Tagged / Nepal

Building Strong Primary Health Care in Nepal

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

 

New COVID-19 publication by FHSS academics

Congratulations to Dr. Preeti Mahato, Dr. Nirmal Aryal and Dr. Pramod Regmi  in the Faculty of Health & Social Sciences on their latest COVID-19 publication.  Yesterday the Europasian Journal of Medical Sciences informed us of its acceptance of the article ‘Effects of COVID-19 during lockdown in Nepal’ [1].  The Europasian Journal of Medical Sciences is a peer-reviewed Open-Accessed journal which is published biannually online as well as in print version. It is an official publication of the Nirvana Psychosocial Care Center & Research Institute.

This is the fifth COVID-19 publication by our team since lock down began (in both the UK and Nepal).  Previous publications with colleagues based in the UK and elsewhere across the globe focused on maternity care, public health, Nepal and the apparent effect of COVID-19 on people from ethnic minorities int he UK [2-5].

 

Prof. Edwin van Teijlingen

CMMPH (Centre for Midwifery, Maternal & Perinatal Health)

 

References:

  1. Mahato, P., Tamang, P., Shahi, P., Aryal, N., Regmi, P., van Teijlingen, E., Simkhada, P. (2020) Effects of COVID-19 during lockdown in Nepal, Europasian Journal of Medical Sciences (accepted).
  2. Sathian, B., Asim, M., Mekkodathil, A., van Teijlingen, E., Subramanya, S.H., Simkhada, S.,Marahatta, S.B., Shrestha, U.M. (2020) Impact of COVID-19 on community health: A systematic review of a population of 82 million, Journal of Advanced Internal Medicine 9(1): 4-11https://www.nepjol.info/index.php/JAIM/article/view/29159
  3. Tamang, P., Mahato, P., van Teijlingen E, Simkhada, P. (2020) Pregnancy and COVID-19: Lessons so far, Healthy Newborn Network [14 April] healthynewbornnetwork.org/blog/pregnancy-and-covid-19-lessons-so-far/
  4. Asim, M., Sathian, B., van Teijlingen, E.R., Mekkodathil, A., Subramanya, S.H., Simkhada, P. (2020) COVID-19 Pandemic: Public Health Implications in Nepal, Nepal Journal of Epidemiology 10 (1): 817-820. https://www.nepjol.info/index.php/NJE/article/view/28269
  5. Alloh, F.T., Regmi, P., van Teijlingen, E. (2020) Is ethnicity linked to incidence or outcomes of Covid-19? (Rapid Response) BMJ (14 May) 369:m1548

Widespread media coverage in Nepal for BU researcher

This week Dr. Preeti Mahato in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) appeared in several newspapers and new website in Nepal. The media reported both in Nepali [1-4] and in English, the latter in South Asia Time [5] on her recently published paper on birthing centres in Nepal.  This latest paper from her PhD was published in the scientific journal  PLoS ONE [6].  The paper is co-authored by CMMPH’s Dr.Catherene Angell, Prof.Edwin van Teijlingen and Prof. Vanora Hundley as well as BU Visiting Professor Padam Simkhada (Associate Dean International at the School of Human and Health Sciences, University of Huddersfield.

We are very grateful to BU’s Dr. Nirmal Aryal for engaging with all his media contacts in Nepal to achieve this great coverage.

 

References:

  1. https://ekantipur.com/diaspora/2020/06/02/159107091260531499.html
  2.  https://www.nepalilink.com/2020/06/02/5326.html
  3. http://www.nepalbritain.com/?p=79336
  4. https://globalnepalese.com/post/2020-06-942777589?fbclid=IwAR3RJlHpeG4p3PdryUWzhvCDG0yiYjNrdnQZNJo4uzznyuFA8cF6DKLbKU8 
  5. https://www.southasiatime.com/2020/06/04/birthing-centers-are-savings-lives-in-rural-nepal/
  6. Mahato, P., van Teijlingen, E., Simkhada, P., Angell, C., Hundley, V. (2020), Evaluation of a health promotion intervention associated with birthing centres in rural Nepal PLoS One 15(5): e0233607. https://doi.org/10.1371/journal.pone.0233607

New BU publication on birth centres in Nepal

Congratulations to Dr. Preeti Mahato in the Centre for Midwifery, Maternal & Perintal Helath (CMMPH) on the acceptance of the  paper ‘ Evaluation of a health promotion intervention associated with birthing centres in rural Nepal’.   This paper is part of Dr. Mahato’s PhD work and will appear soon in the international journal PLOS ONE.   The journal is Open Access so anyone across the world may copy, distribute, or reuse these articles, as long as the author and original source are properly cited.

The research in this thesis used a longitudinal study design where pre-intervention survey was conducted by Green Tara Nepal a local non-governmental organisation (NGO) in year 2012.  The health promotion intervention was conducted by the same NGO in the period 2014 to 2016 and the post-intervention survey was conducted by Dr Mahato in the year 2017.

The intervention was financially supported by a London-based Buddhist charity called Green Tara Trust.   The results of the pre- and post-intervention surveys were compared to identify statistically significant changes that might have occurred due to the intervention and also to determine the factors affecting place of birth.   This study is co-authored by Professors Edwin van Teijlingen and Vanora Hundley and Dr Catherine Angell from CMMPH and FHSS Visiting Professor Padam Simkhada (based at the University of Huddersfield).

 

 

BU midwifery paper cited in WHO report

Last week the Regional Office for South East Asia of the WHO (World Health Organization) published its strategy for strengthening midwifery [1].  The report highlights how Bangladesh, India and Nepal have recently introduced midwifery education. They joined DPR Korea, Myanmar, Sri Lanka and TimorLeste in establishing midwives as an independent cadre of the health workforce.

This report cited our 2015 paper on midwifery developments in Nepal which appeared in the Journal of Asian Midwives [2].  The lead author Jillian Ireland is a Visiting Faculty in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) and Professional Midwifery Advocate at Poole Hospital NHS Foundation Trust, my other co-author, Joy Kemp, is Global Professional Adviser at the Royal College of Midwives (RCM).  The paper reflects on the RCM Global Midwifery Twinning Project in Nepal.  The paper argues that the presence of a strong professional association of midwives in a country yields double benefits. On one side, the association provides inputs into framing policies and developing standards of care, and on the other, it ensures quality services by continuously updating its members with information and evidence for practice.

Bournemouth University’s work in Nepal is ongoing with a project run by CMMPH helping to develop midwifery education and training the trainers funded by the German aid organisation GIZ (Deutsche Gesellschaft für Internationale Zusammenarbeit).

 

References:

  1. World Health Organization. Regional Office for South-East Asia (2020) Regional Strategic Directions for strengthening Midwifery in the South-East Asia Region 2020–2024, Delhi: World Health Organization. Regional Office for South-East Asia.
  2. Ireland, J., van Teijlingen, E, Kemp J. (2015) Twinning in Nepal: the Royal College of Midwives UK and the Midwifery Society of Nepal working in partnership, Journal of Asian Midwives 2 (1): 26-33. http://ecommons.aku.edu/jam/vol2/iss1/5/

 

Motor Neurone Disease

Last night I watched the film ‘The Theory of Everything’ on television. This Oscar-winning film about the live of the brilliant scientist Stephen Hawkins, who was diagnosed with Motor Neurone Disease (MND). MND is also known as Amyotrophic Lateral Sclerosis (ALS) or, as it is known in North America, Lou Gehrig’s disease, named after a famous American professional baseball player who died of MND in 1941.  MND is a group of diseases that affect the nerves (motor neurones) in the brain and spinal cord that tell your muscles what to do. Two decades ago we did some research on the impact on carers of people living with MND in Scotland [1].


Watching ‘The Theory of Everything’  reminded me of Professor Holger Schutkowski in the Department of Archaeology, Anthropology & Forensic Science at Bournemouth University who died two weeks ago.  He spent the last year of his life in a wheelchair and on his memorial website (click here for link) is a request from his family to donate to the MND Association.  Holger was a great colleague, intelligent, kind and passionate about his work and the world of academia.  Holger was someone whom you could have proper academic and political arguments.  I found this out in Kathmandu in 2013 as I didn’t really know Holger very well before I went to Nepal with him an BU trip.

 

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health (CMMPH)

 

Reference

  1. van Teijlingen E, Friend E, Kamal, AD (2001) Service use & needs of people with Motor Neurone Disease & carers in Scotland, Health & Social Care in the Community 9: 397-403.

Psychological skills for health workers in Nepal

Yesterday  Dr. Shanti Shanker (Lecturer in Psychology), BU Visiting Faculty Jillian Ireland and I produced a short three-minute video for health care workers in Nepal on the topic of living with uncertainty and the COVID-19 virus. Hopefully this will be the first in a series from our Bournemouth University team.  The video is based on work funded by GCRF in the United Kingdom and supported by two NGOs (non-Governmental Organisations): (a) Sheetal Astitva and  (b) Green Taral Nepal as well as Symbiosis International (Deemed University).

This video can be accessed here!

Prof. Edwin van Teijlingen
CMMPH

Nepal publication: Smoking & suicide ideation

Published earlier this week in the Nepal Journal of Epidemiology a BU co-authored paper on ‘Cigarette smoking dose-response and suicidal ideation among young people in Nepal: a cross-sectional study’ [1].   The authors conducted a cross-sectional questionnaire-based survey with 452 young people in Nepal’s second largest city Pokhara.  The study matched participants by age and smoking status. The mean age was 21.6 years and 58.8% were males. The overall rate of suicidal ideation in our cohort was 8.9%. Smokers were slightly more likely to report suicidal ideation than non-smokers (aOR 1.12). The risk of developing suicidal ideation was 3.56 (95% CI 1.26-10.09) times more in individuals who smoked greater than 3.5 cigarettes per week (p=0.01).
The paper concludes that the rate of suicidal ideation was slightly higher among smokers and a dose-response relationship  existed linked with the number of cigarettes smoked per week. Being aware of the link between smoking and
suicidal ideation may help health care professionals working with young people to address more effectively the issues of mental well-being and thoughts about suicide.  The Nepal Journal of Epidemiology is an Open Access journal hence this public health  paper is freely available to readers across the globe.

Reference:

  1. Sathian, B., Menezes, R.G., Asim, M., Mekkodathil, A., Sreedharan, J., Banerjee, I., van Teijlingen, E.R., Roy, B., Subramanya, S.H., .Kharoshah, M.A., Rajesh, E., Shetty, U., Arun, M., Ram, P., Srivastava, V.K. (2020) Cigarette smoking dose-response and suicidal ideation among young people in Nepal: a cross-sectional study, Nepal Journal of Epidemiology 10 (1): 821-829 https://www.nepjol.info/index.php/NJE/article/view/28277

COVID-19 Pandemic: Public Health Implications in Nepal

Our editorial today in the Nepal Journal of Epidemiology highlights some of the key issues related to COVID-19 related to a low-income country such as Nepal [1].  There are various Public Health challenges to preventing the spread of COVID-19 in South Asia including Nepal. Learning from the  COVID-19 outbreak in China, there will be slowdown of economic activity with damaged supply chains which impact upon the public health systems in Nepal. Moreover, there is limited coordination among different stakeholders in healthcare management with few policies in place for infection prevention and control, shortage of testing kits and medical supplies (shortages of masks, gloves), and poor reporting are major challenges to be tackled in case of the COVID-19.

All South Asian countries are vulnerable to a mass outbreak with high population density in cities which is challenging to create social distancing, made worse by generally poor hygiene and often low (health) literacy. Additionally, some COVID-19 cases remain asymptomatic; so it is difficult to predict the epidemic outbreak that may introduces further difficulty in diagnosis of newer cases. Finally, healthcare workers across the globe were infected at high rates during the MERS and SARS outbreaks, so Nepal has to initiate health workers’ training including simulation exercises to provide health staff with a clearer picture of the complexities and challenges associated with COVID-19 and containing potential outbreaks.

This editorial has a very different time span between submission and publication than the one highlighted last week on the BU Research Blog (see details here!).  This  COVID-19 editorial took exactly one month between submission and publication, the one mentioned last week took  three-and-a-half years between submission and publication.

 

Prof. Edwin van Teijlingen

CMMPH

Reference:

  1. Asim, M., Sathian, B., van Teijlingen, E.R., Mekkodathil, A., Subramanya, S.H., Simkhada, P. (2020) COVID-19 Pandemic: Public Health Implications in Nepal, Nepal Journal of Epidemiology 10 (1): 817-820. https://www.nepjol.info/index.php/NJE/article/view/28269

Nepal reproductive health paper published yesterday

Congratulations on the latest paper published yesterday by Dr. Preeti Mahato in the Centre for Midwifery, Maternal & Reproductive Health (CMMPH) and colleagues.   This paper ‘Factors associated with contraceptive use in rural Nepal: Gender and decision-making’ [1], is freely available for the next 49 days through our personalized link: click here

 

This research paper in the journal Sexual and Reproductive Healthcare reports on a secondary analysis of pas a quantitative cross-sectional study in four villages of a hilly district in Nepal.  This authors found that gender was associated with current/ever use of contraceptives but decision-making was not found associated with current/eve use of contraceptives.  And, as perhaps was to be expected, socio-economic factors such as husband’s and wife’s education; and indicators showing sharing of childcare responsibilities were found to be associated with contraceptive use.   the paper concludes that educational, health promotional and family planning programmes involving husbands are needed to promote use of contraceptives.


Preeti’s co-authors are based at Dorset County Hospital in Dorchester, at CMMPH and at Singapore Clinical Research Institute/Duke-NUS Graduate Medical School, Singapore.

 

Reference:

  1. Mahato, P., van Teijlingen, E., De Souza, N., Sheppard, Z. (2020) Factors associated with contraceptive use in rural Nepal: gender and decision-making, Sexual & Reproductive Healthcare 24: 100507 https://doi.org/10.1016/j.srhc.2020.100507