This report from the Gavi Zero-Dose Learning Hub (ZDLH) details findings from two online peer learning events organized by The Geneva Learning Foundation, focused on identifying strategies to reach zero-dose children in Bangladesh, Mali, Nigeria and Uganda. These events engaged nearly 1200 practitioners, predominantly from subnational levels, in sharing experiences.  Key strategies for identifying and reaching zero-dose children centered around integration of immunization into other health services and enhancing microplanning processes to more intentionally address local challenges. Case studies highlighted approaches like using antenatal care data to follow-up on home births and involving communities in revising facility microplans. Participants felt community engagement approaches would be critical for solving zero-dose issues.   Significantly, 99.7% of practitioners reported they would apply learnings, suggesting knowledge translation potential. Participation increased motivation and commitment for over 99%, while 95% indicated the events provoked reflective practice.  Methodologically, the approach moved beyond dissemination to promote exchange and practical application of ideas between peers. Allowing participants to identify locally relevant solutions appears important for translating global recommendations into local action. Quantitative and qualitative analyses revealed participation benefited individuals across geographies, system levels and experience, enhancing knowledge, skills, networking, personal growth and vocational development. These professional impacts have implications for strengthening long-term immunization capabilities. The peer learning model seems both appealing across practitioners and impactful. Follow-up is needed to confirm whether intentions translate into changes in practice over time. Nonetheless, initial signs are promising, with several participants already implementing new ideas or planning to integrate learnings into their context. Overall, the report compellingly demonstrates the value of peer learning in driving evidence use and knowledge sharing on practical means of reaching the unreached. It highlights the intrinsic motivation of practitioners to improve and support each other when connected. Fostering such networks can be highly cost-effective while delivering results on coverage, human capital and innovation.

Multiple factors affect health worker performance and, by extension, immunization programme performance. For example, health worker motivation is often seen to be key to programme performance. A less well studied factor with potential impact on programme performance is organizational learning culture – the capacity of the work environment to support learning and change. Evidence-based instruments to assess organizational learning culture have been applied in a wide range of public-sector and private-sector settings, and have shown a correlation between a supportive learning culture and organizational performance. However, these instruments have not yet been applied in immunization. An application form used to recruit participants for the 2022 Immunization Agenda 2030 (IA2030) peer learning programme organized by the Geneva Learning Foundation (TGLF) provided an opportunity to explore questions related to motivation, workplace learning culture and perceptions of immunization programme performance within lowand middle-income countries (LMICs). This report is part of series aiming to capture the perspectives of a diverse group of health practitioners working to deliver or manage immunization services in low- and middle-income countries. Contributing to consultative engagement between international and local levels, each report offers a unique opportunity to discover unfiltered experiences and insights from thousands of people whose daily lives revolve around delivering immunization services. This Immunization Agenda 2030 (IA2030) publication is part of the IA2030 Movement’s Knowledge-to-Action Hub. Learn more about the Hub… Learn more about the Movement…