Next week the Dorset Global Health Network will have its inaugural meeting on April 25th. The meeting will focus on Nepal starting at 18.30 with a Nepalese buffet.
There will be three short presentations followed by the film ‘Hospital’.
Voluntourism in Nepal : A lesson in the grey areas of global health (Dr Emer Forde, Bournemouth University)
The challenge of perinatal mental health in Nepal (Prof. Edwin van Teijlingen, Bournemouth University)
Supporting Training and innovative solutions to the provision of rural health care in Nepal (Dr Ollie Ross, Consultant Anaesthetist, Southampton General Hospital)
The Film “Hospital” provides a portrait of a state-run hospital in one of the most remote and poor districts of Nepal and how individuals can make a difference to people’s lives. It will be introduced by Dr Ollie Ross, who is a consultant to the Nick Simons Institute working in Nepal.
This will be followed by a discussion about the development of Dorset Global Health Network.
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.
As part of the new plan BU2025, “we want to continue to develop our global partnerships and links with other institutions and organisations”. This is an admirable aim, and it is, of course, the best way forward for a truly global Higher Education Institution like Bournemouth University (BU). But to translate this general aim into a particular global partnership we need to consider the underlying processes of initiating and developing such partnerships. We published a paper  on the issues one needs to consider in developing a partnership, based on the example of BU’s partnership with Manmohan Memorial Institute of Health Sciences (MMIHS) in Nepal.
In late February this year MMIHS signed a Memorandum of Agreement (MoA) with BU at a ceremony in the Nepalese capital Kathmandu, where Prof. Stephen Tee represented BU. This MOA is an agreement between us that provides a basis on which the parties will consider potential future collaboration. The UoA formalises a long-standing collaboration between the two institutions, and indicates a desire to collaborate further in the future. MMIHS and BU academics have jointly applied for research grants, conducted collaborative research and published together and it is exactly this personal link between people that allows this, and many other, global partnerships to flourish.
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health
van Teijlingen, E., Marahatta, S.B., Simkhada, P., McIver, M., Sharma, J.P. (2017) Developing an international higher education partnerships between high & low-income countries: two case studies J Manmohan Memorial Inst Health Sci, 3(1): 94-100.
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’. 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.
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 Health7(1): 24–28.
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 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.
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.
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.
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.
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.
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.
This weekend Manmohan Memorial Institute of Health Sciences (MMIHS) in Kathmandu, Nepal signed a Memorandum of Agreement (MoA) with Bournemouth University (BU). The ceremonial signing took place on the final day (24th Feb.) of the International Conference on Quality Education in Federal Nepal. Prof. Stephen Tee, who also spoke at the conference, represented our university.
The UoA formalises a long-standing collaboration between the two institutions. MMIHS and BU academics have jointly applied for research grants, conducted collaborative research and published together. Several BU staff [1-3] and students  in the Faculty of Health & Social Sciences have published in the Journal of Manmohan Memorial Institute of Health Sciences, an Open Access journal. Moreover, Prof. Edwin van Teijlingen in the Centre for Midwifery, Maternal and Perinatal Health has been a Visiting Professor at MMIHS for nearly a decade and has given several guest lectures over the years to staff and students at MMIHS.
Regmi, P., van Teijlingen, E., Simkhada, P, Kurmi, O, Pant, P. (2017) What can we learn from the Nepal Health Facility Survey 2015? Journal of Manmohan Memorial Institute of Health Sciences 3(1): 1-5.
van Teijlingen, E., Marahatta, S.B., Simkhada, P., McIver, M., Sharma, J.P. (2017) Developing an international higher education partnerships between high & low-income countries: two case studies Journal of Manmohan Memorial Institute of Health Sciences, 3(1): 94-100.
Vickery, M. van Teijlingen, E., (2017) Female infanticide in India and its relevance to Nepal Journal of Manmohan Memorial Institute of Health Sciences (JMMIHS) 3(1): 79-85.
The British Ambassador to Nepal Richard Morris hosted the launch of a report of a market study of Nepal’s education sector today (28th February) in his Kathmandu Residence. The report was commissioned to help support UK service providers who are looking for education opportunities in Nepal. The Ambassador invited Bournemouth University’s Prof. Edwin van Teijlingen to highlight the UK’s expertise in research, as well as to share his own experience in UK-Nepal partnerships/ collaborations in education.
Prof. Edwin van Teijlingen is Visiting Professor at colleges in Nepal: (1) Nobel College, affiliated with Pokhara University; and (2) Manmohan Memorial Institute of Health Sciences, affiliated with Tribhuvan University.
Yesterday (Monday 26th February) we disseminated the preliminary findings of our study on ‘Health vulnerabilities of cross border migrants from Nepal.’ The study was funded by IOM (International Organisation for Migration) in Kathmandu. The main findings were outlined one of the researchers from Green Tara Nepal.
The study was conducted in Nepal by Nepali researchers Drs. Pratik Adhikary, Nirmal Aryal and Raja Ram Dhungana, with methodological support from Prof. Padam Simkhada (Liverpool John Moores University) and BU’s Prof. Edwin van Teijlingen. The mixed-methods study included a cross-sectional study of 752 Nepali migrant workers who had returned from working in India as well as focus groups and interviews with a sub-sample of returnees and interviews with two key informants. The research team also highlighted some key issues raised in two recent migration and health papers co-authored by some of the contributors to the dissemination event [1-2].
The project has strong link with Bournemouth University, Prof. Simkhada is Visiting Professor in BU’s Faculty of Health & Social Sciences (FHSS), Dr. Pratik Adhikary is a BU Ph.D. graduate and Dr. Nirmal Aryal has just been appointed in FHSS as a Post-Doctoral Researcher in preparation for REF 2021.
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 Medicine24 (4): 1-9.
Simkhada, P.P., van Teijlingen, E.R., Gurung, M., Wasti, S. (2018) A survey of health problems of Nepalese female migrants workers in the Middle-East and Malaysia, BMC International Health & Human Rights 18(4): 1-7. http://rdcu.be/E3Ro
This morning we disseminated the findings of an evidence synthesis on ‘Effectiveness of community engagement and participation approaches in low and middle income countries’ in the Himalayan Hotel in Kathmandu. The study was designed to identify, analyse and summarise the findings of existing systematic reviews that have examined the effectiveness of community engagement/participation approaches in improving health, service delivery and sustainability outcomes. Therefore the overarching research question was: “How effective are community engagement/participation approaches for delivering better health outcomes, improving service delivery and sustaining benefits?”
Systematic Review of Reviews included 31 systematic reviews which examined community engagement/participation approaches in improving health (maternal and child health, infectious or communicable diseases, ‘other’ disease areas), service delivery and sustainability outcomes. There was wide variation in the aims and objectives, and methods of analysis across the included systematic reviews. In part this reflected a lack of a standard definition or terminology in how community engagement and participation approaches were described or characterised. The overall strength of the systematic review-level evidence has been categorised as of limited or moderate, however many systematic reviews reported consistent findings.
Community engagement and participation approaches continue to be viewed as important, particularly in LMICs. The general trend in the evidence identified suggests that community engagement and participation approaches have played a role in successful intervention delivery across health system domains and areas of health. However the extent to which community ownership and empowerment is achieved greatly impacts on the sustainability of these approaches and our evidence draws out some key factors for consideration in the delivery of successful community engagement and participation.
The study was led by Prof. Padam Simkhada from Liverpool John Moores University with support from staff based at the University of Liverpool, Bournemouth University and Green Tara Nepal. The study was commissioned and funded by the Research and Evidence Division in the Department for International Development. The forthcoming report has been funded by UK aid from the UK Government.
Both the Saturday and the Sunday edition of The Kathmandu Post carried articles on the International Conference on Education in a Federal Nepal. The coverage of this two-day conference (which ran on Friday and yesterday) included Prof. Stephen Tee’s keynote speech and Prof. Edwin van Teijlingen reporting on research findings of an education study amongst health educators in Nepal, as well as FHSS’s Visiting Faculty, Prof. Padam Simkhada (based at Liverpool John Moores University). The conference organised by HISSAN and supported by 16 education partners including Bournemouth University, Liverpool John Moores University and The University of Utah (USA) was attended by some 400 delegates.
As the key note speaker of the second day, Prof. Tee emphasised the need for technology-enhanced teaching/ learning processes. He added that a globalised world requires educational institutions to “recognise students as consumers.” He highlighted a number of common (and not so common) approaches to technology-enhanced teaching in the UK. His key note speech was very well received by colleagues academics and educationalists in Nepal. On the first day of the conference Prof. Tee was welcomed by the Prime Minister of Nepal K.P. Oli.
The two-day International Conference on Quality Education in Federal Nepal has just started in Kathmandu. Prof. Stephen Tee, executive dean of FMC and FMSS is one of the invited guests giving a short opening address. He spoke after the organisers had shown Prof. John Vinney’s recorded supporting message from Bournemouth University. Steve was part of the plenary session with the theme ‘Quality in Higher Education’.
This international conference has already attracted national media attention as the pre-conference press conference was reported in The Kathmandu Post today (click here to read news story).
Just before the start of Bournemouth University’s Global Festival of Learning India (12-16 February) the Journal of Manmohan Memorial Institute of Health Sciences published Michelle Vickery’s paper ‘Female infanticide in India and its relevance to Nepal’ . This article developed out of Michelle’s undergraduate Sociology thesis which she completed as part of her undergraduate degree in 2016. The Journal of Manmohan Memorial Institute of Health Sciences is an Open Access journal which means its content is freely available to any reader with internet access across the globe.
Over the last few years Bournemouth University academic have published papers on a range of topics related to India, for example on Media Studies [2-3], English literature  , Sociology , Public Health  , and environmental science and conservation [7-9].
Prof. Edwin van Teijlingen
Vickery, M., van Teijlingen, E., (2017) Female infanticide in India and its relevance to Nepal.Journal of Manmohan Memorial Institute of Health Sciences (JMMIHS) 3(1): 79-85.
Sudbury, S. (2016) Locating a “third voice”: participatory filmmaking and the everyday in rural India. Journal of Media Practice, 17 (2-3): 213-231.
Goodman, S. (2018) ‘Ain’t it a Ripping Night’: Alcoholism and the Legacies of Empire in Salman Rushdie’s Midnight’s Children. English Studies, (forthcoming).
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.
Sathian, B. , De, A. ,van Teijlingen, E., Simkhada, P. , Banerjee, I. , Roy, B. , Supram, H. , Devkota, S. , E, R. (2015). Time Trend of the Suicide Incidence in India: a Statistical Modelling. American Journal of Public Health Research, 3(5A), 80-87. http://pubs.sciepub.com/ajphr/3/5A/17/index.html
Bower, S. D., Danylchuk, A. J., Raghavan, R., Danylchuk, S. C., Pinder, A. C., Alter, A. M., Cooke, S. J. (2017) Involving recreational fisheries stakeholders in development of research and conservation priorities for mahseer (Tor spp.) of India through collaborative workshops. Fisheries Research, 186, 665-671.
Bower S.D., Danylchuk A.J., Raghavan R., Clark-Danylchuck S.E., Pinder A.C., Cooke S.J. (2016) Rapid assessment of the physiological impacts caused by catch-and-release angling on blue-finned mahseer (Tor sp.) of the Cauvery River, India. Fisheries Management and EcologyDOI: 10.1111/fme.12135
Pinder, A.C., Raghavan, R., Britton, J.R. (2015) Efficacy of angler catch data as a population and conservation monitoring tool for the flagship Mahseer fishes (Tor spp.) of Southern India. Aquatic Conservation: Marine and Freshwater Ecosystems, DOI: 10.1002/aqc.2543
Last week the Journal of Manmoham Memorial Institute of Health Sciences based in Nepal published as its editorial ‘What can we learn from the Nepal Health Facility Survey 2015.  The Nepal Health Facility Survey 2015 is a first of its kind. It is a much needed start to help analyse and improve the workings of the country’s health system. This is very important and timely as one of the targets of the Sustainable Development Goals (SDG) is to reduce premature mortality by one-third from non-communicable diseases. Success in this effort will depend on the concerted efforts on health facilities (for both health promotion, prevention and management) for an early and optimal care. The editorial also raises some of the ethical and methodological issues associated with the first ever Nepal Health Facility Survey 2015. The lead author of the editorial is Dr. Pramod Regmi and our co-authors include Prof. Padam Simkhada (Visiting Faculty in the Faculty of Health & Social Sciences). The Journal of Manmoham Memorial Institute of Health Sciences is an Open Access journal hence freely available to scholars and politicians and health managers across the globe, including those based in low-income countries such as Nepal.
Regmi, P., van Teijlingen, E., Simkhada, P, Kurmi, O, Pant, P. (2017) What can we learn from the Nepal Health Facility Survey 2015? Journal of Manmohan Memorial Institute of Health Sciences (JMMIHS) 3(1): 1-5
Today is the third day of BU’s Global Festival of Learning, after a successful visit to Chennai the team arrived last night in Pune. Today part of the academic programme includes lectures at Symbiosis School of Liberal Arts. The lectures will be given by Dr. Shanti Shanker, Lecturer in Psychology, who is associated with BU’s Ageing & Dementia Research Centre, Dr. Anastasia Veneti, Senior Lecturer in Marketing Communications, and Prof. Edwin van Teijlingen, who is based in the Centre for Midwifery, Maternal & Perinatal Health in the Faculty of Health & Social Sciences.
BU Visiting Prof. Padam Simkhada and BU’s Prof. Edwin van Teijlingen published a blog post about Nepal’s significant progress in improving the health of women and a striking reduction on maternal mortality. The paper highlights that despite difficult terrain, conflict and political turmoil, Nepal was one of the few countries that managed to achieve Millennium Development Goal 5 on maternal health in 2015.