Throughout 2021 and 2022, Pakistan’s Expanded Program on Immunization (EPI) administered millions of doses of COVID-19 vaccinations. This systematic rollout campaign operated at scale – by August 2021, one million doses were being administered a day. However, at a district level, statistics from EPI showed that the rollout was not penetrating equally in all areas. 50 districts in the provinces of Baluchistan, Sindh, and Khyber-Pakhtunkhwa were identified as having the lowest COVID-19 vaccination rates across all districts in Pakistan. These districts are predominantly rural, have lower digital access and lower literacy levels.

Save the Children hypothesized that the population may have been missed by previous COVID-19 communication efforts, due to the identified digital, literacy, and language barriers.