Barriers to sexual and reproductive health care among widows in Nepal

Type Journal Article - International Journal of Gynecology & Obstetrics
Title Barriers to sexual and reproductive health care among widows in Nepal
Author(s)
Volume 125
Issue 2
Publication (Day/Month/Year) 2014
Page numbers 129-133
URL http://whr.org.np/beta/wp-content/uploads/2014/02/2014-in-press-Haviland-et-al-Int-J-Gynec-Obstet-re​pro-health-Nepali-widows1.pdf
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.

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