Milken Institute School of Public Health Receives Grand Challenges Explorations Grant for Research to Improve Vaccination Rates in Nepal

WASHINGTON, D.C. (April 3, 2019) – The Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University (GW) announced today that it is a recipient of a $100,000 Grand Challenges Explorations grant – an initiative funded by the Bill & Melinda Gates Foundation. Rajiv N. Rimal, PhD, MA, chair of the Department of Prevention and Community Health at the Milken Institute SPH is the principal investigator of the award. He will pursue an innovative global health and development research project titled “Rejoice Architecture Meets Social Norms to Accelerate Vaccination in Nepal.”

In Nepal, essential health services like vaccinations are often provided in clinics with long waiting lines, usually in a noisy, stressful environment, according to Rimal. Restroom facilities are usually either in need of repair or do not exist. In addition, clinic staff are rushed, overworked and may seem disrespectful to patients, he points out. That unwelcoming environment might erect a barrier for new mothers in terms of follow up visits for their baby. The end result? Newborns may not get the full complement of vaccines, thus putting them at risk of developing serious diseases like measles, Rimal said.

The new project seeks to create a welcoming environment in these health clinics with the hope that vaccination rates will increase and caregivers will regularly seek essential health care services for their children and families.

“We observed that clinic settings were very stressful and unappealing,” Rimal said. “A busy new mother would often leave and not bring her baby back for the full immunization cycles if she felt unwelcome at the clinic.”

Rimal and his team will work in the Makwanpur District in Nepal where the vaccination rate is 83 percent. The two-pronged study will involve 10 government-owned health clinics – five will receive updates, including fresh paint to the walls, bathrooms equipped with proper cleaning materials like toilet paper and hand soap, and chairs in the waiting area. These five clinics will also be enhanced to provide visitors with additional services, such as the ability to do laundry or purchase groceries while waiting for vaccinations to be completed. The other five clinics in the study will not be changed. Through surveys and medical records, Rimal and his team will observe if the vaccination rate increases among those who visit the upgraded clinics.

“For many people in this region, traveling to the health clinic can be an all-day task. They often travel long distances and are balancing a million other life priorities,” Rimal said. “If we make it an appealing and productive trip, they will be more likely to return for follow-up visits.”

Grand Challenges Explorations (GCE) supports innovative thinkers worldwide to explore ideas that can break the mold in how we solve persistent global health and development challenges. Rimal’s project is one of approximately 50 Grand Challenges Explorations Round 22 grants announced by the Bill & Melinda Gates Foundation.

To receive funding, Rimal and other Grand Challenges Explorations winners demonstrated in a two-page online application a bold idea in one of seven critical global heath and development topic areas. The foundation will be accepting applications for the next GCE round in September 2019.


About Grand Challenges Explorations: Grand Challenges Explorations is a $100 million initiative funded by the Bill & Melinda Gates Foundation. Launched in 2008, over 1420 projects in more than 65 countries have received Grand Challenges Explorations grants. The grant program is open to anyone from any discipline and from any organization. The initiative uses an agile, accelerated grant-making process with short two-page online applications and no preliminary data required. Initial grants of US$100,000 are awarded two times per year. Successful projects have the opportunity to receive a follow-on grant of up to US$1 million.

About Milken Institute School of Public Health: The Milken Institute School of Public Health at the George Washington University is the only school of public health in the nation’s capital.