Vaccination & Hygiene Promotion

WaterAid/Yael Velleman


Diarrhoea is a leading cause of death in children under 5 years of age, due mostly to failures to increase access to safe water and improve sanitation and hygiene practices. Rotavirus vaccines are a useful addition to existing diarrhoeal disease control measures and are recommended for introduction in low-income countries. However, until 2012 there had been little discussion on the delivery of such vaccines as part of a comprehensive package of interventions to reduce diarrhoea, including WASH, and evidence for whether immunisation programmes were a useful entry point for sanitation and hygiene promotion.

So, researchers from LSHTM and WaterAid, with funding from SHARE, conducted a study in Nepal to ascertain whether or not vaccination programmes offer a useful entry point for hygiene promotion and to define options for piloting and scaling up of a hygiene promotion intervention in Nepal. Service-provider and recipient perspectives on integration were explored in focus group discussions with mothers, female Community Health Volunteers and NGOs, and key informant interviews were also held with government and agency officials at the district, regional and national level.

The study confirmed that incorporating hygiene promotion into the immunisation programme was acceptable and fits with the recommendations of the National Committee on Immunisation Practice. It also found that implementation through routine immunisation was preferred over a vaccination campaign approach. Discussions concluded that this approach should be piloted as a next step to ensure the development of a strategy that can optimise hygiene promotion delivery and uptake, and ultimately contribute to the reduction of the burden of diarrhoeal diseases in Nepal.


SHARE contributes to achieving universal access to effective, sustainable and equitable sanitation and hygiene by generating evidence to improve policy and practice worldwide.