REACH-OUT

Closing the immunization gap by reaching zero-dose children through improved equitable and cost-effective vaccine delivery strategies

Principal investigator: Carlo Federici (CeRGAS)

Team UB/Cergas: Carlo Federici, Aleksandra Torbica, Alessia Melegaro, Viviana Mangiaterra, Maria Cucciniello

Partners: AMREF Africa (Kenya), The Centre for Impact, Innovation and Capacity building for Health Information Systems and Nutrition -  CIICHIN (Rwanda), Centre for Integrated Health Programme - CIHP (Nigeria), Heidelberg Institute for Global Health – HIGH (Germany), Institute Of Tropical Medicine Antwerp – ITMA (Belgium), Fondazione Bruno Kessler – FBK (Italy), Swiss Tropical Institute of Public Health – STPH (Switzerland)

Sponsor: GH EDCTP3 joint undertaking

Duration: Jan 2025- Jan 2029

Abstract: 
REACH OUT is 4-year project, funded under the Global Health EDCTP3 Joint Undertaking (Global Health EDCTP3). The project aims to achieve 4 Specific Objectives (SO):  

SO1. Develop robust data and evidence on ZD communities and infection risks: REACH-OUT will generate data to help immunization programs reach Zero Dose (ZD) communities by addressing behavioral, supply, and demand barriers. It will adopt behavioral science and precision public health approaches, using geospatial methods and new data overlays to improve targeting of ZD children and guide tailored interventions to increase vaccination coverage. 
SO2. Co-design of customized intervention bundles for ZD communities in three SSA countries: REACH-OUT will create tailored intervention bundles in three Sub-Saharan African countries to improve vaccination coverage for Zero Dose (ZD) communities. Using a holistic, data-driven, and context-specific approach, interventions will address supply- and demand-side barriers. Community involvement and advanced geospatial methods will optimize micro-plans and support decision-making at all levels. 
SO3. Establish evidence on the impact of intervention bundles on (cost-)effectiveness, implementation processes and equity: REACH-OUT will use implementation science to bridge the gap between research and policy by conducting tailored effectiveness-implementation hybrid trials in Kenya, Nigeria and Rwanda. The project will evaluate interventions on different dimensions, including reach, effectiveness, adoption, implementation and sustainability. Economic evaluations, including distributional cost-effectiveness analyses, will assess impacts on cost, equity, and immunization outcomes. 
SO4. Promote knowledge translation to policy and practice: REACH-OUT aims to impact Zero Dose (ZD) vaccination coverage by promoting knowledge translation into policy and practice. Using an integrated knowledge translation (IKT) approach, the project will engage decision-makers, strengthen local capacity, and develop tools to scale cost-effective interventions. Dissemination plans and a transferability model will ensure uptake in other Sub-Saharan African countries.

REACH-OUT’s ambition is to make country immunization programs more fit to effectively reach and immunize ZD communities, thereby contributing towards the IA2030 objectives of disease elimination, high coverage rates and equitable access to vaccines.

REACH OUT aims to develop innovative interventions to enhance vaccine delivery for ZD communities, supporting global goals such as SDG 3 and targets set by EU2030 and GAVI. It will deliver updated geospatial estimates, infection risk data, and a decision support tool to strengthen health systems. Eventually, the project will benefit vulnerable communities with high ZD prevalence, frontline health workers, and policymakers in Kenya Nigeria and Rwanda as well as in other SSA countries. Community involvement will be facilitated through Society Advisory Groups, ensuring that project outcomes address specific needs and barriers to vaccination.

Expected results

  • New evidence about the supply- and demand-side barriers to immunization
  • Set of freely available geospatial data on ZD children, including a novel ZD vulnerability index
  • Novel data on infection risks for specific vaccine preventable diseases
  • Updated micro-plans for ~200 facilities/districts
  • New robust evidence from implementation study of tailored intervention bundles to reach ZD communities
  • A novel freely available and open source decision support tool to support budgeting, planning, implementation and monitoring of vaccine delivery interventions
  • 3 scale-up plans and a transferability process model for cost- effective interventions