Manish Baidya

• Subedee, Koshal C.; Paudel, Krishna P.; Pandey, Hem Raj; Chaudhary, Mukesh; Kandel, Shashi & Pradhan, Mona [Show all 18 contributors for this article] (2025). Epidemiological investigation of a cholera outbreak in Nepal–India border communities: Public health implications. IJID Regions. 14, p. 100489–100489. doi: 10.1016/j.ijregi.2024.100489. Full text in Research Archive
• Flint, Adrian; Howard, Guy; Nijhawan, Anisha; Poudel, Moti; Geremew, Abraham & Mulugeta, Yohannes [Show all 10 contributors for this article] (2024). Managing climate change challenges to water security: Community water governance in Ethiopia and Nepal. Geo: Geography and Environment. 11(1). doi: 10.1002/geo2.135. Full text in Research Archive Show summary

  Abstract Climate change poses a threat to water security where both current and future generations are concerned, with its accompanying impacts set to be greater in low‐ and middle‐income countries (LMICs). As a result, questions pertaining to climate change adaption in LMICs are receiving increased attention from academics and policymakers alike. It is broadly accepted that top‐down approaches to developing resilience to climate change challenges have been shown to be limited and that concerted efforts need to be made to engage local communities in advancing adaptive strategies. Based on the above, we make two main arguments: (1) while there has been a shift towards acknowledging the importance of community‐driven data in generating a broader and deeper understanding of climate change, far better use could be made of local knowledge and (2) efforts at community‐based solutions to problems of resilience are currently limited by issues of capacity, specifically linked to the need for further education and training, and improved representation with respect to gender, class and caste (as well as financial support). To illustrate these arguments, we present evidence provided by rural communities located in two countries affected heavily by climate change: Ethiopia and Nepal.

• Poudel, Moti; Sharma, Subodh; Ghimire, Anish; Howard, Guy; Flint, Adrian & Baidya, Manish [Show all 7 contributors for this article] (2024). Effectiveness of climate resilient water safety plans in Nepal. Aqua. ISSN 2709-8028. 73(7), p. 1452–1452. doi: 10.2166/aqua.2024.309. Full text in Research Archive Show summary

  ABSTRACT Water supply schemes (WSSs) in Nepal are managed by water user committees with basic knowledge of climate change. The Government of Nepal has committed and prioritized improving the quality of water services by implementing climate-resilient water safety plans (CR-WSPs) in 10 WSSs as pilot projects. In this study, how tough is water sanitation and hygiene (HTIW) framework was adopted to assess the effectiveness of these CR-WSPs, which include four groundwater and six protected springs-based WSSs. Employing the HTIW framework, this study adopted the six key indicators environment, infrastructure, management, community governance and engagement, institutional support, and supply chains to evaluate CR-WSPs effectiveness. The indicators were then assessed using a Likert scale. Resilient schemes are needed to demonstrate a capacity to respond effectively to challenges such as unforeseen extreme events and potential hazards, together with an aptitude for financial management, laboratory maintenance, and social inclusion. Less resilient schemes tend to be those linked to social inclusion or financial issues. Institutional support and supply chain domain scored four and were relatively strong among them. The findings of this study suggest that CR-WSPs can be an important metric tool to assess climate resilience and guide policymakers in low- and middle-income countries.

• Poudel, Prativa; Joshi, Prayon; Tuladhar, Sarana; Ghimire, Anish; Baidya, Manish & Howard, Guy [Show all 7 contributors for this article] (2024). Groundwater implications on methane emission from non-sewered sanitation systems in Nepal. Environmental Pollution (1987). ISSN 0269-7491. 356, p. 124248–124248. doi: 10.1016/j.envpol.2024.124248. Full text in Research Archive
• Joshi, Saugat; Karki, Alisha; Rushton, Simon; Koirala, Bikash; Basnet, Srijana & Rijal, Barsha [Show all 12 contributors for this article] (2023). Gender and caste inequalities in primary healthcare usage by under-5 children in rural Nepal: an iterative qualitative study into provider perspectives and the potential role of implicit bias. BMJ Open. 13(6), p. 069060–069060. doi: 10.1136/bmjopen-2022-069060. Full text in Research Archive Show summary

  Objective This study explored provider perspectives on: (1) why inequalities in health service usage persist; and (2) their knowledge and understanding of the role of patient experience and implicit bias (also referred to as unconscious bias). Design A three stage, iterative qualitative study was conducted involving two rounds of in-depth interviews and a training session with healthcare staff. Interview transcripts were analysed using a reflexive thematic approach in relation to the study’s aims. Setting Participants were recruited from rural hill districts (Mugu, Humla, Bajura, Gorkha and Sindhupalchok) of Nepal. Participants Clinical staff from 22 rural health posts. Results Healthcare providers had high levels of understanding of the cultural, educational and socioeconomic factors behind inequalities in healthcare usage in their communities. However, there was less knowledge and understanding of the role of patient experience—and no recognition at all of the concept of implicit bias. Conclusion It is highly likely that implicit bias affects provider behaviours in Nepal, just as it does in other countries. However, there is currently not a culture of thinking about the patient experience and how that might impact on future usage of health services. Implicit bias training for health students and workers would help create greater awareness of unintended discriminatory behaviours. This in turn may play a part in improving patient experience and future healthcare usage, particularly among disadvantaged groups.

• Poudel, Prativa; Ghimire, Anish; Howard, Guy; Evans, Barbara; Camargo-Valero, Miller A. & Mills, Freya [Show all 14 contributors for this article] (2023). Field-based methods for measuring greenhouse gases emissions from on-site sanitation systems: A systematic review of published literature. Heliyon. 9(9), p. 19947–19947. doi: 10.1016/j.heliyon.2023.e19947. Full text in Research Archive
• Flint, Adrian; Howard, Guy; Baidya, Manish; Wondim, Tadesse; Poudel, Moti & Nijhawan, Anisha [Show all 8 contributors for this article] (2022). Equity in Global North–South research partnerships: interrogating UK funding models. Global Social Challenges Journal. 1(1), p. 93–93. doi: 10.1332/vqil8302. Full text in Research Archive Show summary

  This article considers the degree to which achieving equity in Global North–South research partnerships is possible under current UK funding models. While there has been significant discussion with respect to the decolonisation of research, it will be argued that there is some distance between the language of equity articulated currently by UK funding bodies, and the realities of working as a project partner in the Global South. The article draws on the prior and ongoing experiences of a multidisciplinary team of researchers brought together by a UK-funded research project. In the interests of moving towards more equitable systems of knowledge production and dissemination, it explores the power asymmetries that can be inherent in Global North–South research partnerships, and the extent to which issues of coloniality continue to shape aspects of research agenda setting, project framing, impact, academic publishing and the division of labour within partnerships.

• Shrestha, Manju; Mandal, Anju; Gupta, Sweta Kumari & Baidya, Manish (2022). Maternal Smoking during Pregnancy and its Association with Low Birth Weight. Journal of Nepal Paediatric Society. 42(1), p. 96–96. doi: 10.3126/jnps.v42i1.37197. Full text in Research Archive Show summary

  Introduction: Maternal smoking has been an important risk factor for low birth weight (LBW), preterm birth as well as small for gestational age. In this study, we try to analyze the association of maternal smoking during the different stages of pregnancy with outcome of birth weight. Methods: This is a cross-sectional hospital-based study, which was undertaken comprising of 1240 singleton live born baby in a Tertiary Care Teaching Hospital, Nepal. The enrollment occurred between June 2012 and May 2016 (Four years) among mothers who smoked any time during the current pregnancy. Based on the amount of smoking, the mothers with cigarette smoking were divided into four groups which includes: preconception, the first trimester, second trimester and third trimester. The data analyses were performed using Logistic regression and 95% confidence interval along with p-value. A p-value < 0.05 was considered statistically significant. Results: Of a total of 1240 singleton births, 328 (26.5%) were LBW. Among them, 149 (12.1%) of the mothers reported smoking during pregnancy. When compared with the nonsmoking groups, all the maternal smoking groups had higher incidences of LBW infants, especially when the mothers smoked > 10 cigarettes / day and during any stage of conception. Conclusions: Smoking during pregnancy is associated with an increased incidence of LBW among the infants. In addition, the newborns of mothers who smoked >10 cigarettes / day were most susceptible to having LBW, irrespective of the stage of pregnancy during which the mothers smoked.

• Charles, Katrina J.; Howard, Guy; Prats, Elena Villalobos; Gruber, Joshua; Alam, Sadekul & Alamgir, A.S.M. [Show all 24 contributors for this article] (2022). Infrastructure alone cannot ensure resilience to weather events in drinking water supplies. Science of the Total Environment. ISSN 0048-9697. 813, p. 151876–151876. doi: 10.1016/j.scitotenv.2021.151876. Full text in Research Archive
• Shrestha, Binod; Green, Dan J.; Baidya, Manish; Chater, Tim; Karki, Jiban & Lee, Andrew CK [Show all 10 contributors for this article] (2022). Determinants affecting utilisation of health services and treatment for children under-5 in rural Nepali health centres: a cross-sectional study. BMC Public Health. 22(1). doi: 10.1186/s12889-022-14318-y. Full text in Research Archive Show summary

  Abstract Background Large inequalities in child health remain in Nepal, with caste, ethnicity and sex being major determinants of deprivation and negative outcomes. The purpose of this study was to explore whether key demographics of under 5s were associated with health seeking behaviours, utilisation of health care, and treatment received. Methods Data came from Integrated Management of Neonatal & Childhood Illness (IMNCI) records of 23 health centres across five districts. After digitising the paper records, the data was analysed by district, caste/ethnicity, sex, and age to investigate differences in the time taken to present at a health facility after the onset of symptoms of ARI, diarrhoea and fever; accuracy of diagnosis for pneumonia; and whether the correct treatment was prescribed for pneumonia as per IMNCI guidelines. Results From 116 register books spanning 23 health centres, 30,730 child patient records were considered for analysis. The median age of attendance was 18 months (Inter-Quartile Range = 10, 32), while were more male children that attended (55.7% vs. 44.3% for females). There were statistically significant differences for the time taken to attend a health centre between different districts for ARI, diarrhoea and fever, with children in the remote Humla and Mugu districts taking significantly longer to present at a health facility after the onset of symptoms (all p < 0.001, except Mugu for ARI days). Children from underprivileged ethnic groups, Madhesi and Dalit, were less likely to be given a correct diagnosis of pneumonia (p = 0.014), while males were more likely to receive a correct diagnosis than females (73% vs. 67%, p = 0.001). This sex difference remained in the adjusted regression models for diagnosis of pneumonia (p < 0.001) but not for treatment of pneumonia (p = 0.628). All districts, in comparison to Gorkha, had increased odds of correct diagnosis and treatment of pneumonia, but only significant in children from Mugu after adjustment (p ≤ 0.001). Conclusion Significant demographic differences were found based on ethnicity, sex, and district when examining health seeking behaviours for ARI, diarrhoea, and fever. Significant associations were seen for these same factors when exploring accuracy of diagnoses of pneumonia, but not for treatment. This study has emphasised the importance of a digitalised healthcare system, where inequalities can be identified without the reliance on anecdotal evidence.

• Atreya, Kishor; Rimal, Narayan Sharma; Makai, Prabina; Baidya, Manish; Karki, Jiban & Pohl, Gerda [Show all 7 contributors for this article] (2022). Dalit’s livelihoods in Nepal: income sources and determinants. Environment, Development and Sustainability. ISSN 1387-585X. 25(11), p. 12657–12657. doi: 10.1007/s10668-022-02582-2. Full text in Research Archive
• Nijhawan, Anisha; Howard, Guy; Poudel, Moti; Pregnolato, Maria; Lo, Yuen Tung Eunice & Ghimire, Anish [Show all 10 contributors for this article] (2022). Assessing the Climate Resilience of Community-Managed Water Supplies in Ethiopia and Nepal. Water. 14(8), p. 1293–1293. doi: 10.3390/w14081293. Full text in Research Archive Show summary

  Understanding the resilience of water supplies to climate change is becoming an urgent priority to ensure health targets are met. Addressing systemic issues and building the resilience of community-managed supplies, which serve millions of people in rural LMIC settings, will be critical to improve access to safe drinking water. The How Tough is WASH (HTIW) framework to assess resilience was applied to community-managed water supplies in Ethiopia and Nepal to assess the effectiveness of this framework in field conditions. The resilience of these water supplies was measured along six domains—the environment, infrastructure, management, institutional support, community governance and supply chains—that can affect how they respond to climate change effects. We found that the HTIW framework provided an objective measure of resilience and could be used to rank water supplies in order of priority for action. We also found that systemic issues could be identified. The tools and methods used in the framework were easy to deploy by field research teams. The water supplies studied in Ethiopia and Nepal had low to moderate resilience to climate change. Service management and institutional support were weak in both countries. The data from Ethiopia and Nepal suggests that many water supplies in rural and small-town communities are unlikely to be resilient to future climate change without increased investment and support. The use of simple frameworks such as HTIW will be important in supporting decisions around such investments by identifying priority communities and actions.

• Howard, Guy; Nijhawan, Anisha; Flint, Adrian; Baidya, Manish; Pregnolato, Maria & Ghimire, Anish [Show all 13 contributors for this article] (2021). The how tough is WASH framework for assessing the climate resilience of water and sanitation. npj Clean Water. 4(1). doi: 10.1038/s41545-021-00130-5. Full text in Research Archive Show summary

  Abstract Climate change presents a major threat to water and sanitation services. There is an urgent need to understand and improve resilience, particularly in rural communities and small towns in low- and middle-income countries that already struggle to provide universal access to services and face increasing threats from climate change. To date, there is a lack of a simple framework to assess the resilience of water and sanitation services which hinders the development of strategies to improve services. An interdisciplinary team of engineers and environmental and social scientists were brought together to investigate the development of a resilience measurement framework for use in low- and middle-income countries. Six domains of interest were identified based on a literature review, expert opinion, and limited field assessments in two countries. A scoring system using a Likert scale is proposed to assess the resilience of services and allow analysis at local and national levels to support improvements in individual supplies, identifying systematic faults, and support prioritisation for action. This is a simple, multi-dimensional framework for assessing the resilience of rural and small-town water and sanitation services in LMICs. The framework is being further tested in Nepal and Ethiopia and future results will be reported on its application.

• Sharma, S.; Baidya, Manish; Poudel, P.; Panthi, S. R.; Pote-Shrestha, R. R. & Ghimire, A. [Show all 7 contributors for this article] (2021). Drinking water status in Nepal: an overview in the context of climate change. Journal of Water, Sanitation and Hygiene for Development. ISSN 2043-9083. 11(6), p. 866–866. doi: 10.2166/washdev.2021.045. Full text in Research Archive Show summary

  Abstract Although Nepal has made remarkable progress in the drinking water only sector from past few decades, the status of drinking water, in terms of climate change, is poorly documented and thus less known. This review aims to sum up drinking water status in climate change perspectives by reviewing available secondary data from published and gray literature. Climate change, and its impact on the drinking water sector, is undeniable. Though many policies and laws are enforced to address climate change issues, very few policies and laws have incorporated climate change-resilient WASH as a priority. It is of current need to carry out action-based research followed by eco-region wise interventions for adaptation and mitigation of impacts on WASH sector due to climate change.

• Baidya, Manish; Gopichandran, V & Kosalram, K (2014). Patient-physician trust among adults of rural Tamil Nadu: A community-based survey. Journal of Postgraduate Medicine. ISSN 0022-3859. 60(1), p. 26–26. doi: 10.4103/0022-3859.128802. Full text in Research Archive Show summary

  Background: Trust is the acceptance of a vulnerable situation in which the truster believes that the trustee will act in the truster's best interests. The cornerstone of the patient-physician relationship is "trust". Despite the intensity and importance of trust relationship of patients toward their physician, the phenomenon is rarely studied in developing countries. Objective: Our study aimed to explore the concept of patient-physician trust among adults of rural Tamil Nadu to assess the factors affecting patient-physician trust relationship and patient satisfaction. Materials and Methods: A cross-sectional descriptive household survey was carried out on 112 individuals selected by a multistage random sampling method. Men and women aged above 40 years who have visited a health care service at least once during the last 5 years were included in the study. Thom et al 's modification of the Anderson and Dedrick Physician Trust scale was used to measure patient trust in physician. Results: Trust is a one-dimensional construct in the surveyed population as revealed by an exploratory factor analysis which extracted one component explaining 50% of the overall variance. Trust influences patient's self-reported satisfaction (β coefficient of 0.048; P < 0.001) and remains independent of all the other factors assessed in the study such as, age, gender, education, self-reported health status, time spent with the physician, physician's gender, physician's age, and medical specialty that the physician belongs to. Physician's gender, physician's age, self-reported health status, and time spent with the physician were significantly associated with satisfaction with the physician. Conclusion: Trust in physicians seems to not depend on any of the assessed factors and largely seems to be implicit in the physician-patient relationship. Trust in physician is associated with patient satisfaction. Further studies are needed to assess trust in physicians in developing country settings.

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• Cissé, Guéladio; Sharma, Subodh; Panthi, Sudan Raj; Shrestha, Raja Ram Pote; Baidya, Manish & Poudel, Prativa (2021). Transitioning to Clean Water and Sanitation. MDPI. ISBN 9783038977759. doi: 10.3390/books978-3-03897-775-9. Full text in Research Archive

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