Kakchapati Sampurna, Kc Saugat Pratap, Giri Santosh, Bhattarai Sanju, Baral Sushil Chandra
HERD International, Bhaisepati, Nepal.
Dialogues Health. 2022 Oct 30;1:100068. doi: 10.1016/j.dialog.2022.100068. eCollection 2022 Dec.
The aim of the study is to investigate the relationships between social determinants and disability status and access and use of sexual and reproductive health services among women with disabilities in Nepal.
This study used data on women with disability from the Multiple Indicator Cluster Survey (MICS) of 2019, in which 13,320 women and 290 women with disabilities were included for the analysis. We used bivariate analysis to compare the social determinants with disability status and multivariate logistic regression to determine the association between social determinants and access and use of sexual and reproductive health services among women with disabilities.
The findings showed, in comparison with non-disabled women, women with disabilities had low education, low economic status, low media exposure and low access to sexual and reproductive health. On provincial level, those from Madesh [AOR = 0.22 (95%CI:0.06, 0.76)] and Lumbini [AOR = 0.24 (95%CI:0.06,0.88)] had lower attitude to violence. The usage of family planning (FP) methods among women with disabilities in Karnali [AOR = 3.57 (95% CI: 1.42-13.22)] and Sudurpashchim [AOR = 1.05 (95% CI: 1.01-1.071)] was higher than those in Province 1. Women with disabilities with secondary education were more than nine times [AOR = 9.28(95%CI:2.67,32,26)] and primary education had more than three times [AOR = 3.59 (95%CI:1.07, 12.02)] of knowledge on HIV/AIDS compared to those of no education. The odds of being tested for HIV/AIDS among women with disabilities with secondary education was more than eight times [AOR = 8.8 (95% CI:2.23-34.6)] than those of no education.
This study provides noteworthy findings that women with disabilities have poor socioeconomic status, high-risk behavior, and low access to sexual and reproductive health services in Nepal. This study highlights the significance of actions needed to address sexual and reproductive health services in Nepal that unfairly impact women with disabilities.
本研究旨在调查尼泊尔残疾女性的社会决定因素与残疾状况之间的关系，以及她们获得和使用性与生殖健康服务的情况。
本研究使用了2019年多指标类集调查（MICS）中有关残疾女性的数据，其中13320名女性和290名残疾女性被纳入分析。我们采用双变量分析来比较社会决定因素与残疾状况，并使用多变量逻辑回归来确定社会决定因素与残疾女性获得和使用性与生殖健康服务之间的关联。
结果显示，与非残疾女性相比，残疾女性受教育程度低、经济地位低、媒体接触率低且获得性与生殖健康服务的机会少。在省级层面，来自马德西省[AOR = 0.22（95%CI：0.06，0.76）]和蓝毗尼省[AOR = 0.24（95%CI：0.06，0.88）]的女性对暴力的态度较低。在卡纳利省[AOR = 3.57（95%CI：1.42 - 13.22）]和苏都尔帕希姆省[AOR = 1.05（95%CI：1.01 - 1.071）]，残疾女性使用计划生育（FP）方法的比例高于第一省。与未受过教育的残疾女性相比，受过中等教育的残疾女性对艾滋病毒/艾滋病的了解程度高出九倍多[AOR = 9.28（95%CI：2.67，32.26）]，受过小学教育的高出三倍多[AOR = 3.59（95%CI：1.07，12.02）]。受过中等教育的残疾女性接受艾滋病毒/艾滋病检测的几率比未受过教育的高出八倍多[AOR = 8.8（95%CI：2.23 - 34.6）]。
本研究提供了值得关注的发现，即尼泊尔的残疾女性社会经济地位差、行为具有高风险性且获得性与生殖健康服务的机会少。本研究强调了在尼泊尔采取行动解决不公平影响残疾女性的性与生殖健康服务问题的重要性。
