From Idea to Immunization

The Challenge

Can a BI unit tackle immunization challenges in the Global South?

The Context

Rising misinformation, increased vaccine hesitancy, and growing mistrust in Governments across the world: It’s no longer enough to offer vaccines and services and hope that people will use them. 

Governments and public health organizations are increasingly coming around to the understanding that human behavior is integral to good public health. Reflecting this, the number of institutions setting up Behavioral Insight expertise is on the rise: from 202 behavioral insights teams in 2018 to well over 300 in 2021.  

Gavi wondered whether others were onto something. They called upon us to help them determine whether a BI unit for immunization and demand generation was a good idea.  And if so, how could a team be set up?






We interviewed 25 experts from 12 countries.

In the Global North, insights from behavioural science have been used to increase uptake of the influenza vaccine, reduce the number of missed doctor appointments, encourage healthy habits and influence end-of-life decisions.

Most teams are built anew or are fairly young.

Three-quarters of all behavioural science teams we surveyed had set up their teams in the last 7 years. 

In the Global South, few BI units exist.

Based on 595 identified teams in a 2020 global survey, we estimate that less than a quarter are in the Global South.

What We Heard

Our early research revealed two key insights:

1. Few BI teams were focused on public health, let alone on immunization

2. Even fewer were based in the Global South.

In other words, we were not going to find a model that covered health, a focus on the Global South, and one that operated within complex international organizations and partnerships. Our list of 217 teams originally identified was quickly whittled down to just 56 units we thought might have experiences relevant to the global immunization context. 

Next we found the people – thought leaders, academics, and most importantly those who had experience in applied behavioural science and in establishing teams to do it. This impressive group was able to speak to operating in complex environments, working on public health issues and many had experience setting up and running teams outside of Europe, North America and Australia.  We also knew our literature review was only giving us part of the picture. Our interviews might help us learn more about failed attempts, false starts and the stories of units that failed to get off the ground. What could we learn from those failures?

We interviewed 25 experts from 11 countries.

Our Interviewees


Save the Children
Head of CUBIC

North America

Ideas 42
Managing Director
Head & Health Practice Lead

International Rescue Committee
BI Lead

The Decision Lab
Research Director

United Nations
Senior Adviser for Behavioural Insights

Senior SBC Adviser

Associate Director

World Bank
Co-head of eMBed

World Bank eMBed
Senior Behavioural Scientist

The Americas

National Public Policy Lab, Mexico
Founder of Innovation

Nudge Rio, Brazil
Founder & Director


Principal Adviser

Managing Director

Head of Innovation

EU Policy Lab

EU Policy Lab
Senior Behavioural Economist

London School of Hygiene & Tropical Medicine
Founding Director, Vaccine Confidence Project

Head of Strategic Management & Coordination

Middle East & Africa

Global Lead, Behaviour Change

Busara, Kenya
Senior Adviser

Nudge Lebanon

Design Lab, Tunisia

Our Solution

Our work advised the Global Demand Hub – made up of the world’s leading public health organizations – Gavi, the Bill and Melinda Gates Foundation, UNICEF, WHO, the International Federation of the Red Cross, the Centers for Disease Control – on how they could consider a Behavioral Insights team for Immunization. 

The feedback was clear: immunization is a great candidate for a BI team. As a last-mile problem, behavioural science can bring new thinking and approaches to increase uptake. 

Next, our 25 interviewees shared their experience on everything from team size, to location, to budget and operating models. All of this was distilled into an 8-Step blueprint to setting up a behavioural insights team. Designed to be evidence based, but brutally practical, this work provides a clear roadmap for setting up a BI team with a focus on the Global South. 

Now, in the midst of a global Covid vaccination program, with the rise of vaccine hesitancy and misinformation, and children persistently left unreached by national health systems, the best of behavioural science can be harnessed to increase global immunization coverage. 

See the tool ›

We can do great things together.