Reaching “zero-dose” children remains a significant challenge to achieving equitable immunization coverage in Kano State. To address this, the Clinton Health Access Initiative (CHAI), in collaboration with the Kano State Primary Health Care Management Board (KSPHCMB), is implementing the Zero-Dose Costing Study to generate evidence that will inform equitable and sustainable immunization financing.

DGI Consult was engaged to provide technical support in assessing the cost implications and financial drivers of reaching zero-dose children from both the supply side (health facilities) and demand side (caregivers). The findings from this study are expected to guide the state government and its partners in planning, budgeting, and implementing sustainable, equity-focused immunization strategies.

The project built on a baseline assessment conducted by CHAI; DGI Consult was engaged afterwards to analyse the already-collected data and to develop comprehensive data-collection tools and methods for the endline, capturing costing information at facility, LGA and state levels and including caregivers of zero-dose and non-zero-dose children. DGI Consult provided technical guidance to ensure alignment with the Zero-Dose Learning Agenda. Findings from CHAI’s baseline and DGI Consult’s analysis informed the design of the endline assessment and helped identify key cost drivers (human resources, per diem, transportation, and caregiver opportunity costs).

Ahead of the endline data collection, DGI Consult and CHAI jointly conducted a training for data collectors and supervisors to ensure a common understanding of the study objectives, methodology, and data quality standards. The training enhanced participants’ capacity to apply digital tools and uphold ethical and quality assurance principles during fieldwork. A pilot exercise in selected Nasarawa LGA facilities tested and refined the data collection instruments for usability and accuracy. To maintain data quality during implementation, joint supervisory visits were conducted across the study LGAs, providing real-time technical support and ensuring adherence to research protocols.

With the completion of endline data collection, the project is now advancing to the data cleaning and analysis phase, where findings will be synthesized to estimate the incremental costs of reaching zero-dose children and identify operational and financial bottlenecks in service delivery. These insights will inform state and national-level decision-making, guiding the design and implementation of cost-effective, equity-focused immunization interventions.

Through this collaboration, DGI Consult continues to contribute to evidence generation for strengthening Primary Health Care (PHC) financing, supporting governments and partners to build resilient health systems and ensure that no child is left behind.