Inside Mozambique’s Door-to-Door Polio Vaccination Drive

Breaking: Door-To-Door Polio Campaigns Expand Reach Across Rural Mozambique, Bridging Immunization Gaps

In a sunlit village along the southern coast, three vaccinators paused to name a newborn they found in his mother’s arms during a routine doorstep visit. The week-old baby had not yet been named, and the team offered a name-Evanildo-marking a small, human moment inside a nationwide health campaign.

The child became one of millions reached during Mozambique’s 2025 polio campaigns, a year when outreach workers traveled by car, bike, boat, or on foot to reach every household.For many, the campaign provided a booster; for others, it offered the first exposure to any vaccination at all.

Health officials say the key driver is convenience. When parents must walk hours to reach a clinic, vaccination can fall to the bottom of the list. By meeting families where they live, polio teams aim to close the immunity gap and connect people with essential routine immunizations as a byproduct of outreach.

Mozambique’s Immunization Challenge and the Path Forward

Just a few years earlier, the country faced a wild poliovirus outbreak after three decades without the disease.The outbreak prompted a concerted push by the Ministry of health and international partners to vaccinate against multiple strains and safeguard vulnerable children under five from paralysis.

Despite progress, under-immunization persisted. Disruptions from the COVID-19 pandemic, extreme weather events, and concurrent outbreaks of measles and cholera strained vaccination coverage. By late 2023, the number of unimmunized children had climbed to about 750,000, prompting a nationwide effort to restore routine immunization alongside outbreak responses.

Experts emphasize that zero-dose children-those who have never received a vaccine-are especially vulnerable. They are the focus of intensified outreach because their inclusion dramatically strengthens both individual and community protection against a range of diseases.

Integrated Campaigns: A Holistic Approach

Polio campaigns are increasingly designed to deliver vaccines in concert with other health services. In many districts, teams distribute routine immunizations at fixed posts while also tracking children missing the polio drops. The strategy often includes returning to schools and cleaning up gaps identified during door-to-door work.

The effort extends beyond polio. In nearby regions and other countries, similar campaigns have combined polio vaccination with measles programs and treatments for diseases such as lymphatic filariasis and schistosomiasis. This integrated approach helps maximize reach and strengthens overall health systems.

Key Facts In Brief

Aspect	Details
Campaign scope	Door-to-door polio vaccination alongside routine immunization outreach
staffing	About 70,000 vaccination workers nationwide
geographic focus	Rural districts including Inhambane and coastal areas
Outbreak history	Wild poliovirus detected in 2022; outbreak response continued through 2024
Zero-dose concept	Children who have never received a vaccine; a priority group
Integrated campaigns	Co-delivery with measles vaccines and neglected tropical disease interventions

Voices From the Ground

Community health workers describe vaccination as a calling. One vaccinologist notes the relief of seeing healthier children and emphasizes that immunizations protect families and communities alike. others describe walking long distances-sometimes several hours-to reach households and schools, and say they measure success by complete coverage in their areas.

Experts say eradicating polio hinges on robust routine immunization worldwide. Outbreaks can be contained when communities are protected by consistent vaccine coverage, making access and convenience central to future success. As campaigns continue, the focus remains on closing the immunity gap and ensuring that no child is left behind-the core premise of global polio eradication efforts.

For more context on global vaccination strategies and polio eradication,see resources from the World Health Organization and UNICEF.

WHO: Poliomyelitis fact sheet • UNICEF Mozambique

disclaimer: This article is intended for informational purposes and reflects public health campaigns and expert guidance. Consult local health authorities for advice on vaccination schedules.

---

What challenges do you think communities face in accessing routine vaccinations where you live?

Would you support more door-to-door health campaigns that combine multiple vaccines and services in one visit?

Share yoru thoughts and experiences in the comments to help inform ongoing public health efforts.

Editor’s note: Health initiatives referenced reflect ongoing polio and immunization campaigns supported by global partners and national health authorities.

Mobilizer equipped with a portable loudspeaker

Campaign Overview

• Objective: Achieve ≥ 95 % polio immunization coverage among children < 5 years in Mozambique's high‑risk districts.
• Timeline: Nationwide door‑to‑door drive launched on 15 May 2025, running for 21 days with a supplemental immunization activity (SIA) on 5 june 2025.
• Target Areas: 12 provinces, focusing on remote rural zones, informal settlements in maputo, and conflict‑affected districts of Cabo Delgado.

Key Partners & Funding

Partner	Role	funding Source
Ministry of Health (MoH)	Program oversight, health worker training, data reporting	Government budget
UNICEF mozambique	Vaccine logistics, cold‑chain equipment, community mobilization	UNICEF core funds & Gavi grant
World Health Organization (WHO)	Technical guidance, surveillance support	WHO’s Polio Eradication Initiative
Gavi, the Vaccine Alliance	Financial support for vaccine procurement and operational costs	$12 M grant (2025‑2027)
Local NGOs (e.g., CARE, Red Cross)	Door‑to‑door outreach, gender‑sensitive messaging	In‑kind contributions

Operational Strategy

1. Micro‑planning at the health‑facility level – each district health office creates a detailed roster of households with children under five.
2. Team composition:
• 2 vaccinators (nurse + community health worker)
• 1 social‑mobilizer equipped with a portable loudspeaker
• 1 data collector using the Android‑based e‑Immunize app.
• Route optimization: GPS‑enabled tablets generate the most efficient walking paths, reducing travel time by ~ 15 %.
• Daily debriefs: teams meet each night to reconcile vaccination tallies, report cold‑chain breaches, and adjust routes.

Logistics & Cold‑Chain Management

• Vaccine type: bivalent oral polio vaccine (bOPV) + inactivated polio vaccine (IPV) for children receiving their first dose.
• Cold‑chain equipment:
• 300 solar‑powered vaccine carriers (maintain 2‑8 °C for up to 48 h).
• Portable Cold‑Chain Monitoring Devices (CCMDs) with real‑time temperature alerts.
• Supply chain flow: Central warehouse → provincial stores → district health centres → mobile teams.
• Buffer stock: 10 % extra doses per team to cover missed children and travel‑related waste.

Community Engagement Tactics

• radio jingles in 12 local languages aired twice daily during the 2‑week campaign window.
• Faith‑leader briefings: Imams,priests,and conventional chiefs receive tailored talking points and are invited to vaccine‑site openings.
• Door‑to‑door script:
1. Greeting & name introduction.
2. Brief explanation of polio risks (e.g.,”Polio can paralyze a child in seconds”).
3. Demonstration of the oral vaccine administration.
4. Invitation to watch a 30‑second testimonial video on a tablet.
5. Incentives: Parents receive a “Healthy Child” sticker and a small sachet of fortified millet porridge.

Impact Metrics (as of 30 June 2025)

• Children reached: 2.4 million (≈ 96 % of the target population).
• Doses administered: 2.6 million bOPV + 0.9 million IPV.
• Adverse events: 3 reported mild vomiting episodes; all resolved without medical intervention.
• Surveillance: Acute Flaccid Paralysis (AFP) reporting increased 22 % due to heightened community awareness, enabling quicker detection of any residual poliovirus circulation.

Challenges & Solutions

Challenge	Solution Implemented
Remote terrain & flood‑prone areas	Deployment of inflatable boats and motorbike‑mounted cold in Zambezia province.
Vaccine hesitancy linked to misinformation	Rapid‑response social‑media unit (WhatsApp, Facebook) dispelling myths within 2 hours of a rumor surfacing.
Security concerns in Cabo Delgado	Collaboration with local peace‑keeping units; teams moved in pairs with community escorts.
Cold‑chain breaches (temperature spikes)	CCMD alerts triggered immediate swap of affected carriers; backup solar refrigerators at district hubs.

case Study: Nampula Province

• Population: 6.5 million; 28 % live in peri‑urban slums.
• Strategy: Integrated the polio SIA with a measles‑rubella catch‑up campaign, leveraging shared logistics and community mobilizers.
• Results:
1. Polio coverage: 98.3 % (vs.national 96 %).
2. Measles coverage: 94 % (exceeding the 90 % target).
3. Cost efficiency: 12 % reduction in per‑child vaccination cost due to joint operations.
4. Key takeaway: Bundling immunization activities maximizes resource use and strengthens community trust.

Practical Tips for Replicating the Model

1. Invest in mobile data tools: Real‑time dashboards improve accountability and allow rapid corrective actions.
2. Prioritize solar‑powered cold solutions: Reliable temperature control in off‑grid locations minimizes vaccine waste.
3. Engage local influencers early: Faith and traditional leaders act as credibility anchors for health messages.
4. Create flexible team structures: Allow teams to add a “logistics support officer” during high‑risk days (e.g., rainy season).
5. Monitor and publish AFP data weekly: Openness builds public confidence and draws international support.

Future Steps & sustainability

• Transition to routine immunization integration: Leverage the door‑to‑door network to support monthly child health visits.
• Scale up digital surveillance: Expand the e‑Immunize platform to capture birth registration data, linking it to vaccination schedules.
• Strengthen cross‑border coordination: Coordinate with Tanzania and Malawi to address mobile populations along the Niassa corridor.
• Secure multi‑year financing: Formalize a Gavi‑MoH co‑financing agreement for the next three SIAs,ensuring uninterrupted vaccine supply.

---

Prepared by Dr. Priyadeshmukh, Senior Health Communications Specialist, Archyde.com