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. 2023 Nov 10;11(11):1709.
doi: 10.3390/vaccines11111709.

Using the Journey to Health and Immunization (JTHI) Framework to Engage Stakeholders in Identifying Behavioral and Social Drivers of Routine Immunization in Nepal

Nicole Castle  1 , Surakshya Kunwar  2 , Leela Khanal  3 , Lisa Oot  1 , Katharine Elkes  1 , Swechhya Shrestha  4 , Anjali Joshi  2 , Prasanna Rai  2 , Sanju Bhattarai  4 , Biraj Man Karmacharya  2
Affiliations

Using the Journey to Health and Immunization (JTHI) Framework to Engage Stakeholders in Identifying Behavioral and Social Drivers of Routine Immunization in Nepal

Nicole Castle et al. Vaccines (Basel). .

Abstract

Although the Government of Nepal has achieved high and sustained childhood vaccination coverage, reaching under-immunized and zero-dose children requires different approaches. Behavioral science offers promise in better understanding the drivers of vaccination and development of more effective programs; however, the application of behavioral science to immunization programs in Nepal is nascent. Through the Behavioral Science Immunization Network, JSI, UNICEF Nepal, and Dhulikhel Hospital-Kathmandu University School of Medical Sciences established a Behavioral Science Center to engage a diverse group of stakeholders in increasing the capacity of practitioners to use behavioral science in immunization programming. As a result of the engagement during formative research, government stakeholders requested and applied tools from behavioral science to solve different immunization challenges. Of particular value was the use of the Journey to Health and Immunization framework, which helped stakeholders identify behavioral and social drivers of zero-dose communities in Kathmandu. Our experience in Nepal demonstrates that there is strong demand for approaches and tools from behavioral science to use in relation to immunization and that this type of engagement model is effective for generating demand for and strengthening capacity to use behavioral science approaches.

Keywords: Nepal; behavioral science; stakeholder engagement; vaccination; vaccine acceptance.

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Conflict of interest statement

Authors Nicole Castle, Lisa Oot and Katharine Elkes were employed by the company JSI Research & Training Institute, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The funder participated in the initial review of the study design and in the decision to publish the results.

Figures

Figure 1
Figure 1
Journey to Health and Immunization [21].
Figure 2
Figure 2
Stakeholder engagement throughout the formative research process.
Figure 3
Figure 3
Journey to Health and Immunization map for Kathmandu Metropolitan City.
See this image and copyright information in PMC

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