Tagged / Nepal

New BU mental health publication

Congratulations to Faloshade Alloh (PhD student in Faculty of Health and Social Science), Dr. Pramod Regmi (Lecturer in International Health), Abe (Igoche) Onche (BU  graduate MSc in Public Health) and Dr. Stephen Trenoweth (Principal Academic and Leaded for BU iWell Research Centre) on the timely publication of their paper on mental health in developing countries [1]. 

Despite being globally recognised as an important public health issue, mental health is still less prioritised as a disease burden in many Low-and Middle-Income Countries (LMICs). More than 70% of the global mental health burden occurs in poorer countries. The paper addresses mental health issues in LMICs under themes such as abuse and mental illness, cultural influence on mental health, need for dignity in care, meeting financial and workforce gaps and the need for national health policy for the mental health sector.  This exciting paper has 51 references including several linking to BU publications on research in Africa [2-3] and several papers related to South Asia [4-6], particularly highlighting the recently completed THET project that was led by BU [4-5].

The authors highlight that although mental health education and health care services in most LMICs are poorly resourced; there is an urgent need to address issues beyond funding that contribute to poor mental health. In order to meet the increasing challenge of mental health illness in LMICs, there is a need for effort to address cultural and professional challenges that contribute to poor mental health among individuals. The authors suggest that mental health should be integrated into primary health care in LMICs. Creating awareness on the impact of some cultural attitudes/practices will encourage better uptake of mental health services and increase the ease when discussing mental health issues in these countries which can contribute to reducing the poor mental health in LMICs.

 

Well done!

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal and Perinatal Health (CMMPH)

 

Click here to view the full publication.

 

References:

  1. Alloh, F.T., Regmi, P., Onche, I., van Teijlingen E., Trenoweth, S. (2018) Mental health in low- and middle income countries (LMICs): Going beyond the need for funding, Health Prospect 17 (1): 12-17.
  2. Alloh F, Regmi P, Hemingway A, Turner-Wilson A. (2018) Increasing suicide rates in Nigeria. African Health Journal  [In Press].
  3. Alloh FT, Regmi PR. (2017) Effect of economic and security challenges on the Nigerian health sector. African Health Sciences. 17 (2):591-2.
  4. Acharya DR, Bell JS, Simkhada P, van Teijlingen ER, Regmi PR. (2010) Women’s autonomy in household decision-making: a demographic study in Nepal. Reproductive Health. 7 (1):15.
  5. Simkhada B, Sharma G, Pradhan S, Van Teijlingen E, Ireland J, Simkhada P, et al. (2016) Needs assessment of mental health training for Auxiliary Nurse Midwives: a cross-sectional survey. Journal of Manmohan Memorial Institute of Health Sciences. 2:20-6.
  6. Mahato, P., van Teijlingen, E., Simkhada, P., Angell, C., Ireland, J. on behalf of THET team (2018) Qualitative evaluation of mental health training of Auxiliary Nurse Midwives in rural Nepal. Nurse Education Today 66: 44-50. https://authors.elsevier.com/c/1Wu2axHa5G~S-
  7. Regmi PR, Alloh F, Pant PR, Simkhada P, van Teijlingen E. (2017) Mental health in BME groups with diabetes: an overlooked issue? The Lancet389 (10072):904-5.

New GCRF-funded study in South Asia

A new multidisciplinary project in South Asia, run between two of Bournemouth University’s Faculties, has recently been funded.  The cross-faculty project “Scoping Study to understand the maternal health ageing and wellness in rural India to develop a grass-root centre addressing these issues” has Dr Shanti Shanker (Psychology) as its principal investigator in collaboration with Prof Edwin van Teijlingen (Human Sciences & Public Health).   These BU lead researchers have been working in India and Nepal for more than a decade.

This project was recently awarded £76k from the HEFCE GCRF (Higher Education Funding Council for England, Global Challenge Research Funds) Call, at Bournemouth University.  The project will be running from 2017 to 2021 between Maharashtra, India, Nepal and the UK.  This important research initiative  aligns closely with Bournemouth University’s strategic plan around South Asia through Connect India.  Connect India is BU’s hub of practice which focuses on the world’s most populated areas and a global region which is developing rapidly in many ways.

Dr. Regmi on Editorial Board Journal of Global Health Reports

Dr. Pramod Regmi, FHSS Lecturer in International Health has been appointed as an Editorial Board Member for the Journal of Global Health Reports.   This journal is affiliated with the Journal of Global Health (www.jogh.org).   The Journal of Global Health Reports focuses on “Promoting local research to improve global health”  It is open to all local, small-scale, context-specific studies in global health, both qualitative and quantitative, as long as they are conducted in a rigorous and replicable way and report their results properly.

 

Congratulations!

Prof. Edwin van Teijlingen

CMMPH

 

 

 

Good representation BU research at 2018 BNAC conference

Today on the second day of the 2018 BNAC (Britain-Nepal Academic Council) conference there was a very good representation of Bournemouth University (BU) research at Durham University.  BU’s Professor Michael Wilmore presented his paper: Construction of ‘Community’ in Research on Nepalese Commons.  In the morning FHSS’s PhD student Jib Acharya had an oral presentation on Impact of Healthy Snacks on Children’s Health: An Overview of a Pilot Study.

Prof. Edwin van Teijlingen presented joint work between BU, Liverpool John Moors University (LJMU) and the University of Oxford on the topic Skills transfer, employability & entrepreneurship of returnee labour migrants in Nepal. Bournemouth University was involved in this project through Dr. Pramod Regmi, Dr. Nirmal Aryal and Prof. Edwin van Teijlingen.

The final talk of the day (and of the conference) was by Prof. Padam Simkhada from LJMU.  Prof. Simkhada is also Visiting Professor at the Centre for Midwifery, Maternal & Perinatal Health at Bournemouth University.  He was presenting Debate on Educational Reform in Nepal: Outcomes of the International Conference on Quality of Higher Education in Federal Nepal on behalf of LJMU, Bournemouth University and Manmohan Memorial Institute of Health Sciences (MMIHS) in Nepal.  Earlier this year BU signed a Memorandum of Agreement with MMIHS in Kathmandu.

 

Congratulations to two FHSS PhD students

Congratulations to two Faculty of Health & Social Sciences PhD students, Preeti Mahato and Elizabeth Waikhaka, who co-authored a paper published in the WHO South-East Asia Journal of Public Health. Their paper is called ‘Social autopsy: a potential health-promotion tool for preventing maternal mortality in low-income countries’.[1]   Co-authors include Dr. Puspa Pant from the Centre for Child and Adolescent Health, University of the West of England (Bristol) and Dr. Animesh Biswas based at the Reproductive & Child Health Department, Centre for Injury Prevention & Research, Bangladesh (CIPRB) in the capital of Bangladesh, Dhaka.

The authors argue that verbal autopsy is used to attribute a clinical cause to a maternal death.  The aim of social autopsy is to determine the non-clinical contributing factors. A social autopsy of a maternal death is a group interaction with the family of the deceased woman and her wider local community, where facilitators explore the social causes of the death and identify improvements needed. Although still relatively new, the process has proved useful to capture data for policy-makers on the social determinants of maternal deaths. This article highlights the potential role of social autopsy in health promotion.

Reference:

  1. Mahato, P.K, Waithaka, E., van Teijlingen, E., Pant, P.R., Biswas, A. (2018) Social autopsy: a potential health-promotion tool for preventing maternal mortality in low-income countries. WHO South-East Asia Journal of Public Health 7(1): 24–28.

E-poster presented by CMMPH student Preeti Mahato in Singapore

Last week I attended and presented e-poster at the RCOG (Royal College of Obstetrics & Gynaecology) World Congress 2018 in Singapore. The main congress programme run 22 to 24 March. RCOG president Professor Lesley Regan told in her opening speech that this Congress had more than 2,800 delegates and 150 speakers from 82 countries. Prof Regan also said that the Congress focused on the need for all to work in the field of obstetrics and gynaecology and to act as advocates for women’s health. Furthermore, she stressed that it is necessary to look beyond clinical aspects and provide safe, high-quality care to speak for the needs of the women, many of whom have no choice of their own.

The e-poster I presented ‘Study of rural maternity and childbirth care in a southern district of Nepal’ is part of my PhD study on maternity care in Nepal.

My e-poster

 

 

 

 

 

 

 

My poster was displayed on the morning of 22nd March (8:08– 8:16 AM) under the topic ‘early pregnancy and acute gynaecology’. Over the three days programme schedule, I also attended several plenary sessions, oral presentations and viewed many e-posters. Although there were many topics specific to clinical aspects of obstetrics and gynaecology, I was mostly interested in presentations related to contraception and fertility control, abortion, gender equality, reproductive and sexual health of marginalised communities, female genital mutilation, breastfeeding and so on. Overall, it was a great experience to learn about research in women’s health and maternity care and an opportunity to do networking with researchers with similar interests.

Finally, I would like to thank Santander Awards to provide me fund to cover my expenses to attend this congress and my supervisors for motivating me to apply for this conference.

New CMMPH paper accepted in Nurse Education Today

Congratulations to Mrs. Preeti Mahato on the acceptance of her paper ‘Qualitative evaluation of mental health training of Auxiliary Nurse Midwives in rural Nepal’ by Nurse Education Today, an academic journal published by Elsevier.   Preeti is currently registered as PhD student in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH).  The paper is co-authored by CMMPH’s Catherine Angell and Edwin van Teijlingen as well as BU Visiting Faculty Padam Simkhada and Jillian Ireland.  The paper is a result of the evaluation part of the ‘Mental Health Training for Community-based Maternity Providers in Nepal’ project and written on behalf of this THET team.

Our THET project in Nepal is a collaboration between the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), Tribhuvan University (Nepal’s oldest university) and Liverpool John Moores University (LJMU). The project receives funding from DFID, and is managed through THET and supported locally in Nepal by a charity Green Tara Nepal.

 

THET team:

Edwin van Teijlingen, Padam Simkhada, Shyam K Maharjan Preeti Mahato, Bhimsen Devkota, Padmadharini Fanning, Jillian Ireland, Bibha Simkhada, Lokendra Sherchan, Ram Chandra Silwal, Shyam K Maharjan, Ram K Maharjan, Catherine Angell, Flora Douglas.

 

 

 

Why suicide rates among pregnant women in Nepal are rising

File 20180308 30989 ov7dje.jpg?ixlib=rb 1.1

Shutterstock/By KristinaSophie

By Bibha Simkhada, Liverpool John Moores University and Edwin van Teijlingen, Bournemouth University

Huge numbers of pregnant women and new mothers are taking their own lives in Nepal as they deal with extreme poverty, natural disasters, domestic violence and oppression. Research shows suicide represents 16% of all deaths in women of reproductive age. The rate is higher than previously recorded and there has been a considerable increase over the past few years. But a new project which trained midwives about mental health issues might hold the key to turning this around.

Suicide is primarily associated with unwanted pregnancy or the feeling of being trapped in poverty or situations of sexual and physical abuse. A study of 202 pregnant women (carried out between September and December 2014) found that 91% of them experienced some kind of physical, emotional or sexual abuse – mostly at the hands of their husbands and/or mother-in-laws.

The sad fact is that almost 40% of suicides in the world occur in South-East Asia. And one in three pregnant woman and new mothers are taking their own lives in low-income countries. In Nepal, 21% of the suicides among women aged 15-49 were in girls under 18 due to violence and being powerless in their families and communities.

Pregnancy is a known trigger for mental health problems. But gender discrimination and domestic violence are making matters worse. In addition to these issues, natural disasters are also a huge contributing factor to the spiralling mental health problems of young mothers.

A woman on a collapsed building in Kathmandu after the earthquake in May, 2015. Shutterstock/Somjin Klong-ugkara

Lack of control

In Nepal, making decisions about seeking maternity care is not in the hands of the pregnant woman but usually lies with her mother-in-law or husband. When young women marry they move in with their husbands’ family and their lives are ruled by their in-laws. These women often have little say in seeking health care during pregnancy, childbirth and the postnatal period.

In many poor families, husbands migrate for work leaving their young wives with family. Nepal has a real migrant workers economy with close to 50% of Nepalis relying on financial help from relatives abroad. Mental health problems can worsen for women who have been taken away from their own families. In other cases, young women face domestic violence due to their husbands’ drinking leading to mental health issues and suicide.

There is also a lack of understanding of pregnancy and childbirth-related mental health issues and husbands and mothers-in-law often fail to support these vulnerable young women. They in turn are reluctant to seek help due to the stigma associated with mental illness.

Cultural and social norms

Cultural practices and social norms, like gender inequalities and early marriage, hinder women who have a lack of choice when it comes to their role as mothers. There is also a preference for sons rather than daughters, who are seen as an “economic burden” in many families. If a woman is expecting a daughter, especially for the second or third time, this can also trigger mental health issues.

Depression and anxiety are common and affect ten to 15 out of every 100 pregnant women in the country. Postnatal depression is often reported, but less attention is given to more common and less obvious mental health issues.

Natural disasters and midwives

Recurrent earthquakes and floods exacerbate issues of depression and helplessness as women are forced to live in temporary shelters and have the burden of increased poverty.

For many rural Nepali women, the most qualified birth attendant they can expect to look after them is the Nepali Auxiliary Nurse Midwives (ANMs). But a study found that they received little or no formal training on perinatal mental health issues. Although there have been gradual improvements in health care for women during pregnancy, mental health support is leaving many women feeling that suicide is their only option.

As part of a Tropical Health and Education Trust project, funded by DFID, around 80 ANMs were trained on perinatal mental health issues. The project used UK-based volunteers in Nepal over two years.

The training helped raise awareness of mental health well-being and improved access to mental health care for pregnant women and new mothers. This is a vital first step towards improving community-based services for pregnant women in rural Nepal. But to offer hope to more young women there needs to be a significant increase in this type of training and awareness raising.

Bibha Simkhada, Postdoctoral Researcher in School of Nursing and Allied Health, Liverpool John Moores University and Edwin van Teijlingen, Professor of Reproductive Health Research, Bournemouth University

This article was originally published on The Conversation. Read the original article.