Social determinants of impaired functioning among Nepali widows: A mixed methods study

Kathryne S. Mezzanotte, Anvita Bhardwaj, Yoona Kim, Damodar Rimal, Jane K. Lee, Abina Shrestha, Wietse A. Tol, Nagendra P. Luitel, Pamela J. Surkan

Research output: Contribution to journalArticlepeer-review


Despite considerable stigmatisation of widows in Nepal, little is known about factors affecting their ability to function in society. Using mixed methods, we studied psychosocial factors associated with impaired functioning among Nepali widows. For the qualitative analysis, we analysed 3 focus groups, 25 in-depth interviews, and 12 key-informant interviews. The quantitative analysis was based on data from 204 widows. Odds ratios were calculated linking psychosocial exposures to impaired functioning using adjusted logistic regression models. Low social support (aOR = 2.35, 95% CI: 1.2, 4.6, generally; aOR = 3.3, 95% CI: 1.7, 6.42, specifically from family members), experiences of discrimination (aOR = 2.97, 95% CI: 1.43, 6.14), and low life control (aOR = 4.3, 95% CI: 1.86, 10.1) were risk factors for impaired functioning. Qualitative findings suggested how discrimination and lack of control contribute to impaired functioning. Support from the husband’s family appeared to be more important to a widow’s functioning, compared to from her own parents. Knowledge about risk factors for impaired functioning can help inform interventions for Nepali widows.

Original languageEnglish (US)
Pages (from-to)3853-3868
Number of pages16
JournalGlobal public health
Issue number12
StatePublished - 2022


  • Nepal
  • Social support
  • discrimination
  • social stigma
  • widowhood

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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