Understanding challenges and enhancing the competency of healthcare providers for disability inclusive sexual and reproductive health services in rural Nepal.

Autor:	Neupane P; Master of Arts in Gender Studies, Tribhuwan University, Kathmandu, Bagmati Province, Nepal., Adhikari S; Master of Arts in Gender Studies, Tribhuwan University, Kathmandu, Bagmati Province, Nepal., Khanal S; Central Department of Public Health, Bachelor in Public Health, Tribhuvan University, Kathmandu, Bagmati Province, Nepal., Devkota S; Bachelor in Public Health, School of Health & Allied Sciences, Pokhara University, Kaski, Gandaki Province, Nepal., Sharma M; Bachelor of Public Health, Manmohan Memorial Institute of Health Sciences, Tribhuvan University, Kathmandu, Bagmati Province, Nepal., Shrestha A; Centre for Karnali Rural Promotion and Society Development (CDS-PARK), Mugu, Karnali Province, Nepal., Timilsina A; Research and Community Development Centre, Kathmandu, Bagmati Province, Nepal.
Jazyk:	angličtina
Zdroj:	PloS one [PLoS One] 2024 Dec 13; Vol. 19 (12), pp. e0311944. Date of Electronic Publication: 2024 Dec 13 (Print Publication: 2024).
DOI:	10.1371/journal.pone.0311944
Abstrakt:	Background: Women with disabilities in rural Nepal face many challenges in accessing sexual and reproductive health services including harassment and unpleasant behavior by the healthcare providers. Though National Guideline for Disability Inclusive Health Service in Nepal is in place, there are gaps in providing the sexual and reproductive health needs of women with disabilities. There has been limited research exploring the competency and capacity of health care providers on providing sexual and reproductive health services and information for women living with disabilities. Thus, this study aims to explore the competencies of rural healthcare providers in delivering disability inclusive sexual and reproductive health services for women with disabilities. Methods: The study used qualitative research methodology using thematic research design. Key informant interviews and focus group discussions were conducted using semi-structured interview guidelines to obtain information. Data collection was carried out till the data saturation was reached. Inductive coding was done using Dedoose software. The codebook was developed, sub-themes and themes were developed and presented as result of this study. Results: Knowledge gaps in disability management, procedural skills and biased perception towards sexual and reproductive health need of women with disabilities, were evident among healthcare providers. Additionally, an inadequate skill among health care providers to communicate with women with disabilities for service provision was evident. To address these challenges and enhance the competency of the health care providers there is need for disability management trainings for them. Other important measures such as inclusion of disability and sexual and reproductive health in medical education curriculum, provision of sign language interpreter and disability inclusive information system, decision-making abilities and authority for disability inclusive infrastructure and tool is necessary. Conclusion: To address the existing challenges for disability inclusive health services, it is essential to strengthen the competency and agency of the healthcare providers, and improve the ecosystem of health institution. For this, it is important for health institutions to be disability inclusive, improved behavior and attitude of health care providers, enhanced clinical knowledge on disability management and procedural skills of healthcare providers. Additionally, improving interpersonal communication skills and decision-making autonomy of health care providers is important for disability inclusive SRH services. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2024 Neupane et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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