Nepal birthing centre
On Friday the third cohort of UK volunteers will leave Heathrow as our education project ‘Mental Health Training for Community-based Maternity Providers in Nepal’ . Mental health issues are a seriously underfunded and understudied area in Nepal, and not just in the field of maternity care.  Our project 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.
One of the three latest volunteers, BU Visiting Faculty and Poole Hospital NHS Foundation Trust midwife Jillian Ireland wrote about her forthcoming trainig visit (click here for Jillian’s blog). The other volunteers on this visit are midwife Andrea Lawrie from The Robert Gordon University/Aberdeen Maternity Hospital, Aberdeen) and Dave Havelock, a mental health nurse specialising in high intensity therapy (IAP) from North Yorkshire.
Previous Bournemouth University Research Blogs (see here! and here! ) and blogs by one the earlier UK volunteers retired health visitor Ish Fawcett (click here!) have outlined details of our project. Bournemouth University has a great history of developing and delivering innovative education projects with the support of its Centre for Excellence in Learning (CEL).
Prof. Edwin van Teijlingen
- van Teijlingen, E., Simkhada, P., Devkota, B., Fanning, P., Ireland, J., Simkhada, B., Sherchan, L., Silwal, R.C., Pradhan, S., Maharjan, S.K., Maharjan, R.K. (2015) Mental health issues in pregnant women in Nepal. Nepal Journal of Epidemiology 5(3): 499-501.
- Simkhada, P., Winter, R.C., Fanning, C., Dhungel, A., Marahatta S.B. (2015) Why are so many Nepali women killing themselves? A review of key issues Journal of Manmohan Memorial Institute of Health Sciences 4(1): 43-49.
In two days time the first ever National Conference on Adolescent Health and Development in Nepal starts in Kathmandu. BU has a joint poster at this conference on the topic of Community-Based Menstrual Hygiene Promotion in Rural Nepal. The poster reports on a project led by Ram Chandra Silwal.
The project is an international collaboration between Green Tara Nepal, BU Visiting Fellow Prof. Padam Simkhada (representing Liverpool John Moores University), the University of Tokyo and the Centre for Midwifery, Maternal and Perinatal Health (CMMPH) in BU’s Faculty of Health & Social Sciences.
Prof. Edwin van Teijlingen
- Silwal, R.C., Pradhan, S., Sharma, A., Simkhada, P., van Teijlingen,E., Jimba, M. (2016) ‘Community-Based Menstrual Hygiene Promotion in Rural Nepal’ poster at First National Adolescent Health & Development Conference held in Kathmandu, Nepal, 2-3 May 2016.
This week saw the publication of a new paper co-written by BU staff in the Sociological Bulletin. This is the first paper comparing Indian and Nepali Maoist rebels providing health services and health promotion to the communities under their influence. It presents the key provisions either made by rebel health workers themselves or by putting political pressure on government health workers to deliver better services in the areas controlled by rebels. Prof. Edwin van Teijlingen’s co-authors are based in India and Nepal. Prof. Gaurang R. Sahay is based at the Centre for Study of Developing Societies, Tata Institute of Social Sciences, Mumbai, India, whilst Bhimsen Devkota is Professor in Health Education, Tribhuvan University, Nepal.
This sociological paper is based on a mixed-method approach comprising 15 interviews and a questionnaire survey with 197 Nepalese Maoist health workers and a secondary analysis of policy documents and other published materials on the Maoist health services of India. The paper suggests that rebel health services in India and Nepal followed a fairly similar approach to what and how they offered health care services to local populations. Maoists becoming a government party changed the political landscape for the rebel health workers in Nepal. However, not incorporating the Maoist rebel health workers into the government health system was a missed opportunity. There are lessons that India and Nepal can learn from each other. Should the Maoist rebels and the Government of India come to an agreement, potential for rebel health workers to be integrated in the official health care system should at least be considered.
The paper benefitted from an earlier review through eBU: Online Journal. The feedback from the eBU: Online Journal’s reviewers helped shape and polish the paper before submission to the Sociological Bulletin.
Edwin van Teijlingen
- Sahay, G., Devkota, B., van Teijlingen, E.R. (2016) Rebel Health Services in South Asia: Comparing Maoist-led Conflicts in India & Nepal, Sociological Bulletin 65(1):19-39.
FHSS PhD student Jib Acharya presented a poster from his thesis research at last week’s BNAC (Britain-Nepal Academic Council) Study Days in Liverpool. Jib’s PhD research focused on the knowledge, attitudes and beliefs of poor women about nutritious food and the study also identify major food barriers. He used a mixed-methods approached comprising a survey and qualitative research. The poster at BNAC focused on findings related to mothers’ knowledge, attitudes and beliefs about nutritious food. Jib’s research is supervised by Dr. Jane Murphy, Dr. Martin Hind and Prof. Edwin van Teijlingen. Some of the preliminary findings of this FHSS thesis have recently been published in two academic journals. [2-3]
Prof. Edwin van Teijlingen
- Acharya, J, van Teijlingen, E, Murphy, J, Hind, M. ‘A Comparative Study on Nutritional Problems in Preschool Aged Children of Kaski district of Nepal’ poster at Britain-Nepal Academic Council (BNAC) 14th Annual Nepal Study Days (Liverpool April 2016)
- Acharya, J., van Teijlingen, E., Murphy, J., Hind, M. (2015) Assessment of knowledge, beliefs and attitudes towards healthy diet among mothers in Kaski, Nepal, Participation 17(16): 61-72.
- Acharya, J., van Teijlingen, E., Murphy, J., Hind, M. (2015) Study of nutritional problems in preschool aged children in Kaski District in Nepal, Journal of Multidisciplinary Research in Healthcare 1(2): 97-118. http://dspace.chitkara.edu.in/jspui/bitstream/1/560/1/12007_JMRH_Acharya.
At the 14th BNAC (Britain-Nepal Academic Council) Nepal Study Days starting tomorrow (14th April 2016) FHSS’s PhD student Jib Acharya will presenting his poster on ‘A Comparative Study on Nutritional Problems in Preschool Aged Children of Kaski district of Nepal’. Jib’s PhD project is supervised by FHSS’s Prof. Edwin van Teijlingen, Dr. Jane Murphy and Dr. Martin Hind. Prof. Edwin van Teijlingen is also joint supervisor of Sarita Pandey (based at the University of Sheffield) whose poster ‘Factors that promote and hinder provision of maternal health services by Female Community Health Volunteers (FCHV) in rural Nepal’ will also be on display.
BU Visiting Faculty Dr. Bibha Simkhada (based at Liverpool John Moores University) will be presenting on the on-going THET-funded project ‘Mental Health Training and Education in Nepal’. This paper is part of the education stream of the conference,and its acceptance is a reflection of BU’s reputation in Educational Research. This paper has co-authors based in the UK and Nepal: Bibha Simkhada, Edwin van Teijlingen, Jillian Ireland, Padam Simkhada, Bhimsen Devkota, Lokendra Sherchan, Ram Chandra Silwal, Shyam K. Maharjan, Ram K. Maharjan, Geeta Sharma, and Samridhi Pradhan. Both Prof. Padam Simkhada and Ms. Jillian Ireland are BU Visiting Faculty.
The first Study Day tomorrow starts with an invited Skills-building session on Focus Group Research by Prof. Edwin van Teijlingen. The final day includes a paper on ‘Impacts of Migration in Nepal’ by Prof. Padam Simkhada and Prof. Edwin van Teijlingen.
We are hoping to get the 15th BNAC Study Days to Bournemouth University for this time next year!
Prof. Edwin van Teijlingen
Professor Edwin van Teijlingen will be running a Skills Building Workshop at the 14th national Nepal Study Days of the Britain-Nepal Academic Council (BNAC) in Liverpool. FHSS Professor van Teijlingen is a long-standing member of BNAC. Registration for this year’s Nepal Study Days is open now, if you are interested click here! Edwin van Teijlingen has conducted many qualitative studies and supervised many postgraduate students doing focus group research. He has published widely on qualitative methods, including research papers on Focus Group Research.1-3
Anybody interested in learning more about Focus Group Discussions as a research method should consider signing up for up for Bournemouth University’s two-day Masterclass ‘Focus Group Research‘ to be held next week Monday 18th and Tuesday 19th April in Bournemouth. Over a two-day period this Masterclass will cover the journey for a research project on focus group research. Basic previous knowledge on qualitative research will be assumed.
- van Teijlingen, E.R., Pitchforth, E. (2006) Focus Group Research in Family Planning and Reproductive Health Care, J Fam Plan Reprod Health Care 32 (1): 30-32.
- Pitchforth, E., Teijlingen van, E., Ireland, J. (2007) Focusing the group, RCM Midwives J 10(2): 78-80.
- van Teijlingen, E., Simkhada, P., Stephen, J. (2013) Doing focus groups in the health field: Some lessons from Nepal, Health Prospect 12(1): 15-17. http://www.nepjol.info/index.php/HPROSPECT/article/view/8722/7111
This month a team of FHSS staff published their editorial in the latest issue of the academic journal Health Prospect . The lead author is Dr. Pramod Regmi working in collaboration with CMMPH’s Professor Vanora Hundley, FHSS PhD students Preeti Mahato and Sheetal Sharma, and Professor Padam Simkhada from Liverpool John Moores University who is also Visiting Faculty at BU. The Sustainable Development Goals (SDGs) are the new guidance for nations and international organisations worldwide following the completion of the Millennium Development Goals (MDGs) which run from 2000 to 2015. We wrote about the MDGs and their relevance to midwifery and maternity care in a previous article .
Edwin van Teijlingen
- Regmi, P.R., van Teijlingen, E., Hundley, V., Simkhada, P., Sharma, S., Mahato, P. Sustainable Development Goals: relevance to maternal and child health in Nepal Health Prospect 2016; 15(1): 9-10.
- van Teijlingen, E., Hundley, V., Matthews, Z., Lewis, G., Graham, W.J., Campbell, J., ten Hoope-Bender, P., Sheppard, Z.A., Hulton, L. Millennium Development Goals: All good things must come to an end, so what next? Midwifery 2014; 30: 1-2.
This new issue of the Nepal Journal of Epidemiology contains a systematic review by FHSS Visiting Faculty Prof. Padam Simkhada (based at Liverpool John Moores University). The review was produced in collaboration with Prof. Edwin van Teijlingen in BU’s Centre for Midwifery, Maternal & Perinatal Health (CMMPH). Their paper ‘Factors influencing sexual behaviour between tourists and tourism employees: A systematic review’ is co-written with a researcher from Green Tara Nepal and an independent Public Health Consultant based in the UK.  This systematic review reports on factors influencing sexual behaviour between workers in the tourism industry and tourists, including their risk perceptions when engaging in sexual activities and the knowledge of STIs (sexually transmitted infections).
This is the third paper from this group on sexual health and tourism. The previous two papers were written with BU’s Dr. Pramod Regmi. These two publications reported on sexual behaviour of male trekking guides in Nepal such as sexual interactions with tourists and locals. The qualitative paper based on interviews with trekking guides has been published in Culture, Health & Sexuality  and the quantitative survey paper appeared in Journal of Manmohan Memorial Institute of Health Sciences .
This week’s publication the Nepal Journal of Epidemiology is Open Access, hence freely available, as is the third paper listed below.
Prof. Edwin van Teijlingen
- Simkhada, P.P., Sharma, A., van Teijlingen, E.R., Beanland, R,L. (2016) Factors influencing sexual behaviour between tourists and tourism employees: A systematic review. Nepal Journal of Epidemiology 6(1): 530-538.
- Simkhada, P., Bhatta, P., van Teijlingen E., Regmi, P. (2010) Sexual health knowledge, sexual relationships and condom use among male trekking guides in Nepal. Culture, Health & Sexuality 12(1): 45-58.
- Simkhada, P., van Teijlingen, E., Regmi, P., Bhatta, P., Ingham, R., Stone, N. (2015) Sexual health knowledge and risky sexual behaviour of Nepalese trekking guides. Journal of Manmohan Memorial Institute of Health Sciences 1(4): 35-42.
Since his arrival in the Faculty of Health & Social Sciences last year postdoctoral researcher Dr. Pramod Regmi has been busy getting his publications out. Yesterday saw the latest of his articles appear in print, this time in the latest issue of the Nepal Journal of Epidemiology. The editorial, co-authored with Dr. Om Kurmi (University of Oxford) and Dr. Puspa R. Pant at the University of the West of England, addresses the growing problem air pollution in low-income countries such as Nepal. The paper is called: ‘Implication of Air pollution on health effects in Nepal: Lessons from global research’. 
The journal is Open Access so the article can be accessed by anybody across the globe for free.
Prof. Edwin van Teijlingen
- Kurmi O, Regmi PR, Pant PR. Implication of Air pollution on health effects in Nepal: Lessons from global research. Nepal J Epidemiol. 2016;6(1); 525-527. (online at: http://www.nepjol.info/index.php/NJE/article/view/14733/11949 )
On previous occasions we have written on the BU Research Blog about our THET-funded project, for example earlier this year on the first training sessions in Nepal. Bournemouth University is leading on a project in collaboration with Tribhuvan University (the largest and oldest university in Nepal) and Liverpool John Moores University (LJMU). The project receives funding from DFID, and is managed through THET and supported locally in Nepal by a non-governmental organisation called Green Tara Nepal. We have been working with this charity for nearly ten years.
This time we would like to highlight a regular research blog written by Ish Fawcett who went out to Nepal last month as one of the UK volunteers. She has written some lovely blogs on her time in Nepal, about the training sessions as well as her general experiences of and observations on Nepal. Her blogs can be accessed here!
We would like to take this opportunity to repeat our call for volunteers. If you are a health or education professional with an interest in mental health and/or maternity care and you are interested in volunteering later this year for a week to ten days in Nepal please contact Edwin van Teijlingen (firstname.lastname@example.org ).
Prof. Edwin van Teijlingen
Today saw the publication “Is it realistic?” the portrayal of pregnancy and childbirth in the media, a paper which is truly interdisciplinary, both in terms of its authorship as well as its topics. The lead-author, Dr. Ann Luce is based in the Faculty of Media & Communication, whilst her BU co-authors Dr. Catherine Angell, Prof. Vanora Hundley, Prof. Edwin van Teijlingen and Dr. Marylin Cash are all associated with the Faculty of Health & Social Sciences. Prof. Helen Cheyne, the only non-BU co-author, is based at the University of Stirling.
The paper is a scoping review to assess the influence media have on pregnant women. Much of the academic literature discusses the influence of (reality) television, which often portrays birth as risky, dramatic and painful. Although many claim that the portrayal of childbirth has a negative effect on society, there is little research evidence to support this claim. It has been suggested that women seek out such programmes to help understand what could happen during the birth because there is a cultural void through the increasing anticipation of negative outcomes. However the impact that has on normal birth has not been explored. Our paper highlighted three key themes: (a) the medicalisation of childbirth; (b) women using media to learn about childbirth; and (c) birth as a missing everyday life event. The key conclusions are the media appear to influence how women engage with childbirth. The dramatic television portrayal of birth may perpetuate the medicalisation of childbirth, and last, but not least, portrayals of normal birth are often missing in the popular media. Hence midwives need to engage with television producers to improve the representation of midwifery and maternity in the media.
BMC Pregnancy and Childbirth is an Open Access journal so our paper is freely available to researchers, journalists, childbirth activists as well as pregnant women anywhere in the world. This paper builds on a growing number of academic papers published by staff in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) on the role the media play in health and midwifery, both in the UK [2-3] and in Nepal [4-6].
Prof. Edwin van Teijlingen
- Luce, A., Cash, M., Hundley, V., Cheyne, H., van Teijlingen, E., Angell, C., (2016) “Is it realistic?” the portrayal of pregnancy and childbirth in the media BMC Pregnancy & Childbirth 16: 40
- Hundley, V., Duff, E., Dewberry, J., Luce, A., van Teijlingen, E. (2014) Fear in childbirth: are the media responsible? MIDIRS Midwifery Digest 24(4): 444-447.
- Hundley, V., Luce, A., van Teijlingen, E. (2015) Do midwives need to be more media savvy? MIDIRS Midwifery Digest 25(1):5-10.
- Devkota, S., Simkhada, P., van Teijlingen, E., Rai, L.D. (2012) Media use for Health Promotion: Communicating Childhood Immunisation Messages to Parents. Journal of Health Promotion 4(1): 1-9.
- Devkota, S., Simkhada, P., van Teijlingen, E., Rai, L.D. (2013) Childhood Immunisation in Nepal: Parents’ knowledge, attitudes and behaviour & implications for Health Policy. Health Science Journal 7(4):370-383.
- Devkota, S., Maharjan, H.M., van Teijlingen, E. (2015) Media and Health. In: Wasti, S.P., Simkhada, P.P. & van Teijlingen, E. (Eds.) The Dynamics of Health in Nepal, Kathmandu, Nepal: Social Science Baha & Himal Books: 169-184.
Since late 2015 the world strives to achieve towards the Sustainable Development Goals (SDG). The SDGs bring together the social, economic and environmental aspects of development. There are 17 SDGs sub-divided into 169 targets. One of these 17 goals focuses specifically on health, namely to “ensure healthy lives and promote wellbeing for all at all age”. SDG devotes 13 health-related targets to diverse population health and wellbeing issues including maternal and child health, communicable disease including HIV, non-communicable diseases, substance use, traffic accidents, universal access to sexual and reproductive health, and sanitation.
Nepal is one of the many countries that have signed up to the SDGs. This week BU researchers Dr. Pramod Regmi, Prof. Vanora Hundley, Prof. Edwin van Teijlingen, FHSS, PhD students Sheetal Sharma and Preeti Mahato, and BU Visiting Faculty Prof. Padam Simkhada (Liverpool John Moores University) published an editorial under the title ‘Sustainable Development Goals: relevance to maternal & child health in Nepal’ . This editorial written by health researchers working in Nepal highlights some of the weaknesses in the country’s health care system. These key problems include the persistence of inequalities in health and the limited access to health services and the low uptake of care in many poorer populations especially in the more remote rural regions. For instance, only about one in nine of the poorest women deliver their babies with the aid of a skilled birth attendant (SBA), whilst 81.5% for the richest women benefit form a SBA. Therefore, this editorial stresses the need for a continuum of health care services to be available across the country and for all sections of the society. Moreover, we can only assess whether a country has reached all or any of the SDGs if there is systematic monitoring and regular review of interventions at all levels. Hence, Nepal should develop measureable and time-bond indicators to track its progress towards the SDGs. The country will need support from development partners in both its attempts to achieve the SDGs as well when it tries to collect and analysis data to assess its progress.
Prof. Edwin van Teijlingn
- Regmi, P., van Teijlingen, E., Hundley, V., Simkhada, P., Sharma, S., Mahato, P. (2016) Sustainable Development Goals: relevance to maternal & child health in Nepal. Health Prospect 15(1):9-10. healthprospect.org/archives/15/1/3.pdf
Congratulations to FHSS post-doctoral researcher Dr. Pramod Regmi who is the lead author on the forthcoming editorial ‘Sustainable Development Goals: relevance to maternal and child health in Nepal’. The Centre for Midwifery, Maternal & Perinatal Health (CMMPH) has extensive research experience in the field of maternal and child health in Nepal. This latest editorial was invited by the editors of Health Prospect. The scientific journal Health Prospect is published by the Nepal Public Health Students’ Society.
The editorial outlines the recent history of the Millennium Development Goals which came to an end in 2015  and which are now replaced by the Sustainable Development Goals . The authors argue that continued technical and financial support from external development partners is necessary to sustain Nepal’s achievements in maternal and child health and to strengthen its health-service provision. They also suggest that the Sustainable Development Goals offer an opportunity to change Nepal for the better.
This is a joint publication with BU Visiting Faculty Prof. Padam Simkhada (Liverpool John Moores University) and two of CMMPH PhD students who research aspects of maternity care in Nepal, namely Sheetal Sharma and Preeti Mahato.
Professors Vanora Hundley & Edwin van Teijlingen
- Regmi, PR, van Teijlingen, E, Hundley, V, Simkahda, P., Sharma, S, Mahato, P. (2016) Sustainable Development Goals: relevance to maternal and child health in Nepal, Health Prospect (accepted for publication).
- van Teijlingen, E., Hundley, V., Matthews, Z., Lewis, G., Graham, W.J., Campbell, J., ten Hoope-Bender, P., Sheppard, Z.A., Hulton, L. (2014) Millennium Development Goals: All good things must come to an end, so what next? Midwifery 30: 1-2.
- World Health Organization (2015). Health in 2015: from MDGs, Millennium Development Goals to SDGs, Sustainable Development Goals. Geneva, Switzerland: World Health Organization. Available: http://www.who.int/gho/publications/mdgs-sdgs/en/
On Wednesday Jan. 27th CMMPH PhD student Preeti Mahato will present her PhD research ideas under the title “Addressing quality of care and equity of services available at birthing centres to improve maternal and neonatal health in western Nepal.” Her presentation will be held at the Lansdowne Campus at 13.00 in room 301 in Royal London House.
Preeti’s research focuses on birthing centres in western Nepal; and quality and equity of service available at these facilities. In Nepal, birthing centres act as first contact point for the women seeking maternity services especially the basic obstetric care. The focus of this presentation will be to talk about the first review article Preeti Mahato wrote for the ‘Journal of Asian Midwives’ entitled “Birthing centres in Nepal: Recent development, obstacles and opportunities”. The article has been accepted for publication in June 2016 and focuses on introducing birthing centres, their current state of operation under the health system of Nepal, barriers they are facing and what could be done to improve their present state. The quality of care issue available at birthing centre is emphasised, since the number of these facilities are increasing however there is a growing trend to bypass and uptake services at hospitals. Despite barriers to utilisation of services at birthing centres, they can play an important role in increasing institutional delivery rate and proportion of births benefiting from a skilled birth attendant.
The second part of presentation will provide a brief summary on what Preeti has done since writing a review article, as she has worked on a systematic review on quality of basic obstetric care facilities in low and middle income countries.
Preeti Mahato has worked in the field of public health in Nepal for three years after completing her Master of Public Health. She has an interest in sexual and reproductive health, women’s health and maternal and child health. Working as a public health officer she was involved in maternal and neonatal health that developed her interest in pursuing a doctorate related to maternal and neonatal health. Part of her work in Nepal also included monitoring and supervision of birthing centres in rural areas of Nepal and that is how she became motivated to start a PhD at BU.
Prof. Edwin van Teijlingen
A few days I posted a short report of our first session as part of the THET-funded project ‘Mental Health Training for Community-based Maternity Providers in Nepal’, see this previous post here. Yesterday we completed the final third day training of the first session of this BU-led project. Over three days we had 70 ANMs (Auxiliary Nurse Midwives) in attendance, which we think is (nearly) all such staff based in all birthing centres in the district (=province). The three days were the same, i.e. each session was repeated twice so each day one third of the ANMs could attend, and two-third could be at work in the birthing centre ensuring women could deliver safely.
As part of this project we send UK volunteers (health and/or education) experts to Nepal to offer high quality training in areas where it is most needed. Further detail on this BU-led THET project can be found in our scientific paper Mental health issues in pregnant women in Nepal published in the Nepal Journal of Epidemiology available through Open Access. Mental illness is still very much a taboo topic in Nepal as it has often a serious stigma attached to it. Moreover, the relatively short training of ANMs is often fairly basic and the national curriculum does not cover mental health issues in any detail. This joint project between Bournemouth University, Liverpool John Mooores University, Tribhuvan University and the local charity Green Tata Nepal addresses issues about mental health in general and in pregnant women and new mothers in particular. Tribhuvan University is the oldest university in Nepal and one of the ten largest universities in the world (based on student numbers). The project is multi-disciplinary involving midwives, (mental health) nurses, and doctors as well as global health researchers, educationalists and sociologists.
Prof. Edwin van Teijlingen
Bournemouth University, as all good universities, has an in-depth risk assessment form for staff to complete prior to their travel on university business. The form is required for all travel even it is on the train to Southampton for a research meeting. Before I left for Nepal late last year I completed the form, assessed the usual travel risk to a low-income country, including the risk food poisoning, malaria and road traffic accidents. The latter is usually the most serious risk for a healthy educated academic traveller to a low-income country.
I have been to Nepal nearly twenty times, I have in many a house of office with low ceilings and low door frames, so why did I not duck deep enough this morning in the training centre we use for running our THET project. To add to my shame it was not even the first day in this training centre as we were here all day yesterday. The good thing is (as a sociologist) I got to do some in promptu participant observation in the local A&E in the health centre in Parasi. Not that I can use it in my research as I didn’t apply for ethical approval for this unique additional part of the fieldwork.
For the record, the A&E service in Parasi is excellent, but it helps, of course, that we are doing training with the support of the District Health Office and we were only two minutes driving away from the health post. The other good thing is that it hurts a little, but no damage done! ethical approval for this part of the fieldwork. The other good thing is that it hurts a little, but no damage done!
Finally, I would like to say “Thank you!” to the ANMs (Auxiliary Nurse Midwives) who pick up off the floor and my Nepali colleagues for worrying about me.
Professor Edwin van Teijlingen
Today, after months of delay, UK volunteers managed to deliver the first THET-funded training as part of the BU-led project ‘Mental Health Training for Community-based Maternity Providers in Nepal’. The first serious delays occurred due to the devastating earthquake in April 2015 when we are just about to start our project. Then more delays happened due to the political unrest in the country after the signing of the new Constitution of Nepal in September 2015. Whilst there are still plenty of people living in make-shift shelters today in some of the more remote districts affected by the earthquake and there is still a serious shortage of petrol and cooking gas due to politically-driven blockages at the Indian-Nepali border, the situation is now safe enough to start bringing UK volunteers to Nepal.
Today’s first training was delivered in Kathmandu to our friends and colleagues at MIDSON, the Midwifery Society of Nepal (the equivalent of the Royal College of Midwives in the UK). Joining Prof. Edwin van Teijlingen to deliver the first training session to Nepali midwives is Dr. Bibha Simkhada from Liverpool John Moores University. Bibha is a nurse in Wirral University Teaching Hospital NHS Foundation Trust as well as BU Visiting Faculty. The audience at MIDSON was very helpful in giving feedback on the planned training in the southern district of Nawalparasi (starting Sunday 10th January). The agreement is to run a one-day training session for ANMs (Auxiliary Nurse Midwives), and run this three day in a row for one-third of all the birthing centre staff from across the district. This means that the government birthing centres can stay open with the other two-thirds on the staff on any one day. Further detail on this BU-led THET project can be found in our recent academic article, which is available through Open Access: click here.
Professor Edwin van Teijlingen
Today, as part of several related maternity-care studies, one of Bournemouth University’s (BU) researchers visited a rural birthing centre in Nawalparasi. The first photo is the view from the birthing centre showing exactly how rural it is. This particular birthing centre is based close to the Indian border. It has been supported for over a year by Green Tara Nepal, an organisation which works closely with BU on a range of health and maternity-care projects. The birthing centre has been improved since our last visit one year ago. There now is a newly build decomposition pit for the disposal of placentas. There is a new postnatal recovery room, and the number of local women giving birth in the facility has been increasing! When we arrived a new baby had just been born an hour or so earlier (second photo with proud father on the right).
This and several neighbouring birthing centres are the focus of a PhD study by FHSS’s Preeti Mahato. She recently co-authored an editorial in Nepal Journal of Epidemiology on the role of birthing centres in post-earthquake Nepal . Her PhD is supervised by Dr. Catherine Angell, Prof. Padam Simkhada, based at Liverpool John Moores University (LJMU) and who is also Visiting Faculty at BU, and Prof. Edwin van Teijlingen.
The birthing centre also lies in the area where the charity Green Tara Nepal has been supporting groups for pregnant women and their mothers-in-law. The latter is an important group as they are still key decision-makers on maternity care questions related to their daughters-in-law . The birthing centre is part of a wider intervention to improve the uptake of antenatal and postnatal care and skilled attendance at delivery. BU has been involved in evaluating this intervention with Green Tara Trust (UK) and LJMU for nearly a decade.
Some of the birthing centre staff will attend the mental health and maternity care training organised next week . This training project is run by a consortium of BU, LJMU, and Tribhuvan University (the oldest university in Nepal). This mental health and maternity care project is supported by the Tropical Health & Education Trust (THET) as part of the Health Partnership Scheme, which is funded by the UK Department for International Development (DFID), and in the field our THET project is supported by Green Tara Nepal.
Prof. Edwin van Teijlingen
- Mahato, P.K., Regmi, P.R., van Teijlingen, E., Simkhada, P., Angell, C., Sathian, B. (2015) Birthing centre infrastructure in Nepal post 2015 earthquake. Nepal Journal of Epidemiology 5(4): 518-519. http://www.nepjol.info/index.php/NJE/article/view/14260/11579
- Simkhada, B., Porter, M., van Teijlingen, E. (2010) The role of mothers-in-law in antenatal care decision-making in Nepal: A qualitative study. BMC Pregnancy & Childbirth 10(34) biomedcentral.com/content/pdf/1471-2393-10-34.pdf
- van Teijlingen, E., Simkhada, P., Devkota, B., Fanning, P., Ireland, J., Simkhada, B., Sherchan, L., Silwal, R.C., Pradhan, S., Maharjan, S.K., Maharjan, R.K. (2015) Mental health issues in pregnant women in Nepal. Nepal Journal of Epidemiology 5(3): 499-501. http://www.nepjol.info/index.php/NJE/article/view/13607/11007