Morrison J, Colbourn T, Budhathoki B, Sen A, Adhikari D, Bamjan J, Pathak S, Basnet A, Trani J F, Costello A, Manandhar D, Groce N
Institute ofGlobal Health, University College London, 30 Guilford Street, London WC1N 1EH, UK.
Mother Infant Research Activities (MIRA) Nepal, PO Box 921, Thapathali, Kathmandu, Nepal.
Health Promot Int. 2017 Jun 1;32(3):464-474. doi: 10.1093/heapro/dav099.
There is strong evidence that participatory approaches to health and participatory women's groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women's participation in women's groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world's population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women's groups is particularly important. We used a mixed methods approach to describe attendance in groups among disabled and non-disabled women, considering different types and severities of disability. We found no significant differences in the percentage of women that had ever attended at least one of our women's groups, between non-disabled and disabled women. This was true for women with all severities and types of disability, except physically disabled women who were slightly less likely to have attended. Barriers such as poverty, lack of family support, lack of self-confidence and attendance in many groups prevented women from attending groups. Our findings are particularly significant because disabled people's participation in broader community groups, not focused on disability, has been little studied. We conclude that women's groups are an important way to reach disabled women in resource poor communities. We recommend that disabled persons organizations help to increase awareness of disability issues among organizations running community groups to further increase their effectiveness in reaching disabled women.
有强有力的证据表明，参与式健康方法以及参与式妇女团体在改善资源匮乏地区妇女和儿童健康方面具有巨大潜力。重要的是要考虑干预措施是否覆盖到了最边缘化的人群，因此我们研究了尼泊尔农村地区残疾妇女参与妇女团体及其他社区团体的情况。残疾人占世界人口的15%，面临着高度贫困、耻辱、社会边缘化以及获取卫生资源不平等的问题，所以她们加入妇女团体尤为重要。我们采用混合方法来描述残疾和非残疾妇女参与团体的情况，同时考虑了不同类型和严重程度的残疾。我们发现，在曾经至少参加过一个我们的妇女团体的妇女比例方面，非残疾妇女和残疾妇女之间没有显著差异。对于所有严重程度和类型的残疾妇女来说都是如此，只有身体残疾的妇女参加的可能性略低。贫困、缺乏家庭支持、缺乏自信以及参加多个团体等障碍使得妇女无法参加团体。我们的研究结果尤为重要，因为残疾人参与更广泛的、并非专注于残疾问题的社区团体的情况此前鲜有研究。我们得出结论，妇女团体是接触资源匮乏社区中残疾妇女的重要途径。我们建议残疾人组织帮助提高运营社区团体的组织对残疾问题的认识，以进一步提高这些团体接触残疾妇女的成效。
