Today we offered preliminary feedback to key stakeholders in Kathmandu as part of our research into CPD (Continuous Professional Development) for nurses in Nepal. Today’s presentation is party funded by LJMU (Liverpool John Moores University) and partly funded by BU’s Centre for Excellence in Learning (CEL). Late 2016 CEL funded the qualitative part of our research project. In this CPD project we work with representatives of the Ministry of Health , the Ministry of Education, the Nepal Nursing Association and the Nursing Council, and providers of Nursing Education (both Government-run universities and private colleges).
Today key presenter was BU Visiting Faculty Dr. Bibha Simkhada (based at LJMU). The event was opened by Associate Professor Chandra Kala Sharma, who is also the president of the Nepal Nursing Association (lighting the traditional lamp in photo right).
Our BU contributors, Dr. Catherine Angell and Prof. Edwin van Teijlingen, are both based in the Centre for Midwifery and Maternal & Perinatal Health (CMMPH). We are grateful to our collaborators in Nepal, especially Dr. Sujan Marahatta at Manmohan Memorial Institute of Health Sciences, for organising this event in our absence. The CPD research project is truly a FUSION project in the field of nursing & midwifery since it links Research in the field of Education to help improve Practice in Nepal. Further information can be found on a previous blog post, click here!
Prof. Edwin van Teijlingen
Focus groups in open air in rural Nepal, (c) Sheetal Sharma
Congratulations to Sheetal Sharma, postgraduate student in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) whose latest paper on the process of the research in her PhD fieldwork was accepted today by the Journal of Asian Midwives . Sheetal used an innovative mixed-methods evaluation which was applied to a long-running maternity intervention in rural Nepal. The intervention has been supported for nearly seven years by Green Tara Trust, a Buddhist charity based in London. Sheetal’s supervisors are supervisors are Prof. Vanora Hundley, Prof. Edwin van Teijlingen, Dr. Catherine Angell (all in CMMPH) and Prof. Padam Simkhada, who is Visiting Faculty in the Faculty of Health & Social Sciences and based at Liverpool John Moores University.
This paper is part of a larger body of health research work conducted by CMMPH in Nepal.
Sharma, S., Simkhada, P., van Teijlingen, E., Stephens J, Hundley, V., Angell, C. (2017) Evaluation of Maternity Care Intervention in Rural Nepal: Lessons learnt, Journal of Asian Midwives (accepted Jan. 2017).
The second day of THET training showed again that gender is a critical issue in Nawalparasi, southern Nepal. We asked the ANMs about things they had changed in their own practice. Several ANMs said that they had changed the way they worked. Now they see that having a baby girl can be a significant mental health issue as it causes the women a lot of stress. Interestingly, it also caused them as health workers considerable stress The ANMs said that they had started to counsel families of girl children. They say they emphasise that it is okay to have girls.
This ties in with feedback comments from yesterday in a different group of trainees. In Sunday’s training, one ANM answered when asked about stress at work, that she finds it stressful that a room falls silent when a baby girl is born. She commented that this happens when the family is obviously hoping for a boy. She added that at the very moment a baby girl is born, the family immediately falls silent. She said that this is a great source of stress to her as a health worker.
Coincidently next door to the training venue in Nawalparasi a Hindu wedding has been taking place today. This colourful spectacle represents different roles and expectations of men and women, the bride and the groom, but also the other guests here in Nepal. Weddings everywhere are ceremonies that reflect society. Seeing the wedding from close by and listening to the ANMs over these last two days, we reflected at the end of today that these ANMs are acting bravely in raising such a culturally sensitive issue in their practice, in this largely patriarchal rural society.
Flora Douglas & Edwin van Teijlingen
Today we had our first training session of the final THET mental health in maternity care project. UK volunteer Dr. Flora Douglas spoke about key aspects of health promotion and focused particularly on notions of community-based approaches. Flora is based at the University of Aberdeen and she is also a Visiting Fellow in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH). This was her first visit to Nepal. She was inspired to volunteer as she had been a MSc supervisor some years ago on a project that related to the Green Tara Nepal health promotion intervention. Bournemouth University has been working with Green Tara Trust, a Buddhist charity based in London for many years.
Yesterday Flora had visited one of the 20 birthing centres in Nawalparasi, the district where the THET training takes place. Flora was very humbled by the experiences of the community-based maternity care workers in the light of many constrains. She said: “I have seen pictures of such birthing centres and read about them in the literature, but it is not until you see them first hand that you realise how staff have to work with such limited resources.
The attendees, who are nearly ANMs (auxiliary nurse midwives) were highly enthusiastic and very keen to discuss and learn. They shared some very personal and touching stories about their practice. Flora added: “I am very struck by their understanding of the importance of the social and cultural determinants of both psychical and mental health.” Many found they had learnt something in previous THET sessions in 2016 about communication with women and counselling family members about mental health, and perhaps most importantly, listening more to women. Last, but not least, Flora commented on the dedication of the participants: “At least two of the participants told me they travelled ten hours to get here for our one-day workshop. This really shocked me, particularly having seen the quality of the roads and public transport!”
Prof. Edwin van Teijlingen
Yesterday we come down from Kathmandu, the capital of Nepal, to our THET training area in Nawalparasi. Today we are starting our sixth and last training session on the Mental health training for community-based maternity care providers. Interesting we are starting training on a Sunday as Nepal is largely a Hindu country and most workers have only a one-day weekend (which is the Saturday). This BU-led project is a collaboration between the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), Tribhuvan University (Nepal’s oldest university) and Liverpool John Moores University (LJMU). The project receives funding from DFID, and is managed through THET and supported locally in Nepal by a charity Green Tara Nepal.
The landscape in the photo gives an idea of how rural this part of Nepal is. Nawalparasi is situated in the south of Nepal the India border. It is also largely very flat, not like the Nepal most people envisage namely that of the Himalayans and of Mount Everest. The flatness makes a Dutchman feel at home though.
The project depends on volunteers who work in the health sector in the UK to come out and spend their time and energy preparing and delivering the training. Our project also could not work without the logistical support from Green Tara Nepal and our academic colleagues at Tribhuvan University. The last photo shows one of the UK volunteers Dr. Flora Douglas with the translator Shiwani Manandhar on the way to the training venue.
Prof. Edwin van Teijlingen (from Nepal)
Bournemouth University has been working on a small research project with Pourakhi, a voluntary organisation which helps female migrant workers returning to Nepal, for over a year. Pourakhi advocates for the rights of women migrant workers. Last week they invited me to present a workshop session on Academic Writing & Publishing, this morning I run such workshop. The content of the workshop is based on years of experience of running similar workshops at Bournemouth University, many Higher Education colleges across Nepal and a COST-funded workshop in Malta a few years ago. The eight people (staff and volunteers) who attended the workshop were generally inquisitive and keen to get their work into print. Most of the paper we have written about aspects of academic writing and the publishing process have been published in Open Access journals. [1-8] Therefore, we can easily give workshop attendees copies and/or give them the links to the online version on the web.
Prof Edwin van Teijlingen
- Hundley V, van Teijlingen E, Simkhada P (2013) Academic authorship: who, why and in what order? Health Renaissance 11 (2):98-101 www.healthrenaissance.org.np/uploads/Download/vol-11-2/Page_99_101_Editorial.pdf
- Pitchforth E, Porter M, Teijlingen van E, et al. (2005) Writing up & presenting qualitative research in family planning & reproductive health care, J Fam Plann Reprod Health Care 31(2): 132-135.
- Simkhada P, van Teijlingen E, Hundley V. (2013) Writing an academic paper for publication, Health Renaissance 11 (1):1-5. www.healthrenaissance.org.np/uploads/Pp_1_5_Guest_Editorial.pdf
- van Teijlingen, E., Ireland, J., Hundley, V., Simkhada, P., Sathian, B. (2014) Finding the right title for your article: Advice for academic authors, Nepal J Epidemiol 4(1): 344-347.
- van Teijlingen, E., Hundley, V., Bick, D. (2014) Who should be an author on your academic paper? Midwifery 30: 385-386.
- van Teijlingen, E, Simkhada PP, Rizyal A (2012) Submitting a paper to an academic peer-reviewed journal, where to start? (Guest Editorial) Health Renaissance 10 (1): 1-4.
- van Teijlingen, E, Simkhada. PP, Simkhada, B, Ireland J. (2012) The long & winding road to publication, Nepal J Epidemiol 2(4): 213-215 http://nepjol.info/index.php/NJE/article/view/7093/6388
- Hall, J., Hundley, V., van Teijlingen, E. (2015) The journal editor: friend or foe? Women & Birth 28(2): e26-e29.
Following our health promotion dissemination meeting in Kathmandu last week, we had considerable national media coverage in Nepal. Since I wrote about of this media coverage on the BU Research Blog we have been informed about some further press coverage.
Apparently we appeared on Mountain Television, but I haven’t see the programme myself yet. On January 4th we had a very short piece in The Himalayan Times , a piece which incidentally also failed to mentioned Bournemouth University. Over the weekend we had a little write up in a magazine called New Spotlight (see photo).I have also included the original colour photo as the magazine’s copy looks unclear.
Prof. Edwin van Teijlingen
Yesterday we meet in Kathmandu with colleagues working for Pourakhi. Pourakhi is a charity, a non-governmental organisation (NGO), that helps to advocate for the rights of women who returned to Nepal after migrating for employment. The name Pourakhi, which means self-reliant in Nepali, represents the idea that the organisation is largely run and supported by Nepali women who had migrated abroad for employment.
Globalization and trade liberation have opened up opportunities in the international labour market for women in Nepal. Lack of job opportunity in Nepal and poverty have put a growing demand on women to economically support their family. This means many Nepali women are leaving the country to work abroad. In doing so they contribute to the economic prosperity of their families and also in the poverty alleviation of their country through remittances. However, working abroad comes at a cost, as it is not always easy, especially for women.
The Faculty of Health & Social Sciences at Bournemouth University (Prof. Edwin van Teijlingen) and Liverpool John Moores University (Prof. Padam Simkhada, who is also Visiting Faculty at FHSS) have been working with Pourakhi over the past years and half. The main aim of this collaboration is to set up a proper database of women who return to Nepal, based on paper records collected by Pourakhi and use this data to publish academic papers and reports on the issue. The first academic paper based on data collected up to 2014 has already been submitted.
Prof. Edwin van Teijlingen
Yesterday’s health promotion dissemination meeting in Kathmandu has been widely reported in the national media in Nepal. Some of the national media focused largely (but not solely) on the words of the Minister of Health Mr Thapa, whilst the television news reports included the organisers and presenters at the event. The Green Tara Nepal Health Promotion Dissemination conference in Kathmandu was supported by the Centre for Midwifery, Maternal & Perinatal Health at BU and Liverpool John Moores University (LJMU) and Green Tara Trust UK (a Buddhist charity based in London). BU has been working with Green Tara Nepal for the past eight years on a number of maternal health promotion projects in rural Nepal. Overall the media in Nepal had difficulty understanding the notion of ‘health promotion’, therefore many journalists focused on health services as this was mentioned by the Minister of Health.
The event was also attended by BU Visiting Faculty Prof. Padam Simkhada (based at LJMU), CMMPH PhD student Preeti Mahato and FHSS Post-Doc. Dr. Pramod Regmi.
Prof. Edwin van Teijlingen
Today the charity Green Tara Nepal (GTN) in collaboration with two UK universities, BU and Liverpool John Moores University (LJMU) presented the findings of its long-term maternal project plus a review of health promotion in (a) government policies and strategies and (b) the curricula of university-based health courses in Nepal. The event in Hotel Yellow Pagoda was attended by the Nepal’s Minister of Health Mr. Gagan Kumar Thapa. We presented some of the key research findings of the GTN maternity project which have shown that interventions based on health promotion principles using women’s groups can be effective in the community.
Bournemouth University was represented by Dr. Pramod Regmi (FHSS), Mrs. Preeti Mahato, PhD student in the Centre for Midwifery, Maternal and Perinatal Health (CMMPH) and Prof. Edwin van Teijlingen. One of the strengths of Green Tara’s approach is its collaboration with UK universities for its research. Several excellent MSc and PhD students have been, and some, such as CMMPH’s PhD students Sheetal Sharma and Preeti Mataho, still are, contributing to the health promotion evidence base.
The workshop was attended by a range of directors of NGOs (Non-Governmental Organisations), INGOs (International Non-Governmental Organisations), academics, the Government of Nepal, and many other stakeholders including the media. The GTN Chair Krishna Lamsal commented: “This dissemination workshop follows on from the First National Health Promotion Conference in Nepal in which Bournemouth University was also a joint organiser. The 2003 conference brought together nearly 300 people for the first time to discuss key issues in health promotion.”
In the final week of 2016 the journal Health Prospect published our editorial on the importance of introducing nursing CPD in Nepal . This editorial is based on a collaborative study between BU, Liverpool John Moores University (LJUM), Manmohan Memorial Institute of Health Sciences (MMIHS) in Nepal, Nepal Nursing Council (NNC), and the Nursing Association of Nepal (NAN). The BU part of the study is led by Dr. Catherine Angell based in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) and funded by a small grant from BU’s Centre for the Excellence in Learning. Two of our co-authors from LJMU Dr. Bibha Simkhada and Prof. Padam Simkhada are also Visiting Faculty at BU. The project is a true FUSION project as the Research, will inform Education (in the form of CPD) which will in turn improve Practice (of the many thousands of nurses in Nepal).
Health Prospect is an Open Access journal and therefore freely available for any one to read online.
Prof. Edwin van Teijlingen
- Simkhada, B., Mackay, S., Khatri, R., Sharma, C.K., Pokhrel, T., Marahatta, S., Angell, C., van Teijlingen, E., Simkhada, P. (2016) Continual Professional Development (CPD): Improving Quality of Nursing Care in Nepal, Health Prospect 15 (3):1-3 http://www.nepjol.info/index.php/HPROSPECT/article/view/16326/13255
Yesterday Prof. Edwin van Teijlingen from BU’s Centre for Midwifery, Maternal & Perinatal Health (CMMPH) spoke at the 9th Conference and Seminar on Adolescent’s Health Promotion in Kathmandu. This event was organised by the Health Education Association of Nepal (HEAN). The first keynote speech ‘Adolescent’s Health Promotion: Global Perspectives‘ was presented by BU Visiting Faculty Prof. Padam Simkhada (based at Liverpool John Moores University) on behalf of his BU co-authors Dr. Pramod Regmi and Prof. Edwin van Teijlingen. The second keynote speech ‘Global Health Promotion Approach‘ was presented jointly by Prof. van Teijlingen and Green Tara Nepal country director Mr. Ram Chandra Silwal on behalf of their collaborators Prof. Simkhada and Green Tara Trust, UK (Dr. Jane Stephens and Ms. Colette Fanning).
Both presentations were well received and generated considerable discussion amongst an audience of health educationalists, public health teachers and health promotion experts. Several of the active members of HEAN and conference organisers are collaborators with BU on our THET project on training community-based maternity care providers in rural Nawalparasi, southern Nepal.
Prof. Edwin van Teijlingen
We had the honour to speak to Parliamentarians (MPs) in Kathmandu today (December 29th) as part of workshop to promote evidence-based policy-making. The workshop was organised by a consortium of three UK universities: Liverpool John Moores University (LJMU), Bournemouth University and the University of Sheffield. Fund the Fund supported this Advocacy Workshop with Parliamentarians and Policy Experts on HV and AIDS (Discussion series IV) in the Himalayan Hotel in Lalitpur in Kathmandu Valley. The workshop was attended by some 30 MPs from all major parties and three or four former ministers. The drive to increase evidence-based policy-making in Nepal is led by Dr. Gangalal Tuladhar MP.
Prof. Padam Simkhada from LJMU and BU Visiting Professor addressed ‘key challenges on evidence-based health care delivery in Nepal’ and Prof. Edwin van Teijlingen from the Faculty of Health & Social Sciences compared selected different health-care systems in high-income countries.
At the very end of December, one more academic paper on maternity care in Nepal from the Centre for Midwifery, Maternal and Neonatal Health (CMMPH). Our latest paper ‘The uptake of skilled birth attendants’ services in rural Nepal: A qualitative study’ was published today in the Journal of Asian Midwives . The paper is co-authored with colleagues from London Metropolitan University, and is the third in a series based on the PhD project of the first author Dr. Yuba Raj Baral [1-3]. The Journal of Asian Midwives is an Open Access journal hence the paper is freely available across the globe.
Prof. Edwin van Teijlingen
- Baral, YR., Lyons, K., van Teijlingen, ER., Skinner, J., (2016) The uptake of skilled birth attendants’ services in rural Nepal: A qualitative study, Journal of Asian Midwives 3(2): 7-25.
- Baral, YR, Lyons, K., Skinner, J, van Teijlingen, ER (2012) Maternal health services utilisation in Nepal: Progress in the new millennium? Health Science Journal 6(4): 618-633. www.hsj.gr/volume6/issue4/644.pdf
- Baral, Y.R, Lyons, K., Skinner, J, van Teijlingen, E. (2010) Determinants of skilled birth attendants for delivery in Nepal Kathmandu University Medical Journal 8(3): 325-332. http://www.kumj.com.np/issue/31/325-332.pdf
Many prestigious newspapers across the globe re-published a very interesting Associate Press article called ‘At soaring rate, Nepalis seeking jobs abroad come home dead’ on the plight of Nepali migrant workers in countries such as Malaysia, Korea, India and the Middle East. This article cited our co-author Nirmal Aryal who is a Nepali researcher based in New Zealand. This newspaper piece also quoted our recent paper ‘Injury and Mortality in Young Nepalese Migrant Workers: A Call for Public Health Action’, which was published earlier this year in the Asian-Pacific Journal of Public Health . This scientific journal has an Impact Factor of 1.72
We have received email message and tweets from colleagues and friends who spotted this article in newspapers in the United Kingdom, the United States, New Zealand (NZ), Taiwan, Nepal, India and many more countries as well as on several news websites. The article was sighted in North American papers such as The Washington Post, The New York Times, The Billings Gazette, Dothan Eagle, The Daily Times, The Roanoke Times, Union Times, The Daily Courier, The Journal Times, Medicine Hat News. and many more. Whilst in Britain the article can be found on the webpages of the Mail Online. In the Philippines the piece is on Inquirer.net
Elsewhere we were alerted to The Hindustan Times in India, which is incidently one of the few papers that changed the original title of the Associated Press piece to ‘Mysterious deaths: Nepalis working abroad come back home in caskets’. Furthermore, as our colleague Nirmal Aryal is based in NZ it is not surprising that several newspaper there reported on the issue: The New Zealand Herald, The Dominion Post (NZ), and as expected several English-language daily newspaper in Nepal picked up the story, including The Himalayan Times, and The Kathmandu Post.
It’s a pity that the original Associated Press article only refers to the BU collaborators as ‘colleagues in the United Kingdom’. We have a long-standing interest in the health and well-being of Nepali migrant workers in various host countries. Dr. Pramod Regmi is post-doctoral research fellow in the Faculty of Health & Social Sciences (FHSS). He is part of the BU India-HUB, which involves the study of Nepali migrant workers in India. Prof. Padam Simkhada from Liverpool John Moores University is also BU Visiting Faculty in FHSS. Dr. Pratik Adhikary is a recent BU PhD graduate who has published several articles on Nepalis migrant workers [2-3]. Finally, our work on Nepali migrants has also been submitted as a contribution to the BU’s Global Festival of Learning.
Prof. Edwin van Teijlingen & Dr. Pramod Regmi
Faculty of Health & Social Sciences
- Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Adhikary, P., Bhatta, Y.K.D., Mann, S. (2016) Injury and Mortality in Young Nepalese Migrant Workers: A Call for Public Health Action. Asian-Pacific Journal of Public Health 28(8): 703-705. DOI: http://dx.doi.org/10.1177/1010539516668628
- Adhikary, P., Simkhada, P.P., van Teijlingen E., Raja, AE. (2008) Health & Lifestyle of Nepalese Migrants in the UK BMC International Health & Human Rights 8(6). Web address: biomedcentral.com/1472-698X/8/6.
- Adhikary P., Keen S., van Teijlingen, E (2011) Health Issues among Nepalese migrant workers in Middle East. Health Science Journal 5: 169-175. hsj.gr/volume5/issue3/532.pdf
Some months ago Andy Nobes asked my colleague Prof. Padam Simkhada and I if we could write a blog about why we had so many papers in freely available online journals in Nepal. Andy is the Programme Officer, Research Development & Support at INASP, which is an international development charity based in Oxford working with a global network of partners in Africa, Latin America and Asia.
We had a whole range of immediate answers to Andy’s question, including ones like: we both love Nepal; we are on the editorial board of a few journals that are part of the NepJOL group; and editors invite us to submit articles and/or editorials. Moreover, we feel reasons for Open Access publishing are very similar to our key reasons for working in a low-income country like Nepal. These principles are (a) conducting applied academic research in low-income countries for the greater good; (b) helping to build research-capacity; and (c) telling the world about our research through quality academic publications. This week saw the publication of our blog ‘Publishing in journals of the NepJOL family’ on the AuthorAid website, click here to read the post.
Edwin van Teijlingen, Professor of Reproductive Health Research at Bournemouth University and Padam Simkhada, Professor of International Public Health at Liverpool John Moores University and BU Visiting Faculty.
Congratulations to Dr. Pramod Regmi in FHSS on the publication of the editorial ‘Need and Scope of Global Partnership on Public Health Research’ published this week.  As a global partnership, it is our intention to make a tangible impact upon major public health challenges, whilst strengthening the participating institutions in a sustainable manner. Our collaboration came to a consensus on a number of priority research areas, based on our strengths and collective experience and on our knowledge of the key global issues for the next decades (Table 1). The paper is led by BU Visiting Faculty Prof. Padam Simkhada and co-authored by another BU Visiting Faculty Dr. Bibha Simkhada. The editorial is in an Open Access journal hence freely available to any researcher or practitioner (or policy maker) with internet-access in our collaborating countries.
Table 1 : Key areas of research focus of the consortium
- Reproductive, maternal and child health
- Rural and urban comparisons (Equity and health)
- Environment and health
- Health systems and health workforce
- Health, lifestyle and substance use
- Non-Communicable Diseases
- Preventable road traffic injuries and safety
- Simkhada, P., Poudel, A.N., Simkhada, B., Sumnall, H., Jones, L., Bista, S., McVeigh, J., Gaidhane, A., Zahiruddin, Q.S., Chowdhury, M.E., Bhuiyan, M.B.A.S., Iliyasu, Z., Pant, P.R., Kurmi, O., Hill, R., van Teijlingen, E., Regmi, P. (2016) Need and Scope of Global Partnership on Public Health Research, The Journal of Datta Meghe Institute of Medical Sciences University 11(3): 260-262.
The international journal Sexual & Reproductive Healthcare (Elsevier publication) published the online first version of our latest maternity-care research paper on Nepal . This paper is part of the successfully completed PhD research project of Malin Bogren (first author). The paper uses a qualitative approach based on the framework of Complex Adaptive Systems. Malin conducted semi-structured interviews with 17 key people representing eight different organisations (actors) promoting the development of the midwifery profession in Nepal. The move of midwifery from an occupation to a profession in Nepal is a challenging process. The study indicates the importance of understanding the motivations of, and barriers perceived by, actors that can promote or obstruct the establishment of the midwifery profession. It also points to the importance of informing the wider public about the role and responsibility of an autonomous midwifery profession.
The paper adds to our previous work around midwifery in Nepal [2-3].
Prof. Edwin van Teijlingen
- Bogren, M.U., Berg, M., Edgren, L., van Teijlingen, E., Wigert, H. (forthcoming) Shaping the midwifery profession in Nepal – Uncovering actors’ connections using a Complex Adaptive Systems framework. published online: October 4, 2016
- Bogren M, van Teijlingen E., Berg M. (2013) Where midwives are not yet recognized: A feasibility study of professional midwives in Nepal, Midwifery 29(10): 1103-1109.
- Bogren, M.U., Bajracharya, K., Berg, M., Erlandsson, K., Ireland, J., Simkhada, P., van Teijlingen, E. (2013) Nepal needs midwifery, Journal of Manmohan Memorial Institute of Health Sciences (JMMIHS) 1(2): 41-44.