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Perceived barriers to accessing Female Community Health Volunteers' (FCHV) services among ethnic minority women in Nepal: A qualitative study.

Panday, S., Bissell, P., van Teijlingen, E. and Simkhada, P., 2019. Perceived barriers to accessing Female Community Health Volunteers' (FCHV) services among ethnic minority women in Nepal: A qualitative study. PLoS One, 14 (6), e0217070.

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journal.pone.0217070.pdf - Published Version
Available under License Creative Commons Attribution.


DOI: 10.1371/journal.pone.0217070


Despite the efforts of community health workers to increase access to healthcare among ethnic minority groups in low- and -middle income countries, members of ethnic minorities are less likely than women from other ethnic groups to use maternal and child healthcare services. However, much less is known about the factors that limit access of ethnic minorities to healthcare services, including the services of community health workers in Nepal, who are known as Female Community Health Volunteers (FCHVs). To address this issue, we conducted a qualitative study to explore perceived barriers to accessing maternal and child healthcare services among ethnic minority groups in two different geographical locations (the hill and Terai regions- flatland bordering south India) with varying degrees of access to local healthcare centres. Between April 2014 and September 2014, semi-structured interviews were conducted with twenty FCHVs, 26 women service users and 11 paid local health workers. In addition, 15 FCHVs participated in four focus group discussions. A thematic analysis of the data identified five major themes underlying barriers to accessing available maternal and child healthcare services by ethnic minority groups such as Dalits, Madhesi, Muslim, Chepang and Tamang. These themes include: a) lack of knowledge among service users; b) lack of trust in volunteers; c) traditional beliefs and healthcare practices; d) low decision-making power of women; and e) perceived indignities experienced when using health centres. We conclude that community health programmes should focus on increasing awareness of healthcare services among ethnic minority groups, and the programmes should involve family members (husband and mothers-in-law) and traditional health practitioners. Both the FCHVs and local healthcare providers should be trained to communicate effectively in order to deliver respectful care among ethnic minorities if we want to achieve universal healthcare coverage for maternal and child health in low- and -middle income countries.

Item Type:Article
Additional Information:Funding: The School of Health Related Research, The University of Sheffield provided a small amount of fund (£1180) for data collection. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Uncontrolled Keywords:Nepal Pregnancy Nepal; Pregnancy; Health care providers; Child health; Ethnic epidemiology; Human families; Religion; Ethnic groups
Group:Faculty of Health & Social Sciences
ID Code:32400
Deposited By: Symplectic RT2
Deposited On:17 Jun 2019 12:55
Last Modified:14 Mar 2022 14:16


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