Timilsina Amit, Neupane Pabitra, Pandey Janaki, Subedi Aastha, Thapa Subash
Department of Gender Studies, Tribhuvan University, Kathmandu, Nepal.
Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.
Dialogues Health. 2024 Jan 26;4:100171. doi: 10.1016/j.dialog.2024.100171. eCollection 2024 Jun.
Despite global progress in gender equality, still not every woman has access to safe and the highest quality health care. Visually impaired young adult women represent one of the most vulnerable groups with a poorer ability to access necessary healthcare services. This study aims to explore and comprehend the experiences of visually impaired young adult women in accessing healthcare services in Nepal.
A descriptive phenomenological study was conducted among 16 visually impaired women aged 20 to 35 years who had utilized healthcare services within the past 12 months. Face-to-face, in-depth interviews were conducted for data collection, and thematic analysis was conducted for data analysis.
Our study revealed a range of challenges faced by visually impaired young women that impeded their healthcare-seeking. These challenges included sexual harassment by male healthcare providers, disability-related stigma, financial difficulties, limited autonomy in decision-making, and a lack of disability-friendly healthcare facilities and services. Particularly, experiencing sexual harassment from male healthcare providers, coupled with underlying disability-related stigma, profoundly influenced the avoidance of healthcare. To navigate these challenges, some women sought support by having family members or friends accompany them or by requesting to be seen by a female healthcare provider. Nevertheless, financial dependence on families and women lacking employment and income led to a feeling of burden on the family, contributing to a reluctance among women to seek expensive healthcare. Social organization-based, collaborative efforts and peer support networks played a significant role in breaking down barriers and improving overall healthcare experiences.
While integrating disability-friendly healthcare services and infrastructure is essential, fostering attitudinal and behavioral change-particularly among male healthcare providers-is more important to ensure safety for young women in healthcare settings. The implementation of anti-sexual harassment policies is imperative to ensure a safe and respectful environment. Community mobilizing and peer group-based programs can be tested for increasing visually impaired women's utilization of relevant healthcare services.
尽管全球在性别平等方面取得了进展，但并非每位女性都能获得安全且质量最高的医疗保健服务。视力受损的年轻成年女性是最弱势群体之一，她们获取必要医疗服务的能力较差。本研究旨在探索并理解尼泊尔视力受损的年轻成年女性在获取医疗服务方面的经历。
对16名年龄在20至35岁之间、在过去12个月内使用过医疗服务的视力受损女性进行了描述性现象学研究。通过面对面深入访谈收集数据，并进行主题分析以进行数据分析。
我们的研究揭示了视力受损年轻女性在寻求医疗保健时面临的一系列挑战。这些挑战包括男性医疗服务提供者的性骚扰、与残疾相关的耻辱感、经济困难、决策自主权有限以及缺乏对残疾人士友好的医疗设施和服务。特别是，遭受男性医疗服务提供者的性骚扰，再加上潜在的与残疾相关的耻辱感，对她们避免寻求医疗保健产生了深远影响。为了应对这些挑战，一些女性通过让家人或朋友陪同或要求由女性医疗服务提供者诊治来寻求支持。然而，对家庭的经济依赖以及女性缺乏就业和收入导致她们感到给家庭带来负担，这使得女性不愿寻求昂贵的医疗保健。基于社会组织的协作努力和同伴支持网络在打破障碍和改善整体医疗体验方面发挥了重要作用。
虽然整合对残疾人士友好的医疗服务和基础设施至关重要，但促进态度和行为的改变——尤其是在男性医疗服务提供者中——对于确保年轻女性在医疗环境中的安全更为重要。实施反性骚扰政策对于确保安全和尊重的环境至关重要。可以测试社区动员和基于同伴群体的项目，以提高视力受损女性对相关医疗服务的利用率。
