Tagged / Nepal

Congratulations to BU sociologist

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Congratulations to Dr. Shovita Dhakal Adhikari on the publication of her paper ‘Understanding ‘trafficking vulnerabilities’ among children: the responses linking to child protection issues in Nepal’ [1].  This academic paper was published earlier this month in the journal Children’s Geographies.   Shovita and her co-author Dr. Jackie Turton discuss child trafficking in Nepal within the broader framework of child protection.

The paper examines both individual (gender, ethnicity and caste) and structural (their experiences in relation to work, migration, education and lack of birth registration) vulnerabilities and their links with child trafficking as a child protection concern. The authors suggest there is a need for a more nuanced understanding of trafficking vulnerabilities as part of a continuum, rather than a distinct event, to improve outcomes for children. They use the evidence presented here to call for a holistic approach. Policies and programmes in Nepal and across the globe must be integrated within the broader concerns of child protection, thus strengthening the system from local to national level, while recognising the importance of children’s rights to participate in any decision-making.

Well done.

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

  1. Adhikari, S.D. & Turton, J. (2019) Understanding ‘trafficking vulnerabilities’ among children: the responses linking to child protection issues in Nepal, Children’s Geographies (online first) https://www.tandfonline.com/doi/full/10.1080/14733285.2019.1676398

 

New BU paper: Health of Nepali migrants in India

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Today the International Journal of Environmental Research and Public Health accepted our paper ‘The health of Nepali migrants in India: A qualitative study of lifestyles and risks’ [1].  The research in this paper was funded through Connect India is Bournemouth University’s Hub of Practice for the Indian subcontinent.  It brought together a community of researchers, educators, practitioners and students, both at Bournemouth University and across the Indian subcontinent.

The lead author, Dr. Pramod Regmi, is lecturer in International Health in the Department of Nursing & Clinical Science.  His co-authors are based in the UK, Nepal and India.  BU authors are: Pramod Regmi, Edwin van Teijlingen, Preeti Mahato and Nirmal Aryal as well as BU Visiting Faculty Prof. Padam Simkhada.  The  International Journal of Environmental Research and Public Health is an interdisciplinary Open Access journal, hence when published this paper will be freely available to readers across the globe, including India and Nepal.

Reference:

  1. 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 (forthcoming)

 

 

Migration & health research in Middle East & Malaysia

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Yesterday the Journal of Immigrant and Minority Health published the final version of Dr. Pratik Adhikary’s paper ‘Workplace Accidents Among Nepali Male Workers in the Middle East and Malaysia: A Qualitative Study’ [1].  This is the fourth paper originating from Pratik’s Ph.D. research conducted in the Faculty of Health & Social Sciences, the first three papers appeared in the period 2011-2018 [2-4].

The paper highlights that many Nepali men work in the Middle East and Malaysia and media reports and anecdotal evidence suggests they are at a high risk of workplace-related accidents and injuries for male Nepali workers.   Pratik’s Ph.D. study used face-to-face interviews to explore the personal experiences of twenty male Nepali migrants of unintentional injuries at their place of work.  His study found that almost half of study participants experienced work-related accident abroad. The Participants suggested that the reasons behind this are not only health and safety at work but also poor communication, taking risks by workers themselves, and perceived work pressure. Some participants experienced serious incidents causing life-long disability, extreme and harrowing accounts of injury but received no support from their employer or host countries.

The paper concludes that Nepali migrant workers are at a high risk of occupational injuries owing to a number of interrelated factors poor health and safety at work, pressure of work, risk taking practices, language barriers, and their general work environment. Both the Government of Nepal and host countries need to be better policing   existing policies; introduce better legislation where necessary; ensure universal health (insurance) coverage for labour migrants; and improve preventive measures to minimize the number and severity of accidents and injuries among migrant workers.

 

References:

  1. 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
  2. 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
  3. 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.
  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

 

Promoting Nursing CPD in Nepal

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Bournemouth University facilitated a Strategic planning meeting to develop a Continuing Professional Development (CPD) Framework for Nepal last week in Kathmandu. The planning meeting was held on 30th July 2019 at the Institute of Medicine IOM Maharajgunj Nursing Campus.  Midwifery is not formally recognised in Nepal, i.e. as a profession separate from nursing, therefore when refer to nursing CPD in this blog we mean both ‘nurses’ and ‘nurse-midwives’.

Bournemouth University is collaborating in this project with Liverpool John Moores University (LJMU) in the UK, the IOM Nursing Campus, the Nursing Association of Nepal (NAN), MIDSON, the Nepal Nursing Council (NNC) and several other key stakeholders in Nepal to support nursing regulatory bodies to establish mandatory CPD and/or post-registration training programmes relevant to their current practice in nursing. 

The Bournemouth team (led by Dr. Bibha Simkhada with Prof. Edwin van Teijlingen and Dr.Pramod Regmi) argued that CPD offers nurses the opportunity to maintain, improve and broaden knowledge, expertise and develop their personal and professional qualities to enhance practice and career development. Nepal has had limited process and progress in ensuring CPD for nurses and the uptake of post-registration education and training  programmes or CPD tends to be ad hoc.  Generally, CPD in Nepal remains under-developed as showing evidence of having received CPD is not currently a requirement of nurses when they re-register every five year.

This project is a good example of a BU FUSION project as our earlier Research in the form of a needs assessment will to the introduction of CPD which is of course, post-registration Education in nursing, helping to improve Practice in a low-income country.  We think we have had at least some impact on nursing in Nepal as the general feeling of our strategic planning meeting positive towards introducing CPD in the near future in Nepal.

 

 

New CMMPH publication on health promotion in post-earthquake Nepal

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Today saw the publication of a new paper from an international research team from the UK, Japan and Nepal.  Our research article ‘Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal’ has been published in the Open Access journal PLoS ONE [1]. 

The paper reminds us that natural disasters often disrupt health systems affecting the whole population, but especially vulnerable people such as pregnant women, new mothers and their babies. Despite the global progress in maternal, newborn and child health (MNCH) programmes over the years, emergency responses after a disaster are often poor. Post-disaster health promotion could play an important role in improving MNCH outcomes. However, evidence remains limited on the effect of post disaster health promotion activities in low-income countries such as Nepal.

The paper reports on an post-disaster intervention study aimed at women in Nepal following the 2015 earthquake. In total, 364 mothers were recruited in the pre-intervention group and 377 in the post-intervention group. The post-intervention group was more likely to have knowledge of at least three danger signs in pregnancy (AOR [Adjusted Odds Ratio] = 2.96, P<0.001), at least three danger signs in childbirth (AOR = 3.8, P<0.001), and at least five danger signs in newborns (AOR = 1.56, P<0.001) compared to the pre-intervention group. The mothers in the post-intervention group were also more likely to ever attend ANC (AOR = 7.18, P<0.001), attend a minimum of four ANC sessions (AOR = 5.09, P<0.001), and have institutional deliveries (AOR = 2.56, P<0.001).

Religious minority groups were less likely to have knowledge of all danger signs compared to the majority Hindu group. Mothers from poorer households were also less likely to attend four ANC sessions. Mothers with higher education were more likely to have knowledge of all the danger signs. Mothers whose husbands had achieved higher education were also more likely to have knowledge of danger signs and have institutional deliveries.  The paper concludes that the health promotion intervention helped the disaster-affected mothers in improving the knowledge and behaviours related to MNCH. However, the authors also comment that vulnerable populations need more support to benefit from such intervention.

 

Reference:

Dhital R, Silwal RC, Simkhada P, van Teijlingen E, Jimba M (2019) Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal. PLoS ONE 14(7): e0220191. https://doi.org/10.1371/journal.pone.0220191

Research Capacity Building in Nepal: 600 reads

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A few times a month ResearchGate alerts me that another paper has reached a miles stone of so having been read some many times.   Today the ResearchGate message is about 600 reads for our paper ‘Research Methods Coverage in Medical and Health Science Curricula in Nepal’. [1]  This paper was a report  on research methods teaching in health-related Higher Education (HE) courses in the health and medical field in Nepal.  This paper originates from a DelPHE (Round 4), British Council award.  Our study ‘Partnership on Improving Access to Research Literature for HE Institutions in Nepal’ (PARI Initiative) was a collaboration between the oldest university in Nepal, namely Tribhuvan University and two UK university of which BU was one.    A further paper from the PARI Initiative was published a year later.  [2]   The lead author of both papers in BU Visiting Faculty Prof Padam Simkhada, who is Professor of International Public Health at the Public Health Institute at Liverpool John Moores University.

The Nepal Journal of Epidemiology is a full Open Access journal which means anybody across the globe can access it for free.  The Nepal Journal of Epidemiology is part of  Nepal Journals Online (NepJOL) a service established by INASP in 2007,  which provides online publication of Nepali journals.

 

Prof. Edwin van Teijlingen

References:

  1. Simkhada, P., van Teijlingen, E., Pokharel, T., Devkota, B., Pathak, R.S. (2013) Research Methods Coverage in Medical & Health Science Curricula in Nepal, Nepal Journal Epidemiology 3(3): 253-258. www.nepjol.info/index.php/NJE/article/view/9185
  2. Simkhada, P., van Teijlingen, E., Devkota, B., Pathak, R.S., Sathian, B. (2014) Accessing research literature: A mixed-method study of academics in Higher Education Institutions in Nepal, Nepal Journal of Epidemiology 4(4): 405-14. http://www.nepjol.info/index.php/NJE/article/view/11375

Key role of volunteers in the health system

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This week saw the publication of ‘Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study’ [1].  This article in the Open Access journal PLoS ONE highlights the key role volunteers play in delivering health services to minorities/the poorest people, especially in low-income countries like Nepal.

This paper studies community health workers in Nepal, who are known as Female Community Health Volunteers (FCHVs). To address this issue, we conducted a qualitative study to explore perceived barriers to accessing maternal and child healthcare services among ethnic minority groups in two different parts of Nepal with varying degrees of access to local healthcare centres. Semi-structured interviews were conducted with twenty FCHVs, 26 women service users and 11 paid local health workers. In addition, 15 FCHVs participated in four focus group discussions.

A thematic analysis of the data identified five major themes underlying barriers to accessing available maternal and child healthcare services by ethnic minority groups. These themes include: a) lack of knowledge among service users; b) lack of trust in volunteers; c) traditional beliefs and healthcare practices; d) low decision-making power of women; and e) perceived indignities experienced when using health centres.  The paper concluded that community health programmes should focus on increasing awareness of healthcare services among ethnic minority groups, and the programmes should involve family members (husband and mothers-in-law) and traditional health practitioners. Both the FCHVs and local healthcare providers should be trained to communicate effectively in order to deliver respectful care among ethnic minorities if we want to achieve universal healthcare coverage for maternal and child health in low- and -middle income countries.

The paper is based on the PhD research conducted by Dr. Sarita Panday in ScHARR at the University of Sheffield.  Dr. Panday is currently affiliated with the Walter H. Shorenstein Asia-Pacific Research Centre (APARC) at Stanford University in the USA.  Her co-authors are Prof. Paul Bissell at the University of Huddersfield, FHSS’s Visiting Prof. Padam Simkhada at the Liverpool John Moores University and BU Prof. Edwin van Teijlingen.  This is the second paper from Dr. Panday’s excellent thesis, the first paper was also published in an Open Access journal BMC Health Services Research [2].

 

References:

  1. Panday S, Bissell P, van Teijlingen E, Simkhada P (2019) Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study. PLoS ONE 14(6): e0217070.
  2. Panday S, Bissell P, van Teijlingen E, Simkhada P (2017) The contribution of female community health volunteers (FCHVs) to maternity care in Nepal: a qualitative study. BMC Health Services Research 17(1):623.