Yesterday the international journal PLoS ONE published the latest paper of former Centre for Midwifery & Women’s Health (CMWH) PhD student Dr. Sulochana Dhakal-Rai [1]. As in many countries, Caesarean Section (CS) rates are rising in urban hospitals in Nepal. However, the reasons behind these rising rates are poorly understood. Therefore, this study explores factors contributing to rising CS rates in two urban hospitals as well as strategies to make a more rational use of CS. Dr. Dhakal-Rai was supervised by Dr. Juliet Wood, Dr. Pramod Regmi and Prof. Edwin van Teijlingen all based in the Faculty of Health & Social Sciences.
The paper highlights that high CS rates in the private hospital reflects the medicalisation of childbirth, a public health issue which needs to be urgently addressed for the health benefits of both mother and baby. Multiple factors affecting rising CS rates were identified in urban hospitals. This study provides insights into factors affecting the rising CS rate and suggests that multiple strategies are required to stem the rise of CS rates and to make rational use of CS in urban hospitals.
The journal is Open Access and the paper is freely available to read in Nepal (and elsewhere) for anyone with internet access.
Reference:
- Dhakal Rai S, van Teijlingen E, Regmi PR, Wood J, Dangal G, Dhakal KB (2025) Explaining rising caesarean section rates in urban Nepal: A mixed-methods study. PLoS ONE 20(2): e0318489. https://doi.org/10.1371/journal.pone.0318489


Preventative measures to reduce these challenges include choosing appropriate cut-off scores for correctly identifying participants; highlighting whether mental health questionnaires used may elicit negative emotional or psychological reactions related to suicide ideation; specifying the criteria for referral to clinical services; detailing the intended referral processes; including approaches where the researcher directly connects participants with a psychological service provider; and including a passive referral method such as contact details for participants to initiate their own referrals to clinical care. The authors offer a guide for researchers aiming to collect data on mental health through questionnaires, and they conclude that ethical challenges should be considered and reviewed at all stages of the research project.


















Last month we reported on this Bournemouth University Research Blog (click here!) that Ms. Amshu Dhakal, presented findings from our Nepal Federal Health System Project in Nepal. Amshu’s presentation at the Nepal Health Conclave 2024, organised by the Ministry of Health and Population and supported by WHO (World Health Organization) Nepal and UNFPA, resulted in an online article in Nepal. This article in Nepali in Swasthya Khabar Patrika features lessons learnt and evidence from our research project “The Impact of Federalisation on the Health System of Nepal.”
This is one of several news articles from this project which have appeared in both English and Nepali in national media in Nepal.
Our interdisciplinary research project ‘













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