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Implementation Research on Health Behavior

The project “Implementation Research on Health Behavior is a research project carried out by the Department of Community programs, Dhulikhel Hospital- Kathmandu University Hospital in collaboration with the John Snow Inc (JSI) and UNICEF. The project is funded by JSI. The consortium intends to develop and establish tools and methodologies to strengthen the national immunization program and minimize the under-five mortality and morbidity caused by vaccine preventable diseases.

The project overall aim is to improve the routine immunization program in Nepal. It focuses to gather evidence from the community regarding the routine immunization services uptake from the community people’s perspectives.  As per the work activity, the project has three phases. All the project phases will be led by DHKUH in close collaboration with JSI and UNICEF. 

  • Phase 1: Rapid Assessment of behavioral factors that influence vaccine uptake for Covid-19 and routine immunization (using a COM-B model approach).
  • Phase 2: – Implementation research based on the findings from the rapid assessment.
  • Phase 3– Support the coordination and implementation of Behavioral Science Network.

Vaccination is one of the most effective measures to prevent the spread of the disease and limit the severity of conditions caused by preventable diseases. However, according to the HMIS-DoHS data, routine and COVID-19 vaccine uptake are low in some areas of Nepal. The Nepal government is proving the routine and COVID-19 immunization services free of cost and hosting immunization camps in various parts of the country. Yet not every child is vaccinated against routine immunization, and people are against COVID-19 vaccines.  Evidence suggests that the spread of infectious diseases is due to un immunization against the disease. It is crucial to vaccinate timely with completed doses of vaccines so as to prevent the spread of infectious diseases.  Many studies have reported the potential causes of not vaccinating their child against routine immunization and COVId-19 vaccines. However, the behavioral and social factors responsible for not vaccinating against the routine and COVID-19 immunization lacks in the context of Nepal. Therefore, the main objective of this project is to explore the behavioral and social factors associated with routine immunization and COVID-19 vaccine uptake among caregivers and community members in the selected three provinces of Nepal. The findings from the rapid assessment will further add value in the implementation research on vaccine uptake applying the behavior science model. 

Current progress:
The project is in its early phase i.e phase 1.We have developed proposal and tools for the phase 1 in close supervision with the JSI and UNICEF. We have formed project management team, steering committee, national advisory committee as well as advisory group. We have conducted first provincial consultative meeting on 1st and 2nd July 2022 to discuss about rapid assessment. The meeting was organized by the DHKUH. Particpants for the consultative meeting were provincial health directorate from Bagmati, Madesh and Sudurpaschim province, members from NHRC and academia institutions, health coordinator of Dhulikhel Municipality, UNICEF team member, JSI team member and project member from DHKUH. The meeting was very much insightful as it played a foundation role in developing the proposal and tools for rapid assessment. 
Similarly, we had one orientation and training program for the research assistants on the Rapid assessment at Dhulikhel Hospital. The training was provided jointly by DHKUH and UNICEF. We are now at Phase 1: Rapid assessment. We have submitted tour proposal on rapid assessment for ethical clearance at NHRC and are about to submit the proposal for the KUIRC.

Monitoring 
The intervention will be monitored at frequent intervals from the time of initiation or the start of implementation after the training until the conclusion of the Implementation visit by program manager was done to ensure whether any field staffs faced any kind of trouble in the health facilities. Furthermore, monitoring will consist of the in-person monthly visits conducted by the field research staff to intervention facilities.

Core Team 

We have an energetic and big team composing Public Health professionals including clinicians, nurses. 

Project Principal InvestigatorDr. Biraj Man Karmacharya

Project CoordinatorPrajita Mali 

Project CoordinatorSurakshya Kunwar, Anjali Joshi, Prasanna Rai

Research Assistant: Bidhya Chaudhary, Deepa Guragain, Manish Rajbanshi, Ishwori Shrestha, Namita Dahal, and Anusha Basnet.