Social determinants of impaired functioning among Nepali widows: A mixed methods study

ABSTRACT

Despite considerable stigmatisation of widows in Nepal, little is known about factors affecting their ability to function in society. Using mixed methods, we studied psychosocial factors associated with impaired functioning among Nepali widows. For the qualitative analysis, we analysed 3 focus groups, 25 in-depth interviews, and 12 key-informant interviews. The quantitative analysis was based on data from 204 widows. Odds ratios were calculated linking psychosocial exposures to impaired functioning using adjusted logistic regression models. Low social support (aOR = 2.35, 95% CI: 1.2, 4.6, generally; aOR = 3.3, 95% CI: 1.7, 6.42, specifically from family members), experiences of discrimination (aOR = 2.97, 95% CI: 1.43, 6.14), and low life control (aOR = 4.3, 95% CI: 1.86, 10.1) were risk factors for impaired functioning. Qualitative findings suggested how discrimination and lack of control contribute to impaired functioning. Support from the husband’s family appeared to be more important to a widow’s functioning, compared to from her own parents. Knowledge about risk factors for impaired functioning can help inform interventions for Nepali widows.

KEYWORDS:

• Social support
• widowhood
• social stigma
• discrimination
• Nepal

Acknowledgments

We would like to thank the women who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was partially supported by a fellowship from the Center for Human Rights and Public Health and the Center for Global Health at Johns Hopkins Bloomberg School of Public Health. Funders were not involved in the design of the study, data collection, analysis and interpretation, manuscript preparation, or the decision to submit this work for publication.