Disabled women׳s maternal and newborn health care in rural Nepal: a qualitative study.
OBJECTIVE
there is little evidence about disabled women׳s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women׳s experiences of maternal and newborn care in rural Nepal.


METHODS
we used a qualitative methodology, using semi-structured interviews.


METHODS
rural Makwanpur District of central Nepal.


METHODS
we purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women.


RESULTS
married disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women.


CONCLUSIONS
integration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care.
Institute for Global Health, University College London, 30 Guildford Street, London WC1N 1EH, UK. Electronic address: Joanna.morrison@ucl.ac.uk.
Joanna
J
Morrison
MIRA, PO Box 921, Thapathali, Kathmandu, Nepal.
Machhindra
M
Basnet
MIRA, PO Box 921, Thapathali, Kathmandu, Nepal.
Bharat
B
Budhathoki
MIRA, PO Box 921, Thapathali, Kathmandu, Nepal.
Dhruba
D
Adhikari
MIRA, PO Box 921, Thapathali, Kathmandu, Nepal.
Kirti
K
Tumbahangphe
MIRA, PO Box 921, Thapathali, Kathmandu, Nepal.
Dharma
D
Manandhar
Institute for Global Health, University College London, 30 Guildford Street, London WC1N 1EH, UK.
Anthony
A
Costello
Leonard Cheshire Disability and Inclusive Development Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Nora
N
Groce
D006233:Persons with Disabilities; D005260:Female; D006297:Health Services Accessibility; D006700:Home Childbirth; D006801:Humans; D000068101:Maternal-Child Health Services / Q000592:standards*; D009390:Nepal; D011247:Pregnancy; D011295:Prenatal Care; D036301:Qualitative Research; D012424:Rural Population
Access; Disability; Equity; Neonatal; Quality; Respectful care