HERD International, Kathmandu, Nepal.
UNICEF, UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
Infect Dis Poverty. 2023 Aug 22;12(1):77. doi: 10.1186/s40249-023-01126-8.
Lymphatic filariasis (LF) is a debilitating and painful neglected tropical disease and is one of the leading causes of permanent disability. In many countries, the intersection of gender with various social stratifiers has influenced exposure to LF and ultimately impacting the disease burden and its elimination. This study aimed to explore the influence of gender and its intersection with other social stratifiers for the prevention and care seeking behavior of LF in Nepal.
This study employed qualitative research methods: in-depth interviews (IDIs) and focus group discussions (FGDs) for data collection in Bardiya, Nepal. A total of 22 IDIs (11 male, 11 female) and 2 FGDs (1 male and 1 female) were conducted with the community people between January and March 2020. The participants were purposively selected to represent different social stratifiers including age, sex, ethnicity, occupation. The data collected were analyzed using a thematic framework approach with use of intersectional gender analysis matrix.
The study findings revealed that men spend more time outside their household compared to women while fulfilling their roles and responsibilities, largely determined by societal expectations and gender norms. This resulted in limited access to preventive health services for men, as they often missed annual mass drug administration programme in their community and limited access to preventive methods. Further traditional occupation, specific to particular ethnicity, influenced the vulnerability to LF for certain ethnic groups. The ability to prevent exposure varied among individuals. Although women made decisions regarding the use of protective methods, it was influenced by patriarchal and gender norms. They often felt a responsibility to take care and priorities males and other family members when resources are limited. The intersectionality of gender with other social stratifiers such as marital status, ethnicity, and geographical areas influenced individual's ability to access information related to LF and care seeking.
Overall, the findings emphasized how access to resources, division of work, norms and values and decision-making power alone and its interaction with various social stratifiers shaped peoples' vulnerability to disease, ability to prevent exposure and response to illness.
淋巴丝虫病（LF）是一种使人虚弱和痛苦的被忽视的热带病，也是导致永久性残疾的主要原因之一。在许多国家，性别与各种社会分层因素的交叉影响了人们接触 LF 的机会，最终影响了疾病负担及其消除。本研究旨在探讨性别及其与尼泊尔 LF 预防和寻求护理行为的其他社会分层因素的交叉影响。
本研究采用定性研究方法：在尼泊尔 Bardiya 进行深入访谈（IDIs）和焦点小组讨论（FGDs）收集数据。2020 年 1 月至 3 月，共进行了 22 次 IDIs（11 名男性，11 名女性）和 2 次 FGDs（1 名男性和 1 名女性）。参与者是根据年龄、性别、族裔、职业等不同社会分层因素有目的地选择的。使用交叉性别分析矩阵，采用主题框架方法对收集的数据进行分析。
研究结果表明，男性在履行角色和责任时，比女性更多地花时间在家庭之外，这主要是由社会期望和性别规范决定的。这导致男性很难获得预防性卫生服务，因为他们经常错过社区内的年度大规模药物治疗方案，也很难获得预防性方法。此外，特定族裔特有的传统职业也影响了某些族裔群体对 LF 的易感性。个体预防暴露的能力各不相同。尽管女性对使用保护方法做出决策，但这受到父权制和性别规范的影响。当资源有限时，她们往往感到有责任照顾和优先考虑男性和其他家庭成员。性别与其他社会分层因素（如婚姻状况、族裔和地理位置）的交叉影响了个人获取与 LF 相关的信息和寻求护理的能力。
总的来说，研究结果强调了资源获取、工作分工、规范和价值观以及决策权本身及其与各种社会分层因素的相互作用，如何塑造了人们对疾病的易感性、预防暴露的能力以及对疾病的反应。
