Tagged / federalisation

Impact of federalisation on Nepal’s health system

conferences, international, Publishing, writing

On Boxing Day and the following day (Dec. 27th) a member of our research team, Amshu Dhakal based at Manmohan Memorial Institute of Health Sciences (MMIHSS), presented findings from our Nepal Federal Health System Project in Kathmandu.  The event, Nepal Health Conclave 2024, was organised by the Ministry of Health and Population and supported by WHO (World Health Organization) Nepal and UNFPA.  The event aimed to help strengthen Nepal’s health services.  This year’s conclave, themed “Bridging the Gap Between Global Expertise and National Needs”, brought together Nepalese diaspora health professionals and national stakeholders to foster collaboration and innovation in health systems.

Amshu presented two posters at the event: (1) The Impact of Decentralisation on Health Systems: A Systematic Review of Reviews which systematically reviewed how decentralisation affects health systems globally, highlighting key opportunities and challenges across WHO’s six building blocks; and (2) Transforming the Health System in Nepal: The Impact of Federalisation, which examined how the transition to a federal system reshaped Nepal’s health system, identifying gaps, opportunities, and actionable recommendations for improvement.

Our research team produced policy briefs in collaboration with government officials/stakeholders from all three levels of government.  The policy briefs can be accessed at the website of our Nepal Federal Health System Project.  This study was funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1] to study the consequences for the health system of Nepal’s move from a centralised political system to a more federal government structure in 2015.  This joint project was led by the University of Sheffield in collaboration with Bournemouth University, the University of Huddersfield, Canter Bury Christ Church University and two institutions in Nepal, namely MMIHS and PHASE Nepal. 

In late 2022 further funding was awarded by the Medical Research Foundation to Prof. Julie Balen, from Canterbury Christ Church University, to disseminate the findings of our UK Health Systems Research Initiative-funded research in Nepal. In terms of academic dissemination, we have published eight papers from this interdisciplinary project [1-8].

 

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health

 

References:

  1. Koirala, B., Rushton, S., Adhikary, P., Balen, J., et al. (2024) COVID-19 as a challenge to Nepal’s newly federalised health system: capacities, responsibilities, and mindsets, Asia Pacific Journal of Public Health (online first) https://doi.org/10.1177/1010539524125012.
  2. Sapkota, S., Rushton, S., van Teijlingen, E., et al. (2024) Participatory policy analysis in health policy and systems research: reflections from a study in Nepal. Health Research & Policy Systems, 22 (No.7) https://doi.org/10.1186/s12961-023-01092-5 .
  3. Wasti, S.P., van Teijlingen, E., Simkhada, P., et al. (2023) Selection of Study Sites and Participants for Research into Nepal’s Federal Health System, WHO South-East Asia Journal of Public Health 12(2):116-119.
  4. Sapkota, S., Dhakal, A., Rushton S., et al. (2023) The impact of decentralisation on health systems: a systematic review of reviews. BMJ Global Health 8:e013317. doi:10.1136/bmjgh-2023-013317.
  5. Wasti, S.P., van Teijlingen, E., Rushton, S., et al. (2023) Overcoming the Challenges Facing Nepal’s Health System During Federalisation: An Analysis of Health System Building Blocks, Health Research Policy & Systems 21(117) https://doi.org/10.1186/s12961-023-01033-2
  6. Sapkota, S., Panday, S., Wasti, S.P., et al. (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of the Nepal Public Health Association 7(1):36-42.
  7. Adhikary, P., Balen, J., Gautam, S., et al. (2020) The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system, Journal of Karnali Academy of Health Sciences 3 (3): 1-11.
  8. Rushton, S., Pandey, S., van Teijlingen, E., et al. (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146

Media coverage in Nepal

international

Last week Mr. Yogesh Dhakal, who is Deputy Editor at Shilapatra, an online newspaper in Nepal, interviewed three UK professors: Julie Balen (Canterbury Christ Church University), Simon Rushton (the University of Sheffield) and Edwin van Teijlingen (Bournemouth University).  The focus of the interview (see interview online here) was our recently completed interdisciplinary study ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’.

In this Nepal Federal Health System Project we studied the consequences for the health system of Nepal’s move from a centralised political system to a more federal structure of government.  This three-year project is UK-funded by the MRC, Wellcome Trust and FCDO (Foreign, Commonwealth & Development Office; formerly DFID) under the Health Systems Research Initiative.  This joint project is led by the University of Sheffield in collaboration with Bournemouth University, the University of Huddersfield, Canterbury Christ Church University and two  institutions in Nepal, namely MMIHS (Manmohan Memorial Institute of Health Sciences) and PHASE Nepal. 

Today (23rd January) the article appeared online in Nepali.  We have seen the transcript in English of the actual interviews with the three of us, but I have no idea how the journalist has edited, selected and translated the relevant text.

Prof. Edwin van Teijlingen

CMWH (Centre for Midwifery & Women’s Health)

Successful event with senior policymakers in Nepal

international

Today, the last day of the Nepalese year 2079, we held a well attended event to discuss the preliminary findings of the interdisciplinary study of the impact of federalisation on health system in the country.  We invited policymakers and politicians from all three levels of government in the country to help the research team to analyse the large amount of high-quality data.  This meeting helped to validate the study results and guide our future capacity building as part of this project.  We were pleasantly surprised by the number who turned up and with their  active engagement!

One of the interesting comments made by the participants was that this was the first time that they had met with staff from differ levels to discuss the working of the system.  In fact, participants expressed that they wanted more opportunities to have this kind of discussions across all three levels of government. The researchers reported both positive and negative developments in the decentralized health system of Nepal.  Positive aspects included, for example, improvements in the availability of resources for health, the construction of new health posts and hospitals, better availability of essential medicines in many places.  We also commented on the positive management of COVID-19, compared to other many countries.  The policymakers from local, provincial and national level largely agreed with our findings and analyses.

This stakeholders’ event is part of the Nepal Federal Health System Project, our major collaborative project examining the consequences for the health system of Nepal’s move to a federal government structure in 2015.  This is a joint project (2020-2024) led by colleagues the University of Sheffield in collaboration with the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) Bournemouth University, the University of Huddersfield, with two partners in Nepal, namely Manmohan Memorial Institute of Health Sciences (MMIHS) and PHASE Nepal.  This longitudinal interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1].

Prof. Edwin van Teijlingen

CMMPH

 

Conference presence in Nepal

international

Our study on the impact of federalism on the health system in Nepal got great coverage at the ‘Ninth National Summit of Health and Population Scientists in Nepal’ on Tuesday 11th April.  This annual conference in Kathmandu is organised by the NHRC (Nepal Health Research Council).

In the morning Prof. Sujan Marahatta (who is Visiting Professor at Bournemouth University) and Prof. Simon Rushton from the University of Sheffield presented in the plenary session.  They jointly outlined the preliminary study findings.  In the afternoon, our collaborator Dr. Jiban Karki (Liverpool School of Tropical Medicine) presented more detailed findings on ‘Human resource management at local level in Nepal’s federalised health system’ from the same study.

During the whole day we also had a poster presentation on display under the title ‘COVID-19 as a challenge to Nepal’s newly-federalised health system: Capacities, responsibilities, and mindsets’.

All dissemination was part of the Nepal Federal Health System Project, our major collaborative project examining the consequences for the health system of Nepal’s move to a federal government structure in 2015.  This is a joint project (2020-2024) led by the University of Sheffield and collaborating with Bournemouth University, the University of Huddersfield, Manmohan Memorial Institute of Health Sciences (MMIHS) and PHASE Nepal.  This longitudinal interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1].

 

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health (CMMPH)