Tagged / Health systems

Federalisation & health research presented in Nepal

BU Challenges, international, Knowledge Exchange, Publishing, writing

Last month we reported on this Bournemouth University Research Blog (click here!) that Ms. Amshu Dhakal, presented findings from our Nepal Federal Health System Project in Nepal.  Amshu’s presentation at the Nepal Health Conclave 2024, organised by the Ministry of Health and Population and supported by WHO (World Health Organization) Nepal and UNFPA, resulted in an online article in Nepal.  This article in Nepali in Swasthya Khabar Patrika features lessons learnt and evidence from our research project “The Impact of Federalisation on the Health System of Nepal.”
Our project ran from 2020 to 2024, and it was funded by the Health System Research Initiative, a UK collaboration between three funders: the MRC (Medical research Council), the Foreign, Commonwealth & Development Office, and the Welcome Trust.  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 Manmohan Memorial Institute of Health Sciences and PHASE Nepal.  In 2023 further funding was awarded by the Medical Research Foundation to Prof. Julie Balen, from Canterbury Christ Church University, to disseminate the findings in Nepal.  Furthermore, to date we have published eight papers from this interdisciplinary project [1-8].
This is one of several news articles from this project which have appeared in both English and Nepali in national media in Nepal.  In early 2024 two daily English-language media outlets: The Annapurna Express and Gazzabkoo Magazine published articles covering our project.  The latter used the title ‘Strengthening Health Systems for Better Health‘ and the former opted for the headline ‘Forum on health system strengthening’.
In the same month last year three UK professors: Julie Balen (Canterbury Christ Church University), Simon Rushton (the University of Sheffield) and Edwin van Teijlingen (Bournemouth University) were interviewed (see interview here) about the study.  Our interdisciplinary research project ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’ was also previously reported in several national media in Nepal in the spring of 2023. 
 
Prof. Edwin van Teijlingen
Centre of 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

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

BU e-health paper read 4,000 times

international, Publishing, Women's Academic Network, writing

Our paper ‘Midwives’ views towards women using mHealth and eHealth to self-monitor their pregnancy: A systematic review of the literature’ [1] reached 4,000 reads on ResearchGate today.  Obviously, there is a growing interest in the use of mobile apps as well as the more general application of mHealth and eHealth in the UK and elsewhere.

 

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health

Reference:

  1. Vickery, M., van Teijlingen, E., Hundley, V., Smith, G. B., Way, S., Westwood, G. (2020). Midwives’ views towards women using mHealth and eHealth to self-monitor their pregnancy: A systematic review of the literature. European Journal of Midwifery, 4: 1-11. https://doi.org/10.18332/ejm/126625

BU Workshop on Health Systems in Nepal

open access, writing

You are invited to a two-hour ‘Workshop on Health Systems in Nepal’ at Bournemouth University (BU) on Thursday 25th May in the Bournemouth Gateway Building (BGB room 315) starting at 14.00, aiming to finish at 16.00.  We have the pleasure of welcoming three academic visitors from Manmohan Memorial Institute of Health Sciences (MMIHS) in Kathmandu who are at BU on an Erasmus+ exchange.

‘Prof. Sujan Marahatta, Dr. Sujata Sapkota and Dr. Sujan Gautam from MMIHS are part of an international project examining the consequences for the health system of Nepal’s move to a federal government structure.  This project, launched in 2020 at the beginning of the COVID-19 pandemic, is led by the University of Sheffield, in collaboration with BU, the University of Huddersfield, PHASE Nepal and MMIHS.  This nearly four-year project is UK-funded by the MRC (Medical Research Council), the Wellcome Trust and DFID (now called Foreign, Commonwealth & Development Office [FCDO]) under the Health Systems Research Initiative.

The project has resulted in several publications, all in Open Access journals.  The first of three papers introduced the research project ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’ [1], the second focused on COVID-19 when examining the effects of changing Nepal’s constitution towards a federal republic on its health system [2], and the third one highlighted  Public Health approaches around the ongoing federalisation of the state of Nepal and the associated decentralisation processes in its health system [3].

 

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (formerly CMMPH)

 

References:

  1. Sapkota, S., Panday, S., Wasti, S.P., Lee, A., Balen, J., van Teijlingen, E., Rushton, S., Subedi, M., Gautam, S., Karki, J., Adhikary, P., Marahatta, S., Simkhada, P. for the Nepal Federal Health System Team (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of Nepal Public Health Association 7 (1): 36-42.
  2. Rushton, S., Pandey, S., van Teijlingen, E., Subedi, M., Balen, J., Karki, J., Simkhada, P. on behalf of the Nepal Federal Health System Team (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
  3. Adhikary, P., Balen, J., Gautam, S., Ghimire S., Karki J.K., Lee A.C., Marahatta S.B., Pandey S., Pohl G., Ruston S., Sapkota S., Simkhada P.P., Subedi M., van Teijlingen E.R., on behalf of the NFHS Team (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)

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)

Summit of Health & Population Scientists in Nepal 2022

international, Publishing, writing

Today say the start of the Eight National Summit of Health & Population Scientists in Nepal.  Bournemouth University is involved in two presentation.  The first will be one by University of Huddersfield PhD student Tamang Pasang, and her supervisors Prof. Padam Simkhada (FHSS Visiting Faculty), Dr. Bibha Simkhada (former BU Lecturer in Nursing and current FHSS Visiting Faculty) and Prof. Edwin van Teijlingen.  Pasang will be talking about her thesis fieldwork: ‘Impact of Federalisation in Maintaining Quality of Maternal and Neonatal Care in Nepalese Health System’.

The second presentation will focus 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 led by the University of Sheffield with Bournemouth University, the University of Huddersfield, and two institutions in Nepal: Manmohan Memorial Institute of Health Sciences MMIHS) and PHASE Nepal.  This interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref.
MR/T023554/1]. 

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternity & Perinatal Health (CMMPH)

 

 

FHSS PhD student’s poster at prestigious GLOW conference

conferences, international, PG research, Publishing, student research, Women's Academic Network, writing

Today and tomorrow Sulochana Dhakal-Rai will have her poster ‘Factors contributing to rising Caesarean Section rates in South Asia: a systematic review’ online at this year’s GLOW Conference [Global Women’s Research Society Conference].  This year for the first time, this international conference is held completely online.  Sulochana’s PhD project is supervised by Dr. Pramod Regmi, P., Dr. Juliet Wood and Prof Edwin van  Teijlingen at BU with Prof. Ganesh Dangal [Professor of Obstetrics and Gynaecology at Kathmandu Model Hospital] who acts as local supervisor in Nepal.  Sulochana has already published two papers from her on-going thesis research [1-2].

References

  1. Dhakal-Rai, S., Regmi, PR, van Teijlingen, E, Wood, J., Dangal G, Dhakal, KB. (2018) Rising Rate of Caesarean Section in Urban Nepal, Journal of Nepal Health Research Council 16(41): 479-80.
  2. Dhakal Rai, S., Poobalan, A., Jan, R., Bogren, M., Wood, J., Dangal, G., Regmi, P., van Teijlingen, E., Dhakal, K.B., Badar, S.J., Shahid, F. (2019) Caesarean Section rates in South Asian cities: Can midwifery help stem the rise? Journal of Asian Midwives, 6(2):4–22.

Building Strong Primary Health Care in Nepal

international, Publishing, writing

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