Across Nigeria, Democratic Republic of the Congo, and Ethiopia, a consistent pattern is becoming clear: when women are given real authority, training, and institutional support, vaccination coverage rises. The methods vary by context, culture, and community dynamics, but the outcome is remarkably similar. Each vaccinated child is the result of conversations, relationships, and persistence—often led by women working within their own communities.
Behind every child protected from polio is a moment of connection: a door opened, a question answered, a fear eased. Across these three countries, thousands of women are making those moments possible.
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| Women volunteers of the Mama2Mama initiative in Bauchi State, Nigeria. © UNICEF/UNI570905/Fashina |
In Northern Nigeria, community-based initiatives have demonstrated how empowering women can close persistent vaccination gaps. One such initiative, the Mama2Mama programme, recruits local mothers as peer facilitators who engage directly with families. Moving house-to-house, they share health information, counter misinformation about vaccines, and support other women in navigating household decision-making around children’s health.
Their approach works because it is rooted in lived experience. Conversations between mothers often carry more weight than messages delivered through distant institutions.
Complementing this effort is the Community Reorientation Women Network (CRoWN), which equips women with both health knowledge and economic opportunities. By strengthening members’ financial independence, the network ensures that their roles as community health advocates continue long after initial programme funding ends.
Research led by women has also helped shape broader engagement strategies. One outcome is the Fathers for Good Health initiative, which brings men—often the primary decision-makers in households—into conversations about vaccination. By addressing both maternal influence and paternal authority, communities are seeing more consistent support for childhood immunization.
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| Community outreach worker Cecile Kyakimwa is the president of the Congo/ACK community animation cell supervising 113 members. Through the Village Savings and Loan Association, she has supported small businesses, met essential needs, and contributed to building a functioning health centre. © UNICEFDRC/Ushindi |
In the Democratic Republic of the Congo, progress against polio has been dramatic. Reported cases dropped from 115 in early 2022 to just two by 2025. Among the initiatives contributing to this shift is the Washindi Initiative, which focuses on creating safe spaces for women and adolescent girls to learn, discuss, and advocate for immunization.
Through peer discussions and health education, participants gain the knowledge and confidence to speak about vaccines within their families and communities. But the initiative goes further—pairing health education with economic empowerment to ensure women can sustain their roles as community advocates.
Women are also moving into formal leadership roles. In many communities, they now sit on local health committees responsible for planning immunization campaigns, monitoring implementation, and communicating feedback between households and health systems.
The impact is measurable. In provinces such as Maniema Province and Haut-Katanga Province, vaccination coverage has consistently exceeded national averages where women hold meaningful positions within these structures.
Importantly, programmes like Washindi also encourage dialogue with men. Community discussions around shared parenting and joint decision-making are helping reshape household dynamics that influence whether children receive vaccines.
Women make up the majority of the health workforce network driving the charge against polio in Ethiopia. © UNICEF Ethiopia/Ayene
Ethiopia’s Frontline Workforce
In Ethiopia, the scale of the challenge is immense. The country has faced one of Africa’s largest recent outbreaks of polio and is home to approximately 3.9 million “zero-dose” children—those who have not received a single routine vaccine.
At the center of Ethiopia’s response is a vast health extension workforce composed largely of women drawn from the communities they serve. As vaccinators and mobilizers, they form the backbone of nationwide immunization campaigns.
A key pillar of Ethiopia’s strategy is the house-to-house campaign model. By bringing vaccination directly to families, the system removes many barriers women face, including the cost of transportation, the need to travel long distances, or negotiating permission to leave the home.
Persistence is also built into the approach. If a child is missed during the first visit, follow-up visits ensure the household is not overlooked.
Ethiopia is also addressing structural barriers affecting female health workers themselves. In some cases, wages earned by women have historically been intercepted by other household members. To tackle this, pilot programmes are introducing direct digital payments so frontline workers receive their salaries personally.
The results are already visible. Two nationwide campaigns in 2025 reached more than 110,000 previously unvaccinated children and achieved quality benchmarks exceeding 90 percent. Behind those numbers are the women who organized the campaigns, walked the neighborhoods, and earned the trust of families.
A Common Lesson Across Borders
Despite differences in culture, geography, and health systems, one lesson is emerging across Africa: empowering women is not just a matter of equity—it is a practical strategy for improving public health.
When women are given leadership roles, training, and financial independence, vaccination programmes gain something invaluable: trusted messengers who understand the realities of the communities they serve.
In the ongoing effort to eradicate polio, that trust may be one of the most powerful tools available. And across Nigeria, the Democratic Republic of the Congo, and Ethiopia, women are proving every day that investing in their leadership can help protect the next generation.