1 Introduction
The Kano State Ministry of Health in Nigeria is working to reduce the number of children who have not received any routine vaccinations—often called “zero-dose” children. According to the World Health Organization (WHO) definition, zero-dose children are those who have not received at least the first dose of the Diphtheria-Pertussis-Tetanus (DPT) vaccine (WHO n.d.). These children face a higher risk of vaccine-preventable diseases. Within Nigeria, Kano State is consistently identified as one of the states with the largest absolute numbers of zero-dose children (Ibrahim 2025).
Several factors stand in the way of universal immunization in Kano. Poverty and limited access to education, especially for mothers, play a major role (Etim et al. 2025). Cultural barriers—such as religious beliefs and norms, misconceptions and myths about vaccines, and mistrust of immunization initiatives—also contribute (Etim et al. 2025). Weak health infrastructure, limited vaccine supply chain logistics, and shortages in the health workforce also make it harder to reach every child (Eti et al. 2024).
To tackle these issues, the Kano State Ministry of Health is leading efforts to identify the root causes of low vaccination rates and develop strategies to fix them. This includes improving sampling and data collection methods, mapping vaccination coverage gaps, and guiding targeted policy interventions.
This study aims to gather baseline data on zero-dose children in Kano State and test alternative, lower-cost survey methods that can be scaled up. This report presents findings from the “gold standard” approach (multistage stratified sampling), which will serve as the benchmark for comparing the other methods used (to be covered in an upcoming report).
This study supports the broader Zero-Dose Learning Agenda (ZDLA) and contributes to global efforts to reduce the number of unvaccinated children, including the WHO Immunization Agenda 2030 (WHO n.d.). It also ties into Sustainable Development Goal (SDG) 3: ensuring healthy lives and promoting well-being for all (UN n.d.). Findings from this report will help the Kano State Ministry of Health and other stakeholders address immunization gaps, improve data collection efforts, and inform national health strategies.