This document summarizes the challenges faced by the immunization supply chain (iSC) in reaching the communities with the most zero-dose children, namely urban poor, remote rural and conflict-affected communities. It also provides guidance on the iSC strategies and interventions that may be used to address them. It ultimately aims to enhance coverage and equity in the three most underserved community types. ‘Remote rural’ refers to settings that are physically distant from cities and characterized by low population densities and small settlements. ‘Urban poor’ refers to settings “characterized by high population density, high mobility and unevenly distributed wealth and services”. ‘Conflict’ settings are involved in an active or long-standing conflict that limits the choice of iSC strategies, and are becoming increasingly prevalent, with the highest concentrations of zero-dose children. These three settings share common challenges, for which cross-cutting strategies have been identified.

isc-integration

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• Cold chain integration

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