Fostering empowerment: Transition from self-help groups to cooperatives in leprosy-affected communities in Nepal

Introduction: Although leprosy is curable, many affected individuals continue to face disability, stigma, and poverty. In Nepal, sustaining progress after elimination remains challenging, making community-based approaches such as self-care and self-help groups crucial for long-term health and social inclusion. This study investigates how self-help groups and cooperatives contribute to sustaining community-driven leprosy management efforts. Methods: For this study only qualitative data are utilized which involves people affected by leprosy, single women, community stakeholders, and facilitators. Conventional content analysis was employed to examine the data, focusing on participants’ experiences and perceptions. Results: Self-help groups were instrumental in reducing social stigma and promoting social inclusion for marginalized individuals. These groups empowered members by building skills in hygiene, self-care, awareness of gender-based violence, and financial management, enabling them to assert their rights, manage finances, and contribute to household decisions, thereby fostering long-term socio-economic resilience. Transitioning to a cooperative model provided legal recognition and financial security, with leadership and trust being crucial for continued growth. Conclusions: The transition to cooperatives offers a promising path for sustainable development, ensuring legal recognition and financial stability while reducing stigma and improving societal perceptions towards leprosy, disability, and marginalized communities. Author summary: Marginalized groups in Nepal including those affected by leprosy face significant psychological, clinical, social, and economic challenges, exacerbated by stigma and limited access to care and integration opportunities. IMPACT intervention addresses these issues through self-help group and cooperatives. In this study, we evaluated the effectiveness and sustainability of the IMPACT intervention in fostering community engagement and resilience. Our findings revealed that intervention profoundly transformed participants, boosting confidence in health and hygiene practices and reducing social stigma. These groups also facilitated empowerment through skill-building in self-care, gender-based violence awareness, and financial management. Additionally, our findings found transitioning these groups into cooperatives further enhanced their impact by providing legal recognition and financial stability.