BU Research Blog

October 24, 2024

Late 2023 paper reaches 400 reads!

international, open access, Publishing, writing Edwin van Teijlingen

Yesterday ResearchGate informed us that our paper ‘The impact of decentralisation on health systems: a systematic review of reviews‘ [1] had reached 400 reads. This paper, published in BMJ Global Health, is one of six papers published from our interdisciplinary research project ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’, the other five include a methods paper and a public health paper [2-6].

This study was funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1]. In this larger Nepal Federal Health System Project we study the consequences for the health system of Nepal’s move from a centralised political system to a more federal government structure in 2015. This joint project was led by the University of Sheffield in collaboration with Bournemouth University, the University of Huddersfield, Canter Bury Christ Church University and two institutions in Nepal, namely MMIHS (Manmohan Memorial Institute of Health Sciences) and PHASE Nepal.

Appropriately on Open Access Week, all six papers are Open Access, i.e. freely available to everyone with internet access in Nepal (and elsewhere in the world).

Prof. Edwin van Teijlingen

References:

Sapkota, S., Dhakal, A., Rushton S., van Teijlingen, E.R. et al. (2023) The impact of decentralisation on health systems: a systematic review of reviews. BMJ Global Health 8:e013317. doi:10.1136/bmjgh-2023-013317.
Sapkota, S., Rushton, S., van Teijlingen, E., Subedi, M., Balen, J., Gautam, S., Adhikary, P., Simkhada, P., Wasti, S.P., Karki, J.K., Panday, S., Karki, A., Rijal, B., Joshi, S., Basnet, S., Marahatta, S.B. (2024) Participatory policy analysis in health policy and systems research: reflections from a study in Nepal. Health Research & Policy Systems, 22 (No.7) https://doi.org/10.1186/s12961-023-01092-5 .
Wasti, S.P., van Teijlingen, E., Rushton, S., et al. (2023) Overcoming the Challenges Facing Nepal’s Health System During Federalisation: An Analysis of Health System Building Blocks, Health Research Policy & Systems 21(117) https://doi.org/10.1186/s12961-023-01033-2
Sapkota, S., Panday, S., Wasti, S.P., et al. (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of the Nepal Public Health Association 7(1):36-42.
Adhikary, P., Balen, J., Gautam, S., et al. (2020) The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system, Journal of Karnali Academy of Health Sciences 3 (3): 1-11.
Rushton, S., Pandey, S., van Teijlingen, E., et al. (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146

January 10, 2024

Latest paper from Federalisation & Health System in Nepal

international, open access, Publishing, writing Edwin van Teijlingen

The sixth paper from our interdisciplinary research team focuses on the effective way we applied participatory policy analysis in a study on the effects on the health system in Nepal. In the research we used a methodological approach using the River of Life which we describe in this paper ‘Participatory policy analysis in health policy and systems research: reflections from a study in Nepal’ [1]. The Lead author is Dr. Sujata Sapkota from Manmohan Memorial Institute of Health Sciences (MMIHS) in Kathmandu.

This study was funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1]. In this larger Nepal Federal Health System Project we study the consequences for the health system of Nepal’s move from a centralised political system to a more federal government structure in 2015. This joint project is led by the University of Sheffield in collaboration with Bournemouth University, the University of Huddersfield, Canter Bury Christ Church University and two institutions in Nepal, namely MMIHS and PHASE Nepal. We have managed to publish five papers from this project prior to today’s one reflecting on the methodology [2-6].

Prof. Edwin van Teijlingen

CMWH (Centre for Midwifery & Women’s Health)

References:

Sapkota, S., Rushton, S., van Teijlingen, E., Subedi, M., Balen, J., Gautam, S., Adhikary, P., Simkhada, P., Wasti, S.P., Karki, J.K., Panday, S., Karki, A., Rijal, B., Joshi, S., Basnet, S., Marahatta, S.B. (2024) Participatory policy analysis in health policy and systems research: reflections from a study in Nepal. Health Research & Policy Systems, 22 (No.7) https://doi.org/10.1186/s12961-023-01092-5 .
Wasti, S.P., van Teijlingen, E., Rushton, S., et al. (2023) Overcoming the Challenges Facing Nepal’s Health System During Federalisation: An Analysis of Health System Building Blocks, Health Research Policy & Systems 21(117) https://doi.org/10.1186/s12961-023-01033-2
Sapkota, S., Dhakal, A., Rushton S., et al. (2023) The impact of decentralisation on health systems: a systematic review of reviews. BMJ Global Health 8:e013317. doi:10.1136/bmjgh-2023-013317.
Sapkota, S., Panday, S., Wasti, S.P., et al. (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of the Nepal Public Health Association 7(1):36-42.
Adhikary, P., Balen, J., Gautam, S., et al. (2020) The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system, Journal of Karnali Academy of Health Sciences 3 (3): 1-11.
Rushton, S., Pandey, S., van Teijlingen, E., et al. (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146

January 9, 2024

Forum on Post-Federalisation Health System Strengthening

Fusion themes, international, Training, writing Edwin van Teijlingen

Today and tomorrow our research team is engaged in discussions with those responsible for running the health system at different levels of the new federal system in Nepal. The aim today and tomorrow of this participatory research project is bring together stakeholders from all levels of government (local, provincial and federal), to develop solutions, practical actions and recommendations for different levels of the political system to address some of the five areas our research identified as possible priorities. Nepal changed from a centralised political system of government to a federal system in 2015. It is easy to see how such change in the political system might affect the organisation, funding, governance, human resources, etc. of all sub-systems in society, such as the education system, the police, and in the area of our particular interest, the health system.

This interdisciplinary study started just before COVID-19 in 2020 and is now coming to a conclusion. The multi-national research team includes researchers from Nepal: MMIHS (Manmohan Memorial Institute of Sciences) in Kathmandu, and PHASE Nepal (Bhaktapur), the University of Sheffield, Bournemouth University, and the University of Huddersfield (the original UK applicants), and researchers currently based at three further UK universities: the University of Greenwich, the University of Essex and Canterbury Christ Church University. This exciting research is funded by the Health System Research Initiative, a UK collaboration between three funders: the MRC (Medical research Council), the Foreign, Commonwealth & Development Office (FCDO), and the Welcome Trust.

December 28, 2023

Interview with BU professor published

Delicious links, international, open access, Publishing Edwin van Teijlingen

Today Madhusudan Subedi and Man Bahadur Khattri published their Interview with Prof. Edwin van Teijlingen in the Dhaulagiri Journal of Sociology & Anthropology [1]. This academic journal is published in Nepal and it is Open Access; hence freely available to read to anybody with access to the internet.

Their abstract reads: “Edwin van Teijlingen is Dutch by birth and a Professor of Reproductive Health at Bournemouth University in the south of England. He has achieved a PhD in Medical Sociology at the University of Aberdeen, UK. Prof. Edwin van Teijlingen connected with Nepal while supervising Nepali PhD scholars in UK, and he has been a frequent visitor to Nepal since 2006. He has supervised more than 35 PhDs, among which 13 are Nepali. He has examined more than 50 PhDs. He has published around 300 academic papers and book chapters in health promotion, midwifery, and health services research. He serves as a peer reviewer for worldwide famous health journals such as PLOS One and BMC Pregnancy & Childbirth. He delivered a speech to the Members of Parliamentarians in Kathmandu in 2016 as part of a workshop to promote evidence-based policy-making. He is a committee member on various grant-awarding bodies in the UK, Belgium, the Netherlands, Norway, Switzerland, and the USA. He is a visiting Professor at the Centre for Disability Studies, Mahatma Gandhi University, Kerala in India (2020-present); the School of Health Sciences at the University of Nottingham in England (2017-2026); Nobel College, affiliated with Pokhara University, Nepal (2012-present); and Manmohan Memorial Institute of Health Sciences affiliated with Tribhuvan University (2009-present). We would like to express our gratitude for his acceptance to share personal and academic lives, which can inspire young and energetic scholars in Nepal and elsewhere.”

Reference:

Subedi, M., Khattri, M. B. (2023). Interview with Professor Edwin van Teijlingen. Dhaulagiri Journal of Sociology and Anthropology, 17(01), 79–88. https://doi.org/10.3126/dsaj.v17i01.61149

December 5, 2023

Paper in BMJ Global Health

international, open access, writing Edwin van Teijlingen

Today we received notice that our paper ‘The impacts of decentralisation on health systems: a systematic review of reviews’ has been accepted by the international journal BMJ Global Health. [1] This review of reviews was produced as part of the Nepal Federal Health System Project, examining the consequences for the health system of Nepal’s move to a federal government structure. This is a joint project (2020-2024) led by the University of Sheffield and in collaboration with Bournemouth University, the University of Huddersfield, Manmohan Memorial Institute of Health Sciences (MMIHS) and PHASE Nepal. This longitudinal interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1] and has resulted in four previous publications. [2-5]

The latest paper is a review which synthesizes evidence generated by previous reviews on the impact of decentralising health system governance on the six WHO (World Health Organization) health system building blocks. We systematically searched for reviews exploring the impact of decentralisation on the health system from five databases. Reviews, both systematic and non-systematic, published in the English language from 1990 to February 2022 were included. Nine reviews, each addressing slightly different questions, contexts and health system issues, were synthesised. They showed that devolution can have positive or negative impacts on the health system and its components. Moreover, impact assessments are significantly affected by complexities surrounding decentralisation and health system concepts: their dynamic mechanisms, inconsistent and often differently operationalized health system and health system component variables, and methodological challenges. For the WHO health system components, more negative than positive impacts were reported. The reviews highlight the importance of closely assessing (pre-)existing (political and non-political) characteristics of countries and their health systems to better understand impacts. This review of reviews concludes that decentralisation can have a negative or a positive impact on the health system and its components; the impacts are shaped by pre-existing country contexts. Generating conclusive and generalisable evidence of the impacts of decentralisation on health systems is challenging. Whilst decentralisation may seek to enhance community engagement and improve the responsiveness of decision-making, it has the potential to create serious challenges to the health system, the manifestations of which are likely to be context-specific.

Prof. Edwin van Teijlingen

CMWH

Sapkota, S., Dhakal, A., Rushton, S., van Teijlingen, E., Marahatta, S.B., Balen, J., Lee, A. for the Nepal Federal Health System Team (2023) The impacts of decentralisation on health systems: a systematic review of reviews, BMJ Global Health (forthcoming)
Wasti, S.P., van Teijlingen, E.,Rushton, S., Subedi, M., Simkhada, P., Balen, J. for the Nepal Federal Health System Team (2023) Overcoming the Challenges Facing Nepal’s Health System During Federalisation: An Analysis of Health System Building Blocks, Health Research Policy & Systems 21(117) https://doi.org/10.1186/s12961-023-01033-2
Sapkota, S., Panday, S., Wasti, S.P., Lee, A., Balen, J., van Teijlingen, E., Rushton, S., Subedi, M., Gautam, S., Karki., J., Adhikary, P., Marahatta, S., Simkhada, P., for the Nepal Federal Health System Team (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of the Nepal Public Health Association 7(1):36-42.
Adhikary, P., Balen, J., Gautam, S., Ghimire, S., Karki, J., Lee, A.C.K., Marahatta, S.B., Panday, S., Pohl, G., Rushton, S., Sapkota, S., Simkhada, P.P., Subedi, M., van Teijlingen, E. for the Nepal Federal Health System team (2020) The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system, Journal of Karnali Academy of Health Sciences 3 (3): 1-11.
Rushton, S., Pandey, S., van Teijlingen, E., Subedi, M., Balen, J., Karki, J., Simkhada, P. on behalf of the Nepal Federal Health System Team (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146

November 3, 2023

New health policy paper published this week

international, open access, Publishing, writing Edwin van Teijlingen

This week the Nepal Federal Health System Team published its latest paper the international journal Health Research Policy & Systems [1]. This Open Access paper ‘Overcoming the challenges facing Nepal’s health system during federalisation: an analysis of health system building blocks‘ reports on two separate methods: interviews and participatory policy analysis workshops, to offer an in-depth understanding of stakeholders’ practical learning, experiences, and opinions. Participants included policymakers, health service providers, local elected members, and other local stakeholders. All interviews were audio-recorded, transcribed, translated into English, and analysed thematically using the six WHO (World Health Organization) health system building blocks [2] as its theoretical framework.

Wasti et al. found that participants noted both opportunities and challenges around each building block. Identified opportunities were: (a) tailored local health policies and plans, (b) improved health governance at the municipality level, (c) improved health infrastructure and service capacity, (d) improved outreach services, (e) increased resources (health budgets, staffing, and supplies), and (f) improved real-time data reporting from health facilities. At the same time, several challenges were identified including: (a) poor coordination between the tiers of government, (b) delayed release of funds, (c) maldistribution of staff, (d) problems over procurement, and (e) limited monitoring and supervision of the quality of service delivery and data reporting.

The paper concludes that since federalisation, Nepal’s health system performance is improving, although much remains to be accomplished. For Nepal to succeed in its federalisation process, understanding the challenges and opportunities is vital to improving each level of the health system in terms of (a) leadership and governance, (b) service delivery, (c) health financing, (d) health workforce, (e) access to essential medicines and technologies and (f) health information system.

This publication is the fourth one originating from our Nepal Federal Health System Project, our major collaborative project examining the consequences for the health system of Nepal’s move to a federal government structure [2-5]. This is a joint project (2020-2024) led by the University of Sheffield and in collaboration with Bournemouth University, the University of Huddersfield, Manmohan Memorial Institute of Health Sciences (MMIHS) and PHASE Nepal. This longitudinal interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1].

Prof. Edwin van Teijlingen

Centre for Midwifery & Women’s Health (CMWH)

References:

Wasti, S.P., van Teijlingen, E.,Rushton, S., Subedi, M., Simkhada, P., Balen, J. for the Nepal Federal Health System Team (2023) Overcoming the Challenges Facing Nepal’s Health System During Federalisation: An Analysis of Health System Building Blocks, Health Research Policy & Systems 21(117) https://doi.org/10.1186/s12961-023-01033-2
World Health Organization (2007) Everybody’s business: strengthening health systems to improve health outcomes. WHO’s Framework for Action. Geneva: World Health Organization.
Sapkota, S., Panday, S., Wasti, S.P., Lee, A., Balen, J., van Teijlingen, E., Rushton, S., Subedi, M., Gautam, S., Karki., J., Adhikary, P., Marahatta, S., Simkhada, P., for the Nepal Federal Health System Team (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of the Nepal Public Health Association 7(1):36-42.
Adhikary, P., Balen, J., Gautam, S., Ghimire, S., Karki, J., Lee, A.C.K., Marahatta, S.B., Panday, S., Pohl, G., Rushton, S., Sapkota, S., Simkhada, P.P., Subedi, M., van Teijlingen, E. for the Nepal Federal Health System team (2020) The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system, Journal of Karnali Academy of Health Sciences 3 (3): 1-11.
Rushton, S., Pandey, S., van Teijlingen, E., Subedi, M., Balen, J., Karki, J., Simkhada, P. on behalf of the Nepal Federal Health System Team (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146

April 24, 2023

Several BU papers at this week’s BNAC Nepal Study Days

conferences, international, Publishing, writing Edwin van Teijlingen

The BNAC (Britain-Nepal Academic Council) twentieth Nepal Study Days (24-25 April) start today in Huddersfield. BU is directly represented through Dr. Pramod Regmi who will be presenting ‘Health Research Priorities and Needs in Migrant Health: A Review of Reviews’ today. Dr. Regmi based in the Department of Nursing Sciences and Prof. Edwin van Teijlingen in the Department of Midwifery & Health Sciences are also part of the paper ‘Nepal Family Cohort Study: Starting a Longitudinal Population Health Study’ which will be presented by our colleague Dr. Om P. Kurmi from Coventry University.

There will also be a BU paper on ‘Perceptions Around Covid-19 and Vaccine Hesitancy: A Qualitative Study Among People Living in Kaski, Western Nepal’ , presented by Dr. Preeti Mahato. Preeti is based at Royal Holloway (University of London) and she is also a Visiting Faculty member of FHSS. She’ll presenting a study recently published in PLOS Global Public Health.

These Nepal Studies Days pay serious attention to our ongoing interdisciplinary study ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’ which was reported in several national newspapers in Nepal last week. Tomorrow there will be a plenary session by Prof. Simon Rushton, the PI on this project in which BU collaborates. He will be talking about ‘Nepal’s Health System During Federalisation: Emerging Issues and the Co-production of Policy and Practice Recommendations’. Later that day there will be two further presentations based on this large-scale study, the first one by Dr. Sharada P. Wasti followed by one delivered by Dr. Sujata Sapkota.

April 13, 2023

Successful event with senior policymakers in Nepal

international Edwin van Teijlingen

Today, the last day of the Nepalese year 2079, we held a well attended event to discuss the preliminary findings of the interdisciplinary study of the impact of federalisation on health system in the country. We invited policymakers and politicians from all three levels of government in the country to help the research team to analyse the large amount of high-quality data. This meeting helped to validate the study results and guide our future capacity building as part of this project. We were pleasantly surprised by the number who turned up and with their active engagement!

One of the interesting comments made by the participants was that this was the first time that they had met with staff from differ levels to discuss the working of the system. In fact, participants expressed that they wanted more opportunities to have this kind of discussions across all three levels of government. The researchers reported both positive and negative developments in the decentralized health system of Nepal. Positive aspects included, for example, improvements in the availability of resources for health, the construction of new health posts and hospitals, better availability of essential medicines in many places. We also commented on the positive management of COVID-19, compared to other many countries. The policymakers from local, provincial and national level largely agreed with our findings and analyses.

This stakeholders’ event is part of the Nepal Federal Health System Project, our major collaborative project examining the consequences for the health system of Nepal’s move to a federal government structure in 2015. This is a joint project (2020-2024) led by colleagues the University of Sheffield in collaboration with the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) Bournemouth University, the University of Huddersfield, with two partners in Nepal, namely Manmohan Memorial Institute of Health Sciences (MMIHS) and PHASE Nepal. This longitudinal interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref. MR/T023554/1].

Prof. Edwin van Teijlingen

CMMPH

June 26, 2022

Building International Partnerships

conferences, Fusion themes, international Edwin van Teijlingen

On Monday 27th June Prof. Edwin van Teijlingen will be presenting at the ‘Global Partnership for International Research Meeting’ at the University of Huddersfield. The meeting is organised by Prof. Padam Simkhada, who is Associate Dean International and Professor of Global Health, as well as Visiting Professor at Bournemouth University. Edwin will be talking about his experience in building long-term sustainable and effective international partnerships, using examples from both the health and sociology field.

A current example he will highlight is one of Bournemouth University’s international research collaborations is the Nepal Federal Health System Project, led by the University of Sheffield. This three-year project (2020-2023) is funded by the Health Systems Research Initiative (incorporating the MRC, DFID, Wellcome Trust), it has partners in the UK and Nepal and bring together an interdisciplinary team of specialists in public health, sociology, health systems, social geography, health economic, political science, anthropology, medicine, emergency management, nursing & international development.

June 17, 2022

New paper on federalisation of health system in Nepal

international, Publishing, writing Edwin van Teijlingen

Earlier this week the editor of the Journal of Nepal Public Health Association informed us the journal had accepted our latest paper ‘Health System Strengthening: The Role of Public Health in Federal Nepal’ [1]. This article addresses some of the key Public Health approaches around the ongoing federalisation of the state of Nepal and the associated decentralisation processes in its health system. This is the third paper of our three-year project, which is UK-funded by the MRC, Wellcome Trust and DFID under the Health Systems Research Initiative and led by Dr. Julie Balen and Prof. Simon Rushton based at the University of Sheffield. The first two papers introduced our international research project ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’ [2], and focused on COVID-19 when examining the effects of changing Nepal’s constitution towards a federal republic on its health system [3].

Prof. Edwin van Teijlingen

CMMPH (Centre for Midwifery, Maternal & Perinatal Health Research)

References

Sapkota, S., Panday, S., Wasti, S.P., Lee, A., Balen, J., van Teijlingen, E., Rushton, S., Subedi, M., Gautam, S., Karki, J., Adhikary, P., Marahatta, S., Simkhada, P. for the Nepal Federal Health System Team (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of Nepal Public Health Association (forthcoming).
Rushton, S., Pandey, S., van Teijlingen, E., Subedi, M., Balen, J., Karki, J., Simkhada, P. on behalf of the Nepal Federal Health System Team (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146
Adhikary, P., Balen, J., Gautam, S., Ghimire S., Karki J.K., Lee A.C., Marahatta S.B., Pandey S., Pohl G., Ruston S., Sapkota S., Simkhada P.P., Subedi M., van Teijlingen E.R., on behalf of the NFHS Team. The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system. Journal of Karnali Academy of Health Sciences. 2020; 3(3)

April 10, 2022

Summit of Health & Population Scientists in Nepal 2022

international, Publishing, writing Edwin van Teijlingen

Today say the start of the Eight National Summit of Health & Population Scientists in Nepal. Bournemouth University is involved in two presentation. The first will be one by University of Huddersfield PhD student Tamang Pasang, and her supervisors Prof. Padam Simkhada (FHSS Visiting Faculty), Dr. Bibha Simkhada (former BU Lecturer in Nursing and current FHSS Visiting Faculty) and Prof. Edwin van Teijlingen. Pasang will be talking about her thesis fieldwork: ‘Impact of Federalisation in Maintaining Quality of Maternal and Neonatal Care in Nepalese Health System’.

The second presentation will focus of the Nepal Federal Health System Project, our major collaborative project examining the consequences for the health system of Nepal’s move to a federal government structure in 2015. This is a joint project led by the University of Sheffield with Bournemouth University, the University of Huddersfield, and two institutions in Nepal: Manmohan Memorial Institute of Health Sciences MMIHS) and PHASE Nepal. This interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref.
MR/T023554/1].

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternity & Perinatal Health (CMMPH)

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