Stigma and Perceived Satisfaction from Social Support towards Persons with Physical Disabilities in Western Nepal: Are They also Suffering from Limited Use of Health Services?

Abstract

Background: Accesses to health services by persons with physical disabilities (PWPDs) are a great challenge in developing countries such as Nepal. The use of health services by PWPDs can be influenced by a variety of factors, including infrastructure, geographical conditions, lack of health service providers, and social conditions. Health Service Report of the Government of Nepal showed that PWDs had lower access to health services than general population in 2011. However, little evidence is available about how social conditions can influence their use of health services. Therefore, this study aimed to examine how perceived social support, stigma, and discrimination are influencing access to health care services by PWPDs in Western Nepal. Methods: This study was a cross-sectional study, which was conducted in the Far-Western Region of Nepal, targeting 240 PWPDs. Data collection was carried out in July to August 2013. Descriptive analyses were done to summarize general characteristics of participants. Also, multiple logistic regression analyses were performed to examine the associations between perceived social support, stigma, discrimination, and the use of health services. Results: Out of 240 PWPDs, 148 (62%) needed health services in the past one year. Out of them, 75 (51%) were not able to receive any health services. PWPDs who perceived more satisfaction from social support were more likely to use health services compared to those who perceived less satisfaction from support (Adjusted Odd Ratio (AOR): 2.3, 95% Confidence Interval (CI): 1.7-4.0; p < 0.001). Other factors, such as perceived discrimination, stigma, degree of disability, and type of family, were not statistically associated with the use of health services by PWPDs. Conclusions: About half of PWPDs who needed health services were not able to use them in rural Nepal. However, those who perceived more social support had better access to health service. In resource limited settings, increasing perceived social support is a key to improve PWPDs’ access to health services. Keywords: discrimination; Nepal; persons with disabilities; social support; stigma.