Tagged / Nepal

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

 

Congratulations to Dr. Pratik Adhikary

Congratulations to Dr. Pratik Adhikary on the fifth (and final paper) from his PhD in the Faculty of Health & Social Sciences. This latest paper ‘Support networks in the Middle East & Malaysia: A qualitative study of Nepali returnee migrants’ experiences’ was recently published in the International Journal of Occupational Safety and Health [1].

This is one of the few studies focusing on the support networks of Nepali migrant worker in the Middle East and Malaysia.  The previous four papers have focused more on living conditions and working conditions of migrant workers as well as occupational health and safety abroad [2-5].

 

References:

  1. Adhikary P, van Teijlingen E. (2019) Support networks in the Middle East & Malaysia: A qualitative study of Nepali returnee migrants’ experiences’ – International Journal of Occupational Safety and Health  9(2): 31-35.
  2. 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
  3. Adhikary P, Sheppard, Z., Keen S., van Teijlingen E. (2018) Health and well-being of Nepalese migrant workers abroad, International Journal of Migration, Health and Social Care 14(1): 96-105.   https://doi.org/10.1108/IJMHSC-12-2015-0052
  4. Adhikary, P., Sheppard, Z., Keen, S., van Teijlingen, E. (2017) Risky work: Accidents among Nepalese migrant workers in Malaysia, Qatar and Saudi, Health Prospect 16(2): 3-10.
  5. Adhikary P., Keen S., van Teijlingen, E. (2011) Health Issues among Nepalese migrant workers in Middle East. Health Science Journal 5: 169-175. www.hsj.gr/volume5/issue3/532.pdf

The last Christmas present

“On the twelfth day of Christmas ….” the editor  of the Journal of Health Research Ms Sunanta Wongchalee informed us that our paper ‘Silicone use in Nepali transgender women: The hazards of beauty’ has been accepted for publication [1].  That is nice belated Christmas present to receive on January 6th and a good start of the New Year.  The paper is written by FHSS’s Dr. Pramod Regmi and Prof. Edwin van Teijlingen with Sanjeev Raj Neupane in Nepal.  This is the second paper from this unique study on transgender women in Nepal, the first one was published last year in BMJ Open [2].

References:

  1. Regmi, P., van Teijlingen, E.,, Neupane, S. (2020) Silicone use in Nepali transgender women: The hazards of beauty, Journal of Health Research (accepted)
  2. Regmi, P., van Teijlingen, E., Neupane, S., Marahatta, S. (2019) Hormone use among Nepali transgender women: a qualitative study, BMJ Open 9: e030464. doi:10.1136/bmjopen-2019-030464.

 

Nepal’s migrant workers & risk at the workplace

For nearly a decade BU researchers have published widely about the hazards and risk of Nepali migrant workers in Asia and the Middle East [1-9].  Despite the fact that most migrant workers end up in semi-skilled and unskilled jobs in their host countries, only a minority report poor working environments.  For example, in Pratik Adhikary’s PhD study in FHSS only just over a fifth of migrant workers reported that their work environment in the Middle East or Malaysia was poor or very poor [4].  This relatively high level of satisfaction appears to seems contradict reports in local media on the risks associated with Nepali migrants working abroad, especially focusing on the football world cup in Qatar [7], official reports that many hundreds of bodies of dead Nepali migrants return home every year [10], and the fact that many of these Nepali migrant workers end up doing the jobs the local populations finds too dirty, dangerous and demeaning (colloquially referred to as 3D-jobs).  Why do so many who travel abroad take to do risky, dirty and otherwise undesirable jobs, but still assess their working environment as not too bad?

More theoretical papers on the drivers of migration have referred to many interconnected factors and links [11-12].  Local drivers in Nepal include poverty, lack of employment opportunities, having a history of work-related migration, a growing culture of migration (i.e. it becomes more or less an expectation) and many more.  One local element that is perhaps too easily ignored is that many Nepali migrant workers would have ended up in dirty, dangerous and demeaning jobs at home too.  And the risk, on for example building sites in Nepal might be even greater than that in Qatar or elsewhere in the Middle East as some of the photos below illustrate.  These photos of an accident involving an external building lift were taken today on a building site in Kathmandu.  

 

 

 

 

 

 

 

 

 

 

References:

  1. 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
  2. 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.
  3. Simkhada, P.P., Regmi, P.R.van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature. Journal of Travel Medicine, 24 (4). https://doi.org/10.3126/nje.v9i3.25805
  4. 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
  5. Regmi, P.van Teijlingen, E.Mahato, P.Aryal, N., Jadhav, N., Simkhada, P., Zahiruddin, Q.S., Gaidhane, A. (2019) The Health of Nepali Migrants in India: A Qualitative Study of Lifestyles and Risks. International Journal of Environmental Research and Public Health, 16 (19). https://doi.org/10.3390/ijerph16193655
  6. Aryal, N., Regmi, P.R., Faller, E.M., van Teijlingen, E., Khoon, C.C., Pereira, A., Simkhada, P. (2019) Sudden cardiac death and kidney health related problems among Nepali migrant workers in Malaysia. Nepal Journal of Epidemiology, 9 (3), 788-791. https://doi.org/10.3126/nje.v9i3.25805
  7. 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
  8. Regmi, P., van Teijlingen, E., Mahato, P., Aryal, N., Jadhav, N., Simkhada, P., Syed Zahiruddin, Q., Gaidhane, A., (2019) The health of Nepali migrants in India: A qualitative study of lifestyles and risks, Journal of Environmental Research & Public Health 16(19), 3655; doi:10.3390/ijerph16193655.
  9. Regmi, P., Aryal, N., van Teijlingen, E., Adhikary, P. (2019) Nepali migrant workers and the need for pre-departure training on mental health: a qualitative study, Journal of Immigrant & Minority Health https://link.springer.com/content/pdf/10.1007/s10903-019-00960-z.pdf
  10. Ministry of Labour and Employment, Government of Nepal. (2018) Labour migration for employment: a status report for Nepal: 2015/2016 – 2016/2017. In. Kathmandu, Nepal: Ministry of Labour and Employment.
  11. Van Hear, N., Bakewell, O., Long. K. (2018) Push-pull plus: reconsidering the drivers of migration, Journal of Ethnic & Migration Studies, 44:6, 927-944, DOI: 10.1080/1369183X.2017.1384135
  12. Iqbal, M., Gusman, Y. (2015) Pull and Push Factors of Indonesian women migrant workers from Indramayu (West Java) to work abroad. Mediterranean Journal of Social Sciences, 6(5): 167   https://www.mcser.org/journal/index.php/mjss/article/view/7893