Miriam J Haviland1, Abina Shrestha2, Michele R Decker1, Brandon A Kohrt3, Hari Maya Kafle2, Srijana Lohani2, Lily Thapa2, Pamela J Surkan4. 1. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. 2. Women for Human Rights, Single Women Group, Baluwatar, Nepal. 3. Duke Global Health Institute Department of Psychiatry and Behavioral Sciences, Duke University, Durham, USA. 4. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. Electronic address: psurkan@jhsph.edu.
Abstract
OBJECTIVE: To investigate how the social status of high-caste Nepali widows of reproductive age impacts their sexual and reproductive health care. METHODS: Twenty-one in-depth interviews and 1 focus group (n=6) were conducted between September and November 2012 in the Kathmandu, Kavre, and Chitwan districts of Nepal. Participants were members of Women for Human Rights, Single Women Group. Interviews and the focus group with widows followed a semi-structured interview guide designed to elicit information on sexual and reproductive health problems, knowledge about them, and barriers to care. Two researchers used inductive and deductive coding to analyze transcripts for themes using ATLAS.ti. RESULTS: Widows reported facing substantial obstacles to accessing sexual and reproductive health care. Widows suspected of having sexual and reproductive health problems, or who discussed or tried to access these services, could be ostracized by their families and experience severe economic and psychological consequences. Additionally, widows feared discrimination, lack of confidentiality, and sexual harassment by male providers if their status was known. These barriers appeared to stem from the perception that sexual relationships are necessary for widows to require care for gynecologic problems. CONCLUSION: Widows expressed a need for sexual and reproductive health care and described cultural and systematic barriers to accessing this care; these barriers need to be addressed.
OBJECTIVE: To investigate how the social status of high-caste Nepali widows of reproductive age impacts their sexual and reproductive health care. METHODS: Twenty-one in-depth interviews and 1 focus group (n=6) were conducted between September and November 2012 in the Kathmandu, Kavre, and Chitwan districts of Nepal. Participants were members of Women for Human Rights, Single Women Group. Interviews and the focus group with widows followed a semi-structured interview guide designed to elicit information on sexual and reproductive health problems, knowledge about them, and barriers to care. Two researchers used inductive and deductive coding to analyze transcripts for themes using ATLAS.ti. RESULTS: Widows reported facing substantial obstacles to accessing sexual and reproductive health care. Widows suspected of having sexual and reproductive health problems, or who discussed or tried to access these services, could be ostracized by their families and experience severe economic and psychological consequences. Additionally, widows feared discrimination, lack of confidentiality, and sexual harassment by male providers if their status was known. These barriers appeared to stem from the perception that sexual relationships are necessary for widows to require care for gynecologic problems. CONCLUSION: Widows expressed a need for sexual and reproductive health care and described cultural and systematic barriers to accessing this care; these barriers need to be addressed.
Authors: Yoona Kim; Asmita Ghimire; Molly E Lasater; Brandon A Kohrt; Pamela J Surkan; Nagendra P Luitel Journal: Glob Ment Health (Camb) Date: 2021-09-15
Authors: Kamal Gautam; Mark J D Jordans; Brandon A Kohrt; Elizabeth L Turner; Dristy Gurung; Xueqi Wang; Mani Neupane; Nagendra P Luitel; Muralikrishnan R Kartha; Anubhuti Poudyal; Ritika Singh; Sauharda Rai; Phanindra Prasad Baral; Sabrina McCutchan; Petra C Gronholm; Charlotte Hanlon; Heidi Lempp; Crick Lund; Graham Thornicroft Journal: Implement Sci Date: 2022-06-16 Impact factor: 7.960