Suicide and deliberate self-harm among women in Nepal: a scoping review

Abstract

Background Suicide is a growing public health problem globally. Suicide accounts for 70% of violent deaths among women in low and middle income countries. In Nepal suicide is the single leading cause of death among women of reproductive age. The aim of this scoping review is to explore and understand the various contexts related to vulnerability of Nepalese woman towards suicide and deliberate self-harm. Methods A scoping review based on Arksey and O’Malley’s methodological framework including a combination of peer-reviewed publications and grey literature was conducted. The National Library of Medicine’s PubMed and Google Scholar search engines were used during July 2019 applying a Boolean search strategy. Results Suicide incidence was found to be higher among younger age group and married women, with poisoning as the most common means of suicide. Psychosocial and economic factors such as abuse, interpersonal conflicts, marital disputes, relationship problems, adjustment problems, unpaid loans and financial losses; and mental health conditions such as mood disorder, adjustment disorder and substance abuse disorder were found to be contributing factors for suicide and deliberate self-harm among women in Nepal. Conclusion Socio-cultural and economic factors shape family and marital relationships which impacts psycho-social and mental wellbeing of women in Nepal inciting suicidal attempts and deliberate self-harm. However, very few studies were found that explore the context of poverty, social exclusion, gender inequality, education, traditional/cultural and patriarchal system in which suicide among women in Nepal occurs.

Marital status and suicidal behavior in South Asia: A systematic review and meta‐analysis

“…4,70 However, studies in South Asia have shown a higher proportion of married individuals among those engaging in suicidal behavior. 59,68,[71][72][73] This contrasting finding suggests that the association between marital status and suicidal behavior may be influenced by cultural, social, and economic factors specific to the South Asian region. Specifically, gender stereotyping, limited agency for women, and the expectation of fulfilling certain marital responsibilities may contribute to stress and psychological distress within marriages, potentially increasing the risk of suicidal behavior among married individuals, particularly among women.…”

“…In many Western countries, being unmarried or divorced is often associated with a higher risk of suicidal behavior, while being married is generally considered protective 4,70 . However, studies in South Asia have shown a higher proportion of married individuals among those engaging in suicidal behavior 59,68,71–73 . This contrasting finding suggests that the association between marital status and suicidal behavior may be influenced by cultural, social, and economic factors specific to the South Asian region.…”

Mortalidade Por Violência Autoprovocada Em Mulheres Em Idade Fértil No Rio Grande Do Norte

“…No Nepal, houve um considerável aumento na contribuição do suicídio (16%) para mortes de mulheres em idade reprodutiva, de modo que o suicídio em 2009 foi a principal causa de morte entre mulheres em idade reprodutiva 26 . Estudo mostrou que o contexto social caracterizado pelo patriarcado, pela desigualdade de gênero, pela pobreza, por normas socioculturais rígidas, relações familiares e conjugais conflituosas no Nepal contribuem para essa realidade pois tornam as mulheres vulneráveis à ideação suicida, tentativas de suicídio e automutilação 27 .…”

Marital Status and Suicidal Behavior in South Asia: A Systematic Review and Meta-Analysis

“…In many Western countries, being unmarried or divorced is often associated with a higher risk of suicidal behavior, while being married is generally considered protective (4,70). However, studies in South Asia have shown a higher proportion of married individuals among those engaging in suicidal behavior (59,68,(71)(72)(73). This contrasting finding suggests that the association between marital status and suicidal behavior may be influenced by cultural, social, and economic factors specific to the South Asian region.…”