Journal article
Applying a human-centered design approach to increase immunization coverage and reduce the number of zero-dose children in Tshopo Province, Democratic Republic of the Congo: A costing analysis
The Democratic Republic of the Congo (DRC) is among the countries with the highest number of zero-dose and under-immunized children in the world. Tshopo Province, located in the North-Central area of the country, is particularly impacted, with alarmingly low immunization rates and a proportion of zero-dose children higher than 60%. Innovative and targeted interventions are required to reach children missed by the immunization program. In collaboration with the DRC Ministry of Health, PATH implemented a human-centered design (HCD) project to co-create and test solutions that could help the community address the issue in four targeted health areas of Tshopo Province.
As part of the project, we conducted a study to assess the incremental financial, opportunity, and economic costs of implementing the HCD approach and derived prototype interventions. The aim was to inform decision-makers and technical and financial partners about the economic viability of the HCD approach and its potential for scale-up, and to provide a basis for comparison with other strategies to improve immunization coverage. Using a microcosting, ingredients-based approach, we documented and valued all resources used during the project and reported cost per pre-defined activities and cost categories.
Among the interventions implemented, the involvement of private health facilities in immunization activities resulted in a financial and economic cost per zero-dose child vaccinated with Penta 1 of US$16 and US$31 respectively; community engagement activities resulted in a financial and economic cost per zero-dose child identified of US$10 and US$17, respectively. The overall implementation costs of the interventions are expected to decrease after the initial design, testing, and refinement phrases are completed. Given these results, HCD-developed approaches may provide a feasible mechanism for identifying locally adapted strategies to improve childhood immunization coverage.
Authors
Languages
- English
Publication year
2026
Journal
Vaccine
Volume
88
Type
Journal article
Categories
- Global initiatives
Countries
- Democratic Republic Of The Congo
Organisations
- Gates Foundation
- PATH
Tags
- Zero-dose
ZDLA-DRC
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The resource is included in the following table:
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| Programme d’apprentissage des enfants zéro-dose (Tshopo): Que faut-il pour concevoir des interventions visant à lutter contre les facteurs à la base des Zéro dose | PATH Living Labs DRC | 2026 | Report | French |
| Programme d’apprentissage des enfants zéro-dose (Tshopo) | PATH Living Labs DRC | 2025 | Report | French |
| Zero-Dose Child Learning Agenda (Tshopo): What is needed to design interventions to address the factors that underlie Zero Dose | PATH Living Labs DRC | 2025 | Report | English |
| Zero-Dose Learning Agenda (Tshopo) | PATH Living Labs DRC | 2025 | Presentation | English |
| Applying a human-centered design approach to increase immunization coverage and reduce the number of zero-dose children in Tshopo Province, Democratic Republic of the Congo: A costing analysis | Mamadou Sanogo, Cyprien Tendo-Bugondo, Médard Abedi, Dominique Kabengele Kasongo, Rene Kalimira Rusangiza, Logan Brenzel, Frédéric Debellut | 2026 | Journal article | English |
