A photo from the Airbel Impact Lab archive

Impact and embedded process evaluation of the IRC’s Fifth Child community engagement strategy aimed at increasing immunization coverage

The purpose of this study was to evaluate IRC’s “Fifth Child” strategy on community engagement in defaulter-tracing and outreach planning, implementation, and monitored strategy as a potential solution to address stagnating immunization coverage in remote areas.

The evaluation team specifically measured the extent to which the data-informed community co-managed defaulter-tracing approach works to increase diphtheria-tetanus-pertussis coverage, reduce drop-outs, and improve timeliness of immunization uptake. Heterogeneity analyses of subgroups included impact amongst 1,760 children ages 12-13 months in households across socio-economic quintiles, by distance from a health facility, and by ethnic group.

Findings concluded that the mobile data-informed community engagement strategy did not show a significant impact on coverage of the primary outcome between intervention and control clusters. However, there was a significant increase in valid coverage from baseline to endline.


  • Health Cost-Effectiveness Brief - Fifth Child
  • Ingredients List - Fifth Child Uganda
  • Coût-Efficacité Santé – Fifth Child (FR)