Introduction
This report presents a detailed analysis of Zimbabwe’s immunization data from 2019 to 2024, focusing on the number of children receiving the third dose of the diphtheria, tetanus, pertussis (DTP3) vaccine. The data, sourced from the DHIS2 health information system, cover the national total, all provincial totals and district-level breakdowns for each province. All charts were produced by the Afrique Center for Statistics, Artificial Intelligence & Innovation Research (ACSAIR) using the provided data. The report describes observed trends and patterns at each administrative level without drawing external conclusions or recommendations, explaining the data as given.
National Trend
Figure 1: National trend of children receiving the third DTP3 dose in Zimbabwe, 2019 to 2024.
Figure 1 shows the national DTP3 immunization trend from 2019 through 2024. The national total number of children immunized with the third DTP dose was 407,459 in 2019, followed by a slight decline to 399,906 in 2020. After 2020, the trend rises each year: 409,496 in 2021, 430,507 in 2022, 449,430 in 2023, reaching 462,895 in 2024. Overall, this represents an increase of about 13.6% from 2019 to 2024. The dip in 2020 is notable, after which counts recovered and grew annually, peaking in 2024 at the highest value in the period. The upward trajectory after 2020 indicates broad improvement in DTP3 vaccination coverage nationally over the six-year span.
Provincial Trends
Figure 2: Trends in DTP3 immunization by province (including Harare and Bulawayo), 2019 to 2024.
Figure 2 compares provincial DTP3 immunization trends across Zimbabwe’s provinces from 2019 to 2024. Each colored line represents one province’s total number of children who received DTP3 each year. All provinces generally experienced an upward or stable trend over this period, though the size and pattern of increase vary. Harare Province, which includes the capital city, consistently shows the highest values among provinces, starting around 65,946 in 2019, dipping in 2020 to 2021, then rising to 71,778 by 2024, the highest provincial total. Manicaland also increases strongly, from 55,775 in 2019 to 68,280 in 2024, becoming one of the top contributors by the end of the period. Mashonaland East rises notably as well, from 46,902 to 65,520, nearly closing in on Manicaland. In contrast, provinces such as Matabeleland South and Matabeleland North have the lowest totals and modest growth, for example Matabeleland South remains around 18 to 19 thousand over the years, 18,677 in 2019 to 18,967 in 2024. Most provinces show a slight dip or plateau in 2020, followed by recovery and growth through 2024. By 2024, besides Harare, Manicaland (68,280) and Mashonaland East (65,520) stand out with high immunization counts, whereas Matabeleland South (18,967) and Matabeleland North (22,528) remain the lowest. This indicates a disparity where more populous provinces and metropolitan areas contribute a larger share of DTP3 vaccinations, while smaller provinces lag in absolute numbers. Overall, the provincial comparison highlights that, although all provinces improved or maintained immunization levels, the scale of improvement differs, with some making significant gains by 2024.
Manicaland Province
Figure 3: DTP3 immunization trends by district in Manicaland Province, 2019 to 2024.
Figure 3 breaks down Manicaland Province into its districts, showing each district’s DTP3 immunization counts from 2019 to 2024. Manicaland’s overall upward trend appears in most districts, but growth is uneven. In 2019, Mutare District had the highest number of children immunized, around 13,225, followed by Chipinge, about 12,128, and Makoni, about 8,581. Buhera was mid-range in 2019 with about 7,871 children. By 2024, Buhera shows a remarkable increase, climbing to approximately 17,171, the highest in the province. Buhera’s count more than doubled over the six years, overtaking Mutare. Mutare, the provincial capital area, also grows from about 13.2k to 14,575 in 2024, though more gradually, and ends as the second highest. Chipinge maintains a high count with 12,245 in 2024, growing moderately. Other districts like Makoni see a slight decrease, from about 8.6k in 2019 to 8,016 in 2024, and Mutasa and Chimanimani remain relatively low, around 5 to 6 thousand in 2024, with minor growth. Nyanga consistently has the lowest numbers in Manicaland, around 3,862 in 2019, edging up to 4,376 by 2024. In summary, within Manicaland, the data indicate that Buhera’s immunization counts improved dramatically over the period, whereas other districts saw steady but smaller increases. The gap between the highest, Buhera, and the lowest, Nyanga, widened, suggesting improvements were not uniformly distributed across the province.
Mashonaland Central Province
Figure 4: DTP3 immunization trends by district in Mashonaland Central Province, 2019 to 2024.
Figure 4 shows Mashonaland Central’s DTP3 trends for each district. The provincial total grew moderately from 2019 to 2024, and the district-level data reveal which areas drove this change. Mazowe District has the highest immunized counts throughout the period, about 8,387 children in 2019, increasing to 9,589 by 2024. Mount Darwin and Guruve also contribute relatively high numbers; for instance, Mount Darwin rises to around 7,694 in 2024. Bindura, which includes a major town, remains mid-range with approximately 6,637 in 2019 to 6,637, around 6.6k, by 2024, a fairly flat trend. Many smaller districts maintain lower counts. Rushinga has the fewest DTP3 immunizations in the province, with roughly 2,255 children in 2019, slightly decreasing to 2,109 in 2024, indicating virtually no growth and a minor decline. Mbire and Centenary are also on the lower end, each in the 2 to 5 thousand range by 2024. Most districts show subtle upward trends or plateaus, meaning the province’s overall increase is driven largely by improvements in higher population districts like Mazowe, which added about 1,200 immunizations over the years. The persistent gap between Mazowe and a district like Rushinga, about 9.6k vs 2.1k in 2024, highlights significant disparities in coverage within Mashonaland Central.
Mashonaland East Province
Figure 5: DTP3 immunization trends by district in Mashonaland East Province, 2019 to 2024.
Figure 5 illustrates district-level DTP3 trends in Mashonaland East. The province shows one of the strongest overall growth patterns, largely attributable to major increases in a few key districts. Goromonzi has a substantial rise, from roughly 9,811 children in 2019 to 15,809 in 2024, becoming the top-performing district in Mashonaland East. Seke, which includes areas near Harare, climbs from about 9,668 to 13,213 over the same period. These two districts have the highest counts in 2024, reflecting significant improvements. In contrast, several districts have much lower numbers. Hwedza consistently reports the fewest DTP3 immunizations, approximately 1,809 in 2019, increasing to only 2,270 by 2024, indicating a minimal contribution. Chikomba and Mudzi are also on the lower end, each under 5,000 by 2024. Notably, Murewa improves from 5,179 to 7,642, and Marondera from about 5,047 to 7,120, showing moderate gains. Overall, Mashonaland East’s upward trajectory is driven by dramatic gains in Goromonzi and Seke, while smaller districts see modest growth. By 2024, the range within the province is wide. The largest district, Goromonzi at about 15.8k, has roughly seven times the immunizations of the smallest district, Hwedza at about 2.3k. This underscores significant internal disparities, even as all districts trend upward to some degree.
Mashonaland West Province
Figure 6: DTP3 immunization trends by district in Mashonaland West Province, 2019 to 2024.
Figure 6 shows the trends for Mashonaland West districts, where the provincial total grows modestly over 2019 to 2024. Hurungwe has the highest DTP3 counts in this province throughout the period, rising from about 12,590 in 2019 to 13,498 in 2024. It remains the dominant contributor in Mashonaland West. Makonde also shows a notable increase from 8,959 to 10,966, becoming the second highest by 2024. Other sizable districts include Zvimba, climbing from about 8,270 to 9,257, and Chegutu, around 8,441 in 2019 to 8,621 in 2024, although their growth is relatively small in absolute terms. On the lower end, Kariba consistently reports the fewest immunizations, roughly 2,419 children in 2019 and 2,468 in 2024, essentially stagnating at around 2.4 to 2.5k. Mhondoro and Sanyati, rural districts, also stay relatively low. For instance, Sanyati has about 7,432 in 2019 and increases only modestly to 7,829 by 2024. In summary, Mashonaland West’s data indicate steady but uneven progress. A couple of districts, Hurungwe and Makonde, account for much of the province’s growth, whereas others see little to no increase. By 2024, immunization numbers across districts range from roughly 2.5 thousand in Kariba to 13.5 thousand in Hurungwe, reflecting a significant disparity within the province.
Matabeleland North Province
Figure 7: DTP3 immunization trends by district in Matabeleland North Province, 2019 to 2024.
Figure 7 focuses on Matabeleland North, a province with generally lower DTP3 numbers. The overall trend is relatively flat with slight growth, and district-level data show consistently low counts across all areas. Binga has the highest numbers in Matabeleland North, with about 4,850 children immunized in 2019 increasing to 5,511 in 2024. This improvement, while positive, is small in absolute terms. Hwange, which includes a major town and national park area, follows, rising from approximately 3,685 to 4,010 over the six years. Most other districts remain under 3,500 immunizations annually. For example, Tsholotsho and Nkayi hover around the mid-2000s, Tsholotsho at about 2,624 in 2019 to 2,576 in 2024, essentially no change, and Nkayi at about 3,234 to 3,153. Bubi has the lowest recorded immunizations, with only 2,055 in 2019 and 2,075 in 2024, virtually static at just over two thousand. Umguza and Lupane also show minimal change, each ending around 3,000 to 4,000 in 2024. The pattern in Matabeleland North suggests challenges in increasing coverage, as even the best-performing district, Binga, remains around 5.5k by 2024. The spread between districts is narrower here than in other provinces, roughly 2k to 5.5k, indicating uniformly low coverage. Overall, Matabeleland North sees only slight growth, and the province continues to record the lowest DTP3 figures nationally, highlighting a need for continued focus without venturing into recommendations.
Matabeleland South Province
Figure 8: DTP3 immunization trends by district in Matabeleland South Province, 2019 to 2024.
Figure 8 presents the DTP3 trends for Matabeleland South, another province with low absolute numbers. The provincial total changes little from year to year, and district-level lines show mostly flat or gently rising trends. Beitbridge, at the border, consistently immunizes the most children in the province, with about 4,262 in 2019 and a slight increase to 4,419 in 2024. Gwanda, the provincial capital area, follows, moving from approximately 3,687 to 3,911 over the period. While these two districts are the highest in Matabeleland South, their counts are still modest compared to other provinces. The remaining districts each have very small numbers. Umzingwane has the fewest DTP3 immunizations, around 1,705 in 2019 and declining to 1,598 by 2024. Similarly, Bulilima, about 1,775 in 2019, is only 1,765 in 2024, essentially unchanged. Districts like Insiza, Mangwe, and Matobo show only minor fluctuations in the range of roughly 1.8k to 3.0k over the six years. This indicates that coverage in Matabeleland South stagnated or grew very slowly in most areas. By 2024, the difference between the highest and lowest districts is small in absolute terms, Beitbridge’s about 4.4k vs Umzingwane’s about 1.6k. All district values are relatively low, reflecting the province’s overall low contribution to national totals. Despite minor improvements in a couple of districts, Matabeleland South does not exhibit significant growth in DTP3 immunizations during 2019 to 2024.
Midlands Province
Figure 9: DTP3 immunization trends by district in Midlands Province, 2019 to 2024.
Figure 9 shows Midlands Province with its district-level DTP3 trends. Midlands has a mid-range provincial total that increases moderately over time, and the district data reveal which areas contribute to this growth. The Gokwe region stands out. Gokwe South immunizes the most children, about 9,931 in 2019, inching up to 10,172 by 2024, while Gokwe North increases more substantially from 7,555 to 9,109. By 2024, Gokwe South and Gokwe North are the top two districts in Midlands, each around nine to ten thousand. Kwekwe also maintains high figures, from about 9,216 in 2019 to 9,562 in 2024, nearly on par with the Gokwe districts. Gweru, including the provincial capital city, is slightly lower, relatively steady around 7,300 to 7,424 over the period. On the lower end, Chirumhanzu has the fewest immunizations, about 2,970 in 2019 dropping to 2,765 in 2024. Shurugwi and Zvishavane are also toward the lower side, both in the 3,000 to 4,000 range by 2024. Most districts in Midlands show stable or gradually increasing trends. For example, Mberengwa rises from 5,753 to 6,999, and Shurugwi from 2,970 to 3,639 over the six years. The range in 2024 spans from about 2.8k in Chirumhanzu to about 10.2k in Gokwe South, indicating considerable variation. In summary, Midlands Province sees moderate growth driven by increases in Gokwe North, which closes in on Gokwe South’s long-held lead, and steady performance in other major districts like Kwekwe, whereas some smaller districts lag or decline slightly.
Masvingo Province
Figure 10: DTP3 immunization trends by district in Masvingo Province, 2019 to 2024.
Figure 10 depicts Masvingo Province with trends for each district. The province-wide total shows only a slight increase over 2019 to 2024, and the district breakdown reveals a mixed picture, including an estimated series for Masvingo City, the urban center, derived from the data. Chiredzi consistently has the highest DTP3 counts among the listed districts, with about 8,241 in 2019 rising to 9,142 in 2024. Zaka is notable in 2019, around 6,377, but it decreases to 5,706 by 2024, suggesting a decline there. Gutu, Mwenezi, and Chivi hover in the mid-range. For instance, Gutu has about 5,394 in 2019 and 5,375 in 2024, essentially unchanged, while Mwenezi shows a slight drop from about 5,628 to 5,376. Chivi records the lowest figures in 2024 with 4,950 children, indicating a minor increase from 4,352 in 2019 but remaining the smallest contributor. The chart also includes Masvingo City as a separate series, calculated as the difference between the province total and other districts. This urban center’s immunization count is approximately 8,718 in 2019, increasing to about 9,093 in 2024. Masvingo City’s trajectory is relatively flat, and it ends virtually tied with Chiredzi for the highest immunizations in the province. Overall, Masvingo’s districts do not experience large changes; some increase slightly while others decrease. By 2024, most district values cluster between about 5,000 and 9,000. The province’s modest net growth in DTP3 coverage can be attributed primarily to small gains in the largest districts, Chiredzi and Masvingo urban, offsetting stagnation or declines elsewhere, such as in Zaka or Mwenezi.
Harare and Bulawayo (Urban Areas)
Figure 11: DTP3 immunization trends in Harare City, Chitungwiza, and Bulawayo City, 2019 to 2024.
Figure 11 highlights the major urban areas, Harare City, its satellite city Chitungwiza and Bulawayo City. Harare City shows a dynamic trend. It immunized an estimated 52,470 children in 2019, calculated by subtracting Chitungwiza from the Harare province total, and saw a decline to roughly 44,928 in 2021. After 2021, Harare City’s numbers climb significantly, reaching about 57,187 by 2024. This means Harare’s urban center ends the period higher than it began, despite the mid-period dip. Chitungwiza, represented separately, starts at 13,476 in 2019, drops to 10,791 in 2021, then recovers to 14,591 by 2024. By the final year, Chitungwiza’s DTP3 immunizations slightly exceed its 2019 level, indicating a full rebound after the early decline. Bulawayo City, which is both a city and a province, has a relatively flat trend compared to Harare. It records 17,030 children in 2019, fluctuates modestly around that value, and ends with 16,959 in 2024. Bulawayo’s totals peak at about 17,698 in 2023, then dip back in 2024, showing no substantial net growth over the six years. In comparison, Harare’s trajectory is more pronounced, dropping then rising to achieve roughly a 9% increase from 2019 to 2024. The contrast between the two main cities is clear. Harare, including Chitungwiza, manages to increase DTP3 coverage by 2024, while Bulawayo remains steady. These urban trends also influence their provincial totals. Harare Province’s overall increase, to 71,778 in 2024, is driven by its urban population’s recovery and growth, whereas Bulawayo’s provincial total, the same as the city’s, stays around 17k.
The DTP3 immunization data for Zimbabwe, 2019 to 2024, indicate a generally positive upward trend at the national level and in many provinces, with some interruptions and significant regional variation. The national total of children receiving the third DTP dose grew from about 407k to 463k over the six-year period. Most provinces mirror this growth to some extent, though the extent of improvement differs. Populous provinces such as Harare, Manicaland and Mashonaland East show substantial increases, whereas provinces like Matabeleland North and South have minimal changes and remain at low absolute levels. District-level analysis further reveals that within each province, certain districts drive improvements, for example Buhera in Manicaland, Goromonzi in Mashonaland East, and the Gokwe districts in Midlands, while others lag or stagnate. The largest urban centers have mixed outcomes. Harare, with Chitungwiza, rebounds strongly after an initial dip, whereas Bulawayo maintains steady coverage without growth. These findings provide a detailed breakdown of immunization performance across Zimbabwe’s administrative units, highlighting both the progress made and the areas that remain relatively unchanged. All observations are directly based on the provided DHIS2 data, and they present a comprehensive picture of how DTP3 coverage evolved across the country from 2019 to 2024.