Disability In Nepal Research Articles

Identifying Challenges to the Equal Realization of Human Rights for Individuals with Psychosocial Disability in Nepal

Nepal is currently facing a severe mental health crisis characterized by a significant prevalence of mental illness that remains largely unaddressed. The issue is exacerbated by pervasive social stigma, lack of awareness, and insufficient political commitment, pushing mental health to the bottom of the political agenda. In Nepal, mental health treatment predominantly focuses on biomedical interventions, mainly ignoring the human rights aspects, highlighting the crucial need for a paradigm shift in approach. The enactment of the Convention on the Rights of Persons with Disabilities (CRPD) on June 6, 2010, presents an opportunity for a transformative shift in Nepal’s approach to mental health. This research investigates the barriers within Nepal’s rights-based mental health framework, drawing insights from individuals with psychosocial disabilities, their families, policymakers, legal experts, and NGO representatives. It features four case studies that highlight the challenges these individuals face, and the roles played by their families and communities in providing care. The objective is to provide insights into the daily realities of community members in Nepal. In summary, the study highlights the importance of adopting a robust human rights-based approach to quality practice. Such an approach, which fosters trust in engaging individuals with psychosocial disabilities, their families, the community, and mental health service providers, is not merely a theoretical concept but a vital requirement for enhancing mental health practices in Nepal.

Exploring Parental Involvement in Providing Education to Children with Disabilities in Nepal

This study aims to explore parental involvement in community schools for providing education to children with disabilities. It is based on qualitative with phenomenological research design. Three schools conducted with resource classes were chosen purposively from the Nawalparasi district. Interviews and questionnaires were used as research instruments to collect the data. The semi-structured interview schedule was applied for resource teachers and parents; whereas, questionnaire forms were used for teachers. The results demonstrate that parents’ attitudes toward these children are gradually moving positively; and they accept, respect and value their differences. Further, the results show that schools have not adequately involved parents in activities such as planning, monitoring and decision-making processes. Parents are less familiar with inclusive education policy and legal instruments. Although they are supportive of providing education for their children, their efforts are hindered by knowledge gap, poverty and inaccessibility of schools from their residence. Finally, Epstein's framework of parental involvement partially fits with the parental involvement in community schools in Nepal. This study is equally important for policymakers and programmes designers at the federal, provincial and local level to ensure parents involvement in school education.

Accessibility and Utilization of Sexual and Reproductive Health Services among People with Disabilities in Nepal

The study aims to assess the factors determining the access and utilization of sexual and reproductive health (SRH) services among people with disabilities residing in the Kathmandu Valley of Nepal. A cross-sectional study was conducted among randomly selected 422 people with disabilities in Kathmandu Valley. Data were collected through face-to-face interviews using structured questionnaires. Bivariate and multivariate logistic regression analyses were conducted. Among a total of 422 participants, 32.7% had utilized SRH-related education, information, and counselling services. Contraceptive-related services were utilized by 47.6% of participants, pregnancy-related services by 27.7%, safe abortion-related services by 13.0%, and HIV testing and treatment services by 3.6%. Likewise, 16.8% of participants utilized STI screening, diagnosis, and management services. Males were 2.5 times more likely to utilize SRH services compared to females (AOR = 2.5, 95% CI = 1.4-4.2), whereas unmarried participants were less likely to utilize SRH services as compared to single/separated/divorced (AOR = 0.2, 95% CI = 0.0-0.5). Similarly, participants who were living with their families compared to those living alone (AOR = 3.4, 95% CI = 1.4-7.7), and participants who were unemployed compared to employed (AOR = 1.8, 95% CI = 1.0-3.5) had higher odds for utilization of SRH services. There are significant variations depending on the intersections of various characteristics affecting the utilization rate across different SRH services among people with disabilities. Contraceptive-related services were the most utilized service, whereas safe abortion, pregnancy related services, STI screening and management services and HIV testing and treatment services were less utilized services.

Socio-physical and Health Conditions of Person with Disability in Nepal

Socio-physical and Health Conditions of Person with Disability in Nepal

Unlocking Potential: A Comprehensive Analysis of Inclusive Education Policies for Children with Disabilities in Nepal

Special Education Council was established in 1973 after the 1971 National Education System Plan transformed inclusive education in Nepal. Despite delays, 2015 constitutional mandates and 2019 National Education Policy support inclusive education. This review article examines Nepal's inclusive education policies from 1996 to 2017 focusing on changes and challenges. Recent successes include the 2010 ratification of the Convention on the Rights of Persons with Disabilities and the 2018 Compulsory and Free Education Act. The 2019 policy merger and 2076 Education Policy lack inclusive education implementation plans, indicating areas needing improvement. Utilizing Policy Implementation Theory alongside SWOT Analysis, this study endeavors to assess the efficacy of existing policies, evaluate historical adaptations, and scrutinize adherence to international commitments within the Nepalese context. As the International Institute for Educational Planning highlights, legislative frameworks play a pivotal role in fostering parity and inclusivity, underscoring the imperative for stakeholder consensus. Nepal's 2015 constitution meets international standards; however, physical accessibility is still a concern. The study focuses on accessibility, inclusive party laws, manifestos, and collaboration with OPDs, which are recommended for effective representation. Similarly, equal education and employment require inclusive curriculum design and barrier removal in inclusive education and vocational training. Nepal faces policy discrepancies, a lack of trained special educators, and insufficient resources. Implementing inclusive education policies in Nepal is challenging due to contextual, organizational, and policy barriers. It requires infrastructure investments, awareness campaigns, and targeted regulations. Infrastructure investments, awareness campaigns, and targeted regulations are needed implementing inclusive education policies in Nepal is complicated by contextual, organizational, and policy barriers. The study recommends a comprehensive, situation-specific strategy using school psychologists to promote inclusive mindsets in technical and vocational education with invest in infrastructure development to ensure physical accessibility for individuals with disabilities and enact policies that promote inclusive practices within educational and vocational training institutions.

Factors Impacting Employment Opportunities and Outcomes for Individuals with Disabilities in Nepal

This study was undertaken to analyze the factors impacting employment opportunities and outcomes of People with disabilities (PWDs). Also, to measure the satisfaction level of employed PWDs on their current work. The study has collected the required information and data from 200 PWDs using a purposive sampling method. Logistics regression analysis was carried out to analyze the factors impacting employment opportunities and outcomes of PWDs. Likert scale analysis was carried out to measure the satisfaction level of employed PWDs with their current work. The study found that the age at which disability onset, marital status, family size, years of schooling, severity, and access to assistive devices had a significant association with employment of PWDs. Fewer employed PWDs (7.7%) had permanent work status. However, most of the employed PWDs were satisfied with their current work. The family support and level of education of PWDs were the major predictors of employment. The study recommends providing counselling services to the families of PWDs along with sensitizing concerned stakeholders to improve the well-being and participation of PWDs.

Impacts of neoliberal school reforms policy on students with disabilities in Nepal

This article argues that special and inclusive education policies in Nepal have been influenced by neoliberal policy reforms. The study employs discourse analysis as a theoretical perspective to analyse the effects of market-based schooling practices on students with disabilities in Nepal. The findings of this study are informed to some extent by the outcomes of the doctoral research project (Thapaliya, 2018). Data was collected through policies and documents. A selection of key education policies and documents between 1990 to 2020 were examined and analysed. One core theme and five sub-themes were identified from the data analysis. Disability as a resource management issue was a main theme. (i) Managing resources; (ii) resource allocation criteria; (iii) professional experts deciding resource funds; (iv) competing for limited resources; and (v) competition and school choice were sub-themes. The available evidence signals that the marketisation model of education does not assist students with disabilities adequately. The findings of this study reveal that the current policy and practice signal changes in government structure rather than working to fulfil these commitments in the everyday practice of students with disabilities. The limitations of the study and recommendations of this research are also discussed.

Socio-cultural Challenges Faced by People with Physical Disabilities

This qualitative study explores the challenges and the problems faced by people with physical disabilities in Nepal's cultural and social systems. In-depth interviews were conducted with eighteen participants living with physical disabilities in Kathmandu. Findings reveal significant challenges arising from exclusive social traditions, discrimination based on physical impairments, inaccessible infrastructure, and prejudiced social practices. These challenges hinder educational and employment opportunities, exacerbating vulnerability and exclusion from the mainstream socio-cultural system. The study also highlights limitations in government policies and programs, with poor implementation and cumbersome procedures leading to inadequate benefits for people with disabilities. Prejudiced social practices, discrimination, and inaccessible infrastructure further impede day-to-day activities, education, and employment, deepening vulnerability and marginalization. Institutional barriers within Nepali socio-cultural practices perpetuate the labeling of individuals with disabilities as incompetent and deficient, marginalizing their inclusion in social and cultural systems. Addressing these challenges requires comprehensive interventions promoting inclusivity and accessibility.

Navigating Insights and Perspectives of Students with Disability to Include in Nepalese Classroom

Integrated schools with resource classes and special schools provide education for children with disability in Nepal. Government funds and the partial support of national and internal donor partners run these schools. This study intends to seek how children with disability normalize in regular classes after the additional support service in resource class to become a case of inclusion in the education system of Nepal. The study explored the adjustment challenges and identified coping strategies in a regular course. The four students with disability from integrated schools representing children with visual impairment and children with deaf were purposively selected and interviewed through semi-structured interview guidelines in a natural setting. The interview responses were transcribed verbatim and analyzed by extracting themes within a theoretical framework based on post-structuralism and discourse analysis. More than five themes were identified from the discussion of students' reports regarding adjustment challenges in the students' narratives. The study explored significant challenges such as the lack of disabled-friendly physical facilities, domination of traditional methods, presence of an untrained teacher, lack of expanded core curriculum, lack of peer support and poor psychological attachment. The exploration of challenges assists policymakers and well educators set up strategies for effective inclusion in school education and the community. The extreme mitigation of challenges promotes an inclusive atmosphere in regular classrooms.

Technology Utilization and Physical Engagement Among Children with Disabilities in Nepal

This study aims to explore how the utilization of modern technology by children with disabilities may lead to sedentary behaviors. This study is informed by the interpretive paradigm. An explorative qualitative research design was adopted to approach the phenomenon. This study has covered three different disability groups: visual impairment, hearing impairment, and physical disability. In order to cover these groups, three integrated schools were purposively selected for the study. Altogether, 22 participants—head teachers, teachers, students, parents, and members of Disabled People Organization— were purposively selected. In-depth interview guidelines and key informant interview guidelines were used as data collection tools. The obtained data were analyzed and interpreted thematically by using multiple facts and critical views. Children with disabilities were found to be interested in participating in various kinds of physical activities. Children are increasingly attracted to the newest forms of technology. With the exponential development of smartphones and tablets, the use of technology devices has become unavoidable and is now viewed as an integral part of life. Digital technology was found to be one of the main causes of physical inactivity among children with disabilities. The entire group of stakeholders is advised to increase outdoor activities to promote physical fitness and health of children with disabilities.

The right to health: An examination of health care access for women with disability in Nepal

The right to health: An examination of health care access for women with disability in Nepal

MRI Evaluation in Acute Spinal Trauma in Tertiary Center of Nepal

IntroductionSpine injury is one of the leading caused for disability in Nepal. Patients with trauma relatedspine injury leads to neurological dysfunction, focal deficits and even fatal life threating events.The timely intervention in acute spinal trauma injury could save the patients from disability andmortality risk. Imaging modalities like Xray, CT Scan and MRI helps in diagnosis and managementof spinal trauma. MRI plays crucial role in detection of spinal cord and soft tissue injuries. It issuperior than CT scan in evaluation of spinal cord injuries, ligament, soft issue structures, disc,and occult osseous injuries. The objective of this research is to evaluate MRI in acute spinal traumain tertiary center of Nepal. MethodsThis is descriptive hospital based observational study in those patients who were admitted andreferred in hospital for MRI with acute spinal trauma injury. Data were analysed by SPSS 2022. ResultsAcute spinal trauma is most common in male with ratio of 1.7 with the mean±SD of age was foundto be 50.98±19.26 years. Most common mode of injury were fall injury (76%). Most common spinalregion involved were lumbar (42%) followed by thoracic (36%), dorso-lumbar (14%) and cervical(8%) region respectively. Spinal cord contusion with edema, disc rupture, paravertebral collectionand ligament injury were seen. Most common type of fractures were simple compression fracture(72%), followed by burst fracture (16%), both (6%) and listhesis and sub/dislocations (6%). Spinalcord injury were seen in 22%, followed by disc rupture, paravertebral collection and ligamentinjury. ConclusionsMRI helps in evaluating vertebrae, spinal cord, ligament and disc injuries. We can assess the cordcontusion, edema and canal compression. It provides involvement, extension and severity of cordinjury. It endowed about outcome of surgery as well as conservative management in patient ofspinal injury.

Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study.

Monitoring ocular morbidity among pediatric patients requires regular follow-up visits. We found that the follow-up rate was poor among children in our setting. Therefore, we intended to assess the effectiveness of 2 interventions-(1) counseling and (2) SMS text messaging and phone calls-to improve the follow-up rates. This study aimed to evaluate the effectiveness of 2 interventions, counseling and SMS and phone calls group, as well as a routine standard care for improving the follow-up rate of pediatric patients. A Nonrandomized, quasiexperimental design was used. Children (aged 0-16 years) with ocular conditions requiring at least 3 follow-up visits during the study period were included. A total of 264 participants were equally allocated to the 3 intervention groups of (1) counseling, (2) SMS and phone calls, and (3) routine standard care group. A 20-minute counseling session by a trained counselor with the provision of disease-specific leaflets were given to those in the counseling group. For the second intervention group, parents of children received an SMS text 3 days before and a phone call 1 day before their scheduled follow-up visits. Participants allocated for the routine standard care group were provided with the existing services with no additional counseling and reminders. Participants attending 3 follow-ups within 2 days of the scheduled visit date were considered compliant. The difference in and among the proportion of participants completing all 3 follow-up visits in each group was assessed. The demographic characteristics of the participants were similar across the study groups. Only 3% (8/264) of participants completed all 3 follow-up visits, but overall compliance with the follow-up, as defined by the investigators, was found to be only 0.76% (2/264). There was no statistically significant difference in the proportion of follow-up between the intervention groups. However, the proportion of participants attending the first and second follow-ups, as well as the overall total number of follow-ups, was more in the SMS and phone-call group followed by the counseling group. We did not find any evidence on the effectiveness of our interventions to improve the follow-up rate. The primary reason could be that this study was conducted during the COVID-19 pandemic. It could also be possible that the intensity of the interventions may have influenced the outcomes. A rigorously designed study during the absence of any lockdown restrictions is warranted to evaluate intervention effectiveness. The study also provides useful insights and highlights the importance of designing and systematically developing interventions for improving the follow-up rate and ensuring a continuum of care to children with visual disabilities in Nepal and similar contexts. ClinicalTrials.gov NCT04837534; https://clinicaltrials.gov/ct2/show/NCT04837534. RR2-10.2196/31578.

Factors associated with access to sexual and reproductive health services among women with disabilities in Nepal.

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.

Trends and geographical variation in leprosy case detection and disability in Nepal, 2010–2021

Objective Although elimination of leprosy was achieved in Nepal at national level in 2009, around 3000 new cases are still detected every year and 5% of these cases have Grade 2 disability (G2D). This study aims to describe the geographical distribution of leprosy new case detection (NCD) and G2D from 2010 to 2021 in two leprosy endemic provinces in Nepal. Methods We collected the geolocations and leprosy-related data of patients registered from 2010 to 2021 in Provinces 1 and 7. The geographical distribution of NCD and G2D was analysed in Quantum Geographic Information Systems (QGIS) at district, municipality and ward level, and we calculated the trends in Eye Hand Foot (EHF) impairment scores among cases with disabilities. Results From 2010 to 2021, a decrease in NCD and G2D cases was identified in Province 1, and an increase in NCD and G2D cases in Province 7. Geographical variations were visible between wards within highly endemic districts in both provinces. The mean EHF score in cases with disability increased from 1.7 in 2017 to 2.5 in 2020 in Province 1 and fluctuated between 2.3 and 4.5 in Province 7. Conclusions This study shows that the leprosy problem is still current in Nepal. Geographic variations in case detection and disability indicators are seen best when mapping at ward level. Leprosy programme managers can use the maps to develop long-term strategies at district, municipality or ward level that include intensified active case finding, preventive treatment and disability services, while considering costs and efficient use of resources.

Educating Students with Intellectual Disabilities in Nepal: Exploring Realities and Challenges fromTeachers’ Perspectives

This study aims at exploring the realities and challenges that have been taking place for years while providing educational servicesto students with intellectual disabilities in Nepal. Interpretive-constructivist paradigm accompanied by phenomenological research design was usedto carry out this research. Eight teachers teaching to thestudents with intellectual disabilities were chosen from four special schools (two from each) located within Kathmandu valley by using purposive sampling method, and then all sample teachers were interviewed by using in-depth interview technique to collate credible and authenticinformation required for the study. Study results reveal that a number of attempts such as special education services in a separate setting, distinct structure of curriculum, community-based instruction, etc. had been made to optimize the access of these students to educational program. Nevertheless, thestudents with intellectual disabilitieswere not receiving quality educational services because of various challenges such as inadequate training to teachers, poor expectations from children, insufficient resources, etc. These students, therefore, should be taught in an inclusive educational setting byproviding community-based services based on the severity of their disability.

Patterns of Disease Presentations in an Adult Outpatient Neurology Clinic of a Neurologist

Introduction: Neurological disorders are very common all over the world. The most common neurological disorders causing maximum disability in Nepal are migraine and tetanus whereas the most common neurological causes of death are ischemic strokes and primary intracerebral hemorrhage. This small-scale study has been carried out to find out the frequency and types of disorders presenting in adult outpatient neurology clinic in a tertiary care hospital in Nepal.
 Materials and Methods: This is a retrospective descriptive study carried out in the outpatient department of the department of neurology at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The diseases were classified based on the 11th revision of the International Classification of Diseases. Chi-square test and Fisher’s exact test were used to calculate the significance of the different types of variables when applicable.
 Results: Of 1939 patients seen over a period of 12 months, diseases of the musculoskeletal system were the commonest (28.7%) followed by headache disorders (18.4%). Diseases of the musculoskeletal system, ischemic stroke, primary intracerebral hemorrhage, movement disorders, diseases of the inner ear were more common in patients more than 50 years and headache disorders; mental, behavioral or neurodevelopmental disorders; seizures and multiple sclerosis or other white matter disorders were more common patients aged 50 years or less. These differences were statistically significant.
 Conclusion: Almost all types of neurological disorders were seen in the adult outpatient neurology clinic providing the opportunity to carry out research and to uplift academic activities in a tertiary care hospital.

Role of Physical Education for the Students with Disabilities in Nepal in the Era of Digitization

This study aims to critically analyze the role of physical education as a natural method of coping with challenges posed by technology for children with disabilities in Nepal in the era of digitization. A qualitative research design was applied to approach the phenomenon. The phenomenon was lokked through a critical paradigm based on the demand of research questions. The primary data were collected from the participants using the in-depth interview guidelines. However, the secondary data were collected through a desk review. This study includes only physically disabled students. Khagendra Nawajeev Special School Jorpati was selected purposively as the research site. Five disabled students (from grade 10) and one Health and Physical Education Teacher were also selected purposively as the respondents for the study.
 Moreover, one person involved in policymaking specifically regarding special needs education was interviewed. The obtained data were analyzed and interpreted thematically using multiple facts and critical views. The study found that students with disabilities using information technology are mentally engaged but have stopped physical activities. Techno-addiction has become a big problem. Just as the addiction to marijuana, hashish, and alcohol weakens the level of human consciousness, addiction to technology weakens the essential human potential. Physical activities are the ultimate prescription, as sports and physical education allow students to get active and live healthier lifestyles even in the era of digitization.

Disability and Gender: A study of Lived Experiences of Economic Hardships Faced by Women with Disabilities from Sudurpaschim Province, Nepal

According to the 2011 census, people with disabilities in Nepal are estimated to constitute 1.9% of the total population, out of which 3% are women with disabilities. Studies made on women with disabilities in Nepal show that they suffer violence and discrimination because of their subordinate position in society. Researches on women with disabilities in Nepal seem to focus on social barriers, exploitations and violence faced by them. In the short of researches and reports about the economic challenges faced by women with disabilities, this study uses the concept of intersectionality as a lens to analyze and interpret the economic hardships faced by women with disabilities from Sudurpaschim Province of Nepal. For the purpose of the study in-depth interviews were conducted among eight women with disabilities from Sudurpaschim Province. Though the study is made among women with disabilities from Sudurpaschim Province, the study does not intend to be location specific as such. The study is less about the geographical location of women with disabilities and more about their social location as women with disabilities. The study also delves into the social construction of gender and disability and how it has affected the lives of women with disabilities. Overall, the findings of the study give an impression of high economic dependency of women with disabilities and intensified economic hardships among women with severe form of disabilities. Int. J. Soc. Sc. Manage. Vol. 9, Issue-2: 55-62.

"We'll starve to death": The consequences of COVID-19 over the lives of poor people with disabilities in rural Nepal.

There is no doubt that the sudden outbreak of COVID‐19 negatively impacted billions of people worldwide, and among them, people with disabilities became most susceptible. However, little is known about the impact of COVID‐19 on the lives of people with disabilities in Nepal. Using empirical data from semi‐structured in‐depth interviews with people with disabilities, disability specialist, and community leaders, this study discusses the lived experiences of people with disabilities who have been affected by COVID‐19 in Nepal. This study revealed that the outbreak of COVID‐19 impacted people with disabilities by worsening their vulnerability. In particular, the majority of people with disabilities became further isolated, were disconnected from existing services such as access to information, education, and health care and many lost their income opportunities. Findings from this study further show that this pandemic affected the rights of people with disabilities guided by the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Immediate financial and non‐financial support for people with disabilities from government and other stakeholders, such as non‐governmental organizations (NGOs), is needed, indicating the need for policymakers to reassess policies to ensure that they adequately protect the rights of people with disabilities.