The Sakhee Project is an inclusive urban health initiative designed to improve immunization uptake among under-served populations living in urban slums, with a specific focus on Mumbra and Kausa in Thane District, Maharashtra. These densely populated, low-income settlements experience persistent public health challenges, including high levels of zero-dose and under-immunized children, particularly among marginalized and hard-to-reach communities. Structural barriers, social exclusion, misinformation and vaccine hesitancy further limit access to timely immunization services.

The Sakhee Project adopts an innovative, community-driven approach by engaging transgender individuals as trusted health intermediaries and influencers. Leveraging their strong social presence and extensive informal networks within urban slum communities. Sakhees play a critical role in identifying high-risk populations such as newborns, immunization dropouts and fallouts. This enables timely follow-ups, referral support and an effective reminder–recall system to ensure continuity of immunization services. Transgender Sakhees, who often reside in these communities and earn livelihoods as street performers through singing, dancing and offering blessings, are uniquely positioned to overcome trust deficits and social barriers. Equipped with the mobile-based Sakhee App, they support real-time immunization tracking, referrals to public health facilities and coordination with frontline health systems. The app also enables systematic data capture to strengthen outreach planning and service delivery.