Krishna Regmi

Understanding the Processes of Translation and Transliteration in Qualitative Research

There has been growing interest in the use of qualitative methods in health research amongst health and social care professionals. Good qualitative cross-cultural research analysis is not an easy task as it involves knowledge of different approaches, techniques and command of the appropriate languages. This article aims to discuss and explore some of the key processes and concepts involved in conducting translation and transliteration of qualitative research.

Decentralization and district health services in Nepal: understanding the views of service users and service providers.

BACKGROUND Within the decentralization framework of Government, the Ministry of Health (MoH) Nepal initiated the decentralization of primary care services closer to citizens. This paper aims to examine and understand the effect of decentralization at the district health service from the perspectives of service users and providers. METHODS Using non-probability purposive sampling, we conducted a series of in-depth interviews and focus group discussions in four primary health care institutions with service users, providers and other stakeholders. QSRNVivo7 software was used to analyse and categorize the data under emerging themes. RESULTS Decentralization was positively associated with increased service access and utilization and improved service delivery. The study also revealed areas of concern and possible improvement and identified the barriers to implementing these improvements. Problems described included three main areas: functions, functionaries and funding. CONCLUSION Both service users and providers convey a generally positive message about the health sector decentralization. The active involvement of service users, providers, policy-makers in the process of decentralization and clear national and local policy agendas may bring positive changes in district health services.

Opportunities and Challenges of Sexual Health Services among Young People: A Study in Nepal

INTRODUCTION It has been well documented that young people are more likely to engage in high-risk sexual activity. Appropriate understanding of safe sex, sexual practices, and related behaviors must recognize the importance of socioeconomic and cultural factors in prevention efforts related to HIV and other sexual transmitted infections (STIs). AIM To examine and summarize the opportunities and challenges of sexual health services among young people in Nepal. MAIN OUTCOME MEASURES Review of literature--assessing knowledge, attitudes, and understanding of sex, sexual health, and related sexual risk behaviors, among young people (15-24), in line with the current sociocultural and health service practices. METHODS Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science, Cochrane database, and Google were searched. Similarly, documents published at the WHO, United Nations Population Fund, United Nations Development Program, and at national/local level--Ministry of Health, National Center for AIDS, and STD Control were also assessed to access the relevant reports and articles. Published and gray articles were also reviewed. RESULTS This study contends growing expansion of communication and transportation networks, urbanization, and urban in-migration is creating a different sociocultural environment, which is conducive to more social interactions between young girls and boys in Nepal. Rising age at marriage opens a window of opportunity for premarital and unsafe sexual activity among young people and this creates risks of unwanted pregnancy, STIs/HIV and AIDS. Socioeconomic, demographic, and cultural factors have been identified as encouraging factors for risk-taking behaviors among young people. CONCLUSIONS Understanding safer sex and responsible sexual/reproductive behavior is important. Effective and appropriate interventions on sexual and reproductive health education directed at young people and the whole family, including fathers, could have significant effect on reducing risk and related risk practices in the context of Nepal.

How can health systems be strengthened to control and prevent an Ebola outbreak? A narrative review.

The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC) in West Africa, with a projected estimate of 1.2 million deaths expected in the next 6 months. Ebola virus is a highly virulent pathogen, often fatal in humans and non-human primates. Ebola is now a great priority for global health security and often becomes fatal if left untreated. This study employed a narrative review. Three major databases – MEDLINE, EMBASE, and Global Health – were searched using both ‘text-words’ and ‘thesaurus terms’. Evidence shows that low- and middle-income countries (LMICs) are not coping well with the current challenges of Ebola, not only because they have poor and fragile systems but also because there are poor infectious disease surveillance and response systems in place. The identification of potential cases is problematic, particularly in the aspects of contact tracing, infection control, and prevention, prior to the diagnosis of the case. This review therefore aims to examine whether LMICs’ health systems would be able to control and manage Ebola in future and identifies two key elements of health systems strengthening that are needed to ensure the robustness of the health system to respond effectively.

A qualitative study on the food habits and related beliefs of pregnant British Bangladeshis.

It is quite challenging to deal with the health care needs of migrant populations in general, especially pregnant women, due to their diverse sociopolitical and cultural beliefs and practices. In this article, we aim to examine and understand the food habits and beliefs of pregnant British Bangladeshis using qualitative methods. Our results indicate some positive associations between the increased intakes of particular foods to ensure healthy outcomes. We also note that migration affects pregnant Bangladeshi womens physical and mental conditions. We conclude that effective health care and awareness about traditional food beliefs and habits, and their subsequent reflection into the national and local policy agendas, may bring forth positive changes and improve the overall health of pregnant women.

Adult Learning Opportunities in Nepal.

This paper presents the initial findings from a study of education system in Nepal. This paper examines the adult learning opportunities within the educational and cultural contexts by reviewing available literature relevant to Nepal. Findings show that there are wider opportunities for adult learning than those considered from education and policy research perspectives, and these include autonomous and self-directed learning as well as learning from life experiences. Study also shows that learning among adults is more than a set of basic skills to be acquired and that literacy, equality and creativity can be understood through the everyday lives and sociocultural practices of learners. The paper concludes by considering the implications of these findings on teaching-learning methodologies suitable for adult education initiatives and for professional practice in Nepal.

Reflection – a preferred method of teaching in higher education. A probationer teacher’s experience

Probationer teachers are faced with many challenges in the UK’s higher education teaching/learning process. In this paper, the author examines some of the arguments about whether reflection is a preferred method of teaching in higher education by reflecting on his own experience of teaching at a UK university, the experiences of students and the relevant teaching context.

A systematic review of knowledge, attitudes and beliefs about malaria among the South Asian population

Background Malaria is one of the deadliest mosquito-borne diseases in the world. More than 80% of the total populations are at risk of malaria in the 22 countries in Asia and the Pacific. South Asia alone is home to an estimated 1.4 billion people at risk of contracting malaria. Despite the remarkable progress in reducing the burden of malaria, evidence of the disease based on knowledge of the social and cultural contexts from a South Asian perspective is limited. Our objective was to understand the knowledge, attitudes and beliefs about malaria in South Asian communities. Methodology We conducted a systematic literature review, searching six databases, between 1990 and 2015, focusing on knowledge, attitudes and beliefs about malaria in South Asia. Databases were searched using both ‘free terms’ and ‘index terms’ funnelled using Boolean operators and truncations. Inclusion and exclusion criteria were set, and included papers were scrutinised, employing a critical appraisal tool to find the best available evidences to support the study purpose. Results and discussion Evidence from 32 articles (26 quantitative, four qualitative and two mixed methods). General knowledge and awareness of the disease, its transmission, and control and preventative measures were generally found to be lacking amongst both the general public and healthcare professionals. In addition, the study shows that poor socio-economic factors – including limited access to services due to poor/limited availability – and issues of affordability are considered as major risk factors. Conclusion This review suggests the importance of increasing health awareness, mobilising the local or community healthcare professionals, for prevention as well as early detection and effective treatment of malaria among people who are at risk. Malaria is also a disease associated with poverty and socio-cultural factors; therefore, strong political will, wider partnerships between health and non-health sectors, and strengthening health systems’ technical and managerial capabilities at all level of primary healthcare systems, is inevitable.

Assessing students’ written work: experience of a student practice lecturer in the UK

Assessment is one of the most important tools in teaching and learning in any academic institution, but it is rarely measured in effort, time and effectiveness. As a student practice lecturer, I faced many challenges as well as learning opportunities while working in higher education in the UK. In this paper, I explore some of the important concepts and issues to be considered while assessing or marking students’ written work – academic essays and reports – by reflecting on my own experience of learning at a UK university. This paper concludes that providing appropriate advice and guidance, i.e. feedback, would help students develop strategies for improving their learning and performance.

People living with facial disfigurement after having had noma disease: A systematic review of the literature

Noma disease often results in impairment, morbidity and severe facial disfigurement. This article reports a systematic review of literatures published between 2006 and 2015 to establish existing knowledge about social stigma associated with facial disfigurements. Five databases were searched and 114 citations were screened, of which only 15 met the relevant criteria. Titles and abstracts of the retrieved articles were independently reviewed. The research was heterogeneous; therefore, overall synthesis using meta-analysis was inappropriate. It can be seen that the review demonstrates that facial disfigurements are far more complex than was previously thought.