Childhood immunization remains one of the most critical and cost-effective public health interventions globally. In Tanzania, however, recent data highlights significant gaps in vaccine coverage, particularly among zero-dose children. The Ministry of Health’s efforts have led to progress, yet disparities remain, with regional variations in vaccination rates and persistent challenges in reaching underserved populations.

This position paper outlines the current state of childhood immunization in Tanzania, analyzes the barriers to achieving full vaccine coverage, and provides strategic recommendations for strengthening the immunization program. Emphasis is placed on the need for enhanced domestic financing, better stakeholder collaboration, and tailored community outreach to ensure equitable vaccine access for all children.

In Tanzania, children living with HIV face unique challenges in understanding their condition and the importance of adhering to antiretroviral therapy (ART). Many children, especially those under 10, struggle with complex HIV terminologies and the importance of their treatment. This lack of understanding often leads to poor adherence to ART, which is critical for viral suppression and maintaining good health. Additionally, the conventional methods used to educate children on HIV and ART were not engaging enough to make the information memorable and impactful.

The USAID Afya Yangu (My Health) Northern Project embarked on a journey to address the complexities surrounding HIV and ART understanding and management. Recognizing the critical role of human-centered design (HCD) the project initiated a comprehensive process that began with immersion interviews in the Dodoma and Manyara regions. Through these interviews, we gained deep insights into the lives of children living with HIV, their caregivers, and the healthcare providers who support them.

Understanding means engaging with people and asking them these questions and it is through understanding that we can promote social and behavioral change. This is especially important when understanding why persons living with HIV (PLHIV) may choose to adhere with their antiretroviral therapy regime or not.

The USAID, Afya Yangu (My Health) Northern (AYN) Project has embraced this challenge and deployed human centred design (HCD) as a method of engaging with PLHIV to understand their decision making around ART compliance or non-compliance. The B-OK Kit and animation video were developed in earlier phases of the AYN Project. These visual tools explain how antiretrovirals (ARVs) work in the body and encourage ARV adherence for PLHIV to maintain good health and viral suppression. The tools themselves were developed by understanding why people either do or do not comply with their ART regime. This next phase of the AYN Project aims to explore how people in the community understand these tools and their efficacy in encouraging PLHIV to stay on ARTs.

In the Manyara region of Tanzania, helping ensure that Persons Living with HIV (PLHIV) continue to take their antiretroviral therapy (ART) is a labor of love. It is a continuous effort that has a myriad of factors to contend with for success to be met. are all implications of how PLHIV do or do not continue to take their ARTs. Recognising these challenges, the USAID Afya Yangu (My Health) Northern (AYN) Projectused Human Centred Design (HCD) to engage with a wide range of stakeholders to better understand their experiences around HIV care, both accessing care and providing it. After an in-depth co-creation process, the B-Ok kit emerged as a tool to facilitate the provision of care. The B-Ok helps guide Healthcare Providers (HCP) as they encourage PLHIV to comply with their ART regime.