Wellbeing As Participation and Liberation: Lessons from Post-Conflict Nepal

Background and Purpose: The establishment of the Federal Democratic Republic of Nepal, ending ten years of armed conflict, presented an opportunity to address years of brutal marginalization affecting Nepali women, based on caste, gender, ethnicity, and socio-economic status. In order to facilitate their full participation in the new democratic processes, Nepali civil society organizations developed community based psychosocial support programs for the most affected women. The programs were complex, multifaceted and defined by the members. The goal was to improve participants well-being in the belief that this would enable participation. Social work science was tasked with developing ways in which such participatory program designs could be measured for effectiveness, and if effective, made replicable for use by other populations experiencing similar degrees of structural, institutional and interpersonal violence.

Methods: This study was completed in four regions of Nepal and included poor, landless, national minority women, widows, ex-combatant women, women with disabilities and those marginalized by caste. The sample comprised 461 participants in 34 focus groups and 37 key informant interviews. The study was conducted in two rounds. The first elicited free listing of ideas, words, phrases, and examples that defined emic conceptions of psychosocial wellbeing. These were transcribed verbatim and then coded thematically in an iterative process, with like operational definitions forming domains. The results were then presented to a second round of focus groups in which participants were shown the domains and their operational definitions in graphic form and asked to validate the findings by participatory ranking, then eliminate irrelevant ones and alter any that were incorrectly captured.

Findings: The study produced 6 domains of wellbeing that were operationalized by specific measurable indicators of psychosocial wellbeing: quality education; power to access resources; freedom of movement; basic needs met; love and harmony in the family; and friendship and support outside of the family. The participants described the domains as interlinked and indivisible. The domains were used to monitor and evaluate the programs that they participated in, and others like them.

Conclusion and Implications: A framework for evaluation was created in which program participants could measure program effectiveness by tracing progress toward domain goals. In this way, the study contributed to the literature demonstrating that participatory methods of program design monitoring and evaluation can produce replicable results. The participants found it important to be asked to understand the elements they required for well-being, rather than focus exclusively on their suffering, as this enabled them to articulate and to fight for that which was most important to them. They experienced the detailed study of their wellbeing as a form of epistemic resistance. In this way the study social work science contributed to a liberatory approach to social programming that can be replicated among other populations affected by structural violence, such as those in the US.