Programme expanded nationwide, reaching 1.8 million caregivers since scale-up
KATHMANDU, MARCH 25
The government on Wednesday unveiled the federal-level evaluation report of the Hygiene Promotion through Routine Immunization (HPTRI) programme, showing significant improvements in hygiene practices and immunization coverage across the country.
The programme, led by the Family Welfare Division under the Ministry of Health and Population in collaboration with WaterAid Nepal, has expanded from a pilot phase to nationwide implementation, reaching more than 530,000 mothers and caregivers annually.
The report was presented at a dissemination event attended by policymakers, development partners, health experts and media representatives. Officials reviewed the programme's progress since its launch and discussed strategies for long-term sustainability.
HPTRI was initially piloted in 2014 in four districts-Jajarkot, Bardiya, Nawalparasi and Myagdi-and later scaled up nationwide in 2018 following positive outcomes. In 2020, it was further expanded to all 77 districts alongside the introduction of the rotavirus vaccine into the national immunization programme.
According to the report, the programme reaches more than 530,000 mothers and caregivers annually. The initiative has so far reached around 1.8 million caregivers of children under 15 months of age. Services are delivered through more than 19,000 immunization sessions each month, supported by over 24,000 trained health workers, who receive refresher training every three years.
The programme promotes key hygiene and health behaviours among caregivers, including handwashing with soap, safe preparation of food and drinking water, exclusive breastfeeding, proper sanitation practices and ensuring full immunization of children within 15 months.
Based on a behaviour-centred design approach, HPTRI uses visual tools, demonstrations and community engagement to encourage behaviour change. Under its "Clean Family, Happy Family" campaign, households completing all required sessions are recognised as model families.
Findings from the pilot phase showed hygiene practices improved significantly, rising from 2 percent to 53 percent within a year. The programme also recorded higher immunization coverage, reduced dropout and vaccine wastage rates, and a decline in diarrhoeal disease prevalence from 15 percent to 5 percent.
The latest national evaluation for 2025/26 confirms continued progress, alongside improved efficiency and confidence among health workers. The programme has also been identified as cost-effective, with an estimated cost of around Rs 380 (USD 2.6) per child.
To sustain these gains, the government is preparing a "Transition to Sustainability" strategy, focusing on institutionalising hygiene integration within immunization services, strengthening government ownership, ensuring sustainable financing, and promoting digital monitoring systems.
The report also underscores the need for continued investment in behaviour change initiatives, capacity building, availability of essential materials, and stronger monitoring and coordination mechanisms.