Immunity for All: How UNICEF-supported e-vouchers encourage vaccination in remote communities

By Joy Wanja,

In the heart of Boni Forest, Garissa County, a quiet change is happening for children in the Aweer community, a minority group that has long been left outside Kenya’s health system.

An innovative programme involving local champions - from community leaders, shop owners, and health promoters - encourages parents and guardians in remote communities to promote and increase vaccination uptake against polio among families with children under five years of age, as well as those with ‘zero-dose’ children (children who have never been vaccinated since birth).

In addition, a practical reward called an ‘e-voucher’ delivered to a mobile phone is at the centre of this unique vaccination campaign. The e-voucher is given to parents and guardians who take children under five and zero-dose children to be vaccinated against polio, to be redeemed at a local store in exchange for food items and essential household supplies. 

Mohamud Amin Hussein is a local shop owner and local leader in Bodhai village.  At the same time, he is a passionate supporter and champion for vaccination against polio and other preventable diseases, helping ensure children in his local village and neighbouring communities get the protection they need against deadly but preventable childhood diseases like polio.

The Aweer people have lived in Boni Forest for generations. Their way of life as traditional hunter-gatherers is deeply tied to the forest. They are used to living in isolation — away from other communities, which means their access to basic services like schools or health facilities is almost non-existent. Only 5 per cent of Aweer children attend school.

The nearest health facility is hours away, and the constant threat of armed groups along the way makes travel dangerous. Many Aweers do not have birth certificates, which means they cannot be issued national IDs, making it difficult for families to access school and health facilities.

The presence of armed groups within Boni Forest further hampers their ability to travel from their community. For years, these challenges caused children to fall victim to diseases like polio and other preventable childhood diseases.

For the Aweers, trust in modern medicine has been a long journey. Many rely on traditional remedies and are cautious of outsiders.

But Mohamud, as a familiar face and trusted local community leader, bridges that gap. In addition to redeeming the e-vouchers for food and essential supplies, he raises awareness about the benefits of immunization and promotes upcoming health campaigns during his routine daily interactions with community members who come to his shop. 

“This is about protecting our children and our community. If we don’t act now, we risk losing another generation to preventable diseases. It’s our shared duty as a community to keep our children safe. If we work together, we can defeat polio,” Mohamud said.

At his shop, where most community members buy basic household items, he makes it a personal duty to engage with his customers and stress the importance of the polio vaccine for children. “Since the e-voucher programme began, I see mothers from nomadic and hard-to-reach communities like the Aweer using safe transportation to bring their young children to health centres to get immunized,” said Mohamud.

The UNICEF-supported e-voucher programme is designed to facilitate families from indigenous communities like the Aweer people to access vaccination services for their young children.  By working with local shopkeepers like Mohamud, the e-voucher system complements other outreach activities in the communities, including door-to-door awareness campaigns to reach parents about the importance of immunization, dispel myths and traditional beliefs.

The e-voucher system also provides a tracking mechanism for the vaccination status of young children in the community, with the help of local champions like Mohamud, who keep track of how many children get vaccinated through the number of e-vouchers redeemed from his customers.

“When parents and guardians redeem their e-vouchers in my store, champions like me are trained to take the opportunity and discuss the benefits of childhood vaccines. It is a source of pride that when they leave my shop, they often share the information they learned about immunization more widely with their neighbours in the community,” he said.

Polio poses a serious threat with devastating effects on children. It is a highly contagious viral disease primarily affecting children under five.

The virus spreads from person to person through the faecal-oral route, via contaminated water or food. It multiplies in the intestines and can invade the nervous system, causing paralysis.

While there is no cure for polio, it can be prevented with an oral vaccine.

UNICEF Kenya, together with the Ministry of Health, the Garissa County Department of Health, with the support of Gavi the Vaccine Alliance, are making every effort to reach children under five and “zero-dose” children—to provide them with essential vaccines against deadly diseases like polio.

Ayub Duale, UNICEF Kenya’s Social & Behaviour Change Officer, noted: “Through the innovative e-vouchers system, complemented with targeted SMS reminders and tracking of immunizations through the Afya Tracker Platform, we have managed to serve children living beyond the reach of frontline health workers in insecure and inaccessible zones within the country.”

"Our collaboration with UNICEF showcased the impact of working together to reach children once beyond the reach of essential health services. Through this expanded immunization effort in border and hard-to-reach areas along the Kenya–Somalia frontier, we are closing immunity gaps and safeguarding our communities from vaccine-preventable diseases. We will continue to build on these approaches to ensure every child receives life-saving vaccines,” said Aden Hussein, Garissa County Director of Health

UNICEF Kenya Health Specialist Dr Collins Tabu said: “Polio respects no boundaries; an unvaccinated child is a risk to every child. Ensuring every child can get immunized against polio and other vaccine-preventable diseases is an important step for a healthy start in life,” said Dr. Tabu.

Observed every October 24, this year‘s World Polio Day theme is ‘End Polio: Every Child, Every Vaccine, Everywhere.’ The e-voucher system delivered through local champions like Mohamud is a clear example of what’s possible when communities come together to prevent polio transmission and protect children, especially those who are hardest to reach.  

The story of the Aweer community also recognizes the role and contribution that parents, professionals, and volunteers bring to make polio eradication possible. And for the Aweer people and other hard-to-reach communities in Kenya, the journey continues—one voucher, one conversation, one child at a time.