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Health promotion moves beyond changing the health-related knowledge, attitudes and behaviour of individuals and covers a wide range of social and environmental interventions. Nepal has also introduced health promotion policies targeting health education, information and communication. Auxiliary Nurse Midwives (ANMs), who are responsible for delivering primary care maternity services, especially in birthing centres located in rural areas of Nepal, also have an important role to play in the promotion of women’s health during pregnancy, intra-partum and post-partum. However, in the present context, health promotion provided by ANMs in Nepal is confined mostly to health education and behavioural-change communication. There are a range of health promotion activities relevant to maternity care and midwifery that ANMs can practice even in low-technology rural birthing centres. Such health promotion offers an opportunity to move away from a very medical and behavioural model to a more empowering one in order to prevent health problems in a cost-effective way.

BACKGROUND AND OBJECTIVES: Mental illness is increasingly recognized as a global health problem. However, in many countries, including Nepal, it is difficult to talk about mental health problems due to the stigma associated with it. Hence a training programme was developed to train auxiliary nurse midwives, who otherwise are not trained in mental health as part of their pre-registration training in rural Nepal, on issues related to maternal mental health. After the training programme a selection of auxiliary nurse midwives were interviewed to establish their views on the training, its usefulness and ways to improve it. METHODS: This qualitative study reports on the analysis of interviews conducted with auxiliary nurse midwives who participated in the training programme. The interviews addressed issues associated with the training programme as well as perceptions around mental health in rural Nepal. Transcripts were thematically analysed. RESULTS: Three themes emerged from analysis: (1) issues related to training; (2) societal attitudes; and (3) support for women. The 'training' theme describes the benefits and limitations of training sessions. 'Societal attitudes' describes society's attitude towards mental health which is largely negative. 'Support' describes the positive behaviour and attitude towards pregnant women and new mothers. CONCLUSION: The study supports the need for continued training for auxiliary nurse midwives who are based in the community. This gives them the opportunity to reach the whole community group and potentially have influence over reduction of stigma; offer support and diagnosis of mental ill-health. There is still stigma around giving birth to a female child which can lead to mental health problems. It is imperative to increase awareness and educate the general public regarding mental health illnesses especially involving family members of those who are affected.

The creative research method ‘draw and write’ has been used in health, social care and education research\ud for several decades. A literature search of studies utilising this method was conducted during the planning\ud stages of a study exploring primary school children’s perceptions of infant feeding. A review of this literature\ud noted a range of benefits of ‘draw and write’ in enabling child participation. However, it also identified that\ud the method has been used inconsistently and found that there are issues for researchers in relation to\ud interpretation of creative work and analysis of data. As a result of this, an improvement on this method,\ud entitled ‘draw, write and tell’, was developed in an attempt to provide a more child-orientated and consistent\ud approach to data collection, interpretation and analysis. This article identifies the issues relating to ‘draw\ud and write’ and describes the development and application of ‘draw, write and tell’ as a case study, noting its\ud limitations and benefits

Infant feeding is a fundamental element in the childbirth continuum. A woman’s decision about whether to breastfeed, and the duration and exclusivity of this, has the potential to affect short and long term health for both herself and her baby (Vitora et al. 2016). When making infant-feeding choices mothers often feel obliged to conform to the expectations of their family, social group and culture (Angell et al. 2011). In addition, women are influenced by the wider society in which they live, and many report feeling pressurized, shamed and marginalised by other people in relation to their infant feeding (Thomson et al. in Maternal & Child Nutrition 11: 33–46, 2015). Although women’s choices are essentially personal and private, strong public opinions on the subject transform it into ‘everybody’s business’. This is exacerbated by mass media, which has become a conduit through which social and individual views on infant feeding are presented and debated. Curiously, the ‘everyday’ nature of this subject means that it often appears in the media in a covert manner, when it is unconsciously included as a minor element in a wider story. In other cases infant feeding is the story, and it appears in the media as a problematic issue and the focus of discussion (Henderson et al. in British Medical Journal 321: 1196–1198, 2000). During the past two decades a small body of research has emerged which has explored how infant feeding is presented in newspapers, magazines and television, in a range different countries and cultures. This chapter will review the existing literature and consider how the media might influence infant feeding behaviour, both currently and in the future.

PurposeThe purpose of this paper is to identify key concepts in the literature relating to the release of open educational resources (OER), with specific reference to the emergence of public health OER.Design/methodology/approachA review of the literature relating to the development of OER was followed by an online search for OER literature relating specifically to public health. This was supplemented with evidence gathered during the Public Health Open Resources for the University Sector (PHORUS) project.FindingsA wide array of OER literature was identified, although there was a limited number of public health‐related papers. The key concepts influencing public health OER release were identified as quality, ethics and values, rewards, risks and practical aspects, such as technological developments.Research limitations/implicationsThere is a limited amount of public health‐related OER literature. Whilst it was possible to draw some conclusions using more general OER literature there is a need for more research in the specific area of public health OER.Originality/valueThe PHORUS project was the first to consider the literature relating to the release of public health OER. Understanding the enablers and barriers to OER is key to developing resources in this key area of health education.

Despite a wide range of interventions, the effective promotion of breastfeeding continues to be challenging, particularly among women from communities where infants are usually formula milk fed. It has been suggested that infant feeding education in primary schools might enable positive breastfeeding attitudes to be adopted that could influence choices in adulthood. However, little is known about children's awareness or receptiveness to this subject, and there is a lack of evidence on which to base potential educational interventions. Although breastfeeding research in primary schools may perhaps appear unnecessary or premature, a case for study in this field can be demonstrated.

Background: Breastfeeding is the optimal feeding method for human infants. In the United Kingdom some women do not initiate breastfeeding, and many commence formula milk feeding after a brief period of breastfeeding. Infant feeding perceptions may develop early in life, and this research aimed to explore infant feeding awareness among primary school children as a first step toward informing appropriate health education interventions. Method: Fifty-six children aged 5/6, 7/8, and 10/11 years were recruited from three schools in southern England. Children were shown a series of drawings, and were read a story about a hungry newborn baby. A creative method, “draw, write and tell,” was developed for this research. Children were asked to finish the story, showing how they thought the baby might be fed. They were given the opportunity to verbally interpret their work. A constant comparison method was used to analyze the data. Results: Children were aware of formula milk, breastfeeding, and solid foods. Formula milk feeding was referred to more frequently than breastfeeding. Some children combined feeding methods. Children appeared to have gained their awareness in various settings. Conclusions: Children have a range of perceptions around infant feeding. They appear receptive to new ideas on the subject while of primary school age. An opportunity for education in primary schools arises to present breastfeeding to children as a normal way to feed a baby, but it is vital that education is evidence based and any interventions are evaluated. (BIRTH 38:4 December 2011)

Background: Pregnancy and childbirth are socio-cultural events that carry varying meanings across different societies and cultures. These are often translated into social expectations of what a particular society expects women to do (or not to do) during pregnancy, birth and/or the postnatal period. This paper reports a study exploring beliefs around childbirth in Nepal, a low-income country with a largely Hindu population. The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted (or dirty even) after childbirth. Methods: A qualitative study comprising five in-depth face-to-face interviews and 14 focus group discussions with mainly women, but also men and health service providers. The qualitative findings in Nepal were compared and contrasted with the literature on practices and cultural beliefs related to the pregnancy and childbirth period across the globe and at different times in history. Results: The themes that emerged from the analysis included: (a) cord cutting & placenta rituals; (b) rest & seclusion; (c) purification, naming & weaning ceremonies and (d) nutrition and breastfeeding. Physiological changes in mother and baby may underpin the various beliefs, ritual and practices in the postnatal period. These practices often mean women do not access postnatal health services. Conclusions: The cultural practices, taboos and beliefs during pregnancy and around childbirth found in Nepal largely resonate with those reported across the globe. This paper stresses that local people’s beliefs and practices offer both opportunities and barriers to health service providers. Maternity care providers need to be aware of local values, beliefs and traditions to anticipate and meet the needs of women, gain their trust and work with them.