COMMUNITY CASE STUDY article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1625514
Bridging Immunization Gaps: Lessons from Zambia's 2024 Measles-Rubella Supplementary Immunisation Activity (SIA)
Provisionally accepted
Moses Mwale1*
Penelope Masumbu1Peter Chipimo1Patrick Sakubita1Andrew Phiri1Kennedy Matanda2
Kelvin Mwangilwa3Andrea Carcelen4Simon Mutembo4
Freddie Masaninga1Jacob Sakala2
Clement Peter Lusaba1- 1World Health Organization, Lusaka, Zambia
- 2Ministry of Health, Lusaka, Zambia
- 3Zambia National Public Health Institute, Lusaka, Zambia
- 4Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
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Zambia's 2024 Measles-Rubella Supplementary Immunization Activity (SIA), conducted from 23-28 September across all 116 districts, targeted children aged 9-59 months to address immunization gaps exacerbated by COVID-19 disruptions and responding to ongoing measles outbreaks. This community case study evaluates the effectiveness of microplanning, the feasibility of real-time digital monitoring, and the equity of reaching zero-dose children during Zambia's 2024 Measles-Rubella SIA, using a mixed-method approach to inform scalable immunization strategies in resource-limited settings. Through comprehensive microplanning, strategic community engagement, and real-time digital monitoring, the campaign achieved 97% national coverage and reached 165,000 previously zero-dose children in underserved communities. Implementation utilized Google Sheets and Open Data Kit tools, with quality assurance through over 7,500 supervisory visits. Despite achieving high overall coverage, several challenges emerged: funding delays, logistical constraints in remote areas, 2 and data quality issues. Key lessons include the necessity of timely funding disbursement, strengthened cold chain infrastructure, and rigorous data verification processes. Community involvement through local leadership engagement and radio campaigns proved essential to success, while digital monitoring enabled rapid adaptation to emerging challenges. This case study provides actionable insights for designing equitable immunization campaigns in resource-limited settings, supporting global measles and rubella elimination goals through evidence of effectively tailored, data-driven strategies.
Keywords: Zambia immunization, measles-rubella campaign, Zero-dose children, Community Engagement, Digital monitoring, Supplementary immunization, Low-resource settings
Received: 09 May 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Mwale, Masumbu, Chipimo, Sakubita, Phiri, Matanda, Mwangilwa, Carcelen, Mutembo, Masaninga, Sakala and Peter Lusaba. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Moses Mwale, World Health Organization, Lusaka, Zambia
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