Strengthening Immunization Program Implementation in Sub-National Consequential Geographies - Ethiopia - Save the Children (SC) is the world’s leading independent organization for children. We work in child protection, global health, education, hunger and livelihoods, and humanitarian relief. In Ethiopia SC leads multi-million-dollar portfolios implementing immunization programs to the marginalized and vulnerable in collaboration with the government and partners. SC is pleased to submit this joint application with our partner, the Consortium of Christian Relief and Development Association (CCRDA) in response to the Centers for Disease Control and Prevention (CDC) Notice of Funding Opportunity (NOFO) aimed at Strengthening Immunization Program Implementation in sub-National Consequential Geographies (CDC-RFA-GH-24-0058). The application builds on the CDC’s investments and SC’s and CCRDA’s immunization expertise, deep local presence, and longstanding relationships with the government of Ethiopia (GOE) to strengthen immunizations program implementation in sub-national consequential geographies, specifically in Ethiopia. SC Ethiopia will function as the co-lead in a consortium consisting of CCRDA and contractors Viamo and Acasus; each bringing their unique and complementary skills to the program. The proposed project supports CDC’s Global Immunization Division (GID) activities in countries at the highest risk for Vaccine Preventable Diseases (VPD) to prevent outbreaks, limit disease transmission and importation and ultimately protect the lives of the American people. By the end of the project, we will have strengthened immunization programs in consequential geographies in Ethiopia, bringing closer to reality a vision of a world that is fully protected from VPDs regardless of where someone lives. In collaboration with the Ethiopian Ministry of Health (MOH) and other key stakeholders from the public and private sectors at the national and global level, SC and CCRDA will increase immunization program capacity in targeted sub-national consequential geographies of Ethiopia. The partnership will identify underserved populations with immunity gaps and implement tailored interventions to vaccinate these populations, foster social support for change, tackle confidence, convenience, and complacency barriers to immunization uptake, implement comprehensive VPD surveillance systems, improve preparedness and response to outbreaks of VPDs, and strengthen quality and sustainability of routine immunization delivery systems while building the capacity of the MOH and other relevant government and community structures. Relying on strong technical capacity and expertise in building and strengthening existing immunization programs, we will improve the performance and expand the reach of immunization programs to underserved Ethiopian populations. This approach and its desired outcomes are in line with the MOH efforts to deliver contextualized vaccine services through a phased approach, conducting microplanning, establishing cold chain and vaccine access pathways, setting up data management systems, engaging the community and building the capacity of the vaccination workforce across the targeted sub-national consequential geographies in Ethiopia. SC’s and CCRDA’s national and sub-national presence with committed staff, network of partners, institutional knowledge, technical expertise, lengthy experience, and well-earned reputation for excellence make it uniquely qualified to help CDC reach its immunization goals in Ethiopia. Our proposed project uniquely and sustainably enhances Ethiopia's immunization services by partnering with the CCRDA to build the capacity of government and civil society partners; leveraging our extensive country presence through three area offices and nine field offices for widespread impact and immunization programming across seven regions; and pioneering and scaling up digital innovations to enhance immunization data's accuracy, completeness, timeliness, and use to foster SBC.