Tagged / Asia

Building Strong Primary Health Care in Nepal

New  BU co-authored article ‘Building Strong Primary Health Care to Tackle the Growing Burden of Non-Communicable Diseases in Nepal’ will be published soon [1].  This paper has been accepted by the international journal Global Health Action (published by Taylor & Francis).  The international authorship comprises Nepal, Denmark and the UK.

Nepal is currently facing a double burden of non-communicable diseases (NCDs) and communicable diseases, with rising trends in the former. This situation will add great pressure to already fragile health systems and pose a major challenge to the country’s development unless urgent action is taken. The paper argues that while the primary health care approach offers a common platform to effectively address NCDs through preventive and curative interventions, its potential is not fully tapped in Nepal. In line with the Alma-Ata and Astana declarations, the authors propose an integrated approach for Nepal, and other low-and middle-income countries, including six key reforms to enhance the primary care response to the increasing burden of NCDs.  These six key areas are: (1) Life-course approach to addressing NCDs; (2) Task shifting for NCD risk factor management; (3) Strengthening informal care givers; (4) Strengthening quality of PHC and health systems;  (5) Establish strategic information management system; and (6) Healthcare financing.

Publication Cover

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

  1. Gyawali, B., Khanal, P., Mishra, S.R., van Teijlingen, E., Meyrowitsch, D.W. (2020) Building Strong Primary Health Care to Tackle the Growing Burden of Non-Communicable Diseases in Nepal, Global Health Action (accepted) https://doi.org/10.1080/16549716.2020.1788262

 

Nepal’s migrant workers & risk at the workplace

For nearly a decade BU researchers have published widely about the hazards and risk of Nepali migrant workers in Asia and the Middle East [1-9].  Despite the fact that most migrant workers end up in semi-skilled and unskilled jobs in their host countries, only a minority report poor working environments.  For example, in Pratik Adhikary’s PhD study in FHSS only just over a fifth of migrant workers reported that their work environment in the Middle East or Malaysia was poor or very poor [4].  This relatively high level of satisfaction appears to seems contradict reports in local media on the risks associated with Nepali migrants working abroad, especially focusing on the football world cup in Qatar [7], official reports that many hundreds of bodies of dead Nepali migrants return home every year [10], and the fact that many of these Nepali migrant workers end up doing the jobs the local populations finds too dirty, dangerous and demeaning (colloquially referred to as 3D-jobs).  Why do so many who travel abroad take to do risky, dirty and otherwise undesirable jobs, but still assess their working environment as not too bad?

More theoretical papers on the drivers of migration have referred to many interconnected factors and links [11-12].  Local drivers in Nepal include poverty, lack of employment opportunities, having a history of work-related migration, a growing culture of migration (i.e. it becomes more or less an expectation) and many more.  One local element that is perhaps too easily ignored is that many Nepali migrant workers would have ended up in dirty, dangerous and demeaning jobs at home too.  And the risk, on for example building sites in Nepal might be even greater than that in Qatar or elsewhere in the Middle East as some of the photos below illustrate.  These photos of an accident involving an external building lift were taken today on a building site in Kathmandu.  

 

 

 

 

 

 

 

 

 

 

References:

  1. 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
  2. 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.
  3. Simkhada, P.P., Regmi, P.R.van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature. Journal of Travel Medicine, 24 (4). https://doi.org/10.3126/nje.v9i3.25805
  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
  5. Regmi, P.van Teijlingen, E.Mahato, P.Aryal, N., Jadhav, N., Simkhada, P., Zahiruddin, Q.S., Gaidhane, A. (2019) The Health of Nepali Migrants in India: A Qualitative Study of Lifestyles and Risks. International Journal of Environmental Research and Public Health, 16 (19). https://doi.org/10.3390/ijerph16193655
  6. Aryal, N., Regmi, P.R., Faller, E.M., van Teijlingen, E., Khoon, C.C., Pereira, A., Simkhada, P. (2019) Sudden cardiac death and kidney health related problems among Nepali migrant workers in Malaysia. Nepal Journal of Epidemiology, 9 (3), 788-791. https://doi.org/10.3126/nje.v9i3.25805
  7. 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
  8. 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 16(19), 3655; doi:10.3390/ijerph16193655.
  9. Regmi, P., Aryal, N., van Teijlingen, E., Adhikary, P. (2019) Nepali migrant workers and the need for pre-departure training on mental health: a qualitative study, Journal of Immigrant & Minority Health https://link.springer.com/content/pdf/10.1007/s10903-019-00960-z.pdf
  10. Ministry of Labour and Employment, Government of Nepal. (2018) Labour migration for employment: a status report for Nepal: 2015/2016 – 2016/2017. In. Kathmandu, Nepal: Ministry of Labour and Employment.
  11. Van Hear, N., Bakewell, O., Long. K. (2018) Push-pull plus: reconsidering the drivers of migration, Journal of Ethnic & Migration Studies, 44:6, 927-944, DOI: 10.1080/1369183X.2017.1384135
  12. Iqbal, M., Gusman, Y. (2015) Pull and Push Factors of Indonesian women migrant workers from Indramayu (West Java) to work abroad. Mediterranean Journal of Social Sciences, 6(5): 167   https://www.mcser.org/journal/index.php/mjss/article/view/7893

A research seminar session ‘A Story of Blockchain Impact in Asia’ 😇 is on the way! 19th December 2019, 11:30-12:30. Venue: EB602

We will have a seminar session with the guest lecturer, Professor Nariaki Ikematsu (Consultant, National Institute of Information and Communications Technology; NICT). This session is the third ‘spin-out’ event from DEEP TRANSFORMATIONS AND THE FUTURE OF ORGANIZATIONS (6-7 December 2019). This research seminar is conducted as a Skype video conference.

Professor Ikematsu will present a contemporary topic of blockchain impact in the Asian countries, Thailand and Vietnam. He will talk about some cases including the business practices of ‘PIZZA 4P’S Makes the World Smile for Peace through “Edutainment”’ referring to the key factors ‘local consumption’ and ‘innovative supply chain management’. https://www.earthackers.com/pizza-4ps-makes-the-world-smile-for-peace-through-edutainment/ (Accessed 12 December 2019).

This seminar is held in line with the suggestions from a Key Note Speech made by Professor Sangeeta Khorana at the conference, DEEP TRANSFORMATIONS AND THE FUTURE OF ORGANIZATIONS on the 6th December in Tunis.

This session will provide unique topics in line with the UN Sustainable Development Goals (SDGs), such as ‘Goal 9: Industry, Innovation and Infrastructure’ and ’Goal 17: Partnerships for the Goals’.

This session also aligns with BU2025 strategic investment areas (SIAs), Simulation & Visualisation and Assistive Technology.

The BU ECRs, PhD researchers, and MSc students are welcome to this session.

The session will be facilitated by Dr Hiroko Oe and an ECR, Ediz Akchay. Mr. Gideon Adu-Gyamfi (MSc International Management) will also contribute as a discussant.

*For more details, please email to hoe@brounemouth.ac.uk

New Sociology and Development publication

Congratulations to Professors Sara Ashencaen Crabtree and Jonathen Parker in the Faculty of Health & Social Sciences on the recent publication of their paper ‘‘Behaving like a Jakun!’ A case study of conflict, ‘othering’ and indigenous knowledge in the Orang Asli of Tasik Chini’ in the Journal of Sociology and Development [1]. This paper reports on an ethnographic study of the indigenous Jakun Orang Asli in West Malaysia.

Congratulations!

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

  1. Parker, J., Ashencaen Crabtree, S., Crabtree Parker, M., Crabtree Parker, I., 2019. ‘Behaving like a Jakun!’ A case study of conflict, ‘othering’ and indigenous knowledge in the Orang Asli of Tasik Chini. Journal of Sociology & Development, 3 (1):23-32.

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

 

MIDIRS reproduced Afghanistan paper

Dr. Rachel Arnold’s paper ‘Parallel worlds: an ethnography of care in an Afghan maternity hospital’ [1] originally published in Social Science & Medicine (Elsevier) has been reprinted in full in MIDIRS.  This is quite an accolade and should help this paper reach a wider audience.  Rachel graduated with a Ph.D. from the Faculty of Health & Social Sciences in 2016, illustrating that some of the best papers get into print (long) after completing one’s Ph.D. thesis.

 

 

Reference:

  1. 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.

BNAC presentation Jib Acharya

Jib poster BNAC +Edwin 2016FHSS PhD student Jib Acharya presented a poster from his thesis research at last week’s BNAC (Britain-Nepal Academic Council) Study Days in Liverpool.[1]  Jib’s PhD research focused on the knowledge, attitudes and beliefs of poor women about nutritious food and the study also identify major food barriers.  He used a mixed-methods approached comprising a survey and qualitative research. The poster at BNAC focused on findings related to mothers’ knowledge, attitudes and beliefs about nutritious food.  Jib’s research is supervised by Dr. Jane Murphy, Dr. Martin Hind and Prof. Edwin van Teijlingen.  Some of the preliminary findings of this FHSS thesis have recently been published in two academic journals. [2-3]

 

Prof. Edwin van Teijlingen

CMMPH

References:

  1. Acharya, J, van Teijlingen, E, Murphy, J, Hind, M. ‘A Comparative Study on Nutritional Problems in Preschool Aged Children of Kaski district of Nepal’ poster at Britain-Nepal Academic Council (BNAC) 14th Annual Nepal Study Days (Liverpool April 2016)
  2. Acharya, J., van Teijlingen, E., Murphy, J., Hind, M. (2015) Assessment of knowledge, beliefs and attitudes towards healthy diet among mothers in Kaski, Nepal, Participation 17(16): 61-72.
  3. Acharya, J., van Teijlingen, E., Murphy, J., Hind, M. (2015) Study of nutritional problems in preschool aged children in Kaski District in Nepal, Journal of Multidisciplinary Research in Healthcare 1(2): 97-118. http://dspace.chitkara.edu.in/jspui/bitstream/1/560/1/12007_JMRH_Acharya.

New health editorial on Sustainable Development Goals & Nepal

Regmi SDG 2016SDG 17Since late 2015 the world strives to achieve towards the Sustainable Development Goals (SDG). The SDGs bring together the social, economic and environmental aspects of development. There are 17 SDGs sub-divided into 169 targets. One of these 17 goals focuses specifically on health, namely to “ensure healthy lives and promote wellbeing for all at all age”. SDG devotes 13 health-related targets to diverse population health and wellbeing issues including maternal and child health, communicable disease including HIV, non-communicable diseases, substance use, traffic accidents, universal access to sexual and reproductive health, and sanitation.

Nepal is one of the many countries that have signed up to the SDGs. This week BU researchers Dr. Pramod Regmi, Prof. Vanora Hundley,  Prof. Edwin van Teijlingen, FHSS, PhD students Sheetal Sharma and Preeti Mahato, and BU Visiting Faculty Prof. Padam Simkhada (Liverpool John Moores University) published an editorial under the title ‘Sustainable Development Goals: relevance to maternal & child health in Nepal’ [1]. This editorial written by health researchers working in Nepal highlights some of the weaknesses in the country’s health care system.   These key problems include the persistence of inequalities in health and the limited access to health services and the low uptake of care in many poorer populations especially in the more remote rural regions. For instance, only about one in nine of the poorest women deliver their babies with the aid of a skilled birth attendant (SBA), whilst 81.5% for the richest women benefit form a SBA. Therefore, this editorial stresses the need for a continuum of health care services to be available across the country and for all sections of the society. Moreover, we can only assess whether a country has reached all or any of the SDGs if there is systematic monitoring and regular review of interventions at all levels. Hence, Nepal should develop measureable and time-bond indicators to track its progress towards the SDGs. The country will need support from development partners in both its attempts to achieve the SDGs as well when it tries to collect and analysis data to assess its progress.

 

Prof. Edwin van Teijlingn

CMMPH

 

Reference:

  1. Regmi, P., van Teijlingen, E., Hundley, V., Simkhada, P., Sharma, S., Mahato, P. (2016) Sustainable Development Goals: relevance to maternal & child health in Nepal. Health Prospect 15(1):9-10. healthprospect.org/archives/15/1/3.pdf