The results from this review provide an overview of the information about suicide and DSH among women in Nepal based on available literature. Findings from this study suggest that suicide and DSH among women is a worrisome public health problem in Nepal due to various underlying socio-cultural, economic and environmental factors. Based on our review, although suicide can occur at any age during the lifespan of an individual , suicide and DSH attempts are higher among younger females aged between 15–35 years compared to older ones [11, 15,16,17,18]. According to the MMMS (2008–2009), suicide stood out as the single leading cause of death among WRA in Nepal with 63% of suicide deaths occurring among women between 15–29 years . Various studies conducted on DSH also highlighted higher DSH among married women aged between 15–30 years [11, 15, 17, 20, 21]. This apparently highlights the severity of suicide and DSH as a major health challenge with young women observed to be more vulnerable to suicide in comparison to older women.
These findings are similar to suicide among women in India where young women below the age of 30 are at higher risk of committing suicide . Suicide among women in Asia may well be related to lack of the awareness of women’s rights, women’s dependency on men, and women’s social status. As women in Asian countries often have a subordinate position, they may experience high levels of stress which are intensified by family hierarchy and dynamics in societies . Younger individuals are not sufficiently mature to handle stressors in general, and young women in Asia, including Nepal, face higher social, emotional or financial dependency on their families and husbands, which makes them vulnerable to such stressors with no one to turn to, potentially leading them towards DSH or suicide as a cry for help or a perceived route of escape. The reviewed literature identified young women to be more vulnerable to suicide compared to older women indicating age as a risk factor. Nonetheless, the studies do not explore in depth the conditions and reason behind it, untangling whether it is the younger age or rather the conditions and circumstances in the given age which could be the actual risk factor.
In most of our reviewed studies the majority of the suicide and DSH victims were found to be married (i.e., up to 84% in a review of police records) [5, 19]. In Nepal, as in other South Asian Countries, it is common for women to get married at a young age through arranged marriages with often a large age gap between husband and wife. As divorce is culturally demeaning and highly stigmatized, Nepalese women will stay married even after enduring abuse in an unhappy marriage . Young women’s household decision-making capability and the challenges they face in dealing with the distribution of power and the dynamics within the in-law family are shaped by socio-cultural factors. This in turn not only increases their vulnerability towards being overburdened with domestic responsibilities and psychological abuse, but also physical violence . Along with this, married South Asian women may also endure other pressures such as young motherhood, low social status and economic dependency making them susceptible to suicidal ideation and acts . Nepalese women’s lower status in the family …….