KINSHASA and LUMUMBASHI, October 7, 2025 (The Geneva Learning Foundation) — “Young girls who get pregnant when they don’t plan to often leave their babies to care for themselves after they give birth,” says Marguerite Bosita. She runs a community group in Kinshasa.
“When children don’t get information about vaccines, they face even more health problems as they grow up.”
Her voice joined hundreds of others on October 7, 2025. She was calling in from her work in Kongo Central province.
This was the second day of a 16-day peer learning exercise. The goal was to find and help “zero-dose” children in the Democratic Republic of the Congo (DRC).
These are the hundreds of thousands of babies who have not received any vaccines to protect them from diseases.
The 1,617 health workers taking part knew this was not a regular training session. It was an important step in a much bigger movement.
The Geneva Learning Foundation organized this exercise. It is a key part of the Congolese Movement for Vaccination by 2030 (IA2030).
The DRC Ministry of Health supports this work through its Expanded Program on Immunization (EPI). UNICEF and Gavi, the Vaccine Alliance, also support it.
This approach flips the usual model of international aid.
Instead of bringing in outside experts, it starts with a simple but powerful idea.
Health workers themselves have the best knowledge to solve the challenges they face every day.
The group of participants shows how deep this work goes.
More than half come from local and regional levels of the health system. This is where vaccination happens.
One out of every five works at the national level. They connect national policies with what happens on the ground.
The participants have many different backgrounds.
A third are doctors. Thirty percent work in public health. Community health workers make up 13 percent. Nurses make up 9 percent.
Nearly half work directly for the Ministry of Health through the Expanded Program on Immunization (the “EPI”).
This large number of government staff, along with people from community groups and private health services, shows that the country owns this work.
What workers on the ground see
“The challenges are huge,” said Franck Kabongo. He is a public health consultant in Lubumbashi, in Haut-Katanga province.
The challenges that participants described are indeed huge.
He pointed to two major problems.
First, it is hard to reach children in remote communities.
Getting supplies and people where they need to go is a “headache” for many health workers doing vaccination work.
For Ms. Bosita in Kinshasa, the problem goes deeper than logistics.
Her organization supports vulnerable children. This includes orphans and children living on the streets. Many were born to young mothers who had no medical care.
“Not enough people on the ground know about this,” she said. She explained why she wants to make vaccination part of her organization’s work.
These stories, shared from the very start, show a clear picture of dedicated health workers.
They face a complex mix of problems with logistics, social support, and information. These barriers leave the most vulnerable children without protection.
Getting to the root causes
The goal is not just to share problems. It is to take them apart.
Participants use a method called “five whys.”
This method helps them dig past what they see on the surface to find the real cause of a problem.
During one session, Charles Bawande shared a common challenge. He works with communities in the Kalamu health zone in Kinshasa.
He sees many zero-dose children among families living on the streets. These families move often. Many children do not go to school.
At first, the problem looked simple. People did not have enough information.
But as the group kept asking “why,” a bigger picture came into view.
Why are children missed?
Because community health workers do not have the information they need.
Why do they not have this information?
Because they often skip key meetings.
Why do they skip meetings?
Because they are busy with other work.
“They have to live. They have to eat. They pay rent,” Mr. Bawande explained.
The last question got to the heart of the problem.
Why are they busy with other work?
Because they work as volunteers. They do not get paid.
These workers are expected to volunteer. But many are parents. They support families. They must earn money first.
What looked like a simple information gap turned out to be about money. The volunteer health system does not pay people who need to feed their families.
Many challenges across the country
Participants split into nearly 80 small groups. Their talks revealed many different barriers. Each one was tied to where people live.
The groups painted a detailed picture of what stops vaccination across this large country.
Near Goma in North Kivu, Clémence Mitongo’s group named war and violence as the main barrier. These have forced people to move and have broken down health services.
In Kasaï province, Yondo Kabonga’s group talked about rumors and false information. They also talked about rivers and deep valleys that make it hard to reach families.
Other groups reported pushback from religious beliefs. Some churches teach that faith alone will protect children.
One group talked about refugees who came back from Angola. Many parents did not know when children should get vaccines.
This work showed the power of peer learning.
No single expert could know this much about challenges across the whole country.
A new way to learn
This work is different from regular training programs.
Participants create knowledge and lead the actions that follow.
During the program, each participant will develop their own field project. They will share it with their team, health center, or district.
This is a concrete plan to tackle a zero dose challenge in their own community.
After they submit a draft by Friday, October 10, they will enter a peer review phase.
Each participant will get feedback from three colleagues. They will also give feedback to three others. This builds stronger work through the group’s combined thinking.
Charting the way forward
The next step for these thousands of health workers is to pull together their group discussions and keep working on their projects before the Friday deadline.
The program continues with peer review, project revision, and a closing meeting to share the improved plans.
This intensive work is more than an event.
It is a catalyst for the Congolese Movement for Vaccination by 2030.
The goal is to turn the global strategy of the Immunization Agenda 2030 into real actions, led locally, that make a real difference.
The solution, as this movement shows, does not come from guidelines written in Geneva. It comes from the combined wisdom, creativity, and commitment of thousands of Congolese practitioners working together across the whole country.
Illustration: The Geneva Learning Foundation Collection © 2025