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Nguyen M, Kim Y, Choi Y, Jang J, Shakya M, Adhikari A, Luitel NP, Surkan PJ. Guardians Looking From Outside: Gendered Experiences of Labor Migration and Psychosocial Health Among Nepalese Migrant Fathers and Left-Behind Mothers. QUALITATIVE HEALTH RESEARCH 2024:10497323241265291. [PMID: 39293817 DOI: 10.1177/10497323241265291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2024]
Abstract
Nepalese migrant workers are at heightened risk of adverse mental health problems. However, the social mechanisms by which experiences of labor migration create such vulnerabilities are not well understood. Moreover, limited attention has been paid to the experiences of left-behind spouses. This study explores how migrant fathers and left-behind mothers experience labor migration and how migration affects mental health across migrant household members, paying special attention to the role of gender. We conducted 29 in-depth interviews with Nepalese migrant fathers (N = 18) in South Korea and left-behind mothers (N = 11) in Nepal. Labor migration imposes substantial stress on the entire family. Migrant fathers discussed their feelings of guilt and worry regarding their relationships with their children due to physical and emotional distance. Left-behind mothers indicated loneliness and caregiver stress due to additional responsibilities as a single parent. Migrant fathers reported that they felt respected by their communities for their work, while left-behind mothers felt heavily scrutinized. Our findings highlight how labor migration reinforces gender inequalities in domestic responsibilities and norms regarding the expected roles of migrating men and left-behind women. These findings suggest that psychosocial services must be tailored to the unique needs of migrant workers and left-behind families.
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Affiliation(s)
- Megan Nguyen
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yoona Kim
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yuni Choi
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joyce Jang
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manju Shakya
- Hankuk University of Foreign Studies, Seoul, South Korea
| | | | - Nagendra P Luitel
- PRIME Nepal, Chitwan, Nepal
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Kathmandu, Nepal
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Kim Y, Hendrickson ZM, Shakya M, Park YS, Jung M. Unmet Need for Family Planning and Spousal Separation in Nepal: A Spatial and Multilevel Analysis. Int J Public Health 2023; 68:1606395. [PMID: 38130472 PMCID: PMC10733444 DOI: 10.3389/ijph.2023.1606395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives: In Nepal, where increasing numbers of married couples live apart due to migration, progress in reducing unmet need for family planning (UMN) is stagnant. This study aims to identify spatial patterns of UMN of married women and spousal separation in Nepal and explore associations between UMN and spousal separation at individual- and district-levels. Methods: We used 2016 Nepal Demographic and Health Surveys data to conduct spatial and multilevel logistic analyses. Results: This study shows evidence of similar geographical patterns in UMN of married women and spousal separation. At the individual level, women living with their spouses had 88% (aOR = 0.12, 95% CI 0.11-0.13) decreased odds of experiencing UMN compared to those living apart from their spouses. While not statistically significant, increasing odds of UMN were observed with higher prevalence of spousal separation at the district level. Conclusion: This study contributes to the existing literature by showing similar geographical patterns of UMN and spousal separation across Nepal and demonstrating both individual and contextual effects of spousal separation on UMN among married women. Theoretical and policy implications are discussed.
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Affiliation(s)
- Yoona Kim
- Moon Soul Graduate School of Future Strategy, College of Liberal Arts and Convergence Science, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | | | - Manju Shakya
- International Development Studies, Hankuk University of Foreign Studies, Seoul, Republic of Korea
| | - Young Su Park
- Department of the History of Medicine and Medical Humanities, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Myunggu Jung
- Moon Soul Graduate School of Future Strategy, College of Liberal Arts and Convergence Science, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
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Dahal P, Joshi SK, Swahnberg K. A qualitative study on gender inequality and gender-based violence in Nepal. BMC Public Health 2022; 22:2005. [PMID: 36320057 PMCID: PMC9628167 DOI: 10.1186/s12889-022-14389-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/19/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Gender inequality and violence are not mutually exclusive phenomena but complex loops affecting each other. Women in Nepal face several inequalities and violence. The causes are diverse, but most of these results are due to socially assigned lower positioning of women. The hierarchies based on power make women face subordination and violence in Nepal. The study aims to explore participants' understanding and experience to identify the status of inequality for women and how violence emerges as one of its consequences. Furthermore, it explores the causes of sex trafficking as an example of an outcome of inequality and violence. METHOD The study formulated separate male and female groups using a purposive sampling method. The study used a multistage focus group discussion, where the same groups met at different intervals. Six focus group discussions, three times each with male and female groups, were conducted in a year. Thirty-six individuals, including sixteen males and twenty females, were involved in the discussions. The study used constructivist grounded theory for the data analysis. RESULTS The study participants identify that a power play between men and women reinforce inequality and increases the likelihood of violence for women. The findings suggest that the subjugation of women occurs due to practices based on gender differences, constricted life opportunities, and internalization of constructed differences among women. The study identifies that interpersonal and socio-cultural violence can result due to established differences between men and women. Sex trafficking, as an example of the outcome of inequality and violence, occurs due to the disadvantageous position of women compounded by poverty and illiteracy. The study has developed a concept of power-play which is identified as a cause and consequence of women's subordination and violence. This power play is found operative at various levels with social approval for men to use violence and maintain/produce inequality. CONCLUSION The theoretical concept of power play shows that there are inequitable power relations between men and women. The male-centric socio-cultural norms and practices have endowed men with privilege, power, and an opportunity to exploit women. This lowers the status of women and the power-play help to produce and sustain inequality. The power-play exposes women to violence and manifests itself as one of the worst expressions used by men.
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Affiliation(s)
- Pranab Dahal
- grid.8148.50000 0001 2174 3522Department of Health and Caring Science, Linnaeus University, 391 82 Kalmar, Sweden
| | - Sunil Kumar Joshi
- grid.415089.10000 0004 0442 6252Department of Community Medicine, Kathmandu Medical College, 446 00 Kathmandu, Nepal
| | - Katarina Swahnberg
- grid.8148.50000 0001 2174 3522Department of Health and Caring Science, Linnaeus University, 391 82 Kalmar, Sweden
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Cheng S, Kuo CC, Chen HC, Lin MC, Kuo V. Effects of Workplace Gossip on Employee Mental Health: A Moderated Mediation Model of Psychological Capital and Developmental Job Experience. Front Public Health 2022; 10:791902. [PMID: 35493358 PMCID: PMC9041444 DOI: 10.3389/fpubh.2022.791902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Research has demonstrated the effects of workplace gossip on employees' work attitudes and behaviors. However, little emphasis has been placed on the psychological influence of workplace gossip on employees. The present study investigated the relationships among workplace gossip, psychological capital, and individual mental health. Data were collected in three waves from 222 full-time employees of a Taiwanese tourism company to explore the effect of workplace gossip on employees' mental health. The results suggested that workplace gossip was associated with employees' mental health through psychological capital. Moreover, developmental job experience plays a moderator role in the relationships among workplace gossip, psychological capital, and mental health. A moderated mediation model was also proposed in this study.
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Affiliation(s)
- Sheng Cheng
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Chien-Chih Kuo
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Huai-Chieh Chen
- School of Business, Huaiyin Institute of Technology, Huaiyin, China
| | - Mei-Chi Lin
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Vincent Kuo
- Department of Entrepreneurship, Marketing and Management Systems, Nottingham University Business School China, Ningbo, China
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Khan R, MacQuarrie KL, Sultana M, Nahar Q. Intermittent Needs for Family Planning among Women with an Internal Migrant Husband in Bangladesh: A Qualitative Study. Sex Reprod Health Matters 2022; 29:2097044. [PMID: 35939308 PMCID: PMC9364705 DOI: 10.1080/26410397.2022.2097044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Bangladesh is one of the major labour-exporting countries in the world, with large-scale labour migration flows occurring both internationally and domestically. Spousal separation due to migration has the potential to disrupt women’s ability to use contraception in line with their reproductive goals. This qualitative study complements the 2014 Bangladesh Demographic and Health Survey (BDHS) data; we conducted in-depth interviews with a sub-sample of 23 BDHS respondents whose husbands stayed elsewhere but returned at least once a year to Barisal Division, Bangladesh. The study explores how husbands’ migration patterns influence couples’ fertility intentions, contraceptive decision-making and behaviour, and unintended pregnancies. Results showed that contraceptive use was high among the study participants, with nearly all couples using some method to avoid pregnancy – usually pills and condoms. However, the use was episodic and inconsistent, reducing effectiveness. Experiences of side effects were commonplace, which contributed to this pattern of inconsistent use: women used pills only during the duration of their husband’s visits. Half of the informants experienced unintended pregnancies either due to the inconsistent use of pills or other method failures. The study findings indicate that women with migrant husbands need family planning education related to their particular circumstances and access to a wider range of family planning choices. Quality counselling should respect women’s experiences with side effects and include thorough discussion of viable alternatives.
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Affiliation(s)
- Rasheda Khan
- Co-principal Investigator, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh. Correspondence:
| | | | - Marzia Sultana
- Co-investigator, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Quamrun Nahar
- Principal Investigator, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
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Wu WJ, Tiwari A, Choudhury N, Basnett I, Bhatt R, Citrin D, Halliday S, Kunwar L, Maru D, Nirola I, Pandey S, Rayamazi HJ, Sapkota S, Saud S, Thapa A, Goldberg A, Maru S. Community-based postpartum contraceptive counselling in rural Nepal: a mixed-methods evaluation. Sex Reprod Health Matters 2020; 28:1765646. [PMID: 32546070 PMCID: PMC7887993 DOI: 10.1080/26410397.2020.1765646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Unmet need for postpartum contraception in rural Nepal remains high and expanding access to sexual and reproductive healthcare is essential to achieving universal healthcare. We evaluated the impact of an integrated intervention that employed community health workers aided by mobile technology to deliver patient-centred, home-based antenatal and postnatal counselling on postpartum modern contraceptive use. This was a pre–post-intervention study in seven village wards in a single municipality in rural Nepal. The primary outcome was modern contraceptive use among recently postpartum women. We performed a multivariable logistic regression to examine contraceptive use among postpartum women pre- and one-year post-intervention. We conducted qualitative interviews to explore the implementation process. There were 445 postpartum women in the pre-intervention group and 508 in the post-intervention group. Modern contraceptive use increased from 29% pre-intervention to 46% post-intervention (p < 0.0001). Adjusting for age, caste, and household expenditure, time since delivery and sex of child in the index pregnancy, postpartum women one-year post-intervention had twice the odds (OR 2.3; CI 1.7, 3.1; p < 0.0001) of using a modern contraceptive method as compared to pre-intervention. Factors at the individual, family, and systems level influenced women’s contraceptive decisions. The intervention contributed to increasing contraceptive use through knowledge transfer, demand generation, referrals to healthcare facilities, and follow-up. A community-based, patient-centred contraceptive counselling intervention supported by mobile technology and integrated into longitudinal care delivered by community health workers appears to be an effective strategy for improving uptake of modern contraception among postpartum women in rural Nepal.
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Affiliation(s)
- Wan-Ju Wu
- Assistant Professor, Possible, New York, NY, USA; Boston Medical Center, Department of Obstetrics and Gynecology, Boston, MA, USA; Boston University School of Medicine, Department of Obstetrics and Gynecology, Boston, MA, USA
| | - Aparna Tiwari
- Research Analyst, Nyaya Health Nepal, Kathmandu, Nepal
| | - Nandini Choudhury
- Delivery Science Analyst, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Arnhold Institute for Global Health, New York, NY, USA
| | - Indira Basnett
- Health Advisor, Ministry of Health and Population, Nepal Health Sector Support Programme, Kathmandu, Nepal
| | - Rita Bhatt
- Community Health Nurse, Nyaya Health Nepal, Kathmandu, Nepal
| | - David Citrin
- Director of Evidence to Policy, Possible, New York, NY, USA; Departments of Global Health and Anthropology, Henry M Jackson School of International Studies, University of Washington, Seattle, WA, USA
| | - Scott Halliday
- Senior Implementation Research Manager, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Arnhold Institute for Global Health, New York, NY, US; Department of Global Health, Henry M Jackson School of International Studies, University of Washington, Seattle, WA, USA
| | - Lal Kunwar
- Independent Consultant, Nyaya Health Nepal, Kathmandu, Nepal
| | - Duncan Maru
- Senior Advisor, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Departments of Internal Medicine and Pediatrics, Arnhold Institute for Global Health, New York, NY, USA
| | - Isha Nirola
- Doctoral Candidate, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sachit Pandey
- Mobile Systems Engineer, Nyaya Health Nepal, Kathmandu, Nepal
| | | | - Sabitri Sapkota
- Director of Implementation Research, Nyaya Health Nepal, Kathmandu, Nepal
| | - Sita Saud
- Community Health Programme Associate , Nyaya Health Nepal, Kathmandu, Nepal
| | - Aradhana Thapa
- Director of Healthcare Design, Nyaya Health Nepal, Kathmandu, Nepal
| | - Alisa Goldberg
- Associate Professor, Brigham and Women's Hospital, Department of Obstetrics, Gynecology and Reproductive Biology, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Planned Parenthood League of Massachusetts, Boston, MA, USA
| | - Sheela Maru
- Assistant Professor, Possible, New York, NY, USA; Icahn School of Medicine at Mount Sinai, Department of Obstetrics, Gynecology, and Reproductive Science, Arnhold Institute for Global Health, New York, NY, USA
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