Community-based organizations and social services providers often find themselves supporting clients to navigate digital barriers. Yet, these organizations are too often overlooked and under-supported, with few resources tailored to their context and integrated approach to serving their communities.

17勛圖厙 Education, a 17勛圖厙 initiative, has published a new resource that directly addresses these challenges by treating digital literacy not as an isolated, standalone program, but rather as a critical thread woven into the fabric of daily community support.

Developed with strategic support from AT&T, the is a comprehensive, human-centered resource designed to empower nonprofits, libraries, and public-sector agencies to seamlessly integrate digital opportunity and skill-building into their existing community services.

Empowering Trusted Community Messengers

Community-based organizations possess the deep relationships and local trust that no algorithm can replicate. Frontline staff���such as case managers, youth mentors, and adult educators���constantly step up to help clients navigate technology barriers but often do so without formal recognition, resources, or strategic frameworks.

“Organizations are already doing extraordinary work of meeting people where they are, from food pantries to housing registries,” said Priyanka Sharma, Director of 斑釦梆���s 17勛圖厙 Education initiative. “This playbook is built directly around their existing programs and goals. It is designed to turn daily technology hurdles into meaningful, teachable ‘pivots’ that build long-term digital resilience.”

Inside the Playbook: Five Stages from Design to Implementation

The playbook offers a flexible, non-prescriptive framework built across five distinct strategic scenarios:

1. Review and Discover: Aligning digital opportunity efforts directly with an organization’s core mission and conducting asset mapping to leverage existing community strengths.
2. Ideate and Strategize: Identifying precise points of “digital friction”���where technology creates a barrier for the client���and designing community-led, flexible service delivery models.
3. Plan for Success: Designing localized “Impact Roadmaps” (Logic Models) and risk-mitigation plans to translate daily tasks into long-term funding and measurable outcomes.
4. Activate Your Strategies: Preparing staff capacity, establishing strict data privacy protocols to maintain client trust, and delivering culturally responsive, individualized digital navigation.
5. Iterate, Improve, and Grow: Continuous program refinement through feedback loops, storytelling techniques that humanize data, and diversified funding models to sustain long-term digital opportunity.

Proven Real-17勛圖厙 Strategies

17勛圖厙 Education developed the strategies compiled in the playbook through our work supporting community-based organizations that host . AT&T CLCs deliver vital, no-cost tools to community members���ranging from internet connectivity and hardware to personalized coaching and skill-building.

The playbook highlights how local organizations are already putting these principles into practice. A few examples:

• North Carolina: At the , the Club���s career coach partnered with a local driving school to offer a fully online driver���s education course inside the club���s computer lab, providing a critical stepping stone to employment and independence for rural youth.
• Northeast Mississippi: in Tupelo tapped existing and community resources, including workshop space and volunteers, to offer computer basics workshops and integrate digital skills into programming related to financial literacy, small business ownership, and home ownership.
• Dallas, Texas: seamlessly embedded technology instruction into their existing English Language Learning classes, food-bank distributions, and resume workshops.

The Connected Futures Playbook features ready-to-use, practical toolkit resources, including frameworks for developing client profiles, identifying digital friction points and turning them into opportunities, and mapping metrics, privacy needs, and sustainability strategies.

���AT&T is committed to expanding digital opportunity through our Connected Learning Center initiative, and 17勛圖厙 Education has helped community organizations and frontline staff turn that commitment into action,��� said Mylayna Albright, Vice President, Corporate Responsibility, AT&T. ���The Connected Futures Playbook means that organizations everywhere can access a blueprint for creating digital opportunity in their community and is one way our initiative can have ripple effects far beyond the walls of the 100 Connected Learning Centers.���

To access the free digital version of the playbook and learn more about 17勛圖厙 Education���s ongoing digital opportunity initiatives, visit .

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The Routine Data Quality Assessment (RDQA) is a national tool designed to evaluate the quality of routinely reported health data and assess its supporting systems. RDQAs can contribute a clear picture of the country���s health care landscape, but until 2025, they were held back by the very inefficiency they sought to solve. Relying on paper-based surveys, RDQAs were time-consuming and prone to manual-entry error.

Building a Digital Brain

To eliminate paper-based bottlenecks in favor of automated, real-time insights, 17勛圖厙 partnered with the Amhara Regional Health Bureau (RHB) during the second half of 2025. We created a digitized RDQA through Open Data Kit (ODK), an open-source platform enabling form creation, offline data capture, and submission management.

The data captured through the digitized RDQA fed directly into an interactive Power BI dashboard, transforming field metrics into actionable visual intelligence. This instantaneous data flow empowers regional leaders to promptly pinpoint vulnerabilities and launch targeted interventions. To guarantee long-term sustainability, 248 health management and IT professionals were trained through a mentorship model integrated into regional continuous professional development centers.

Faster Decisions and Better Care

By transitioning from paper to real-time dashboards in Amhara, aggregation, analysis, and reporting times were reduced from over seven days to less than one, accelerating the insight-to-action cycle by more than 85%. More than 573 health facilities are now using this digital practice, and the proportion of health facilities meeting minimum data verification standards has grown from 59% to 80%.

Beyond time savings, digitized RDQA excels at delivering accurate data that empowers health leaders to make data-driven decisions. For instance, RDQA assessments revealed a shortage of Health Management Information System (HMIS) materials���the standardized data collection system essential for health facility planning and administration. Prompted by this insight, Amhara RHB leadership mobilized 16 million ETB (~$280,000 USD) to rapidly source and distribute 20 essential register types to facilities in need.

Blueprint for Scale

The successful implementation in Amhara provides a tested, cost-effective blueprint for regional authorities and international partners looking for impactful investments in digital health. By deploying intuitive digital solutions and automated feedback systems, the Amhara Region has shown that data quality can be elevated substantially while enhancing timely decision-making. To contribute to universal health coverage and data-informed decision-making nationally and globally, this digitized RDQA model stands ready for expansion across Ethiopia’s remaining regional states and broader adaptation throughout sub-Saharan Africa.

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A global leader in institutional capacity strengthening, 17勛圖厙 Education is a trusted partner of communities, school leadership, and the government in C繫te d���Ivoire. COGES, established by national decree to foster community-driven, participatory governance in public schools, play a crucial role in improving educational outcomes. 17勛圖厙 Education has partnered with MENAET for over a decade to strengthen more than 100 COGES across C繫te d���Ivoire through thoughtful, participatory institutional strengthening that builds community leadership in education.

The agreement, signed on August 27, 2026, in Abidjan by Moustapha Sangar矇, Chief of Staff representing MENAET, and Ferdinand Leammayon Beblai, Country Director of 17勛圖厙 Education C繫te d’Ivoire, provides a formal institutional framework to support activities funded by Mondelez International���s Cocoa Life initiative.

Under the agreement, 17勛圖厙 Education and MENAET will focus on enhancing the governance and management capacities of COGES, conducting training for education actors in target cocoa-producing communities, and supplying necessary equipment to support learning environments.

“We have been negotiating this type of partnership for several years, and this agreement strengthens the credibility of our work with COGES in C繫te d’Ivoire,” said Mr. Beblai. “It is a formal recognition of 17勛圖厙 Education���s work over the years in partnership with the government and provides a solid institutional framework for continued partnership.”

The agreement reinforces a shared commitment to sustainable educational quality, school governance, and child protection in C繫te d’Ivoire’s cocoa-growing regions. Joint oversight will be managed through a dedicated steering committee alongside MENAET���s Directorate for the Promotion and Monitoring of COGES.

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“We were doing our best,” recalls Awoke Friew, a senior midwife who attended Momina at Awash Health Center. “Momina was losing blood quickly, and in the past, estimating blood loss visually meant we often guessed. Moments like those leave every midwife feeling defenseless, you know time is running but you lack tools to act decisively.”

Causes Inform Solutions

Working with local health leaders through our Strengthening Service Delivery (SSD) project, 17勛圖厙 evaluated the causes of PPH in these regions. According to Etaferahu Yimam, a senior health worker and clinical supervisor in the Afar Region, early detection was the greatest barrier to life-saving action. ���Health workers had to rely purely on subjective measurement of blood loss, often ending with delayed detection of PPH, which led to life threatening complications and maternal death.���

In March 2025, 17勛圖厙, with the Ministry of Health, regional health leaders, and local health administrators introduced a targeted, evidence based, comprehensive PPH management initiative, called the E-MOTIVE bundle. This bundle includes:

1. Blood collection calibration drapes, which give midwives precise real-time blood loss measurements;
2. Intravenous fluids, Oxytocin, and tranexamic acid to stop bleeding; and
3. Non-pneumatic anti-shock garments
4. Clinical job aids

The e-MOTIVE bundle approach was launched through training among midwives and care providers on comprehensive PPH prevention, early detection and management. The training included offering uterine massage, evaluation, and escalation. Further, regular, on-site supportive supervision, clinical mentorship, and review were offered to reinforce skills, maintain facility supply readiness and facilitate cross learning sessions.

���They placed a plastic bag under me to monitor my blood loss and gave me intravenous fluids in both arms. They saved my life.��� Momina recalls her post-delivery care at the onset of bleeding.

Results

Between April 2025 and May 2026, 17勛圖厙, in collaboration with regional health bureaus, trained 155 health providers (106 through blended learning and 49 via traditional face-to-face methods) across four regions. We distributed 16,500 bundles.

Progressive improvement in drape application and early detection of PPH: Out of 15,770 vaginal deliveries recorded, calibrated drapes were applied in 14,239 cases (90%). A total of 348 PPH cases (2%) were detected, and the full E-MOTIVE bundle treatment was administered to 342 (98%).

There was an 83% reduction in blood transfusion rates (dropping from a baseline of 52% to 8%) and an 80% reduction in referrals to higher-level care facilities (dropping from a baseline of 19% to 4%).

In remote areas of low- and middle-income countries, emergency transfers to higher-level care centers are a high-stakes race against time; this is especially critical in PPH. Consequently, objective, real-time blood loss measurement and early intervention can ultimately ensure that mothers like Momina return home safely with their newborns.

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The primary consequences of birth facility closures are increased distance to care, reduced perinatal workforce, and a decrease in birth facility and provider choice. The ripple effects can include gaps in care and/or hindrances to accessing timely and risk-appropriate care that increase maternal and infant risks, such as higher rates of preterm and unplanned out-of-hospital births. Birth facility closures also impact the local economy and can result in a loss of community trust and a damaged reputation for the facility writ large.

Best Practice Guidelines for a Birth Facility Closure

While we strengthening the perinatal system of care to prevent closures, there are ways to mitigate the impact of a facility closure when it happens. As part of the Colorado study, 17勛圖厙 developed best practice guidelines to ensure access to essential obstetric services, support care transitions, and reduce the impact on families, providers, and communities when a birth facility closes. The best practice guidelines are informed by the study findings, the literature, and the , which provides a policy framework to guide states as they address health care closures, consolidations, and/or acquisitions of facilities or key service lines. 17勛圖厙 also engaged Colorado perinatal access experts in the development process to inform the guidelines. While the guidelines were developed specifically for Colorado, they could be adapted by other states to make them contextually relevant and operationally realistic.

The guidelines are categorized into three areas: Oversight and Review, Timely Communication, and Coordinated Transfers of Care. Each guideline has a set of implementation steps.

1. Oversight and Review. State government and state agencies play an important role in ensuring that policies and resources support access to perinatal care. The guidelines for oversight and review focus on the role of the state in assessing and managing perinatal care access and risks at the health systems level. This includes assessing how a birth facility closure will affect perinatal care cost, quality, and local access, and intervening as needed to protect access to care.
2. Timely Notification and Supportive Communication. Clear and timely communication about a closure can support facilities, providers, and staff in delivering patient-centered care. This includes planning warm handoffs and emergency readiness, connecting patients to supportive resources, and providing patients with sufficient time to identify and establish new care. Ultimately, these timely actions can mitigate patient stress, poorly coordinated care, and gaps in care. The guidelines include notifying patients, staff, providers, the community, and the state at least 90 days before a birth facility discontinues services.
3. Coordinated Transfers of Care. Transfer planning ensures patients experience continuous, safe, and appropriate perinatal care during a facility closure. The guidelines focus on coordinated transitions in patient care by developing: system-level transfer of care plans that establish transfer agreements and referral pathways with other facilities and practices in the region and support local planning for community-to-hospital transfers; individual patient transfer of care plans; and emergency response plans, including training Emergency Department staff for obstetric and neonatal emergencies.

A complete listing of the guidelines is available . Read the for a summary of the findings and recommendations to explore how states and birth facilities can address the negative effects of closures, support patients and families with continuous and coordinated transfers of care, and support positive maternal and infant health outcomes.

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Alberto Ndoca starts his mornings early at Chicoa Primary School, in Mozambique���s Niassa Province. Within a few hours, he will have moved between six grades, checked exercises and notebooks, and tried to understand which children can already read, write and count and which need extra support. The school has three classrooms and 249 students. Ndoca is the only teacher. In the morning, he teaches Grades 1, 2 and 6; in the afternoon, he continues with Grades 3, 4 and 5. There is little time to stop between classrooms. When one lesson ends, another begins. After classes, administrative responsibilities continue. Ndoca is a teacher, but he is also the school director, pedagogical lead, and administrative officer.

���It is me. I am alone,��� he says.

Ndoca participated in a professional development training organized through the Empowering Educators project, funded by the Embassy of Ireland and implemented by 17勛圖厙 Education, a 17勛圖厙 initiative, in partnership with the Ministry of Education and Culture. During this training, he briefly shared his experience at Chicoa, which led our project team to visit Ndoca at his school and to interview him to better understand how Continuous Professional Development (CPD) can support education professionals like him who work in demanding contexts every day.

At the school, Ndoca���s role goes far beyond the classroom. He prepares assessments for all six grades, follows up with students, handles administrative tasks, and oversees pedagogical activities. When an assessment needs to be prepared, he does it. When documents need to be organized, he handles them. When a class needs attention, he is the one who enters the classroom. The Chia Pedagogical Influence Zone (ZIP), to which the school belongs, has five schools with three to six teachers each, but at Chicoa the daily responsibility for six grades rests with one person.

This reality comes at a cost. Ndoca acknowledges that there are days when he feels he cannot teach. One day, a severe headache prevented him from entering the classroom, and there was no other teacher to replace him, so classes were cancelled. Still, when asked whether he has ever thought about leaving the profession, his answer is no: ���I have never thought of giving up, because I know that this is my daily bread. I have had to sacrifice so that I can keep doing this work.���

Keeping Kids in School through Community Outreach

When Ndoca arrived at Chicoa Primary School in late March, he found 150 students in a school with limited resources���a box of chalk, erasers, and three attendance books���and no other teachers. Classes started about two months after the official beginning of the school year, and the school needed to regain its momentum. Today, there are 249 students. This growth didn���t happen because of a major physical transformation of the school. It happened because of the way Ndoca chose to work with students, families, and the community.

Chicoa Primary School, the only school building serving the community, where teacher Alberto Ndoca teaches six grades while also serving as the school director and pedagogical lead. Credit: 17勛圖厙 Mozambique.

Ndoca realized he could not open up the school every day and simply wait for children to come. Some children live nearby, while others walk for about 45 minutes to reach the school. In a community where getting to school already requires effort, Ndoca understood that keeping children in school also required attention. When attendance began to decline, he decided to talk with students and their families. On the weekends, he visited families to talk with parents and caregivers about the importance of education and keeping children in school. He also worked with the village���s traditional leaders, who helped him mobilize families and reinforce the importance of regular school attendance. Whenever he could, he bought biscuits and juice with his own money to give to the children as a small form of motivation. This small act didn���t solve the school���s challenges, but it did show the children that their presence mattered.

Of the 249 students, approximately 103 are girls. According to Ndoca, he closely monitors girls��� participation and has not observed significant dropout rates among them. Ensuring that both girls and boys remain in school is part of the same reason that brings him to the classroom every day: ���My mission is for the children to learn to read, write, and count.���

Giving Teachers the Tools to Succeed

The 17勛圖厙 Education team met Ndoca during a training supported by the Empowering Educators project. His story stood out not only because of the challenges he faces but also because of the way he speaks about his school. Rather than focusing on what is missing, he talks about what he can do. His experience shows that teaching means understanding students��� circumstances, talking with families, following up on attendance, making sure all children stay in school, and thinking of the school as a place of learning and belonging.

Ndoca received CPD training in positive discipline, fair treatment of girls and boys, and welcoming school planning, which can reinforce and strengthen the approaches he already uses to create more respectful learning environments, respond to the needs of both girls and boys, and turn school priorities into concrete actions. CPD does not replace the need for more teachers, desks, or improved infrastructure, but it can strengthen the ability of professionals working inside schools every day to teach, lead, and respond to the challenges they face. The CPD program goes beyond the training itself and includes ongoing support, follow-up, and supervision through the education system.

Alberto Ndoca teaching one of his classes outside. Credit: 17勛圖厙 Mozambique

Leading Chicoa Primary School into the Future

Chicoa Primary School still needs more teachers, better conditions, and more resources. Ndoca knows this. But the school���s transformation began when Ndoca arrived, found 150 students, and decided to stay, work with the community, and help bring children back to school.

In Chicoa, Ndoca continues to arrive early, enter one classroom, and then another. He continues to teach, assess, guide, and lead. The school still does not have everything it needs. But it is no longer the same school he found in March. Ndoca���s dedication and skills, supported by CPD training, are improving the school���and his students��� lives���one day at a time.

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For nearly two decades, Mrs. Favour refused vaccines for her five children. At age one, her youngest, Rejoice, had never received a single immunization. At an outreach session in Nigeria’s Bayelsa State, that longstanding mistrust broke with a single, empathetic conversation.

Mrs. Favour, a hairdresser and mother of five from the Yenegwe community of Bayelsa State, became ambivalent after her first child experienced fever, restlessness, and intestinal distress following vaccination. Though the child recovered, the experience left Mrs. Favour hesitant about immunizations.

Healthy Behaviors Follow Meaningful Conversations

On June 10, 2026, during an outreach session conducted by Yenegwe Primary Health Center with support from 17勛圖厙, Baby Rejoice was identified as a zero-dose child – one that has not received a single vaccination. At this event, the 17勛圖厙 Bayelsa State advocacy, communication, and social mobilization (ACSM) officer approached Mrs. Favour. He listened carefully to her concerns and explained adverse events following immunization, which do not necessarily have a causal relationship to the vaccine. He explained common reactions, danger signs, and appropriate actions caregivers should take when these occur.

Through respectful dialogue, active listening, empathy, and evidence-based counselling, Mrs. Favour made an informed decision to vaccinate Baby Rejoice. The baby received six life-saving vaccines that protect against TB, polio, hepatitis B, diphtheria, whooping cough (pertussis), tetanus, pneumonia, rotavirus, and meningitis. To reinforce caregiver confidence and reduce the likelihood of defaulting, the officer conducted a follow-up home visit the next day and subsequently shared Baby Rejoice’s details with the Yenagoa immunization officer and health facility team for continued support.

“After my experience with my first child, who is 19 years old, I refused vaccines for all my children because I believed immunization was dangerous. Nobody had explained to me that those reactions could happen and what to do about them. Today, they listened and answered my questions. This gave me the confidence to allow Baby Rejoice to be vaccinated.” – Mrs. Favour

The Road from Hesitancy to Vaccine Acceptance is Non-linear

Bayelsa ACSM Officer Esogenwune Nwabueze counsels the caregiver on AEFI, follow-up vaccination visits, and the importance of completing the child’s immunization schedule

Following her enrolment, Baby Rejoice was scheduled to return for her next vaccination in one month, but missed the appointment. The Yenagoa immunization office visited Mrs. Favour, assuring her that the vaccines Baby Rejoice would receive were age-appropriate and that receiving these antigens was an important step toward closing her immunity gap. The baby received her remaining missed antigens, including subsequent doses of Penta 2, polio 2, rotavirus, and malaria, the following month.

���Every caregiver deserves accurate information so they can make informed decisions for their children. Many vaccine refusals are rooted in fear, misinformation, or past experiences. Listening is often the first step toward building trust.��� – Esogenwune Nwabueze, 17勛圖厙 Bayelsa ACSM officer

Although Baby Rejoice missed her scheduled follow-up immunization, coordination between the 17勛圖厙 Bayelsa state mobilization officer and the Yenagoa immunization officer facilitated her return. This underscores the importance of strengthening defaulter tracking, assigning clear accountability for follow-up, and maintaining communication among providers and caregivers to improve immunization completion.

���No child is beyond reach when communities, health workers, and partners like 17勛圖厙 work together. At the Bayelsa State Primary Health Care Board, we remain committed to identifying and reaching every zero-dose and under-immunized child with life-saving vaccines.������ Dr. Williams Appah, Executive Secretary, Bayelsa State Primary Health Care Board

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Channeling this experience alongside strong partnership and coordination with other global immunization experts and working groups, 17勛圖厙 led the CHOICES 2.0, which provided support to National Immunization Technical Advisory Groups (NITAGs) and Expanded/National Programs for Immunization (EPI or NIP) to conduct new vaccine introduction prioritization for their immunization programs using the . The project also engaged with relevant stakeholders at the global and Africa regional levels to inform and guide the Vaccine Prioritization and Optimization (VPOP) processes as they evolved, including the .

The NVI-PST

The NVI-PST was developed based on a Multi-Criteria Decision Analysis (MCDA) approach and country learning. It was developed by Development Catalysts in collaboration with the original CHOICES project, which was led by the International Vaccine Access Center (IVAC) and supported by 17勛圖厙, US CDC, and Development Catalysts, in collaboration with the 17勛圖厙 Health Organization and Global NITAG Network partners.

• Watch the .
• Learn more about the (including the eLearning facilitator module developed under CHOICES 2.0).

Country Workshops

The CHOICES 2.0 project worked to expand access to the NVI-PST toolkit in 2025 and 2026 through a series of in-person and virtual workshops with Gavi-eligible countries that requested engagement or agreed to participate upon invitation from CHOICES 2.0 leadership. The workshops were convened by NITAGs to prioritize and/or optimize their national immunization program systematically. Across CHOICES and CHOICES 2.0, 17勛圖厙 and our partners supported seven countries through these workshops.

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Webinar Series

To reach more countries beyond the workshops, the project worked with National Immunization Technical Advisory Group Support Hub (NISH) at the University of Cape Town and the 17勛圖厙 Health Organization (WHO) to host a titled Applying Vaccine Prioritization Strategies for Optimized Public Health Outcomes. This series included expertise from NISH, 17勛圖厙, WHO, UNICEF, and NITAG representatives. It provided NITAG members and EPI representatives with an overview of the new vaccine prioritization process, an introduction to the NVI-PST, and the newly developed Optimization Module, sessions on the tools��� methodologies and real-world examples, and a discussion on how the tools complement other decision-support resources.��� With participants representing NITAG members across 19 countries, offering this support virtually enabled broader access to these tools while simultaneously fostering cross-country learning and experience sharing.

• .

The Future of New Vaccine Prioritization and Optimization

Through on-the-ground and virtual convenings, 17勛圖厙 supported over 20 countries as they honed their prioritization and optimization plans for new vaccine introductions via both the CHOICES and the CHOICES 2.0 project. While some countries have dedicated resources to continue this process independently, many countries seek further epidemiological and disease burden data and vaccine market and performance data (from their own and/or similar countries and settings) to inform their decisions. As countries face even greater funding constraints, continuously emerging infectious disease threats and patterns, new vaccine innovations, and a polycrisis of economic and social conditions, this dedicated practice is increasingly important.

It takes dedicated time and collaboration across programs and stakeholders to gather evidence, conduct analysis, and finalize prioritization and optimization recommendations effectively. Most NITAG members serve on a volunteer basis and already have other full-time commitments. In response to the funding and human resource limitations many NITAGs face, CHOICES 2.0 provided administrative and technical support and facilitation, cultivated political buy-in for experts to dedicate the time needed to continue this vital work, and complementary financial support where needed. An enabling environment must continue to be supported by the Ministries of Health and immunization programs, global VPOP technical working group, Global NITAG Network, and resource partners as countries are to routinely update their prioritization and optimization plans.

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Providing zero-dose and under-immunized children with the vaccines they need requires understanding why they haven���t received them and how programs can respond with evidence-driven action. These children are often concentrated in communities faced with geographic barriers they need to overcome, service delivery gaps, financial constraints, and limited access to timely, reliable data. Reaching them requires not only national coverage estimates, but also practical evidence, local adaptation, and technical support that responds to country realities.

Filling the Information Gap through Country Learning Hubs

From 2022���2026, 17勛圖厙 served as the global learning partner for the Gavi-funded , working with consortium partners including the International Institute of Health Management Research and The Geneva Learning Foundation. Together, the consortium supported Country Learning Hubs in Bangladesh, Mali, Nigeria, and Uganda to generate, synthesize, and apply evidence to identify and reach zero-dose and under-immunized children.

ZDLH was designed as a hub-and-spoke learning model. Country Learning Hubs generated country-level programmatic data and evidence, with a focus on subnational learning and application. At the global level, 17勛圖厙 and partners supported technical assistance, evidence synthesis, knowledge translation, and cross-country learning. Through this bidirectional flow of evidence, the experiences, questions, and constraints identified by country teams shaped the global learning agenda.

Uganda Learning Hub team members share findings with Village Health Teams to support local action for reaching ZD and UI children. Photo credit: Uganda Learning Hub/IDRC.

Adapting Technical Support to Address Emerging Needs

A defining feature of 斑釦梆���s global learning partner role was demand-driven technical assistance. Rather than delivering a standardized package of support, 17勛圖厙 worked as a thought partner alongside country teams, adapting technical assistance to the needs emerging through implementation research and evidence generation and use. Support included operational troubleshooting, technical review, capacity strengthening, methods guidance, workshops, mentorship, and knowledge translation.

This approach created a feedback loop between country-level implementation and global learning. When a technical gap surfaced in one country, 17勛圖厙 supported that team directly. When similar needs emerged across countries, those repeated challenges signaled broader gaps in global guidance. Over time, this demand-driven technical assistance model helped convert country-level needs into practical global tools.

A Nigeria Learning Hub team member engages caregivers during household survey data collection focused on ZD and UI children. Photo credit: Nigeria Learning Hub/AFENET.

Building Resources in Response to Persistent Constraints

One of ZDLH���s clearest legacies is its suite of toolkits and technical resources, which 17勛圖厙 created in response to persistent constraints identified through the learning hubs and Gavi, rather than as stand-alone products. Together, these resources help address global gaps in how teams evaluate zero-dose strategies, estimate costs, monitor performance at decentralized levels, and translate evidence into use.

17勛圖厙 developed the to respond to the need for evaluation approaches that fit complex and changing implementation environments. Across global health programs, teams often need to understand not only whether an approach worked but also why it worked, under which conditions, and what changed along the implementation pathway. Developed through ZDLH���s work on zero-dose programming, the toolkit offers a practical approach for strengthening causal logic, making assumptions explicit, and supporting adaptive learning when experimental designs are not feasible.

斑釦梆���s addresses the need for practical, transparent approaches to estimating costs to reach children consistently missed by routine vaccination services. Costing is essential for planning, budgeting, advocacy, and scale-up, yet the global evidence base for zero-dose intervention costs remains limited. The toolkit supports teams in estimating incremental retrospective costs using a bottom-up, ingredients-based approach, helping programs understand cost drivers, potential efficiencies, and where underfunding could compromise implementation.

17勛圖厙 developed the to support decentralized monitoring and decision-making. National and district coverage estimates can mask local variation, especially when zero-dose and under-immunized children cluster in specific pockets. LQAS helps program managers classify supervision areas against vaccination coverage targets and identify where corrective action may be needed. The toolkit provides operational guidance, practical examples, templates, decision rules, and step-by-step support for using LQAS in immunization monitoring.

17勛圖厙 created a to help close the gap between evidence generation and evidence use. Strong findings do not automatically change policy, programming, resourcing, or practice. The Knowledge Translation Toolkit and companion measurement guidance support teams to plan stakeholder engagement, tailor messages to decision-makers, and track progress across the knowledge translation pathway from dissemination and transmission to acquisition, application, and impact.

These resources reflect 斑釦梆���s broader capability to transform technical assistance into reusable global goods. 17勛圖厙 developed ZDLH���s toolkits to strengthen approaches to reach zero-dose children in the four Country Learning Hub countries, but their utility is not limited to immunization. Each toolkit addresses a core challenge that appears across global health programs: how to evaluate complex strategies, estimate localized costs, monitor performance at decentralized levels, and translate evidence into use.

Because they are built around practical methods, templates, and decision-making processes, the ZDLH toolkits can be adapted and applied to other areas of global health where programs are working to reach underserved populations, respond to local barriers, and use evidence for course correction. The same proven practices���demand-driven technical assistance, country-led learning, adaptive implementation research, practical methods guidance, costing for decision-making, decentralized monitoring, and intentional knowledge translation���can strengthen programs and contexts beyond immunization.

A focus group discussion at CSCom Central in Tominian, Mali, supports Learning Hub rapid assessment activities to understand barriers to reaching ZD and UI children. Photo credit: Mali Learning Hub/GaneshAID.

Applying the ZDLH Model Beyond Zero-Dose

斑釦梆���s ZDLH experience points to important lessons for the future. Data availability has improved, but global and country teams still face persistent issues related to data quality, local-level measurement, and the ability to translate coverage data into actionable decisions. As Gavi moves toward its sixth strategic period, the ZDLH experience offers a model for how global learning investments can strengthen countries��� prioritization of vaccine programs as appropriate to their context, as well as improve programmatic and financial sustainability of these programs.

Through ZDLH, 17勛圖厙 demonstrated that technical assistance is most valuable when we listen first, respond to country needs, and turn recurring implementation challenges into tools that others can use. As the ZLDH concludes in 2026, its legacy is not only the evidence generated or the resources published but also a way of working: supporting country teams to ask better questions, using evidence more effectively, identifying where guidance falls short, and building practical tools that can strengthen decision-making across programs and contexts.

The ZLDH model is indicative of 斑釦梆���s contribution to global health. Across immunization and beyond, 17勛圖厙 brings the technical depth, implementation experience, and knowledge translation expertise needed to move from data to learning, from learning to action, and from country experience to global practice.

The post From Country Learning to Global Tools: 斑釦梆���s Legacy as the Zero-Dose Learning Hub Global Learning Partner appeared first on 17勛圖厙 Research & Training Institute, Inc..

A health system is only as strong as its ability to deliver life-saving commodities to the point of care. Historically, ���last mile��� facilities in Ethiopia struggled with supply chain challenges, low internet connectivity rates, fragmented data, low skill in data use, and high product wastage rates, leading to limited medical product availability in primary health settings.

In March 2025, 斑釦梆���s Strengthening Service Delivery (SSD) project, working with inSupply Health and in collaboration with Ethiopia���s Ministry of Health, launched the Pharmacy Performance Monitoring Team (pPMT) initiative in Sidama, Oromia, and Somali regions. The pPMT was established to enhance supply chain data quality and performance through consistent reviews, proactive problem identification, and timely intervention.

Data-Driven Collaboration

The pPMT, a five-person multidisciplinary team composed of the head of pharmacy, the pharmacy store manager, the maternal and child Health focal person, the health information technologist, and the health site supervisor, was launched in 11 pilot facilities. The team uses a structured data review system wherein they collectively review key performance Indicators, such as essential medicine availability, stock status, inventory accuracy rate, and wastage rates monthly. They use data visualization like fishbone diagrams to find specific answers to stock availability issues (e.g., was it a transport delay or a recording error?). Once specific gaps are identified, the pPMT team proposes solutions, ranging from inventory accuracy checks using Lot Quality Assurance Sampling to routine stock status reviews.

A pharmacy at Bika comprehensive health post. Credit: 17勛圖厙 Ethiopia

Impact: The Biyo Health Center Story

Before pPMT, the Biyo Health Center in Oromia faced significant challenges, including limited stock status data, affecting product availability. The pPMT team proposed a rigorous monthly inventory exercise and exchange of health commodities among Biyo and other nearby health centers. In the past year, Biyo has nearly eliminated essential health commodity understocking through a total of 27 stock transfers.

In my first two visits, I was told to find my medicines elsewhere. Now, there is no queue, the service is swift, and I am given the medicines I was prescribed,��� Chaltu Regaasa, a patient at the center, remarks on the difference in care at Biyo

Early pilot results are encouraging. In Lume woreda, home to six pilot sites and 34 health posts, reporting rates of health post commodity stock and resupply orders surged from 21% to 82%, and good storage practice scores rose to 95% from 84%. Inventory accuracy, which helped Biyo drive commodity transfers, climbed from 73% to 95%. This progress underscores the transformative power of institutionalizing a regular data-use culture to drive supply chain performance.

As stockouts became rare and waiting times in pharmacy departments decreased, facilities saw a consistent upward trend in patient satisfaction scores. The success of the pilot demonstrates that when pharmacy staff are empowered with a structured performance management framework and staff time devoted to supply analysis, they can reliably meet the needs of their communities.

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