight the need to focus on equity in immunization.
Definition:
Number of zero dose children (children who did not receive their first dose of DTP) across the WHO Member States, rounded to the nearest thousandth.
• Baseline year: 2019
• Target:
o Reduction in the number of zero dose children by 50%
o In countries where DTP1 coverage is already 99%, target is to maintain the coverage.
Associated terms:
Zero dose children: Children who did not receive their first dose of DTP
Disaggregation:
WHO Member States
Method of measurement
National immunization programme
M&E Framework:
Outcome
Method of estimation:
Step 1: Calculate the number of zero dose children (children who did not receive their first dose of DTP).
• This is calculated as the difference between the estimated number of surviving infants and the estimated number of children who received their first dose of DTP.
Step 2: Round to the nearest thousandth.
Method of estimation of global and regional aggregates:
Sum (round to the nearest thousandth after summing the number of zero dose children in the countries of interest).
Preferred data sources:
WHO/UNICEF Estimates of National Immunization Coverage (WUENIC)
UN Population Division’s World Population Prospects (UNPD WPP)
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