17 February 2024

Interdisciplinary Research Teams/ Interdisciplinarist

international, open access, writing Edwin van Teijlingen

The Interdisciplinary Research Team not the Interdisciplinarist

Worldwide there is a growing interest in multidisciplinary and interdisciplinary research. This overview paper addresses some of the pitfalls and barriers to being an interdisciplinary researcher. Being involved in interdisciplinary research is not an easy option for an individual discipline expert. It requires individual skills, ability to see beyond one’s discipline and perhaps personality characteristics such as a great team player. Interdisciplinary research may involve a mixed-methods approach underpinned by conflicting, and according to some incommensurable, research philosophies. The paper uses some examples from our own experiences of working in interdisciplinary teams to illustrate its potential.

On Valentine’s Day we received a message from ResearchGate that our paper ‘The Interdisciplinary Research Team not the Interdisciplinarist’ has received 2,000 reads.

Prof. Edwin van Teijlingen

Reference:

Shanker S, Wasti SP, Ireland J, Regmi PR, Simkhada PP, van Teijlingen E. (2021) The Interdisciplinary Research Team not the Interdisciplinarist. Europasian J Med Sci.;3(2):111-5. Available from: https://www.europasianjournals.org/ejms/index.php/ejms/article/view/317

10 February 2024

New BU Public Health publication

open access, Publishing, writing Edwin van Teijlingen

Yesterday we received the proofs of the recently accepted paper ‘Improved Water, Sanitation and Hygiene Facilities at School and their Effect on Educational Achievement in Basic Level Students in Nepal’ [1]. Luckily these are only the proof pages as my family name is misspelt, and the paper still lists the old name of our Centre for Midwifery and Women’s Health, which was, of course, the correct name at the time of submission.

The last time I published a paper on hygiene was also with colleagues in Nepal seven years ago, this time it was on menstrual hygiene [2].

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health

References:

Sharma, M., Adhikari, R., van Teijlingen, E., Devkota, B., Khanal, S. (2024) Improved Water, Sanitation and Hygiene Facilities at School and their Effect on Educational Achievement in Basic Level Students in Nepal, International Journal of Health Promotion & Education (accepted). https://doi.org/10.1080/14635240.2024.2314459.
Budhathoki, S.S., Bhattachan, M., Pokharel, P.K., Bhadra, M., van Teijlingen, E. (2017) Reusable sanitary towels: Promoting menstrual hygiene in post-earthquake Nepal. Journal of Family Planning & Reproductive Health Care 43(2): 157-159.

6 February 2024

Paper by BU MSc student accepted for publication

international, open access, PG research, Publishing, writing Edwin van Teijlingen

Congratulations to Mr. Musa Lewis Nhlabatsi whose paper ‘Clinicians’ barriers to screening and diagnosing diabetes distress in patients with type 1 and 2 Diabetes Mellitus: a systematic review’ has just been accepted by the African Journal of Health Sciences [1].This systematic review’s initial search identified 1,579 studies, but only four primary studies from three countries met the inclusion criteria. The studies reported five barriers: (1) lack of knowledge, (2) lack of time, (3) lack of accessibility to mental health services, (4) lack of motivation and (5) patients’ denial of their diabetes distress. The two most reported barriers were lack of knowledge and time. In conclusion this review identifies critical barriers to the underdiagnosis of diabetes distress by clinicians and highlights the need for policymakers and organisations to conduct pragmatic research to understand clinicians’ experiences in assessing diabetes distress in various healthcare settings to improve diabetes management.

The paper developed from his work on the Systematic Review Module for Masters student. Earlier Musa won The Department of Medical Science and Public Health Award in July 2023 and he graduated in November 2023.

Congratulations!

Profs. Vanora Hundley and Edwin van Teijlingen

CMWH

Reference:

Nhlabatsi, M.L., van Teijlingen, E., Hundley, V. (2024) Clinicians’ barriers to screening and diagnosing diabetes distress in patients with type 1 and 2 Diabetes Mellitus: a systematic review’, African Journal of Health Sciences (forthcoming)

1 February 2024

New Nepalese migrant health paper published

international, open access, Publishing, writing Edwin van Teijlingen

New paper on migrant workers from Nepal was published this week in KMC Journal. The paper ‘Risk Perception and Protective Health Measure Regarding COVID-19 among Nepali Labour Migrants’ Returnee from India’ has Shanti Khanal as lead author [1]. The journal is Open Access, hence freely available online across the globe. The paper examines the association between risk perception and protective behaviour regarding COVID-19 in returnee migrant workers. A total of 384 returnee migrants, based in a quarantine centre on return from India, participated in the study. Using the health belief model (HBM) as a theoretical framework, a structured interview questionnaire was designed and administered. A further three health workers were interviewed face-to-face.

The study showed that the perceived risk of COVID-19 among participants was medium to low. Participants perceived few barriers and had low self-efficacy levels compared to other constructs. This study further showed that participants were more likely to follow a range of protective health behaviours, but not found all. The study revealed a significant association between all risk perception constructs and protective behaviours (p=< 0.05). This study accordingly highlighted a significant relationship between the respondents’ risk perception level and protective health behaviours. The study envisaged that public awareness of risk to the people who returned from India is essential to increase risk perception during the outbreak.

The study works towards fulfilling SDGs (Sustainable Development Goals), especially ‘Good health and well-being’ (SDG 3) and Decent work and economic growth (SDG 8).

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (CMWH)

Reference:

Khanal, S.P., van Teijlingen, E., Sharma, M., Acharya, J., Sharma, C., Kharel, S., Gaulee, U., Bhattarai, K., Pasa, R.B., Bohora, P. (2024) Risk Perception and Protective Health Measure Regarding COVID-19 among Nepali Labour Migrants’ Returnee from India. KMC Journal, 6(1): 313–330. https://doi.org/10.3126/kmcj.v6i1.62364

25 January 2024

Health Promotion article is being read

international, open access, Publishing, writing Edwin van Teijlingen

Our article ‘Understanding health education, health promotion & public health’ [1] is getting read according to ResearchGate. This conceptual/ theoretical paper was published open access in late 2021 in the Journal of Health Promotion and it reached 4,500 reads yesterday. Whilst the web side of the journal suggests today that the PDF of the paper has been downloaded 8,511 times.

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (CMWH)

Reference:

van Teijlingen, K. R., Devkota, B., Douglas, F., Simkhada, P., van Teijlingen, E. R. (2021). Understanding health education, health promotion and public health. Journal of Health Promotion, 9(1): 1–7. https://doi.org/10.3126/jhp.v9i01.40957

12 January 2024

Labour migration: desperation & exploitation

international, Publishing Edwin van Teijlingen

On my latest trip to Nepal I noticed a number of related newspaper stories about those wanting to migrate abroad for work. Yesterday there was an article with the headline ‘Three held for defrauding unemployed youths’ (The Himalayan Times, January 11, page 2), which could be seen as story about crime, just like the one next to it on the same page with was headed ‘Vehicle stolen’ (The Himalayan Times, January 11, page 2) . Both fit under the category of people suffering from crime committed by naughty people. However, having studied labour migration as a sociologist for over a decade it also speaks of the desperation of young people to leave Nepal. In that sense, the ‘Three held for defrauding unemployed youths’ story, is more like the story the day before ‘Family of Nepali who joined Russian Army worried after hearing about his death’ (The Himalayan Times, January 10, page 1).

In the latter story of a tragic death of a Nepalese mercenary, the most unexpected element I found was that Nepalese victim had paid Rs. 500,000 to criminals, who acted as brokers. I would have expected that Putin’s agents operating in the Middle East were paying large amounts of money to potential army recruits to fight in the invasion of Ukraine. To my great surprise, the payment was the other way round, where Nepalese migrant workers are desperate enough to pay the country at war. When people are desperate to work abroad unscrupulous brokers see opportunities to make money.

Whilst at the end of December 2023 two Nepalese men were killed when Korean language test candidates were staging demonstrations in Kathmandu demanding that they be allowed to appear for language tests for jobs in the manufacturing sector in South Korea. When the Minister for Physical Infrastructure and Transport stopped to intervene, he sparked a riot and his car was set on fire. The police opened fire and killed two protesters in a very un-Nepalese way of dealing with protest. Again to me the underlying issue to note is how desperate these men are to go abroad and get to work in South Korea.

Prof. Edwin van Teijlingen

CMWH (Centre for Midwifery & Women’s Health)

10 January 2024

Newspaper coverage in Nepal

international, Public engagement, Publishing Edwin van Teijlingen

One print daily English-language newspaper The Annapurna Express and one online newspaper Gazzabkoo Magazine published articles this week on our project on strengthening the health system in Nepal. The latter used the title ‘Strengthening Health Systems for Better Health‘ and the former opted for the headline ‘Forum on health system strengthening’.

Our interdisciplinary study ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’ is funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1]. In this Nepal Federal Health System Project we study the consequences for the health system of Nepal’s move in 2015 from a centralised political system to a more federal structure of government . This joint project is led by the University of Sheffield in collaboration with Bournemouth University, the University of Huddersfield, Canterbury Christ Church University and two institutions in Nepal, namely MMIHS (Manmohan Memorial Institute of Health Sciences) and PHASE Nepal.

Prof. Edwin van Teijlingen

CMWH (Centre for Midwifery & Women’s Health)

10 January 2024

Communication in the aftermath of an NHS staff suicide: New research published today!

Fusion themes, NHS, open accecss, open access, PG research, Public engagement, Publishing, Research Ethics, student research aluce

Prof. Ann Luce (FMC), Ms. Georgia Turner (PhD candidate FST), Ms. Lauren Kennedy (MSc student FST) and Dr. Reece D. Bush-Evans (Lecturer in FST) are pleased to announce the publication of their most recent work in British Medical Journal: Medical Humanities titled, “Quite simply they don’t communicate: a case study of a National Health Service response to staff suicide”. You can access the article here for free.

Workplace suicide can have significant knock-on effects within an organisation, yet research has shown within the healthcare profession, not all staff receive suicide prevention training, and few employers take the time to reflect on the need to change workplace policies or practices following the death of a staff member to suicide. How staff suicide is communicated across an organisation and to family members is important. Effective crisis communication is critical for effective management for a timely and sensitive response to a staff suicide within an organisation. By doing so, workplaces can help to reduce the significant emotional trauma suicide can have on an employee, and support good mental health across its workforce.

This groundbreaking work in the field of suicide prevention is already having an impact. The work was cited by Parliament’s Public Accounts Committee recent report on “Improving Mental Health Services”. Furthermore, the research has served as the underpinning evidence for NHS England’s National Suicide Prevention Toolkit for England, which will be implemented across all NHS Trusts in England. And, with a renewed focus on healthcare suicide, with a specific focus on female nurses, the research served as underpinning evidence for England’s National Suicide Prevention Strategy that was released in September 2023.

The team would like to thank all research participants as this was a difficult project to complete. Further, thanks must also be extended to NHS England for funding, the BU Open Access Fund, and the colleagues across BU who read drafts of the work prior to publication.

10 January 2024

Latest paper from Federalisation & Health System in Nepal

international, open access, Publishing, writing Edwin van Teijlingen

The sixth paper from our interdisciplinary research team focuses on the effective way we applied participatory policy analysis in a study on the effects on the health system in Nepal. In the research we used a methodological approach using the River of Life which we describe in this paper ‘Participatory policy analysis in health policy and systems research: reflections from a study in Nepal’ [1]. The Lead author is Dr. Sujata Sapkota from Manmohan Memorial Institute of Health Sciences (MMIHS) in Kathmandu.

This study was funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1]. In this larger Nepal Federal Health System Project we study the consequences for the health system of Nepal’s move from a centralised political system to a more federal government structure in 2015. This joint project is led by the University of Sheffield in collaboration with Bournemouth University, the University of Huddersfield, Canter Bury Christ Church University and two institutions in Nepal, namely MMIHS and PHASE Nepal. We have managed to publish five papers from this project prior to today’s one reflecting on the methodology [2-6].

Prof. Edwin van Teijlingen

CMWH (Centre for Midwifery & Women’s Health)

References:

Sapkota, S., Rushton, S., van Teijlingen, E., Subedi, M., Balen, J., Gautam, S., Adhikary, P., Simkhada, P., Wasti, S.P., Karki, J.K., Panday, S., Karki, A., Rijal, B., Joshi, S., Basnet, S., Marahatta, S.B. (2024) Participatory policy analysis in health policy and systems research: reflections from a study in Nepal. Health Research & Policy Systems, 22 (No.7) https://doi.org/10.1186/s12961-023-01092-5 .
Wasti, S.P., van Teijlingen, E., Rushton, S., et al. (2023) Overcoming the Challenges Facing Nepal’s Health System During Federalisation: An Analysis of Health System Building Blocks, Health Research Policy & Systems 21(117) https://doi.org/10.1186/s12961-023-01033-2
Sapkota, S., Dhakal, A., Rushton S., et al. (2023) The impact of decentralisation on health systems: a systematic review of reviews. BMJ Global Health 8:e013317. doi:10.1136/bmjgh-2023-013317.
Sapkota, S., Panday, S., Wasti, S.P., et al. (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of the Nepal Public Health Association 7(1):36-42.
Adhikary, P., Balen, J., Gautam, S., et al. (2020) The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system, Journal of Karnali Academy of Health Sciences 3 (3): 1-11.
Rushton, S., Pandey, S., van Teijlingen, E., et al. (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146

9 January 2024

Forum on Post-Federalisation Health System Strengthening

Fusion themes, international, Training, writing Edwin van Teijlingen

Today and tomorrow our research team is engaged in discussions with those responsible for running the health system at different levels of the new federal system in Nepal. The aim today and tomorrow of this participatory research project is bring together stakeholders from all levels of government (local, provincial and federal), to develop solutions, practical actions and recommendations for different levels of the political system to address some of the five areas our research identified as possible priorities. Nepal changed from a centralised political system of government to a federal system in 2015. It is easy to see how such change in the political system might affect the organisation, funding, governance, human resources, etc. of all sub-systems in society, such as the education system, the police, and in the area of our particular interest, the health system.

This interdisciplinary study started just before COVID-19 in 2020 and is now coming to a conclusion. The multi-national research team includes researchers from Nepal: MMIHS (Manmohan Memorial Institute of Sciences) in Kathmandu, and PHASE Nepal (Bhaktapur), the University of Sheffield, Bournemouth University, and the University of Huddersfield (the original UK applicants), and researchers currently based at three further UK universities: the University of Greenwich, the University of Essex and Canterbury Christ Church University. This exciting research is funded by the Health System Research Initiative, a UK collaboration between three funders: the MRC (Medical Research Council), the Foreign, Commonwealth & Development Office (FCDO), and the Welcome Trust.

8 January 2024

Partnership planning meeting in Kathmandu

international Edwin van Teijlingen

This afternoon Prof. Edwin van Teijlingen attended a partnership meeting with colleagues from Nepal’s Manmohan Memorial Institute of Health Sciences (MMIHS) in Yak & Yeti Hotel in Kathmandu. The discussion highlighted the longstanding partnership and collaboration between MMIHS and BU. The meeting was part of a wider collaboration around between MMIHS, BU and the University of Huddersfield, The University of Sheffield and Canterbury Christ Church University. The latter universities have been working together for over fours years in an interdisciplinary study ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’. This project has been funded by the Health System Research Initiative, a UK collaboration between three funding bodies: the MRC (Medical Research Council), the Foreign, Commonwealth & Development Office, and the Welcome Trust.

The BU-MMIHS collaboration has included successful ERASMUS+ staff and student exchanges as well as student exchanges from BU to Kathmandu as part of the Turing Scheme. Currently various BU academics are also involved a co-supervisors on MSc projects conducted by MMIHS postgraduate students.

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (CMWH)

6 January 2024

New migration paper related to Nepal

international, open access, PG research, Publishing, student research, Women's Academic Network, writing Edwin van Teijlingen

On the last day of 2023 the Journal of Health Promotion published the paper ‘Sexual Harassment Among Nepali Non-Migrating Female Partners of International Labor Migrant Men’ [1]. This paper, in an Open Access journal, addresses one of the consequences of male labour migrants leaving their family members behind in Nepal. While non-migrating spouses often receive financial support in the form of remittances, their husbands’ migration also creates numerous social and personal problems. This qualitative study explored non-migrating spouses’ experience of sexual harassment/abuse and its impact on their mental health. Fourteen in-depth interviews were conducted and women reported experiencing harassment by men they knew, including their teachers and colleagues, who knew their husbands were abroad. But none of the women reported taking any action against their perpetrators, indicating a lack of power in this study population in still predominantly patriarchal society.

The lead author of the paper is Assistant Prof. Kalpana Gyawali from Tribhuvan University, Nepal’s largest and oldest university paper. Her co-authors are: Padam Simkhada, Visiting Professor in BU’s Faculty of Health & Social Sciences as well as Professor in Global Health at the University of Huddersfield, Edwin van Teijlingen in Bournemouth University’s Centre for Midwifery & Women’s Health, Ms. Shraddha Manandhar, PhD. student at the University of Huddersfield, and Mr. Ram Chandra Silwal the Country Director of Green Tara Nepal, the charity we have been working with for nearly twenty years.

References:

Gyawali, K., Simkhada, P., van Teijlingen, E.R., Manandhar, S., Silwal, R.C. (2023). Sexual Harassment Among Nepali Non-Migrating Female Partners of International Labor Migrant Men. Journal of Health Promotion, 11(1): 22–31. https://www.nepjol.info/index.php/jhp/article/view/61198

1 January 2024

The last BU blog of 2023

international, open access, Publishing, writing Edwin van Teijlingen

First of all: Happy New Year!

One of the first message I received this morning was that our editorial ‘Addressing the inequalities in global genetic studies for the advancement of Genetic Epidemiology’ [1] had been published yesterday. If I had know this in time it would have been the proper last Bournemouth University Research Blog of 2023 published yesterday. Interestingly, we only submitted the draft editorial on Christmas Day, got it back for revisions on Boxing Day and resubmitted it and had it accepted on December 28th. It dis, of course, help that both editors-in-chief of the Nepal Journal of Epidemiology are co-authors on this editorial!

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (CMWH)

Reference:

Sathian, B., van Teijlingen, E., Roy., B., Kabir, R., Banerjee, I., Simkhada, P., Al Hamad, H. (2023) Addressing the
inequalities in global genetic studies for the advancement of Genetic Epidemiology. Nepal Journal of Epidemiology, 13(4):1292-1293.
DOI: 10.3126/nje.v13i4.61271

30 December 2023

Well-being of Nepal’s migrant workers no longer on global agenda

international, open access, PG research, Publishing, student research, writing Edwin van Teijlingen

A few days ago were alerted by ResearchGate that our article ‘Migrant Workers in Qatar: Not just an important topic during the FIFA World Cup‘ has reached 300 reads [1]. We (Padam Simkhada, Pramod Regmi and I) wrote this article a year ago to raise publicity about the conditions of Nepalese migrant workers in the Middle East. The hazards faced by migrant workers engaged in building the football stadiums in Qatar have been well documented before and during the FIFA Men’s Football World Cup. Their working conditions are often very dangerous and their living conditions are often very poor.

This time last year Dr. Pramod Regmi, Dr. Nirmal Aryal, Prof. Edwin van Teijlingen, and BU’s Visiting Professor Padam Simkhada also published ‘Excessive Mortalities among Migrant Workers: the Case of the 2022 FIFA World Cup’ [2]. At the time we wrote “The men’s FIFA Football World Cup 2022 is in full flow in Qatar” which finished with a very exciting final between Argentina and France. Around the same time BU’s PhD student Yagya Adhikari also wrote a paper on ‘Forgotten health and social care needs of left-behind families of Nepali migrant workers’ [3]. This paper was co-authored by Dr.Pramod Regmi in the Department of Nursing Sciences, Prof. Edwin van Teijlingen, and BU Visiting Faculty Prof. Bhimsen Devkota.

Unfortunately, since the World Cup finished, the world, the media and our politicians have moved on and the health and well-being of migrant workers are no longer headline news. The reminder this week of 300 reads for our editorial gives us another opportunity to remind everyone of the need to keep the plight of migrant workers in the Middle East (and elsewhere) on the world’s agenda.

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (CMWH)

References:

Simkhada, P., van Teijlingen, E., Regmi, P. R. (2022). Migrant Workers in Qatar: Not just an important topic during the FIFA World Cup 2022 . Health Prospect, 21(3). https://doi.org/10.3126/hprospect.v21i3.49835
Adhikari, Y.R., Regmi, P.R., Devkota, B., van Teijlingen, E.R. (2022) Forgotten health and social care needs of left-behind families of Nepali migrant workers. Journal of Health Promotion, 10(1):1–4.
Adhikari, Y.R., Regmi, P.R., Devkota, B., van Teijlingen, E.R. (2022) Forgotten health and social care needs of left-behind families of Nepali migrant workers. Journal of Health Promotion, 10(1):1–4. https://doi.org/10.3126/jhp.v10i1.50976

30 December 2023

Migration and mental health meeting in Kathmandu

international, Publishing, writing Edwin van Teijlingen

Yesterday (29th December) Prof. Edwin van Teijlingen attended a workshop on ‘Current situation of migration and its impact on Mental health’ in a hotel in Kathmandu, Nepal. This workshop was organised by the Transcultural Psychosocial Organization Nepal (TPO Nepal) and funded by a Finnish aid organisation. Two of BU’s current collaborators were members of the workshop panel. One of the panel members was FHSS Visiting Faculty Prof. Padam Simkhada, who is Professor of Global Health at the University of Huddersfield. He spoke about the limited amount of research into mental health in general in Nepal and in migrant workers in particular. The chair was Mrs. Manju Gurung from the organisation POURAKHI Nepal, who collaborates with BU in the recently started project on health and migration funded by the USA State Department. Unsurprisingly, several speakers at the workshop referred to studies conducted in the field of migrant workers’ health by BU academics, particularly the work published by Dr. Pramod Regmi and Dr. Nirmal Aryal.

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health

23 December 2023

Paper published on ‘living evidence’

international, open access, Publishing, Training, writing Edwin van Teijlingen

The Nepal Journal of Epidemiology published today carries an article on so-called ‘living evidence’ as an on-going synthesis approach that provides up-to-date rigorous research evidence [1]. This short research methods paper argues that living evidence is particularly useful in rapidly expanding research domains, uncertain existing evidence, and incorporating new research evidence that may impact policy or practice, ensuring that health worker, managers and health-policy makers have access to the best, i.e. the most recent evidence.

The Nepal Journal of Epidemiology is an Open Access journal, and hence freely available to researchers across the globe. The paper has been co-authored by researchers from the Denmark, Qatar, Mauritius and the UK.

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (CMWH)

Reference:

Sathian B., van Teijlingen E., do Nascimento I.J.B., Khatib M.N., Banerjee I., Simkhada P., Kabir R., Al Hamad H. (2023) Need for evidence synthesis for quality control of healthcare decision-making. Nepal Journal of Epidemiology 13(3):1288-1291. DOI: 10.3126/nje.v13i3.61004

22 December 2023

New Nepal paper published

international, Publishing, writing Edwin van Teijlingen

BMJ Global Health published our latest paper today under the title ‘The impact of decentralisation on health systems: a systematic review of reviews‘ [1]. This so-called review of reviews is part of a larger study funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1]. in this larger Nepal Federal Health System Project we study the consequences for the health system of Nepal’s move from a centralised political system to a more federal government structure. This joint project is led by the University of Sheffield in collaboration with Bournemouth University, the University of Huddersfield, and two collaborating institutions in Nepal, namely Manmohan Memorial Institute of Health Sciences (MMIHS) and PHASE Nepal. We have managed to publish four papers from this project prior to today’s one. [2-5]

This latest paper, is Open Access and it includes nine reviews, each addressing somewhat different questions, contexts and issues. More negative than positive impacts of decentralisation on health system building blocks were identified. Although inconclusive, evidence suggested that the impacts on leadership and governance and financing components in particular shape the impact on the overall health system. Assessment of how the impact on building blocks translates to the broader impact on health systems is challenged by the dynamic complexities related to contexts, process and the health system itself. This review highlights some of the common potential issues to consider in advance.

Prof. Edwin van Teijlingen

CMWH (Centre for Midwifery & Women’s Health)

References:

Sapkota, S., Dhakal, A., Rushton S., et al. (2023) The impact of decentralisation on health systems: a systematic review of reviews. BMJ Global Health 8:e013317. doi:10.1136/bmjgh-2023-013317.
Wasti, S.P., van Teijlingen, E., Rushton, S., et al. (2023) Overcoming the Challenges Facing Nepal’s Health System During Federalisation: An Analysis of Health System Building Blocks, Health Research Policy & Systems 21(117) https://doi.org/10.1186/s12961-023-01033-2
Sapkota, S., Panday, S., Wasti, S.P., et al. (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of the Nepal Public Health Association 7(1):36-42.
Adhikary, P., Balen, J., Gautam, S., et al. (2020) The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system, Journal of Karnali Academy of Health Sciences 3 (3): 1-11.
Rushton, S., Pandey, S., van Teijlingen, E., et al. (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146

21 December 2023

Viewpoint on free birthing

international, open access, Publishing, writing Edwin van Teijlingen

This week the Journal of Asian Midwives published our short article ‘Out-of-hospital births: A small but growing phenomenon in high income countries: A viewpoint‘ [1]. OOHBs (out-of-hospital births), is also referred to as freebirth (or freebirthing), unassisted childbirth and/or unassisted pregnancy [2]. OOHB does not refer to giving birth at home before the midwife arrives at a home birth or the birth taking place in an ambulance or along the side of the road on the way to a maternity unit, this is called ‘born before arrival’. OOHB suggests an element of planning of planning a birth without a midwife (or other maternity-care professional).

The paper in the Journal of Asian Midwives highlights that during the COVID-19 pandemic, OOHBs were a way to avoid Public Health regulations and lock-down constraints, and to guarantee the presence of a partner at the birth. The authors argue, however, that the pandemic is not at the origin of the trend, but more of a catalyst. Advocacy groups, maternity-service users’ groups, the media, and midwifery organisations in several high-income countries have in recent years underlined the growing criticism of existing maternity care and midwifery services and a long-term shortage of midwives. This is in addition to a longstanding trend in the United Kingdom of closing community-based hospitals, including small, free-standing midwife-led units.

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health

Reference:

Miani, C, Batram-Zantvoort, S, Pitchforth, E, Treadgold, B, Johnston, K, Rozée, V, MacDougall, C, Schantz, C, van Teijlingen, E. (2023) Out-of-hospital births: A small but growing phenomenon in high income countries: A viewpoint. Journal of Asian Midwives 10(2):77–78.
AIMS. (2020) Freebirth, Unassisted Childbirth and Unassisted Pregnancy, published on 30 March 2020, accessed 21 December 2023.

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