Paropakar Maternity and Women’s Hospital UK (above), prayer flags below, and UK and Nepali colleagues get together to share knowledge.
The reality behind the research We were also able to visit two of the hospi- tals being used as study sites for the later stages of the project: Paropakar Maternity and Women’s Hospital (a public hospital) and Kathmandu Medical College Teaching Hospital (a private hospital). At both sites we were very kindly given tours of antenatal clinics, postnatal wards, delivery suites and NICUs, and were able to meet some of the staff and patients. Having previously only encountered Nepali hospitals through the detached, scientific wording of research papers and clinical statistics, I found it fas- cinating and at times eye-opening to see the reality of these two hospitals. For example, I only really grasped the implications of 60 births per day at Paropakar Hospital (South- mead Hospital has around 18 per day) when walking through the busy corridors and bustling ward areas of the hospital, encoun- tering a sea of mothers, partners, family members and staff. Now, when reading about studies conducted at these two Nepali hospitals, I have been able to draw on the sights, sounds, and even smells from my visits to contextualise the scientific text I’m reading.
Another new experience for me was being part of the planning of a healthcare primary research study. This is particularly notewor- thy when you consider that I run training sessions back at Southmead Hospital on evaluating research methodology in academic health papers, and I am familiar with much of the theory and terminology. However, this was the first time I could experience first-hand all the minute plan-
34 INFORMATION PROFESSIONAL
ning behind details such as: the phrasing of focus group questions; which patients and staff to include; concerns about inter-rater reliability of survey tools and so on –i as well as the bigger logistics of project finances and ethics applications. It has certainly made me more appreciative of all the work that goes into the papers I read and evaluate in my day-to-day job!
Systematic review findings
Since coming back to the UK, we have been busy working on the systematic review. It has been interesting to see that quite a few of the studies we’ve retrieved explore the use of information provision as a means to improve ANC. Many of these target specific barriers to dissemination of evidence-based ANC information, such as high illiteracy rates and a large rural population,4
and
draw on unique aspects of Nepali culture and infrastructure to overcome these, for example using community groups, text mes- sage information services, and even song. Nepal-specific solutions such as these will be of particular interest when we come to pull together the findings from all the parts of the project.
Next steps While we’ve been busy with the systematic review, the Nepali team have been carrying out the data collection for the qualitative research arms of the project, and the aim is to complete the whole project by the end of July. Following that, further funding will be sought for the next stage: developing, implementing and evaluating some form of
intervention, or package of interventions, to improve ANC in Nepal. This will draw on the findings from all the elements of this first exploratory stage, ensuring that development of the intervention is informed by a range of stakeholders and, crucially, is evidence-based.
My experience
My week in Nepal was, without doubt, the pinnacle of my professional career so far. I learned a considerable amount in a short space of time, gaining insights into the complexities of carrying out research in clinical settings, the power of collabo- rative working, and the current reality of ANC in Nepal. I returned with a deeper interest in health research and a desire to develop my existing research experience, and the perfect opportunity for this has now arisen: I have been asked to lead on the final stages of the systematic review, meaning new, unchartered territory for me. However, more than anything, the week has augmented the great respect and awe I have for researchers in all fields. I can only hope that when I return from maternity leave I might be able to resume my secondment and continue working with such inspirational colleagues – I’m crossing my fingers and toes! IP
References
1 Centre for Reviews and Dissemination, Universi- ty of York, 2009. Systematic Reviews: CRD’s guid- ance for undertaking reviews in health care, p.v.
2 MIRA, 2019.
http://www.mira.org.np/mira/
3 Ministry of Health, Nepal, 2017. Demographic and Health Survey 2016, pp.151-154. 4 Ibid., p.44
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