Filmmaking is a visual method that provides a unique opportunity for generating knowledge, but few studies have applied filmmaking in public health research. In this article, we introduce Collaborative Filmmaking as a public health research method, including a description of the six steps for implementation and an illustrative example from Nepal. Collaborative Filmmaking is an embodied, participatory, and visual research method in which participants are trained to create, analyze, and screen films to answer a research question. The method is useful for exploring sensitive health topics and providing nuanced insight into practices, relationships, and spaces that are difficult to capture using existing methods; however, its use requires close attention to ethical considerations. Building upon the trajectory of other visual and community-based research methods, Collaborative Filmmaking is valuable for gathering granular details and sensory data, co-analyzing data in partnership with participants, and producing participant-generated films that serve as powerful and authentic advocacy tools.

Menstruation is a natural, physiological process, but it can be a challenging experience for millions of women around the world. In Nepal, a geographically small yet diverse country of 125 caste/ethnic groups, understanding how caste/ethnicity impacts menstrual health is critical for developing context-specific interventions to improve women’s health. A community-based, cross-sectional survey was conducted with 679 women and girls between the ages of 13–51 from the country’s most populous castes/ethnic groups. Forty eight percent had high menstrual knowledge, 60% had positive menstrual attitudes, and 59% had positive menstrual practices. Caste/ethnicity was a significant predictor of menstrual knowledge and practices. The caste/ethnic groups Tarai/Madhesi/Other, Newar, Janajati, and Muslim all had statistically significant fewer odds of positive menstrual practices compared to Brahman/Chhetri (high caste groups), with Janajati (indigenous ethnic groups) having the poorest outcomes. Despite Nepal making impressive advances in health, certain caste/ethnic groups have fallen behind in terms of menstrual health outcomes. Consequently, blanket menstrual health programs may not be sufficient for improving menstrual knowledge and practices for all. Future programming should consider the use of local languages and context-specific content that incorporates indigenous beliefs, as well as cultivate partnerships with indigenous health organizations, and develop outcome indicators disaggregated by caste/ethnicity to ensure improved menstrual health for all.

Among public health researchers, there is growing interest in film methods due to their ability to highlight subtleties in practices, capture emotions, engage hard-to-reach populations, and advocate for social change. Still, little is known about strengths and challenges associated with using film methods in public health. This review synthesizes peer-reviewed, public health research studies that apply film methods, and describes opportunities and challenges. Of the 3,431 identified articles, 20 met the inclusion criteria. Fifteen different film methods were found that offer numerous methodological strengths, including the ability to provide rich descriptions, capture emic perspectives, increase comfort in participation, empower participants, and be used for advocacy. Future studies may explore engaging participants throughout the entire research process and using visuals created in the study to communicate findings. Keeping in mind their challenges, film methods are long overdue in public health and provide unique opportunities to capture sensory data.

A magnitude 7.8 earthquake struck Nepal in 2015, followed by hundreds of aftershocks that led to physical destruction, loss, and negative mental health outcomes. Yet, in the days, months, and years following the disaster, numerous forms of community art rose from the rubble, such as urban murals, spoken word poetry, public dance performances, and sacred art. This study explored the relationship between community art and health, social cohesion, and community resilience in postearthquake Nepal. We utilized photography and audio recorders to capture 19 unique artworks/projects created in the aftermath of the earthquake and conducted in-depth interviews with 19 artists and/or experts about the relationship between art and health in postdisaster contexts. The 19 postearthquake artworks/projects ranged from contemporary paintings to Buddhist ritual dance and reflected the unique combination of the traditional and contemporary necessary for salvaging and restoring Nepali heritage. Findings revealed three key themes regarding linkages between art and mental health in the context of postearthquake Nepal. First, community art offers relief and is a mechanism for coping, through the creation or observation of art. Second, community art can be used as a means of communication, both as a tool for promoting connections and conversations in the community and by communicating messages of hope. Third, community art can promote community cohesion and ultimately serve as a tool to create physical and emotional safe spaces. Overall, there is promise for initiatives that engage artists and communities in arts-based initiatives following traumatic events, such as natural disasters, which can positively affect health. Funding support and development of partnerships with grassroots artists and creators should be promoted in health and development programming, especially for risk reduction and recovery after disasters.

Throughout Nepal, women and girls follow a range of menstrual practices, many of which leave them vulnerable to negative health outcomes. We applied a participatory visual research method called Collaborative Filmmaking to acquire a nuanced and sensory understanding of menstrual practices and motivations in Kanchanpur, Nepal. The study also provides insight regarding menstrual practice complexities across different castes/ethnicities and religions. Results show an array of menstrual practices related to cleansing, cooking, touching, worshipping, and sleeping. Participants’ menstrual practices varied by caste/ethnic and religious background and were motivated by religious and spiritual beliefs, family tradition, negative consequences, and social pressure.

Chhaupadi is a form of menstrual seclusion practiced in Nepal in which women and girls are isolated during their menstrual cycles and follow numerous restrictions. The tradition dates back centuries and can have serious physical and mental health consequences. While the practice was criminalized in 2017 with fines and jail time, this legislative action comes after more than a decade of legal history, from an initial ban in 2006, to declaring it a form of violence against women in 2009, and finally, its criminalization in 2017. Exploring levels of awareness regarding the 2017 chhaupadi criminalization, perceptions of the legal penalties, and whether or not criminalization will lead to behaviour change are imperative next steps for informing the development of evidence-based interventions targeting chhaupadi. In this qualitative investigation conducted in Kalikot district, six focus group discussions and 33 in-depth interviews were conducted with a total of 81 participants. School-going girls, girls who have dropped out of school before completing twelfth grade, mothers, fathers, teachers, health care providers, religious leaders, traditional healers, grandmothers and police participated in the study. The results indicate that criminalization is generally perceived as a positive step for initiating chhaupadi behaviour change, and one-third of participants expressed that they plan to change their behaviours after learning that chhaupadi is publishable with fines and/or jail time. However, accurate information about the criminal code is extremely low and therefore interventions ensuring communities and law enforcement are informed of the criminalization and associated penalties are urgently needed. In addition, even after its criminalization, chhaupadi behaviour change is anticipated to be gradual and is expected to require long-term interventions targeting social pressure associated with upholding the tradition and raising awareness via appropriate trainings, engaging the media, and beyond.