Abstract: Background: Ever since the return of some form of governance and administration (interim/ provisional, state, or federal), Somalia has been struggling to streamline administrative structures capable of handling effective service delivery to the public. The health sector, supposedly one of the priority areas under the public service delivery umbrella, has been ailing and continues to be facing serious encounters which the health authority is grappling with, though yet unable to tackle them independently. Child immunization, the focus of this study, remains a sub-sector the country has been massively underperforming. Objective: The current study aims to review the efforts engaged and challenges needed to be addressed in order to improve the overall approach of the country’s immunization policy. Method: The researchers utilized secondary data to review available literature on immunization selected from various sources to determine the efforts made and challenges faced or being faced in the course of child immunization. Results: The study found that in addition to issues such as security, low education, low coverage, and inaccessibility, factors including resources, language barrier, and trust contribute to the challenges. Conclusion: The health authority and its partners made remarkable efforts and achievements but still need to consider approaches that are friendly to the target groups in the course of enhancing the country’s child immunization programs. Trust, which is built on a smooth flow of communication between the beneficiaries and service providers, needs to be gained through mutual linguistic intelligibility in order to maximize the endeavor toward improving the health sector, particularly immunization of vaccine-preventable diseases and the challenges it is facing towards the realization of national and global health goals.