Immunization remains one of the most effective public health measures to protect populations, prevent outbreaks, and reduce mortality. Across the Eastern Mediterranean Region, routine immunization systems face persistent challenges that widen immunity gaps and increase the risk of vaccine-preventable diseases (VPDs). EMPHNET works with countries to strengthen immunization programs, advance surveillance, expand service reach, and ensure that all populations, including those in fragile and underserved settings, receive the protection they need.

The EMR faces recurring disruptions to immunization services due to conflict, displacement, and health system fragility. These pressures have contributed to declining routine coverage, the persistence of zero-dose communities, and the re-emergence of VPDs in several countries. Cross-border movement and humanitarian crises further challenge national immunization programs and increase the risk of transmission, underscoring the need for strong, coordinated, and resilient immunization systems. 

Check our Immunization profile.

• Strengthening community engagement: Ensuring that immunization programs remain responsive to local needs and driven by trust and participation.
• Ensuring inclusion of marginalized and hard-to-reach communities: Supporting strategies that reach zero-dose children and populations in fragile, conflict-affected, and mobile settings.
• Enhancing communication through tailored and innovative approaches: Increasing public awareness, countering misinformation, and building vaccine confidence.
• Investing in workforce development at all levels: Building the capacities of frontline teams, supervisors, and national-level officers to improve service delivery.
• Empowering decision-making through data and evidence: Enhancing VPD surveillance quality, generating high-quality data, and strengthening research for action.
• Utilizing innovative tools to operationalize global and regional plans: Applying context-specific and digital solutions to strengthen operational efficiency.

Many countries in the region require support to improve the quality, reach, and effectiveness of their immunization systems. Persistent barriers include limited microplanning capacity, weak data systems, low demand in underserved communities, and difficulty reaching populations affected by conflict, mobility, and fragility. We engage to strengthen national and subnational capacities, enhance surveillance and monitoring, improve community engagement, and support countries in sustaining high-quality vaccination services.

• Strengthening community engagement: Ensuring that immunization programs remain responsive to local needs and driven by trust and participation.
• Ensuring inclusion of marginalized and hard-to-reach communities: Supporting strategies that reach zero-dose children and populations in fragile, conflict-affected, and mobile settings.
• Enhancing communication through tailored and innovative approaches: Increasing public awareness, countering misinformation, and building vaccine confidence.
• Investing in workforce development at all levels: Building the capacities of frontline teams, supervisors, and national-level officers to improve service delivery.
• Empowering decision-making through data and evidence: Enhancing VPD surveillance quality, generating high-quality data, and strengthening research for action.
• Utilizing innovative tools to operationalize global and regional plans: Applying context-specific and digital solutions to strengthen operational efficiency.

EMPHNET’s contributions span key components of immunization systems across the region:

• Evidence Generation for Action

We conduct research, operational studies, assessments, and data reviews to strengthen immunization decision-making. This includes intervention evaluations, serosurveys, KAP studies, and surveillance assessments in Iraq, Morocco, Pakistan, Somalia, and Sudan. These efforts have informed tailored strategies, improved data accuracy, and strengthened program performance.

Read our Life Course Immunization: A Safer World for All Ages Policy Brief

• Strengthening NITAG Governance and Functionality

We support National Immunization Technical Advisory Groups by:

• • Developing tailored improvement plans for Afghanistan, Iraq, Jordan, Libya, Morocco, Oman, Tunisia, and Saudi Arabia
  • Creating SOPs, guides, and templates
  • Delivering regional and country-specific training
  • Facilitating regional networking and collaboration
  • Supporting NITAG continuity in fragile contexts, including Sudan

• Strengthening Surveillance Systems

We strengthen VPD surveillance through:

• • CRS surveillance in Afghanistan and Egypt
  • AFP and VPD surveillance capacity building in Afghanistan, Morocco, Iraq, Egypt, and Sudan
  • Surveillance system evaluations, data quality improvements, and national review meetings

These efforts improved timeliness, completeness, and accuracy of reporting and enabled faster detection of outbreaks.

• EPI Workforce Development

We invest in workforce development through:

• • Microplanning training across Iraq, Jordan, Pakistan, Somalia, Sudan, and Yemen
  • Supportive supervision programs in Afghanistan, Iraq, Sudan, Somalia, and Yemen
  • Peripheral service delivery capacity building in Egypt, Afghanistan, Iraq, and Yemen

These investments improved program equity, strengthened district-level planning, and enhanced frontline performance.

• Community Engagement

For Surveillance:

We work with ministries and communities to strengthen community-based surveillance in Yemen, Lebanon, Sudan, and Iraq.

These efforts increased AFP case detection, expanded reporting networks, and improved awareness of VPDs.

Read about one of our community-driven initiatives: Polio Village Volunteers Initiative in Yemen

For Immunization Uptake:

We collaborate with community leaders, religious figures, women’s groups, and volunteers in Afghanistan, Pakistan, Iraq, and Somalia to increase trust and demand for vaccination.

These actions helped improve coverage, address hesitancy, and expand reach to nomadic and remote populations.

• Using different communication channels to combat vaccine hesitancy

We develop national EPI communication strategies, designs IEC materials, trains volunteers, and supports infodemic management.

Implemented in Iraq, Yemen, Sudan, Afghanistan, and Pakistan.

• Expanding Outreach Immunization

We support countries in restoring services post-COVID-19 and expanding immunization sessions in remote areas.

Efforts in Egypt, Sudan, and Iraq helped vaccinate thousands of children in high-risk provinces.

• Digitalizing Immunization Systems

We introduce digital solutions that improve planning, reporting, and data access:

• • Digital GIS microplanning tools (Sudan)
  • Vaccine reporting and dashboard systems (Sudan)
  • EPI database integration and online access system (Afghanistan)