BU Research Blog

February 25, 2020

More BU migration research success

BU research, conferences, Featured academics, Global engagement, international, open access, Publishing, Research news, Uncategorized, writing Edwin van Teijlingen

Last week migration researchers in the Faculty of Health & Social Sciences were awarded two competitive grants through GCRF funding to Bournemouth University. The first project Nepal-Malaysia-UK partnership on Nepali migrants’ health research is led by Dr. Pramod Regmi (lecturer in International Health) and Dr. Nirmal Aryal (Post Doctoral Researcher) and Prof. Edwin van Teijlingen. The second GCRF-funded project focuses on Investigating sudden cardiac death of Nepali labour migrants in Malaysia. The project is the brain child of Dr. Nirmal Aryal who is supported by Dr. Pramod Regmi and Prof. Edwin van Teijlingen.

In the same week the International Journal of Environmental Research & Public Health (IJERPH) accepted our latest migration and health paper: ‘The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study‘. [1] This paper was part of the journal’s Special Issue ‘The Health & Wellbeing of Migrant Populations’ and it is Open Access and hence freely available online. The international authors are all related to Bournemouth University, Dr. Nirnal Aryal and Prof. Edwin van Teijlingen are both in the Centre of Midwifery, Maternal & Perinatal Health (CMMPH) and Dr. Pramod Regmi and Dr. Steve Trenoweth are based in the Department of Nursing Sciences, whilst Dr. Pratik Adhikary was awarded his PhD from Bournemouth University and Prof. Padam Simkhada based at the University of Huddersfield is Visiting Professor at in the Faculty of Health & Social Sciences. The editor emailed us today to say “Thank you very much for your nice paper …. We are pleased to see it has raised a lot of interest since its publication in IJERPH. The article metrics show: in the first week alone we had 474 views and 133 downloads.”

Last, but not least, today we were informed by the review committee that our submission, ‘Workplace Harassment Faced by Female Nepali Migrants Working in Abroad’ has been accepted by the CESLAM (Centre for the Study of Labour and Mobility) Kathmandu Migration Conference 2020.

Prof. Edwin van Teijlingen

CMMPH

Reference:

Aryal, N., Regmi, P.R., van Teijlingen, E., Trenoweth, S., Adhikary, P., Simkhada, P. (2020) The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study, International Journal of Environmental Research & Public Health 17(4), 1292; https://doi.org/10.3390/ijerph17041292

February 15, 2020

Three successful cross-faculty Health-Psychology collaborations

BU research, Featured academics, Global engagement, international, PG research, Publishing, Research news, Uncategorized, writing Edwin van Teijlingen

In the last month we had several FHSS-Psychology success stories. The first one was a recently accepted joint publication between Mr. Paul Fairbairn and Dr. Fotini Tsofliou in the Department of Rehabilitation and Sport Sciences, Dr. Andrew Johnson in BU’s Department of Psychology. The joint paper is called ‘Effects of a high DHA multi-nutrient supplement and exercise on mobility and cognition in older women (MOBILE): A randomised semi-blinded placebo controlled study” in the British Journal of Nutrition [1].

Secondly, Dr. Sarah Collard in the Department of Psychology, Dr. Pramod Regmi in the Department of Nursing Science and FHSS Visiting Professor Katherine Barnard-Kelly are to be congratulated on their publication: ‘Exercising with an automated insulin delivery system: qualitative insight into the hopes and expectations of people with type 1 diabetes’ [2].

And last, but not least, Dr. Bibha Simkhada in the Department of Nursing Science together with FHSS colleagues Dr. Michele Board and Prof. Edwin van Teijlingen and Dr. Shanti Shanker in the Department of Psychology were awarded £17,180 in the most recent internal GCRF call. Their proposed project ‘The key issues in Dementia in South Asia’ will run from 2020-2021. Both Dr. Simkhada and Dr. Shanker are Global Engagement Lead (GEL) in their respective departments.

Good to see so many great cross-BU collaborations!

Professor Edwin van Teijlingen

CMMPH

References:

Fairbairn, P., Tsofliou, F., Johnson, A., Dyall, S.C. (2010) Effects of a high DHA multi-nutrient supplement and exercise on mobility and cognition in older women (MOBILE): A randomised semi-blinded placebo controlled study, British Journal of Nutrition (accepted).

Collard, S.S., Regmi, P.R., Hood, K.K., Laffel, L., Weissberg-Benchell, J., Naranjo, D., Barnard-Kelly, K. (2020) Exercising with an automated insulin delivery system: qualitative insight into the hopes and expectations of people with type 1 diabetes, Practical Diabetes 2020; 37(1): 19–23.

February 14, 2020

New BU diabetes research

BU research, Featured academics, international, open access, Publishing, Research news, Uncategorized, writing Edwin van Teijlingen

Congratulations to Dr. Sarah Collard in the Department of Psychology, Dr. Pramod Regmi in the Department of Nursing Science and FHSS Visiting Professor Katherine Barnard-Kelly on their publication: ‘Exercising with an automated insulin delivery system: qualitative insight into the hopes and expectations of people with type 1 diabetes’ [1]. This paper in Practical Diabetes is a joint publication with several North American scholars.

The authors of this qualitative paper distilled three themes related to the benefits of automated insulin delivery systems: (a) more freedom and spontaneity in the individual’s ability to exercise; (b) relief
from worry of hypoglycaemia as a result of exercise; (c) removing the ‘guesswork’ of adjusting insulin for exercise, as well as two further themes relating to potential concerns with regard to safely exercising while wearing an automated insulin delivery system.

Well done!

Prof. Edwin van Teijlingen

CMMPH

Reference:

Collard, S.S., Regmi, P.R., Hood, K.K., Laffel, L., Weissberg-Benchell, J., Naranjo, D., Barnard-Kelly, K. (2020) Exercising with an automated insulin delivery system: qualitative insight into the hopes and expectations of people with type 1 diabetes, Practical Diabetes 2020; 37(1): 19–23

February 2, 2020

New BU paper published on South Asian maternity care

BU research, Doctoral College, Featured academics, Global engagement, international, open access, PG research, Publishing, Research Centres, Research news, student research, Uncategorized, writing Edwin van Teijlingen

Congratulation to FHSS PhD student Sulochana Dhakal Rai who just published her latest article in the Journal of Asian Midwives. The paper ‘Caesarean Section rates in South Asian cities: Can midwifery help stem the rise?‘ [1] is highly topical in this Year of the Nurse and Midwife (see Bournemouth University’s earlier event on YouTube).

Caesarean section (CS) is a life-saving surgical intervention for delivering a baby when complications arise in childbirth. The World Health Organization (WHO) suggests a rate of CS from 10% to 15%. However, CS rates increased steadily in recent decades and have almost doubled from 12.1% in 2000 to 21.1% in 2015. Therefore, this has become a global public health problem. This scoping review gives an analysis of the rising CS use in four South Asian countries: Bangladesh, India, Nepal and Pakistan. The authors conclude that the increasing CS rates in South Asian cities, particularly in specific groups of women, present a challenge to hospital staff and managers and policy-makers. The challenge is to avoid ‘Too Much Too Soon’ in otherwise healthy urban women and avoid ‘Too Little Too Late’ in women living in remote and rural area and in poor urban women.

This paper is co-authored by Dr. Juliet Wood and Prof. Edwin van Teijlingen in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), Dr. Pramod Regmi Lecturer in International Health in the Department of Nursing Science, Dr. Amudha Poobalan at the University of Aberdeen, Dr. Malin Bogren at the University of Gothenburg in Sweden, Prof. Rafat Jan at the Aga Khan University in Pakistan and Dr. Ganesh Dangal at Kathmandu Model Hospital in Nepal and Dr.Keshar Bahadur Dhakal based at Karnali Academy of Health Science also in Nepal. This is Sulochana’s second PhD paper, her first paper was published last year [2].

References

1. Dhakal Rai, S, Poobalan, A, Jan, R, Bogren, M, Wood, J, Dangal, G, Regmi, P, van Teijlingen, E, Dhakal, K B. (2019) Caesarean Section rates in South Asian cities: Can midwifery help stem the rise? Journal of Asian Midwives, 6(2):4–22.
2. Dhakal Rai, S., Regmi, P.R., van Teijlingen, E., Wood, J., Dangal, G. and Dhakal, K.B., 2019. Rising Rates of Caesarean Section in Urban Nepal. Journal of Nepal Health Research Council, 16(41): 479-480

January 30, 2020

BU academic feature article in national paper Nepal

BU research, Featured academics, humanities, international, Knowledge Exchange, open access, Public engagement, Publishing, Research communication, Research news, Uncategorized, writing Edwin van Teijlingen

Congratulations to Dr. Pramod Regmi, lecturer in International Health, whose article ‘Hazards of Beauty’ featured in Republica, a national daily newspaper published in English in Nepal. Many transgender people who are using hormones are mostly attracted by its short-term benefit of amplification in their feminine look and seem to be ignorant about its dark side. This newspaper article highlights the key issues of a recent paper in BMJ Open published by staff in the Faculty of Health & Social Sciences on transgender in Nepal [1].

Reference:

Regmi PR, van Teijlingen E, Neupane SR, Marahatta, SB. (2019) Hormone use among Nepali transgender women: a qualitative study BMJ Open 9:e030464. doi: 10.1136/bmjopen-2019-030464

January 6, 2020

The last Christmas present

BU research, Featured academics, international, Publishing, Research news, Uncategorized, writing Edwin van Teijlingen

“On the twelfth day of Christmas ….” the editor of the Journal of Health Research Ms Sunanta Wongchalee informed us that our paper ‘Silicone use in Nepali transgender women: The hazards of beauty’ has been accepted for publication [1]. That is nice belated Christmas present to receive on January 6th and a good start of the New Year. The paper is written by FHSS’s Dr. Pramod Regmi and Prof. Edwin van Teijlingen with Sanjeev Raj Neupane in Nepal. This is the second paper from this unique study on transgender women in Nepal, the first one was published last year in BMJ Open [2].

References:

Regmi, P., van Teijlingen, E.,, Neupane, S. (2020) Silicone use in Nepali transgender women: The hazards of beauty, Journal of Health Research (accepted)
Regmi, P., van Teijlingen, E., Neupane, S., Marahatta, S. (2019) Hormone use among Nepali transgender women: a qualitative study, BMJ Open 9: e030464. doi:10.1136/bmjopen-2019-030464.

December 14, 2019

Migration & mental health research in Nepal

BU research, Featured academics, Global engagement, Impact, Research news, research staff, Uncategorized, writing Edwin van Teijlingen

Congratulations to Dr. Pramod Regmi and Dr. Nirmal Aryal, both in the Faculty of Health & Social Sciences (FHSS), who co-authored of our latest health and migration paper which was accepted this week. This paper called “Nepali migrant workers and the need for pre-departure training on mental health: a qualitative study” will appear in the Journal of Immigrant & Minority Health [1]. This is the sixth paper published this year by this FHSS team of researchers on migration and health research about Nepal and the twelfth paper in total on the topic [2-12].

This important health and migration research in Nepal and about Nepali migrant workers is also the foundation of a Bournemouth University REF 2021 Impact Case Study.

Reference:

Regmi, P., Aryal, N., van Teijlingen, E., Adhikary, P. Nepali migrant workers and the need for pre-departure training on mental health: a qualitative study, Journal of Immigrant & Minority Health (accepted).
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.
International Organization for Migration (2019) Research on the Health Vulnerabilities of the Cross-Border Migrants from Nepal, Kathmandu, Nepal: International Organization for Migration.
Dhungana, R.R., Aryal, N, Adhikary, P., KC, R., Regmi, P.R., Devkota, B., Sharma, G.N., Wickramage, K., van Teijlingen, E., Simkhada, P. (2019) Psychological morbidity in Nepali cross-border migrants in India: A community-based cross-sectional, BMC Public Health 19:1534 https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7881-z
Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Mahato, P. (2019) Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal. WHO South East Asia Journal of Public Health 8(1): 38-41.
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
Simkhada, P.P., van Teijlingen, E.R., Gurung, M., Wasti, S. (2018) A survey of health problems of Nepalese female migrants workers in the Middle-East & Malaysia, BMC International Health & Human Rights 18(4): 1-7. http://rdcu.be/E3Ro
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
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.
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): 1-9.
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: www.biomedcentral.com/1472-698X/8/6
Sapkota, T., Simkhada, P., van Teijlingen, E. (2014) Nepalese health workers’ migration to United Kingdom: A qualitative study. Health Science Journal 8(1):57-74.

November 16, 2019

Growing wealth of migration publications at Bournemouth University

BU research, Centre for Excellence in Learning, Featured academics, international, open access, PG research, policy, Publishing, Research news, research staff, student research, Uncategorized, writing Edwin van Teijlingen

Yesterday saw the latest publication based on Bournemouth University (BU) migration research. The international journal BMC Public Health published our quantitative paper ‘Psychological morbidity in Nepali cross-border migrants in India: a community based cross-sectional study’ [1]. This scientific article highlights that since Nepali migrants can freely cross the border with India and hence work and stay there, they are largely undocumented. The majority of these Nepali migrant workers is involved in semi-skilled or unskilled jobs with limited labour rights and social security, which predisposes them to psychological distress. The paper assessed the prevalence of and factors associated with psychological morbidity among Nepali migrants upon their return from India.

Just a few days ago the UN Migration Agency in Nepal IOM (International Organization for Migration) published ‘Research on the Health Vulnerabilities of the Cross-Border Migrants from Nepal‘, an online report to which BU academics (Aryal, Regmi & van Teijlingen) had contributed [2]. Just recently we had published the qualitative sister paper on Nepali migrants working and living in India. [3]. Whilst Dr. Nirmal Aryal was the lead author on a paper highlighting the need for more research specifically focusing on adolescents left behind by migrant workers [4]. Earlier this year BU PhD graduate Dr. Pratik Adhikary published his latest paper from his thesis, the paper is called ‘Workplace accidents among Nepali male workers in the Middle East and Malaysia: A qualitative study’ and was published in the Journal of Immigrant & Minority Health [5].

Last year was also a very good year for BU migration research, including a systematic review on sex trafficking (perhaps the worst kind of migrant workers) [6], an earlier research paper by Dr. Adhikary with his PhD supervisors [7], and one paper on Nepali female migrants workers in the Middle-East & Malaysia [8]. Earlier BU academics published on general health issues and accidents among Nepali migrant workers in Malaysia, Qatar & Saudi Arabia [9-10], Nepali migrants in the UK [11-12] , other papers included: a call for action on Public Health [13]; a systematic review [14]; a paper on migrant workers’ spouses [15]; migrant health workers in the UK [16-17]; migration and tourism industry [18-20]; migrants and space in Italy [21-22]; an anthropological perspective on migration [23]; a media studies’ perspective [24]; and archaeological perspective [25]; and a socio-economic perspective [26]. No doubt there are several other publications I have forgotten or I am simply unaware missed in this list.

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health

References:

Dhungana, R.R., Aryal, N, Adhikary, P., KC, R., Regmi, P.R., et al. (2019) Psychological morbidity in Nepali cross-border migrants in India: A community-based cross-sectional, BMC Public Health 19:1534
International Organization for Migration (2019) Research on the Health Vulnerabilities of the Cross-Border Migrants from Nepal, Kathmandu, Nepal: International Organization for Migration.
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.
Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Mahat, P. (2019) Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal. WHO South East Asia Journal of Public Health 8(1): 38-41.
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
Simkhada, P., van Teijlingen, E., Sharma, A., Bissell, P., Poobalan, A., Wasti, S.P. (2018) Health consequences of sex trafficking: A systematic review, Journal of Manmohan Memorial Institute of Health Sciences, 4(1): 130-149.
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
Simkhada, P.P., van Teijlingen, E.R., Gurung, M., Wasti, S. (2018) A survey of health problems of Nepalese female migrants workers in the Middle-East & Malaysia, BMC International Health & Human Rights 18(4): 1-7. http://rdcu.be/E3Ro
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.
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
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: www.biomedcentral.com/1472-698X/8/6
van Teijlingen E, Simkhada, P., Adhikary, P. (2009) Alcohol use among the Nepalese in the UK BMJ Rapid Response: www.bmj.com/cgi/eletters/339/oct20_1/b4028#223451
Aryal, N., Regmi, PR., van Teijlingen, E., Simkhada, P., Adhikary, P., Bhatta, YKD., 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.
Simkhada, PP., Regmi, PR., van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health & well-being: A review of the literature, Journal of Travel Medicine 24 (4): 1-9.
Aryal, N., Regmi, PR., van Teijlingen, E., Dhungel, D., Ghale, G., Bhatta, GK. (2016) Knowing is not enough: Migrant workers’ spouses vulnerability to HIV SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS 8(1):9-15.
Scammell, J., 2016. Nurse migration and the EU: how are UK nurses prepared? British Journal of Nursing, 25 (13), p. 764.
Sapkota, T., Simkhada, P., van Teijlingen, E. (2014) Nepalese health workers’ migration to United Kingdom: A qualitative study. Health Science Journal 8(1):57-74.
Janta, H., Ladkin, A., Brown, L., Lugosi, P., 2011. Employment experiences of Polish migrant workers in the UK hospitality sector. Tourism Management, 32 (5): 1006-1019.
Dwyer, L., Seetaram, N., Forsyth, P., Brian, K. (2014) Is the Migration-Tourism Relationship only about VFR? Annals of Tourism Research, 46: 130-143.
Filimonau, V., Mika, M. (2017) Return labour migration: an exploratory study of Polish migrant workers from the UK hospitality industry. Current Issues in Tourism, 1-22.
De Martini Ugolotti, N., 2016. ‘If I climb a wall of ten meters’: capoeira, parkour and the politics of public space among (post)migrant youth in Turin, Italy. Patterns of Prejudice, 50 (2), 188-206.
De Martini Ugolotti, N., 2015. Climbing walls, making bridges: children of immigrants’ identity negotiations through capoeira and parkour in Turin. Leisure Studies, 34 (1), 19-33.
Mai, N., Schwandner-Sievers, S. (2003) Albanian migration and new transnationalisms, Journal of Ethnic & Migration Studies 29(6): 939-948.
Marino, S., Dawes, S., 2016. Fortress Europe: Media, Migration and Borders. Networking Knowledge, 9 (4).
Parker Pearson, M., Richards, C., Allen, M., Payne, A. & Welham, K. (2004) The Stonehenge Riverside project Research design and initial results Journal of Nordic Archaeological Science 14: 45–60.
Chowdhury, M., 2014. Migration, Human Capital Formation and the Beneficial Brain Drain Hypothesis: A Note. Migration & Development, 3 (2), 174-180.

November 12, 2019

What makes a Bournemouth University publication?

BU research, Featured academics, international, open access, policy, Publishing, Research Centres, Research communication, Research news, research staff, Uncategorized, writing Edwin van Teijlingen

Last week the IOM (International Organization for Migration) in Nepal, the UN Migration Agency published a new report online: Research on the Health Vulnerabilities of the Cross-Border Migrants from Nepal. This report mentioned the input and advice of Bournemouth University (BU) staff, including Dr. Nirmal Aryal, who worked on the report prior to his appointment at BU and who is listed as Co-Investigator, furthermore listed as Resource Persons are: Dr. Pramod Regmi and Prof. Edwin van Teijlingen. Working with the charity Green Tara Nepal (GTN) on this study has been good for IOM and BU. All of use have worked on the report in different kind of ways and to different degrees. The publication suggested a corporate authorship as ‘International Organization for Migration’, which is great for the status of the report as it is a UN agency. We feel part of this as BU academics and feel we are part of the team despite this not being a BU publication!

Professor Edwin van Teijlingen

CMMPH

Reference:

International Organization for Migration (2019) Research on the Health Vulnerabilities of the Cross-Border Migrants from Nepal, Kathmandu, Nepal: International Organization for Migration. Available at : https://nepal.iom.int/sites/default/files/publication/Research_on_The_Health_Vulnerabilities_of_The_Cross_Border_Migrants_from_Nepal_0.pdf

October 10, 2019

Newly accepted paper on Nepal in BMJ Open

BU research, Featured, Featured academics, Global engagement, international, open access, Publishing, Research news, Uncategorized, writing Edwin van Teijlingen

Congratulations to Dr. Pramod Regmi in the Faculty of Health & Social Sciences (FHSS) who is the lead author of the paper “Hormone use among Nepali transgender women: A qualitative study” which has just been accepted for publication in BMJ Open (Impact Factor 2.376). The paper highlights that there is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. This qualitative study therefore explored: (a) how hormones are used; (b) types of hormones used; and (c) side-effects experienced by transgender women after hormone use. This is the first study in Nepal of its kind addressing this important public health issue.

The paper was co-authored by Sanjeev Neupane, Sujan Marahatta and Edwin van Teijlingen. Prof. Sujan Marahatta is based at Manmohan Memorial Institute of Health Sciences in Nepal. Bournemouth University has a long-standing collaboration with Manmohan Memorial Institute of Health Sciences. Whilst Mr. Sanjeev Raj Neupane is based at the charity Save the Children in Kathmandu.

Reference:

Regmi, P., Neupane, S., van Teijlingen, E., Marahatta, S. Hormone use in the male-to-female transgender population in Nepal: A qualitative study, BMJ Open (accepted).

October 1, 2019

Nepali migrants’ health & wellbeing: Setting research priorities

BU research, Featured academics, Global engagement, international, Knowledge Transfer, PG research, Publishing, Research news, Uncategorized Edwin van Teijlingen

Work-related migration is a common livelihood strategy for many young people in Nepal. It is estimated that about 3.5 million Nepali work abroad, mainly in Malaysia, the Gulf countries, and India. The economic contribution of Nepali migrants to the country is highly significant as they send over US$6.1 billion in remittances which is 26 % of Nepal’s gross domestic product (GDP) [1].

There is a growing global literature on migrant workers’ poor health and wellbeing and of those they leave behind. Over the past decade the media in Nepal have reported on the mortality and morbidity of Nepali migrants abroad. Every year at least one thousand dead bodies of Nepali migrants return back home via Tribhuvan International Airport (the only international airport in Nepal the country). The Government of Nepal estimated 5,982 deaths in migrant workers in the period 2008 to 2017, however there is likely to have been under-reporting [2].

Although there have been studies on Nepali migrants’ health [3-9], these are largely around (a) sexual risk-taking behaviours of Nepali migrants in India; and, (b) occupational health and injuries issues among Nepali migrants in Gulf countries. These studies are carried out with the support from development partners and/or government organisations. However, most migration health research in Nepal has been small-scale for example to collect baseline information or as part of Masters or PhD projects. Currently, there is no research priority agenda on the topic of Nepali migrants’ health and wellbeing issues.

To address this gap in the research agenda staff in BU’s Faculty of Health & Social Sciences and their collaborators organised a consultation workshop on August 2^nd of this year in Kathmandu, Nepal. This workshop aimed to identify Nepali migrant workers’ health research prioritites and gaps. A total of 26 participants representing universities, ministries, non-governmental organisations working for migrants and research organisations attended the workshop.

The workshop was participatory in nature. To start with BU Professor Edwin van Teijlingen and Professor Padam Simkhada (BU Visiting Professor) shared global perspectives on migrant workers health. Whilst BU lecturer Dr Pramod Regmi highlighted key findings of BU’s migration research of Nepali migrants and their left-behinds. This contextual information helped focus the discussion on Nepali migrant health research priorities and gaps.

In order to identify the research agenda and prioritise issues and problems, participants were divided into four groups, each comprising 6-8 experts in the migration field. Groups were purposively formed to include participants from diverse backgrounds, e.g., migration related researchers, migration programme managers and policy-makers. Each member of the team was requested to identify two to five research needs around Nepali migrants’ health and share within their group for consensus. The group then prepared research priorities agreed in their team. Each team presented the research priorities to the wider group. A total of 46 research agenda items were identified which were subsequently prioritised through a voting process. Table 1 shows who participants ranked the top issues requiring further research.

Table 1 Top migration health research priorities in Nepal

Causes of sudden cardiac deaths among Nepali migrant workers in the countries of Gulf and Malaysia
Left-behind adolescents and social blaming/separation
Methods/mixed/iterature searching/before and after study/case study
Cross-border/national studies
Research on undocumented migrants
Culturally appropriate health care to migrants
School education on migration
Living condition of migrants abroad
Pre-departure health status

The way forward

The consultation workshop was very productive in many ways. First, it identified wide ranging health research for Nepali migrants and prioritised these research issues. This information may help guide future research on migration studies. Secondly, the workshop offered a platform to build a network among researchers working for Nepali migrants.

Pramod R Regmi, Nirmal Aryal, and Edwin van Teijlingen

References:

Ministry of Finance. (2018). Economic survey: Fiscal Year 2017/18. In. Kathmandu: Ministry of Finance: Government of Nepal.
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.
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
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
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.
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
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
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
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

September 26, 2019

New BU paper: Health of Nepali migrants in India

BU research, Featured academics, international, open access, Research news, Uncategorized, writing Edwin van Teijlingen

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:

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)

September 12, 2019

Congratulations to Dr. Pramod Regmi

Featured academics, Global engagement, international, open access, Publishing, Research news, writing Edwin van Teijlingen

Congratulations to FHSS’s Dr. Pramod Regmi on the publication of his recent qualitative paper ‘Parents’ and teachers’ perspectives on children’s sexual health education: a qualitative study in Makwanpur Nepal’ [1]. The paper is co-authored by colleagues from Aberystwyth University.

This academic paper in an Open-Access journal, hence freely available to researchers, policy-makers, teachers, etc. in Nepal and elsewhere in the world. This Health Prospect publication is the latest in a series of publications focusing on sex education and sexual health in Nepal by Dr. Regmi [see 2-10].

Well done!

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health (CMMPH)

References:

Acharya, DR, Thomas, M., Cann, R., Regmi, P.R., 2019. Parents’ and teachers’ perspectives on children’s sexual health education: a qualitative study in Makwanpur Nepal Health Prospect, 18(2): 1-6.
Simkhada, P., van Teijlingen, E., Regmi, P., Bhatta, P., Ingham, R., Stone, N., 2015. Sexual health knowledge and risky sexual behaviour of Nepalese trekking guides. Journal of Manmohan Memorial Institute of Health Sciences, 1 (4), 35-42.
Acharya, D., Regmi, P., Simkhada, P., van Teijlingen, E., 2015. Modernisation and changes in attitudes towards sex and relationships in young people. In Wasti, S., Simkhada, P., van Teijlingen, E. (Eds.) The Dynamics in Health in Nepal, Kathmandu, Nepal: Social Science Baha: 63-94.
Regmi, P., Simkhada, P., van Teijlingen, E ., 2011. Dating and sex among emerging adults in Nepal. Journal of Adolescent Research, 26 (6), 675-700.
Regmi, P., Simkhada, P., van Teijlingen, E., 2010. ‘…Boys remain prestigious, girls become prostitutes’: Socio-cultural context of relationships and sex among young people in Nepal. Global Journal of Health Science, 2 (1), 60-72.
Simkhada, P., van Teijlingen, E., Regmi, P., Bhatta, P., 2010. Sexual relationship and condom use among male trekking guides in Nepal: A qualitative study. Culture Health & Sexuality, 12 (1), 45-58.
Regmi, P., Simkhada P., van Teijlingen, E., 2010. ‘…There are too many naked pictures found on the net’: Factors encouraging premarital sex among young people in Nepal. Health Science Journal, 4 (3), 169-181.
Regmi, P., Simkhada, P., Acharya, D., van Teijlingen, E., 2010. Barriers to sexual health services for young people in Nepal. Journal of Health, Population and Nutrition, 28 (6), 619-627.
Upreti, D., Regmi, P., Pant, P., Simkhada, P., 2009 Knowledge, attitude towards HIV and AIDS among Nepalese young people: A systematic review. Kathmandu University Medical Journal, 7(4), 383-391.
Regmi, P., Simkhada, P., van Teijlingen, E., 2008. Sexual and reproductive health status among young people in Nepal: opportunities and barriers for sexual health education and services utilisation. Kathmandu University Medical Journal, 6(2), 245-256.

August 9, 2019

Not all fieldwork goes to plan

BU Challenges, BU research, conferences, Featured academics, Global engagement, international, Public engagement, Research news Edwin van Teijlingen

Hardly ever does a research trip go smoothly and completely to plan. Our latest trip to Nepal was no different. It started really with a delay, I had the money for a flight in the spring, but I really could not find the time to leave Bournemouth University for a three-week trip.

The first little hiccup of this summer’s fieldwork trip, during the monsoon, occurred on arrival at Kathmandu Airport on 23 July. I normally bring three bottles of whisky as a present for my PhD former students and fellow researchers in Nepal. These are bought during my stop-over in the Middle East and this always worked well until this year. This time I was stopped on arrival by a very apologetic customs officer who informed me that the rules for bringing alcohol into Nepal had changed since the beginning of this year and that I could only bring in one bottle. I received a lovely certificate for the two bottles I had to leave behind (see photo).

The second little hiccup was that one of the three research dissemination meetings we had hoped to organise in Kathmandu could not take place. Unfortunately, the organisation we had been collaborating with had not managed to finalise the research report on time. We had also hoped to meet up with staff at Social Science Baha. We have submitted the final draft manuscript for our next book to them and wanted to discuss progress, but the director was unfortunately out of the country.

Further little hiccups were more mundane, such as the electricity going off twice (for perhaps five minutes each time) during one of my teaching sessions on Introduction to Qualitative Research. This meant trying to start a slow laptop as back-up, whilst restarting a still warm overhead projector, etc. But the Nepali audience, being used this, took it all in its stride. And I’ll spare you the details of my day of diarrhoea (either weather or food-hygiene related, probably both).

The biggest problem this time was much more unexpected. Two days ago there was a big fire not too far from in Kathmandu (see picture taken from my bed room). A little later after the photo was taken, we got stuck in traffic because several roads were blocked around the burning building on our way to Tribhuvan University. Later I found out that the fire had destroyed the head office of a national internet provider, which is also the provider for the charity Green Tara Nepal, which we are working with. So I have had hardly any internet for a few days which is really difficult for a 21^st century academic.

However, this fieldwork trip has been very successful to date. We have co-organised two well attended meetings, one on the introduction of CPD in Nursing led by Dr. Bibha Simkhada (see previous BU blog here) and one Consultation meeting on migration and health research led by Dr. Pramod Regmi, both run in collaboration with BU’s Visiting Professor Padam Simkhada. Moreover, I was invited to speak at an international sociology conference last Sunday here in Kathmandu which I did not even know was going on till two days before. I had to pleasure of meeting our midwifery friends in Nepal as well as a representative of the German Aid Agency GIZ. We managed to have dinner in Kathmandu with loads of colleagues and friends who work with BU in one form or another, including one of my recent co-authors from the University of Tokyo who happened to be in Nepal.

Prof. Edwin van Teijlingen

CMMPH

August 3, 2019

Promoting Nursing CPD in Nepal

Events, Featured academics, Fusion, Impact, international, Research news, Uncategorized, writing Edwin van Teijlingen

Bournemouth University facilitated a Strategic planning meeting to develop a Continuing Professional Development (CPD) Framework for Nepal last week in Kathmandu. The planning meeting was held on 30^th July 2019 at the Institute of Medicine IOM Maharajgunj Nursing Campus. Midwifery is not formally recognised in Nepal, i.e. as a profession separate from nursing, therefore when refer to nursing CPD in this blog we mean both ‘nurses’ and ‘nurse-midwives’.

Bournemouth University is collaborating in this project with Liverpool John Moores University (LJMU) in the UK, the IOM Nursing Campus, the Nursing Association of Nepal (NAN), MIDSON, the Nepal Nursing Council (NNC) and several other key stakeholders in Nepal to support nursing regulatory bodies to establish mandatory CPD and/or post-registration training programmes relevant to their current practice in nursing.

The Bournemouth team (led by Dr. Bibha Simkhada with Prof. Edwin van Teijlingen and Dr.Pramod Regmi) argued that CPD offers nurses the opportunity to maintain, improve and broaden knowledge, expertise and develop their personal and professional qualities to enhance practice and career development. Nepal has had limited process and progress in ensuring CPD for nurses and the uptake of post-registration education and training programmes or CPD tends to be ad hoc. Generally, CPD in Nepal remains under-developed as showing evidence of having received CPD is not currently a requirement of nurses when they re-register every five year.

This project is a good example of a BU FUSION project as our earlier Research in the form of a needs assessment will to the introduction of CPD which is of course, post-registration Education in nursing, helping to improve Practice in a low-income country. We think we have had at least some impact on nursing in Nepal as the general feeling of our strategic planning meeting positive towards introducing CPD in the near future in Nepal.

July 27, 2019

IOM or IOM: it can be rather confusing

Events, Featured academics, Global engagement, Impact, international, Research news, Uncategorized Edwin van Teijlingen

This month’s fieldtrip to Nepal has a rather confusing element, namely the two separate organisations the BU team is working with have the same abbreviation. Not only that, each organisation/abbreviation is equally well known in its own field. Dr. Bibha Simkhada, Prof. Edwin van Teijlingen and FHSS’s Visiting Professor Padam Simkhada are here in Kathmandu to work with IOM (Institute of Medicine) Maharajgunj Nursing Campus. It is the pioneer school of nursing in the country and part of Nepal’s oldest university, Tribhuvan University. This collaboration involves studying issues around CPD (Continuous Professional Development) in Nursing in Nepal, and also includes BU’s Dr. Ian Donaldson and Dr. Catherine Angell.

The second research meeting next week or early August in Kathmandu is between BU’s Dr. Pramod Regmi, Prof. Padam Simkhada and Prof. Edwin van Teijlingen on the issue of health and migration with IOM (International Organisation of Migration). IOM, as a United Nations’ agency, is the leading international organization for migration. This health of migrants’ project also involves BU’s Dr. Nirmal Aryal and Dr. Preeti Mahato.

Sometimes it is all a little bit confusing. Perhaps as well that we don’t have a collaborator from the IOM (Isle of Man).

May 20, 2019

Trekking guides paper well read

BU research, Featured academics, Global engagement, open access, Publishing, Research news, Uncategorized, writing Edwin van Teijlingen

Today ResearchGate alerted us that our paper ‘Nepalese Trekking Guides: A Quantitative Study of Sexual Health Knowledge And Sexual Behaviour’ [1] has been cited 300 times. This paper links between Tourism and Public Health in the field of sexually transmitted infections in travellers and tourism workers. This article, in an Open Access journal, is co-authored by BU’s Dr. Pramod Regmi and Prof. Edwin van Teijlingen with BU Visiting Faculty Prof. Padam Simkhada and Psychology colleagues from the University of Southampton.

This study assessed sexual behaviour, knowledge and condom use among male trekking guides in Nepal. A questionnaire (n=324) was administered to Nepali men working as mountain trekking guides. Most respondents (59%) had initiated sex before the age of 18. Most (84 %) reported sexual relations with a woman other than their partner, 46% reported foreign partners, 43% had Nepalese partners, and 28% had concurrent foreign and Nepalese partners. Most (70 %) reported ever having sex with a foreign woman and two-thirds had had sexual intercourse with foreign women in the previous 12 months. Participants’ age, education status, age of first sex, smoking and drinking habits and English proficiency were significant predictors of having sex with foreign women. About 60% reported condom use during their most recent occasion of extra-marital sex. A similar proportion had used a condom during last sexual intercourse with a foreign woman.

The likelihood of condom use was associated with a guide’s age, educational level, ethnicity, age of first sex and work experience. Most trekking guides reported sexual relations with foreign women as well as irregular use of condoms. Although sexual health knowledge about among trekking guides is high, some misconceptions still result in unsafe sex. Hence there is an urgent need to revise the existing training for trekking guides and implement appropriate health promotion programmes.

Reference:

Simkhada, P., van Teijlingen, E., Regmi, P., Bhatta, P., Ingham, R., & Stone, N. (2015). Nepalese Trekking Guides: A Quantitative Study of Sexual Health Knowledge And Sexual Behaviour. J Manmohan Memorial Inst Health Sci, 1(4), 35-42. https://doi.org/10.3126/jmmihs.v1i4.12000

April 24, 2019

BU migration health stakeholders’ meetings in Malaysia

BU research, Events, Featured academics, Fusion, Global engagement, international, policy, Public engagement, Publishing, Research news, Uncategorized, writing Edwin van Teijlingen

BU’s researchers Dr. Pramod Raj Regmi and Dr. Nirmal Aryal have recently visited Malaysia for a consultation meeting. They organised meetings with stakeholders working on migration health related and Nepali migrant workers as Public Patient Involvement (PPI ) in Malaysia. These meetings discussed risk factors for sudden nocturnal deaths and kidney disease among Nepali migrant workers in Malaysia.

More than 350 Nepali migrant workers die in Malaysia every year. Nearly one-fourth of them die from cardiovascular problems often during their sleep, many without previous signs or illnesses. This also seems to be the case in South Asian workers in the Middle-East. The cause of death is hitherto unknown. During a consultation meeting on 19^th April, participants suggested several possible causes of these deaths and strongly supported the idea of carrying out verbal autopsy with close friends, employers, roommates, etc. The emerging health issue of kidney health risk among Nepali migrant workers and its risk factors were also discussed. A total of 25 participants attended the meeting. Participants from many different disciplines [1], including from migration health researchers from several universities, migrant workers’ non-governmental organizations (NGO), the Malaysian Ministry of Health, and International Organization for Migration (IOM) Malaysia. FHSS’s Drs Aryal and Regmi facilitated the consultation workshops.

On the same day, Dr. Regmi and Dr. Aryal met with the Nepali ambassador to Malaysia Mr. Udaya Raj Pandey and his team and discussed migration issues. The Nepali Embassy in Malaysia is aware of these health problems and the ambassador committed to provide any support required for further investigation in these issues.

On 20^th April, another PPI was carried out among Nepali migrant workers at their living quarters. Around 20 Nepali migrant workers participated. During this meeting, issues of sudden nocturnal deaths and acceptability and feasibility of verbal autopsy tools, problem of kidney disease and its possible triggers were discussed. The research into the usefulness of verbal autopsy tool as a good example of BU’s FUSION, since research can lead to a change in practice regarding health of migrant workers through better education of the migrant community, their left-behind families and NGOs working in the field.

These consultation meeting and PPI were intended to develop basis for further research in these area and build collaboration in Malaysia. The NGOs North-South Initiatives (Mr. Adrian Pereira and his team) and Migrant Workers’ Health Alliance (Dr. Erwin Martinez Faller and his team) have locally co-ordinated these events. These activities were conducted from the QR pump-priming fund awarded to Dr. Aryal this year in FHSS.

Finally, on 21^st April, Dr. Regmi and Dr. Aryal were invited to the Philippine Embassy to share knowledge on mental health risk among migrant workers. They have presented findings of previous BU’s research on it as well as existing evidence on mental health risk on migrant workers and their left-behinds. More than 60 Filipino migrant workers attended the event.

As Malaysia is a popular destination for migrant workers from Asia Pacific and South Asia (there are currently more than 700,000 Nepali workers in Malaysia), these consultations will play a significant role in designing and developing grant applications to promote health and wellbeing of migrant workers. This consultation meeting builds on recent work on the topic conducted at BU [2-14] as highlighted in the recent Research Brief Migration and Health (Jan. 2019).

References:

van Teijlingen, E., Regmi, P., Adhikary, P., Aryal, N., Simkhada, P. (2019). Interdisciplinary Research in Public Health: Not quite straightforward. Health Prospect, 18(1), 4-7.
Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Mahat, P. (2019) Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal. WHO South East Asia J Public Health 8 (1): 38-41.
Adhikary P, Sheppard Z., Keen S. van Teijlingen E (2018) Health and well-being of Nepalese migrant workers abroad, Int J Migration, Health Social Care 14(1): 96-105
Simkhada, P.P., van Teijlingen, ER., Gurung, M., Wasti, S. (2018) A study of Health Problems of Nepalese Female Migrants Workers in the Middle-East & Malaysia, BMC Int Health Human Rights 18(1):4.
Adhikary P, Sheppard Z, Keen S, van Teijlingen E (2017) Risky work: Accidents among Nepali migrant workers in Malaysia, Qatar & Saudi, Health Prospect 16(2): 3-10
Simkhada P, Regmi, P, van Teijlingen E, Aryal N (2017) Identifying gaps in Nepalese migrant workers’ health & well-being: A review of literature J Travel Med 24(4): 1-9
Aryal, N., Regmi, PR., van Teijlingen, E., Simkhada, P., Adhikary, P., Bhatta, YKD., Mann, S. (2016) Injury & Mortality in Young Nepalese Migrant Workers: A Call for Public Health Action. Asian-Pacific J Public Health 28(8): 703-705.
Aryal, N., Regmi, PR., van Teijlingen, E., Dhungel, D., Ghale, G., Bhatta, GK. (2016) Knowing is not enough: Migrant workers’ spouses vulnerability to HIV SAARC J Tuberculosis, Lung Diseases HIV/AIDS 8(1):9-15.
Joshi, S., Prescott, G., Simkhada, P., Sharma, N., Bhurtyal, Y. (2014). Knowledge and Risk Perceptions about HIV/AIDS among Nepalese Migrants in Gulf Countries: a Cross-sectional Study. Health Sci J, 8 (3) pp 350-36
Sapkota, T., Simkhada, P., van Teijlingen, E. (2014) Nepalese health workers’ migration to United Kingdom: A qualitative study. Health Sci J 8(1):57-74.
Joshi S, Simkhada, P, Prescott, G (2011) Health problems of Nepalese migrants working in three Gulf countries, BMC Int Health Human Rights, 2011, 11:3
Adhikary P, Keen S, van Teijlingen E. (2011) Health Issues among Nepalese migrant workers in Middle East. Health Sci J 5: 169-75.
van Teijlingen E, Simkhada, P, Adhikary P. (2009) Alcohol use among the Nepalese in UK. BMJ Rapid Response www.bmj.com/cgi/eletters/339/oct20_1/b4028#223451
Adhikary, P., Simkhada, P., van Teijlingen, E., Raja, A. (2008). Health and Lifestyle of Nepalese Migrants in the UK; BMC Int Health Human Rights, 8(6).

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