Category / Sociology & Social Policy

New BU paper: Health of Nepali migrants in India

Today the International Journal of Environmental Research and Public Health accepted our paper ‘The health of Nepali migrants in India: A qualitative study of lifestyles and risks’ [1].  The research in this paper was funded through Connect India is Bournemouth University’s Hub of Practice for the Indian subcontinent.  It brought together a community of researchers, educators, practitioners and students, both at Bournemouth University and across the Indian subcontinent.

The lead author, Dr. Pramod Regmi, is lecturer in International Health in the Department of Nursing & Clinical Science.  His co-authors are based in the UK, Nepal and India.  BU authors are: Pramod Regmi, Edwin van Teijlingen, Preeti Mahato and Nirmal Aryal as well as BU Visiting Faculty Prof. Padam Simkhada.  The  International Journal of Environmental Research and Public Health is an interdisciplinary Open Access journal, hence when published this paper will be freely available to readers across the globe, including India and Nepal.

Reference:

  1. Regmi, P., van Teijlingen, E., Mahato, P., Aryal, N., Jadhav, N., Simkhada, P., Syed Zahiruddin, Q., Gaidhane, A., (2019) The health of Nepali migrants in India: A qualitative study of lifestyles and risks Journal of Environmental Research & Public Health (forthcoming)

 

 

New paper by Dr. Caroline Ellis-Hill

Congratulations to Dr. Caroline Ellis-Hill on the publication of her article ‘We are not the same people we used to be: An exploration of family biographical narratives and identity change following traumatic brain injury’.  This paper was accepted for publication in 2017 and will now be finally published in its final format in the September issue of Neuropsychological Rehabilitation.

This scientific paper focuses recovery and rehabilitation following traumatic brain injury. Accumulation of subjective changes over time has led many to examine the question of “continuity of self” post-injury. Vacillation between feeling the same and different is common and often at odds with the medical narrative preparing families for permanent change. This position of ambiguity was examined in a qualitative narrative study. The aim of this paper is to describe the narrative structures used by uninjured members of a family to understand change. These changes relate primarily, to their perspective of whether and how the injured person had changed, but also secondarily to whether and why they themselves felt they had changed in the first year post-injury. Nine uninjured family members from three families took part in three unstructured interviews during the first twelve months post-injury.

In-depth narrative analysis showed family members used biographical attendance; biographical disruption; biographical continuity; and biographical reconstruction to understand change. Dr. Ellis-Hill and her co-authors argue that concentrating on a narrative of change is too limiting and that engaging in biographical narratives may help humanise care provided to injured individuals and their families. Implications for research and practice are discussed

Prof. Edwin van Teijlingen

CMMPH

Migration & health research in Middle East & Malaysia

Yesterday the Journal of Immigrant and Minority Health published the final version of Dr. Pratik Adhikary’s paper ‘Workplace Accidents Among Nepali Male Workers in the Middle East and Malaysia: A Qualitative Study’ [1].  This is the fourth paper originating from Pratik’s Ph.D. research conducted in the Faculty of Health & Social Sciences, the first three papers appeared in the period 2011-2018 [2-4].

The paper highlights that many Nepali men work in the Middle East and Malaysia and media reports and anecdotal evidence suggests they are at a high risk of workplace-related accidents and injuries for male Nepali workers.   Pratik’s Ph.D. study used face-to-face interviews to explore the personal experiences of twenty male Nepali migrants of unintentional injuries at their place of work.  His study found that almost half of study participants experienced work-related accident abroad. The Participants suggested that the reasons behind this are not only health and safety at work but also poor communication, taking risks by workers themselves, and perceived work pressure. Some participants experienced serious incidents causing life-long disability, extreme and harrowing accounts of injury but received no support from their employer or host countries.

The paper concludes that Nepali migrant workers are at a high risk of occupational injuries owing to a number of interrelated factors poor health and safety at work, pressure of work, risk taking practices, language barriers, and their general work environment. Both the Government of Nepal and host countries need to be better policing   existing policies; introduce better legislation where necessary; ensure universal health (insurance) coverage for labour migrants; and improve preventive measures to minimize the number and severity of accidents and injuries among migrant workers.

 

References:

  1. Adhikary P, van Teijlingen E., Keen S. (2019) Workplace accidents among Nepali male workers in the Middle East and Malaysia: A qualitative study, Journal of Immigrant & Minority Health 21(5): 1115–1122. https://link.springer.com/article/10.1007/s10903-018-0801-y
  2. Adhikary P., Keen S., van Teijlingen E (2011) Health Issues among Nepalese migrant workers in Middle East. Health Science Journal 5: 169-75. www.hsj.gr/volume5/issue3/532.pdf
  3. Adhikary, P, Sheppard, Z., Keen, S., van Teijlingen, E. (2017) Risky work: accidents among Nepalese migrant workers in Malaysia, Qatar & Saudi Arabia, Health Prospect 16(2): 3-10.
  4. Adhikary P, Sheppard, Z., Keen S., van Teijlingen E. (2018) Health and well-being of Nepalese migrant workers abroad, International Journal of Migration, Health & Social Care 14(1): 96-105.  https://doi.org/10.1108/IJMHSC-12-2015-0052

 

BMC blog on latest HSS paper

Dr. Rachel Arnold’s recent paper in BMC Pregnancy & Childbirth was highlighted in a blog promoted by the publisher.  The paper ‘Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care‘ reports on the everyday lives of maternal healthcare providers working in a tertiary maternity hospital in Kabul, Afghanistan (1). BMC Pregnancy & Childbirth is an Open Access journal so the paper is available free of charge to anybody in Afghanistan (and elsewhere) with an internet connection.  The aim was to understand the staff’s notions of care, their varying levels of commitment to providing care for women in childbirth, and the obstacles and dilemmas that affected standards, and thereby gain insight into their contributions to respectful maternity care, whether as ‘villains’ or as ‘victims.’

Dr. Arnold is Postdoctoral Midwifery Researcher in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH).  This is the third paper from Rachel’s excellent PhD project, the previous two papers appeared in BJOG and Social Science & Medicine (2-3).

Click here for BMC Blog post:

Villains or victims? The role of maternity staff in decreasing or enhancing respectful care

Reference:

  1. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2019) Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care, BMC Pregnancy & Childbirth 19 :307 https://rdcu.be/bPqlj
  2. Arnold R., van Teijlingen E, Ryan K., Holloway I. (2015) Understanding Afghan health care providers: Qualitative study of culture of care in Kabul maternity hospital, BJOG 122: 260-267.
  3. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2018) Parallel worlds: an ethnography of care in an Afghan maternity hospital, Social Science & Medicine 126:33-40.

 

New CMMPH publication on health promotion in post-earthquake Nepal

Today saw the publication of a new paper from an international research team from the UK, Japan and Nepal.  Our research article ‘Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal’ has been published in the Open Access journal PLoS ONE [1]. 

The paper reminds us that natural disasters often disrupt health systems affecting the whole population, but especially vulnerable people such as pregnant women, new mothers and their babies. Despite the global progress in maternal, newborn and child health (MNCH) programmes over the years, emergency responses after a disaster are often poor. Post-disaster health promotion could play an important role in improving MNCH outcomes. However, evidence remains limited on the effect of post disaster health promotion activities in low-income countries such as Nepal.

The paper reports on an post-disaster intervention study aimed at women in Nepal following the 2015 earthquake. In total, 364 mothers were recruited in the pre-intervention group and 377 in the post-intervention group. The post-intervention group was more likely to have knowledge of at least three danger signs in pregnancy (AOR [Adjusted Odds Ratio] = 2.96, P<0.001), at least three danger signs in childbirth (AOR = 3.8, P<0.001), and at least five danger signs in newborns (AOR = 1.56, P<0.001) compared to the pre-intervention group. The mothers in the post-intervention group were also more likely to ever attend ANC (AOR = 7.18, P<0.001), attend a minimum of four ANC sessions (AOR = 5.09, P<0.001), and have institutional deliveries (AOR = 2.56, P<0.001).

Religious minority groups were less likely to have knowledge of all danger signs compared to the majority Hindu group. Mothers from poorer households were also less likely to attend four ANC sessions. Mothers with higher education were more likely to have knowledge of all the danger signs. Mothers whose husbands had achieved higher education were also more likely to have knowledge of danger signs and have institutional deliveries.  The paper concludes that the health promotion intervention helped the disaster-affected mothers in improving the knowledge and behaviours related to MNCH. However, the authors also comment that vulnerable populations need more support to benefit from such intervention.

 

Reference:

Dhital R, Silwal RC, Simkhada P, van Teijlingen E, Jimba M (2019) Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal. PLoS ONE 14(7): e0220191. https://doi.org/10.1371/journal.pone.0220191

Dr. Rachel Arnold’s first paper as BU staff

Congratulations to Dr. Rachel Arnold in the Centre for Midwifery, Maternal & Perinatal Health who had her first paper accepted since she started working at BU two months ago. Her paper ‘Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care’ is co-authored with her former PhD supervisors Professor Kath Ryan (BU Visiting Faculy), Professor Emerita Immy Holloway and CMMPH’s Professor Edwin van Teijlingen [1].  The paper is Open Access funded by Bournemouth University’s Open Access Fund which will help promote the visibility of the paper before REF 2021.

I was tempted to head this blog ‘Dr. Arnold only two months at BU and first paper published’, but I decide this would perhaps send the wrong message to other new BU staff.  Rachel completed her PhD in CMMPH and this is paper is the third publication from her thesis.  The other academic publications by Dr. Arnold on Afghanistan have been in BJOG and Social Science & Medicine [2-3].

 

References:

  1. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2019) Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care ,     BMC Pregnancy and Childbirth (accepted).
  2. Arnold R., van Teijlingen E, Ryan K., Holloway I. (2015) Understanding Afghan health care providers: Qualitative study of culture of care in Kabul maternity hospital, BJOG 122: 260-267.
  3. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2018) Parallel worlds: an ethnography of care in an Afghan maternity hospital, Social Science & Medicine 126:33-40.

New BU cross-faculty publication

This week Evidence-Based Midwifery published the latest article from the BU team working on the portrayal of midwifery and maternity in the media.  This qualitative paper ‘Changing the narrative around childbirth: whose responsibility is it?’ is co-authored by a multidisciplinary team including the disciplines of Midwifery, Sociology and Media.[1]  The lead author is Prof. Vanora Hundley in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), one of longest established centres at BU, her co-authors are Dr. Ann Luce in the Faculty of Media & Communication, Prof. Edwin van Teijlingen director of CMMPH and Sophie Edlund, who was based at BU at the time of the research but who is now at Malmö University in Sweden.

The paper addresses societal’s interest in all aspects of childbirth, which is reflected in both social and traditional media. Stories often focus on dramatic, risky and mostly unrealistic events; misrepresenting childbirth and maternity care professionals. The authors raised the question: “Whose responsibility is it to ensure accurate representations of childbirth?”   Using semi-structured in-depth interviews with ten midwives working in the UK some working in the NHS, some in Higher Education or independent practice, the authors distilled four separate but inter-related themes:

(1) not my responsibility;

(2) fear of retribution;

(3) power balance; and

(4) social media.

The themes sat within two wider societal issues that reflect the current challenges for midwifery, these were (a) the ongoing battle between the social and the medical models of childbirth and (b) the impact of gender.  Finding that midwives fear the media resonates with experiences from a number of countries and professional groups. There is a need to change media discourse in both fictional and factual representations of childbirth and midwives have a critical role to play in this, but to do this they need to equip themselves with the skills necessary to engage with the media. Guidelines on responsible media reporting could ensure that media producers portray pregnancy, midwifery and maternity care as naturally as possible.

This paper is paper of a growing body of interdisciplinary research at BU across faculties, which had already resulted in six earlier publications. [2-7]  In addition last month Dr Chapleo from the Faculty of Management submitted a grant application to the ESRC under the title ‘Rebranding childbirth: understanding the role of marketing in influencing uptake of health services’, a joint application with CMMPH staff (Profs. Hundley & van Teijlingen) and the Media School (Dr. Luce).

 

References:

  1. Hundley, V., Luce, A., van Teijlingen, E., Edlund, S. (2019) Changing the narrative around childbirth: whose responsibility is it? Evidence-based Midwifery 17(2): 47-52.
  2. Luce, A., Cash, M., Hundley, V., Cheyne, H., van Teijlingen, E., Angell, C. (2016) “Is it realistic?” the portrayal of pregnancy and childbirth in the media BMC Pregnancy & Childbirth 16: 40 http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0827-x
  3. van Teijlingen, E., Simkhada, P., Luce, A., Hundley, V. (2016) Media, Health & Health Promotion in Nepal, Journal of Manmohan Memorial Institute of Health Sciences 2(1): 70-75. http://www.nepjol.info/index.php/JMMIHS/article/view/15799/12744
  4. Luce, A., Hundley, V., van Teijlingen, E. (Eds.) (2017) Midwifery, Childbirth and the Media, London: Palgrave Macmillan.
  5. Hundley, V., Duff, E., Dewberry, J., Luce, A., van Teijlingen, E. (2014) Fear in childbirth: are the media responsible? MIDIRS Midwifery Digest 24(4): 444-447.
  6. Hundley, V., Luce, A., van Teijlingen, E. (2015) Do midwives need to be more media savvy? MIDIRS Midwifery Digest 25(1):5-10.
  7. van Teijlingen, E., De Vries, R., Luce, A., Hundley, V. (2017) Meer bemoeien met media (In Dutch: more engagement with media). Tijdschrift voor Verloskundigen (in Dutch: Journal for Midwives), 41 (6):28-29.

Challenging paper by Prof. Pritchard and colleagues

Congratulations to Bournemouth University’s Professor Colin Pritchard, Honorary Doctor of Science Anne Silk and their Southampton colleague Lars Hansen who recently published the paper ‘Are rises in Electro-Magnetic Field in the human environment, interacting with multiple environmental pollutions, the tripping point for increases in neurological deaths in the Western World?’  This paper in Medical Hypotheses (published by Elsevier) is a worrying analysis of the effects of (recent) technological progress on our health.  If this paper does not make you worry , at least remember one message: “No mobile phones in trouser pockets or under your pillow as you’re being bathed in 450Mhz.”

Well done!

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

Pritchard, C., Silk, A., Hansen, L. (2019) Are rises in Electro-Magnetic Field in the human environment, interacting with multiple environmental pollutions, the tripping point for increases in neurological deaths in the Western World? Medical Hypotheses 127: 76-83.

 

Are UK universities more ethical than police organisations?

Last week saw BU Lecturer in Criminology and former British police sergeant: Dr Richard Heslop, delivering an invited paper at the Fourth Annual Canterbury Centre for Policing Research Conference.

The conference was held at Canterbury Christchurch University, UK, between 19 – 20 June; on the theme of: ‘Austerity and Ethics: A Paradox for Professionalism’.

A sub-theme of this year’s conference was the forthcoming significant developments in police education in England and Wales, under the Police Education Qualifications Framework (PEQF).[1] The PEQF has been developed to professionalise the public police and to reform perceived problematic aspects of police culture and improve ethical standards. The PEQF provides UK Higher Education Institutions (HEIs) with a key role in police education. From January 2020, all new police recruits will be required to obtain a degree level qualification before joining the police or in the initial years of service.

In his paper entitled:  ‘Are UK universities more ethical than police organisations?’ Dr Heslop compared police organisations and HEIs from the perspective of their ethical behaviours and practices. After discussing historical and contemporary ethical problems in policing, Dr Heslop explored how, in recent years, universities, academics and students have also faced scrutiny and censure in relation to a range of unethical behaviours and practices. These include:

  • Racism on campuses
  • The ‘scandal’ over the pay and ‘perks’ of senior university staff
  • Sexual misconduct by academics and students
  • ‘Lad-cultures’ on campuses
  • Bullying and harassment of university staff
  • ‘Mis-selling’ of degree courses
  • Lack of transparency in some HE institutions.

Dr Heslop concluded that universities are no more ethical than the police and his paper contributes to a body of literature which cautions against assumptions that involving HEIs in police education will lead to improvements in the practices of the police [2].

Dr Heslop is seeking critical feedback on this paper and will be pleased to supply a copy to colleagues with the inclination and time to review it.

 

 

[1] Police Education Qualifications Framework available at: https://www.college.police.uk/What-we-do/Learning/Policing-Education-Qualifications-Framework/Pages/Policing-Education-Qualifications-Framework.aspx

[2] See, for example: Heslop, R (2011). Reproducing police culture in a British university: an exploratory study of police foundation degrees.  Police Practice & Research: An International Journal, 12(4), 293-312.

Key role of volunteers in the health system

This week saw the publication of ‘Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study’ [1].  This article in the Open Access journal PLoS ONE highlights the key role volunteers play in delivering health services to minorities/the poorest people, especially in low-income countries like Nepal.

This paper studies community health workers in Nepal, who are known as Female Community Health Volunteers (FCHVs). To address this issue, we conducted a qualitative study to explore perceived barriers to accessing maternal and child healthcare services among ethnic minority groups in two different parts of Nepal with varying degrees of access to local healthcare centres. Semi-structured interviews were conducted with twenty FCHVs, 26 women service users and 11 paid local health workers. In addition, 15 FCHVs participated in four focus group discussions.

A thematic analysis of the data identified five major themes underlying barriers to accessing available maternal and child healthcare services by ethnic minority groups. These themes include: a) lack of knowledge among service users; b) lack of trust in volunteers; c) traditional beliefs and healthcare practices; d) low decision-making power of women; and e) perceived indignities experienced when using health centres.  The paper concluded that community health programmes should focus on increasing awareness of healthcare services among ethnic minority groups, and the programmes should involve family members (husband and mothers-in-law) and traditional health practitioners. Both the FCHVs and local healthcare providers should be trained to communicate effectively in order to deliver respectful care among ethnic minorities if we want to achieve universal healthcare coverage for maternal and child health in low- and -middle income countries.

The paper is based on the PhD research conducted by Dr. Sarita Panday in ScHARR at the University of Sheffield.  Dr. Panday is currently affiliated with the Walter H. Shorenstein Asia-Pacific Research Centre (APARC) at Stanford University in the USA.  Her co-authors are Prof. Paul Bissell at the University of Huddersfield, FHSS’s Visiting Prof. Padam Simkhada at the Liverpool John Moores University and BU Prof. Edwin van Teijlingen.  This is the second paper from Dr. Panday’s excellent thesis, the first paper was also published in an Open Access journal BMC Health Services Research [2].

 

References:

  1. Panday S, Bissell P, van Teijlingen E, Simkhada P (2019) Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study. PLoS ONE 14(6): e0217070.
  2. Panday S, Bissell P, van Teijlingen E, Simkhada P (2017) The contribution of female community health volunteers (FCHVs) to maternity care in Nepal: a qualitative study. BMC Health Services Research 17(1):623.