VillageReach completed a research study to determine the drivers of delay or dropout between the early infant immunization series and the 9-month touchpoint in DRC, Malawi, Nigeria and Pakistan. From the outset, the team recognized that gender plays an important role in immunization and began with a gender analysis to identify gender-specific needs and develop recommendations to adapt the study’s data collection methods. One key finding was that female caregivers may have limited autonomy to make and carry out vaccination decisions, with social norms further limiting their ability to travel independently. This and other findings shaped the study design, including recruiting heads of household as respondents alongside caregivers and intentionally sampling across urban, rural and culturally diverse communities, recognizing that gender dynamics differ across contexts.

In more than 10 countries across Africa, VillageReach has led projects to strengthen supply chain systems. Given that women and children are the primary beneficiaries of PHC services, women’s perspectives are essential to ensuring supply chains are designed with their needs in mind. Yet a significant gender imbalance exists within the public health supply chain workforce, with women holding only 26% of management positions globally. VillageReach led exploratory research to better understand gender inequities along the career pathway, finding that barriers exist at every stage — from education through career entry to advancement — including cultural restrictions around work-related travel and limited access to training and leadership opportunities. Based on these findings, VillageReach has called on stakeholders to take targeted action, from gender-sensitive recruitment policies to mentorship networks for women in supply chain roles.

As national immunization programs transition from HPV vaccine introduction to long-term sustainability, the shift from short-term campaigns to routine immunization presents operational challenges in planning, delivery and community engagement. In Nigeria and Mozambique, VillageReach is leading a project to test novel learning approaches to support health workers through this transition. Gender plays an important role in designing accessible and effective learning platforms. In some settings, cultural and religious norms mean women may not feel empowered to speak freely in mixed-gender groups — a dynamic heightened by the sensitive nature of HPV and sexual health topics. The project tests different approaches to ensure women’s voices are heard alongside men’s, including women-only discussion groups, virtual peer engagement and AI chatbot use.