Role of civil society organisations in immunisation: A scoping review

BACKGROUND/OBJECTIVES: Civil society organisations (CSOs) are central to reaching zero-dose children and advancing Immunisation Agenda 2030 (IA2030). Yet the evidence on CSO roles is fragmented across settings and CSO types, limiting its value for shaping immunisation policy, financing, governance and CSO engagement. We synthesised global evidence on CSO roles in childhood immunisation, compared routine versus fragile, conflict-affected and vulnerable (FCV) settings, and identified reported barriers and gaps in CSO engagement. METHODS: Following PRISMA-SCR Joanna Briggs guidelines, we searched OVID MEDLINE, OVID Global Health, Global Index Medicus, Web of Science, Scopus and grey literature. Eligible full texts were charted in Excel and analysed using an iterative, inductive thematic synthesis. RESULTS: We included 250 CSO case studies reported in 148 publications, mostly from low- and lower-middle-income countries in Africa and Asia. Over one-third of cases involved international non-governmental organisations (INGOs). Roles reported were demand generation (121; 48.4%), immunisation service delivery (97; 38.8%), research/innovation/monitoring (89; 35.6%), immunisation system strengthening (77; 30.8%), advocacy/policy engagement (53; 21.2%), multi-sectoral coordination/integration (45; 18.0%), and resource mobilisation (13; 5.2%). In FCV settings (42/250), engagement focused on service delivery (Bowes, 1967 [28]), whereas in 208 routine immunisation cases, roles were more diverse. CONCLUSION: CSOs are integral partners performing multi-domain roles and complementing government efforts through community reach, technical expertise, and adaptability. They are diverse and bring unique strengths. Stronger CSO engagement will require flexible, longer-term funding, clearer coordination, and recognition of distinct CSO roles and types. To achieve IA2030, policymakers and funders should deploy equitable, flexible financing (including direct, predictable support to local CSOs), invest in local capacity and data systems, and include CSOs in governance and accountability mechanisms across the health system. Future research should compare which roles work, where, and in what contexts.