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An overview of qualitative research methods and its place in health research in Nepal
Edwin van Teijlingen, Dr Bibha Simkhada, Maureen Porter, Professor Padam Simkhada, Emma Pitchforth, Prakash Bhatta
Kathmandu University Medical 36 (4), 301-5, 2011.
Abstract There has been a steady growth in recent decades in Nepal in health and health services research, much of it based on quantitative research methods. Over the same period international medical journals such as The Lancet, the British Medical Journal (BMJ), The Journal of the American Medical Association (JAMA) and the Journal of Family Planning & Reproductive Health Care and many more have published methods papers outlining and promoting qualitative methods. This paper argues in favour of more high-quality qualitative research in Nepal, either on its own or as part of a mixed-methods approach, to help strengthen the country’s research capacity. After outlining the reasons for using qualitative methods, we discuss the strengths and weaknesses of the three main approaches: (a) observation; (b) in-depth interviews; and (c) focus groups. We also discuss issues around sampling, analysis, presentation of findings, reflexivity of the qualitative researcher and theory building, and highlight some misconceptions about qualitative research and mistakes commonly made.
Knowledge, Attitude and Prevalence of Overweight and Obesity among Civil Servants in Nepal
Prakash Simkhada, Amudha Poobalan, Professor Padam Simkhada, Amalraj Raja, Lorna Aucott
Asia Pacific Journal of Public Health. 23(4), 507-51, 2009.
Obesity threatens developing countries as urbanization increases, with civil servants being particularly vulnerable. The authors assess overweight/obesity prevalence among Nepalese civil servants along with their knowledge and attitudes. A cross-sectional questionnaire survey conducted among 341 participants (97.4% response rate) also recorded height and weight. Participants were 40 ± 6.6 years, mostly males, married, and from a single ethnic group. Overweight/obesity prevalence was 33.4%. Knowledge of obesity was good. However, some attitudes toward obese people were negative, despite half of the participants believing obesity to indicate prosperity. Logistic regression indicated marriage and/or having a better job increased the overweight/obese risk by nearly 8 and 9 times, respectively. Heavier people were more likely to disagree with attitudes that obese people were “lazier” and “untidy.” Obesity prevalence among Nepalese civil servants is already higher than the general population level. Health education and interventions are needed to translate knowledge into attitude and behavior changes in order to prevent this becoming an epidemic.
Reliability of National Data Sets: Evidence from a detailed Small Area Study in Rural Kathmandu Valley, Nepal
Professor Padam Simkhada, Edwin van Teijlingen, Santosh Kadel, Jane Stephens, Sheetal Sharma, M Sharma
Asian Journal of Epidemiology 2 (2), 44-48, 2009.
Abstract Researchers often rely on Census data to provide us with information for local areas. In a study in rural Nepal we came across major discrepancies between the number of women with a child under the age of two as estimated from the national Census and the prevalence rate of this population in our local in-depth household survey. This Research Notes highlights why Census data might not be as reliable as one would hope. In summary, researchers using Census data in developing countries should include an element of quality control of the national dataset. We advise researchers to conduct a small survey from a random sample to provide an estimate of the likely population in the area under study.
Sexual and reproductive health status among young people in Nepal: opportunities and barriers for sexual health education and services utilization
Pramod Regmi, Professor Padam Simkhada, Edwin van Teijlingen
Kathmandu University Medical Journal. 6(2), 248-256, 2008.
Abstract This article attempts to summarise the situation of sexual and reproductive health among young people in Nepal. Modernisation and social transformation are occurring rapidly in Nepalese society. Growing expansion of communication and transportation networks, urbanisation and in-migration of population to urban areas is creating a different sociocultural environment, which is conducive to more social interactions between young girls and boys in Nepal. Rising age at marriage has now opened a window of opportunity for pre-marital and unsafe sexual activity among young people in Nepal which creates risks of unwanted pregnancy, STIs/HIV and AIDS. Several socio-economic, demographic and cultural factors have been identifi ed as encouraging factors for risk taking behaviours among young people. Improving access to youth friendly services, implementing peer education programmes for school and out of school going adolescents, developing effective Information, Communication and Education (IEC) materials and curricula have been highly suggested to improve the existing young people’s sexual and reproductive health status.
Priyamvada Paudyal, Professor Padam Simkhada, Julie Bruce
American Journal of Infection Control. 36(8), 595-597, 2008.
This study was designed to assess the knowledge, attitudes, and infection control practices among Nepalese health care workers (HCWs). The study comprised a questionnaire survey of 324 staff from acute care hospitals in Kathmandu, Nepal. A total of 158 doctors and 166 nurses participated, 27% of whom had received infection control training. Only 16%, 14%, and 0.3% of the respondents achieved maximum scores for knowledge, attitude, and practice items, respectively. Staff had good knowledge and positive attitude toward most aspects of infection control, although only half had heard of methicillin-resistant Staphylococcus aureus. Logistic regression revealed that profession, age, and having studied abroad significantly predicted markers of infection control knowledge, attitudes, and practice. This is the first survey of infection control practice among Nepalese HCWs and provides useful baseline data by professional group. There is ample opportunity for improvement in current practice, which should be recognized by hospital managers and Nepalese health authorities. Nepal is a developing country in South Asia with a population of 23 million and many health problems typical of other developing Asian countries.1 Despite the public health burden from infectious diseases, there are currently no surveillance programs in place for health care–associated infections (HAIs) in Nepal or national guidelines for infection control. The present study is the first to investigate infection control knowledge, attitudes, and practice among nursing and medical health care workers (HCWs) in Nepal.