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’ . 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].
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health (CMMPH)
- 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.
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’ . 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.
- 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
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 21st 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
Yesterday Prof. Edwin van Teijlingen from CMMPH (Centre for Midwifery, Maternal & Perinatal Health) gave a presentation on ‘Social and Medical Model of Childbirth’ at the International Conference 2019 with the specific title ‘Sociology of Nepal: State Restructuring, Good Governance & People’s Participation’. This international conference was organised by NSA (Nepal Sociological Association) in Kathmandu.
Prof. van Teijlingen outlined the notion of the social-medical model [1-5] and linked it to recent developments in Nepal, including the introduction of midwifery education (i.e. midwifery separately from nursing) something tat has been advocated for a long time  and the rising Caesarean Section rate in Nepal, especially in hospitals in the capital .
- van Teijlingen, E. (2017) The medical and social model of childbirth, Kontakt 19 (2): e73-e74
- MacKenzie Bryers H., van Teijlingen, E. (2010) Risk, Theory, Social & Medical Models: critical analysis of the concept of risk in maternity care, Midwifery 26(5): 488-496.
- Ireland, J., van Teijlingen, E. (2013) Normal birth: social-medical model, Practising Midwife 16 (11): 17-20.
- van Teijlingen E. (2005) A critical analysis of the medical model as used in the study of pregnancy and childbirth, Sociol Res Online, 10 (2) Web address: http://www.socresonline.org.uk/10/2/teijlingen.html
- Nieuwenhuijze, M., van Teijlingen, E., MacKenzie Bryers, H. (2019) Denken in risico’s: niet zonder risico?! (in Dutch: Thinking in terms of risk is not without its risks), Nederlands Tijdschrift voor Verloskundigen (in Dutch: Journal for Midwives), (forthcoming)
- Bogren, M.U., Bajracharya, K., Berg, M., Erlandsson, K., Ireland, J., Simkhada, P., van Teijlingen, E. (2013) Nepal needs midwifery, Journal of Manmohan Memorial Institute of Health Sciences (JMMIHS) 1(2): 41-44. www.nepjol.info/index.php/JMMIHS/article/view/9907/8082
- Dhakal-Rai, S., Regmi, P.R., van Teijlingen, E., Wood, J., Dangal, G., Dhakal, K.B. (2018) Rising Rate of Caesarean Section in Urban Nepal, Journal of Nepal Health Research Council 16(41): 479-80.
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 30th 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.
Congratulations to FHSS PhD student Peter Wolfensberger whose article ‘Uncertainty in illness among people living with mental ill health – a mental health nursing perspective’ was accepted yesterday by the British Journal of Mental Health Nursing . The paper introduces the concept of ‘uncertainty in illness’, which is a well-known concept in health care literature and a considerable volume of research has investigated how people adapt to different health conditions and how the concept of uncertainty in illness relates to those populations. However, while there is substantial literature focusing on coping strategies and personal recovery, there is a paucity of research about uncertainty in illness among people living with mental ill health.
This paper therefore, explores uncertainty in illness among mental health nurses and to provide an understanding of its relevance to people living with mental ill health. The paper concludes that even though mental health nursing does not directly address uncertainty, the concept and its implications need to be considered and raised further among mental health professionals in order to improve support for people living with mental ill health in their process of personal recovery.
This paper originated from Peter’s PhD research on insights into mental health nursing in Switzerland, which has had input from Prof Fran Biley (before he passed away) and Dr. Zoe Sheppard (before she moved to her new job in Dorchester). His current BU supervisors are: Dr. Sarah Thomas and Prof. Edwin van Teijlingen and his Swiss supervisor is Prof. Sabine Hahn (Berner Fachhochschule/ Bern University of Applied Sciences).
- Wolfensberger P. Thomas, S., Sheppard, Z., Hahn, S, van Teijlingen, E. ‘Uncertainty in illness among people living with mental ill health – a mental health nursing perspective’ British Journal of Mental Health Nursing (Accepted)
Congratulations to Orlanda Harvey, PhD student in the Faculty of Health & Social Sciences on her PhD publication “Support for people who use Anabolic Androgenic Steroids: A Systematic Scoping Review into what they want and what they access” in the Open Access journal BMC Public Health . Since there is a paucity of research on support for people using Anabolic Androgenic Steroids (AAS), this article searched and synthesised the available evidence in this field. Gaining an understanding of the support both accessed and wanted by recreational AAS users will be of use to professionals who provide services to intravenous substance users and also to those working in the fields of public health and social care, with the aim to increase engagement of those using AAS.
This systematic scoping review identified 23 papers and one report for review, which indicated that AAS users access a range of sources of information on: how to inject, substance effectiveness, dosages and side effects, suggesting this is the type of information users want. AAS users sought support from a range of sources including medical professionals, needle and syringe programmes, friends, dealers, and via the internet, suggesting that, different sources were used dependent on the information or support sought.
The authors argue that AAS users tended to prefer peer advice and support over that of professionals , and access information online/specialist fora, reflecting the stigma that is experienced by AAS users. These tendencies can act as barriers to accessing services provided by professionals. The paper concludes that support needs to be specific and targeted towards AAS users. Sensitivity to their perceptions of their drug-use and the associated stigma of being classified in the same sub-set as other illicit drug users is relevant to facilitating successful engagement.
- Harvey, O., Keen, S., Parrish, M., van Teijlingen, E. (2019) Support for people who use Anabolic Androgenic Steroids: A Systematic Literature Review into what they want and what they access. BMS Public Health 19: 1024 https://rdcu.be/bMFon
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).
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 .
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.
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