The Impact of Federalization on Health Sector in Nepal: New Opportunities and Challenges

The promulgation of constitution of Nepal in 2015 has shifted the unitary government of Nepal towards federalism with significant devolution of power to seven newly created provinces, each with their own unicameral legislature. The major challenges during the transition phase in health sector are spillover effects, unclear roles and responsibilities of local authorities, human resource management and strengthening capacity at local level as per local need. Despite these challenges, federalism brings fertile ground for the local government to work more closely with their people; with more effective financing and planning based on evidences and their need

International Nurses:Transitional Toolkit

National Health Service England has a rich history of recruiting nurses from international labour markets (Nichols and Campbell, 2010), with nearly one in five nurses currently working in NHS Trusts recruited from overseas (Palmer et al., 2021). The Long Term Workforce Plan indicates that we will continue with current levels of ethical international recruitment in the coming years before reducing its reliance in the medium term over time. The NHS has many attributes that attract international nurses including career advancement, superior pay, prospects on offer in the United Kingdom (UK) and opportunities for continuing professional development (Palmer et al., 2021).The contribution that our overseas colleagues make to the health and care sector should be celebrated and each individual recognised for the wide range of cultures and expertise that they bring to the UK. However, international recruitment is complex, with international nurses facing different opportunities and challenges in the process of joining and integrating into the nursing workforce depending on their experience and recruitment approach (Nichols and Campbell, 2010; Davda et al., 2018; Bond et al., 2020; Pressley et al., 2022). International nurses are recruited from across the globe from many different countries, all with their unique healthcare systems and rich cultural backgrounds. As numbers ofinternational nurses rise, it is imperative to understand the broad range of factors that impact the retention of this increasingly crucial workforce including their backgrounds and previous experiences.The team at the University of Huddersfield embarked on a portfolio of research aiming to understand factors influencing recruitment and retention of international nurse

Nepal needs Continuing Professional Development for Re-registration in Nursing and Midwifery

The nursing and midwifery profession needs to stay up to date with the latest developments. In this Viewpoint, we shall be referring to ‘nurses’ and ‘nursing’ to mean ‘nurses and midwives’ and ‘nursing and midwifery’ respectively. Nurses must continue to update their skills and competences to meet changing future population health needs effectively and safely. However, the reality is that many staff are reporting difficulty accessing and completing Continuing Professional Development (CPD) in all settings

Stakeholders' perceptions of continuing professional development among Nepalese nurses: A focus group study.

AIM: This study explores perceptions of Continuing Professional Development (CPD) opportunities among stakeholders in the profession of nursing in Nepal. DESIGN: Qualitative study using focus group discussions (FGDs). METHODS: Eight FGDs were conducted in three major cities of Nepal with nursing stakeholders including nurse managers, matrons and directors/managers of private and public nursing colleges, representatives of nursing organizations, government officials, nursing academics and practitioners from the government and private sectors. The data were analysed thematically using Creswell's six steps of analysis and the Standards for Reporting Qualitative Research (SRQR) guideline was followed. RESULTS: The study generated three major themes: (a) policy level including the national situation of CPD, political influence and training guided by the policy; (b) organizational level incorporating perceptions towards forms of CPD, staff shortage, poor staff retention, seniority for training, financial constraints and lack of continuity of training; and (c) individual level including motivation for training and lack of relevant training

Use of technology to promote health and wellbeing of people who are homeless: a systematic review

Background: People who are homeless experience poorer health outcomes and challenges accessing healthcare contribute to the experienced health inequality. There has been an expansion in using technology to promote health and wellbeing and technology has the potential to enable people who are socially excluded, including those who are homeless, to be able to access health services. However, little research has been undertaken to explore how technology is used to promote health and wellbeing for those who are homeless. This review aims to address the questions: ‘what mobile health (mHealth) related technology is used by homeless populations’ and ‘what is the health impact of mobile technology for homeless populations’? Methods: An integrative review methodology was employed. A systematic search of electronic databases was carried out between 4 January 2021 and 30 April 2021, searching for papers published between 2015 and 2021, which yielded 2113 hits, relevant papers were selected using specified inclusion and exclusion criteria reported using the Preferred Reporting Items for Systematic reviews and Meta-Analysis. The quality assessment of each paper included in the review was undertaken using the Mixed Methods Appraisal Tool. Results: Seventeen papers were selected for review and thematic analysis identified four themes: technology ownership, barriers to use, connectivity and health benefits. Conclusion: It is evident that technology has the potential to support the health and wellbeing of individuals who are homeless; however, there are challenges regarding connectivity to the internet, as well as issues of trust in who has access to personal data and how they are used. Further research is needed to explore the use of health technology with people who are homeless to address these challenges

Factors Influencing COVID-19 Vaccine Uptake among Nepali People in the UK: A Qualitative Study

From MDPI via Jisc Publications RouterHistory: accepted 2022-05-11, pub-electronic 2022-05-14Publication status: PublishedVaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK. Interviews were conducted by a native-Nepali speaker and all interviews were audio-recorded, transcribed, and translated into English before being analysed thematically. Our study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the UK

Reflections on health promotion fieldwork in Nepal: Trials and tribulations

Conducting fieldwork is often a crucial part of community-based public health studies. However, few researchers write about this, often challenging, process. This paper highlights various occasions where fieldwork in the area of public health, health promotion or community health was more difficult than expected or did not go as planned. Our reflections on working in the field will help less experienced health researchers, or those new to conducting research in Nepal, in their research development. Moreover, this paper is also calling upon health promotion researchers to share more details about the process of doing fieldwork and its trials and tribulations. Our key advice is to be inquisitive and openminded around fieldwork, followed by: be prepared for your fieldwork, conduct a risk assessment of what might go wrong and consider your options to overcome such trials and tribulations. Fieldwork is unpredictable; therefore, it is important to share practical lessons from the field which helps other to better understand these tribulations, and learn from them. Moreover, sharing such information may guide new researchers and help them identify strategies that can address those issues and challenges in their future health promotion studies

Factors Influencing COVID-19 Vaccine Uptake among Nepali People in the UK: A Qualitative Study

Vaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK. Interviews were conducted by a native-Nepali speaker and all interviews were audio-recorded, transcribed, and translated into English before being analysed thematically. Our study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and (i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the U

International Nurse Migration Experience of the First Two Years: A Mixed Methods Study

Aim: The aim of this study was to explore experiences of internationally educated nurses' first 2 years working and living in England in an age of contemporary migration. Design: Exploratory mixed method design. Methods: An online survey collected responses from August 2022 to October 2022. A mixed‐methods approach was applied to gain a breadth of understanding through quantitative outcomes integrated with depth of qualitative analysis. Results: Data findings from 773 international nurses identified the recognition of prior professional skills and experiences, induction processes, career development systems and the role of line managers are integral to professional integration and could be improved. Communication barriers were frequently transient and time limited, and participants often had incomplete insight of human resource policies. Personal factors affecting life outside of work revealed compromise and sacrifice with accommodation choices, and participants were often not satisfied with their economic status, housing, cost of living in England, and social support. Mental well‐being scores varied by country of origin and participants happier with decision to migrate to England had significantly higher mental well‐being scores. Conclusion: International nurses have divergent professional and personal motivations for migration unique to individual circumstances. Recognition for transferable skills and experience, receipt of a comprehensive and warm welcome from organisations, safe and well‐maintained suitable accommodation and living conveniently located to shops, work and transportation, improve experience. International nurses must have sufficient financial gains from salaries and opportunity to unite with children and families. Implications for the Profession and/or Patient Care: Progressing migration experience of international nurses can improve retention and augment improving patient care and outcomes. Patient or Public Contribution: No patient or members of public contributed to this research