MERF’s Community Outreach Model Brings Thousands of Children Back to Immunization in Peshawar

Every child reached through immunization represents far more than a vaccine administered, it represents a disease prevented, a family reassured, and a healthier future safeguarded. 

Under the Gates Foundation-supported Polio Eradication Initiative, MERF continues to strengthen routine immunization services across the Super High-Risk Union Councils (SHRUCs) of Peshawar through an integrated model that combines community outreach, Social and Behaviour Change Communication (SBCC), active household tracking, and strengthened primary healthcare services.

Unlike conventional awareness campaigns, MERF’s approach emphasizes persistent household engagement, trust-building, evidence-based counselling, and continuity of care. Community Outreach Workers (COWs) serve not only as mobilizers but as trusted members of their communities who identify vulnerable children, address misconceptions, connect families with health services, and maintain follow-up until vaccination is completed.

June 2026: A Month of Significant Progress

During June 2026, MERF’s trained Community Outreach Workers, working alongside vaccinators and health facility staff, systematically identified children who had missed routine immunization, traced hidden and zero-dose children, counselled hesitant caregivers, and ensured timely referral to vaccination services.

Their efforts resulted in:

• 3,238 defaulter children successfully traced and vaccinated through routine immunization.
• 422 zero-dose children identified and brought into the immunization programme for the very first time.
• 182 vaccine refusals successfully converted through interpersonal counselling, SBCC, and community engagement.

These achievements represent 3,842 vulnerable children and families reached through direct community action, substantially strengthening immunity in some of Peshawar’s highest-risk communities.

More importantly, these numbers reflect renewed confidence in public health services. Many caregivers who were initially hesitant accepted vaccination after multiple respectful counselling sessions, while previously hidden children whose births or vaccination status had never been reported were successfully integrated into the health system. The programme also strengthened collaboration between communities, vaccinators, and health facilities, creating stronger referral pathways and improving continuity of routine immunization services.

Outstanding Health Facility Performance

Several MERF-supported facilities achieved exceptional results during the reporting period.

Defaulters Successfully Recovered

Health Facility	Children Recovered
Hazar Khwani #2 (Dir Colony)	611
Yakatoot #3	366
Shaheen Muslim Town #2	347
Shaheen Muslim Town #1	315
Akhonabad	302
Yakatoot #2	247
Landi Arbab	221
Deh Bahadur	212
Yakatoot #1	167
Deri Baghbanan	141
Notia Jadeed	135

These facilities demonstrated strong coordination between Community Outreach Workers and Expanded Programme on Immunization (EPI) teams, enabling timely identification of children who had missed scheduled vaccinations and ensuring their successful return to the immunization schedule.

Zero-Dose Children Identified

The highest-performing facilities in identifying children who had never received a single routine vaccine included:

• Hazar Khwani #2 (Dir Colony): 69
• Yakatoot #3: 44
• Hazar Khwani #2 (Pandu Road): 43
• Akhonabad: 40
• Shaheen Muslim Town #1: 32
• Shaheen Muslim Town #2: 29
• Landi Arbab: 27
• Deh Bahadur: 26

These figures demonstrate MERF’s ability to identify children who were previously invisible to the health system. Through systematic household mapping, community intelligence, and repeated field visits, Community Outreach Workers were able to locate underserved families who might otherwise have remained unreached, ensuring that children began their immunization journey before becoming vulnerable to vaccine-preventable diseases.

Refusal Conversion Through SBCC

Community dialogue and trust-building also produced encouraging results. 

Facilities recording the highest successful conversion of vaccine refusals included:

• Akhonabad – 30 families
• Deh Bahadur – 24 families
• Shaheen Muslim Town #1 – 22 families
• Yakatoot #3 – 21 families
• Notia Jadeed – 19 families
• Hazar Khwani #2 (Dir Colony) – 16 families

These outcomes reflect the effectiveness of MERF’s evidence-based SBCC approach, which prioritizes respectful communication, caregiver counselling, myth correction, and repeated household engagement instead of one-time awareness activities. Rather than focusing solely on vaccine promotion, Community Outreach Workers listened to caregivers’ concerns, addressed misinformation with empathy, and built lasting relationships that encouraged informed health-seeking behaviour.

Beyond the Numbers

Behind every statistic is a story of persistence. Community Outreach Workers routinely conduct multiple household visits, engage grandparents and other influential family members, collaborate with religious and community leaders, and accompany caregivers to health facilities when needed. Their presence within the community allows them to identify hidden children, respond quickly to missed vaccinations, and maintain ongoing dialogue with families.

The programme has also strengthened the capacity of frontline workers through regular mentoring, supportive supervision, and SBCC training, equipping them with practical communication skills to address vaccine hesitancy and improve service uptake. This integrated approach is helping transform routine immunization from a facility-based service into a community-owned public health effort.

Looking Ahead

MERF remains committed to ensuring that no child is left behind. By combining community trust, data-driven outreach, and strong partnerships with the Department of Health and EPI, the organization continues to close immunization gaps, reduce the number of zero-dose children, and protect communities from vaccine-preventable diseases.

As these achievements demonstrate, sustainable immunization success depends not only on vaccine availability but also on trusted relationships, continuous community engagement, and a health system capable of reaching every child, especially those who are hardest to find.