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The Institute for Global Health and Development

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9

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Start date: 2024Subject: search.filters.subject.Nepal

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    Palliative Care and Pain Management in a Resource-Limited Setting
    (Kathmandu University, 2025-03) Gautam, Araya; Gautam, A; Johnson, S; Rahman, F A
    Palliative care is a vital component of healthcare that aims to alleviate the suffering of patients with life-threatening conditions. This specialized medical care focuses on managing symptoms, addressing social, emotional, and physical needs, and enhancing the quality of life for patients and their families. Palliative care addresses the patient’s medical, psychological, and spiritual requirements, and can be used as the primary focus of care or in conjunction with curative therapies. Pain management is a crucial aspect of palliative care, involving the control or reduction of pain through medication, therapy, and other treatments. However, pain is a subjective sensation, making quantification and effective relief challenging. This review highlights the complex issues associated with pain management in palliative care, emphasizing the need for improved training and accessible pain management techniques, such as the widely recognized “Wong-Baker Face Pain Scale”, particularly in resource-constrained environments like Nepal. The complex nature of pain management in palliative care compromises patients’ quality of life, influenced by factors like chemotherapy and terminal illness. Addressing this issue is imperative, especially in areas like Nepal where there is a shortage of appropriate training among medical personnel. Encouragingly, initiatives like mobile health teams, smartphone apps, and the establishment of a Palliative Care Training Center demonstrate progress in improving end-of-life care.
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    Political economy analysis of health financing reforms in times of crisis: findings from three case studies in south-east Asia
    (BioMed Central, 2025-02-03) Witter, Sophie; Bertone, Maria Paola; Baral, Sushil; Gautam, Ghanshyam; Pratap, Saugat K. C.; Pholpark, Aungsumalee; Saputri, Nurmala Selly; Darmawan, Arif Budi; Toyamah, Nina; Fillaili, Rizki; de Oliveira Cruz, Valeria; Sparkes, Susan
    Background: Over the last decades, universal health coverage (UHC) has been promoted in south-east Asia (SEA), where many countries still need to ensure adequate financial protection to their populations. However, successful health financing reforms involve complex interactions among a range of stakeholders, as well as with context factors, including shocks and crises of different nature. In this article, we examine recent health financing reforms in Nepal, Thailand and Indonesia, using a political economy lens. The objective is to understand whether and how crises can be utilised to progress UHC and to analyse the strategies used by reformers to benefit from potential windows of opportunity. Methods: The study adopted a retrospective, comparative case study design, using a shared framework and tools. The case studies mapped the contexts, including economic, political, social trends and any shocks which had recently occurred. A focal health financing reform was chosen in each setting to examine, probing the role of crisis in relation to it, through the key elements of the reform process, content and actors. Data sources were largely qualitative and included literature and document review (144 documents included across the three cases) and key informant interviews (26 in total). Results: The findings, which bring out similarities and differences in the roles played by change teams across the settings, highlight the importance of working closely with political leaders and using a wide range of strategies to build coalitions and engage or block opponents. Changing decision rules to block veto points was significant in one case, and all three cases used participation and dialogue strategically to further reforms. More broadly, the links with context emerged as important, with prior conflicts and economic crises creating a sense of urgency about addressing health inequities, while in all countries appeal was made to underlying values to enhance the legitimacy of the reforms. Conclusion: The lessons from these case studies include that technical teams can and should engage in Political Economy Analysis (PEA) thinking and strategizing, including being aware of and adaptable to the changing PEA landscape and prepared to take advantage of windows of opportunity, including, but not limited to, those emerging from crisis. There is a need for more empirical studies in this area and sharing of lessons to support future reforms to increase health coverage and financial protection, including in the face of likely shocks.
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    The Role of Faith in Child Marriage: Empirical Evidence from Mozambique, Nepal, and the Philippines
    (Taylor and Francis Group, 2024-08-16) Jailobaeva, Kanykey; Kraft, Kathryn; Barrett, Hazel; Niyonkuru, Pascal; Lim, Desmond; Marin, Alberto; Cossa, Eduardo
    Traditional and religious justifications have been identified to support the continued practice of child marriage. However, the role of faith in child marriage has not been widely studied. This mixed-method study investigates the role of faith in child marriage in Mozambique, Nepal, and the Philippines. Faith and religion are deeply ingrained in these communities, as most survey respondents identified with a faith group and practiced their religion in both private and public domains. Faith was found to have an impact on child marriage through beliefs around gender roles. Although this trend was observed in all countries, there were variations between them, highlighting the significance of local context. Addressing child marriage requires a comprehensive approach that considers both faith and gender norms.