The School of Health & Social Care

Sexual health services limited in Nepal

Page published 15 June 2011

Sex workers face major constraints to accessing sexual health services in Nepal.

Researchers at Bournemouth University and the University of Aberdeen found that the sex workers in the Nepalese capital city of Kathmandu experience discrimination and stigma which prevents many from seeking care from sexual health services.

A study published in BMC Health Service Research found that sex workers in Nepal have limited access to information and to health services, and operate under personal, structural and socio-cultural constraints.

The study included 425 sex workers aged 19 to 35 – half were street workers and the remainder worked in cabins, restaurants, massage centres and hotels. A quarter of sex workers with self-reported symptoms of sexually transmitted infection had never visited any health facilities. Many of the sex workers who had attended clinics had gone to other parts of town to avoid being recognised by health care staff and other patients in the waiting room.

In interviews with a subsample of 15 sex workers the researchers found that sex workers experienced many barriers to accessing appropriate health care. These barriers included inappropriate clinic opening hours, discrimination, the judgemental attitude of the service providers, lack of confidentiality and fear of public exposure. Research participants also commented that private clinics would try to charge them higher fees if they thought they were sex workers.

The study of female sex workers was a key part of Dr. Laxmi Ghimire’s PhD study who was awarded her PhD in Public Health last year by the University of Aberdeen.

Dr. Ghimire said: “What is necessary is education of sex workers to change their individual behaviour, but perhaps more important would be attempts to reduce stigma and discrimination among some of health workers and people in the community.”

The researchers have published their paper ‘Utilisation of sexual health services by female sex workers in Nepal’ in BMC Health Services Research. The paper is just out and it has already been designated as highly accessed by BMC Health Services Research.

Professor Edwin van Teijlingen, Professor of Reproductive Health Medicine in the School of Health and Social Care at Bournemouth University said: “This electronic academic journal is open-access which means that anybody can read it for free. This is very important for readers in developing countries like Nepal, where university libraries often cannot afford the subscriptions to expensive scientific journals.”