Sexual Harassment and its Effects in Nepalese Society - A Systematic Review

Sexual harassment (SH) is a form of illegal, unwelcome sexual act, and other verbal and physical conduct of a sexual nature in the workplace and other environments. This paper aims to analyze the situation and its effect on Nepalese society. The systematic review procedures were followed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This paper has covered to eligible and inclusion of all articles and search databases published on Nepjol, ResearchGate, Taylor and Francis, Mind and Society between 2019 and May 2023, to be written in English, specially, survey relating to the topic of sexual harassment in those open access journal articles. The initial trial and error method was used to select the sample articles at different times, titles and contents. Most of the sexual harassment study was found in Kathmandu Valley targeting the higher school level of female students. The study found that the majority of victims were female, with girls being the most affected by males. The systematic review revealed that the targeted participants were female rather than male. However, there was a sample bias, non-probability sampling techniques, and a lack of inferential research. The findings support that the systematic review identified the common types of it, various perpetrators, and physical,


INTRODUCTION
Sexual harassment (SH) is a widespread occurrence worldwide, spanning from highly developed nations to the least developed ones (Gyawali, & Maharjan, 2022).It covers a wide range of misconduct.The most widely used definition of sexual harassment is that by Michael Rubenstein ( UN, 1979) who has defined it as 'unwanted sexual conduct, which is offensive to the recipient'.It is distinct from friendly interaction, which is reciprocal and welcoming, due to the unwelcome nature of the activity (UN, 1996).
SH is a significant issue for all individuals, including men, women, and children.This phenomenon has emerged in terms of two form activism comprises movement against discrimination in the work place and feminist opposition to violence against women that made women uncomfortable in their workplaces where happening and feminist try to raise awareness (Cuenca-Piqueras et at. 2023).It is often perceived as seeking sexual favors or advances in exchange for higher pay, work benefits, promotion, and retention.However, it can also lead to a hostile work environment, where behavior towards a worker makes it unbearable.While people dismiss SH as harmless, it can be traumatic for those who experience it (ILO, 2004).Thus, the feminist theories on rape and domestic violence are to articulate the explanation of SH (Baker, 2007) whereas most of the used SH model is socio-cultural theories that postulates that the SH is a product of culturally legitimized differences in power and status between men and women (MacKinnon, 1979).Under this, it is originated in the patriarchal society, considered as hegemonic line that is perceived as the way of used by men to control and dominate women at work place as well as in society (Welsh, 1999).In this overview, every person experiences some form of it.Taking this consideration, what do we know the about the sexual harassment?Therefore, this study aims to conduct a systematic review of its types, perpetrators, and effects of sexual harassment in Nepal, aiming to provide a comprehensive understanding of the issue and its impact on society.

Eligibility Criteria
This study assessed journal articles regarding to topic of sexual harassment for this systematic review articles.The eligibility and inclusion criteria were (a) published articles in between 2019 to June 2023 (b) all written in English (c) specially survey relating to topic of sexual harassment (d) all open access journal articles (e) all article papers (f) search database on the Nepjol, ResearchGate, Taylor and Francis, Mind and Society.The systematic review was conducted on data from multiple authors, either single or multiple, published in a database on an authorized institution or organization, rather than selecting at least two independently (Mark et al., 2017;Sinha & Shunmugasundaram, 2023) extracted data from all eligible sources.

Source of Information (Sources and Search)
This review was conducted with the published articles in between 2019 to May 2023 including database via Nepjol, ResearchGate, Taylor and Francis, Mind and Society.There were numerous research articles searched in the above database and after searching article through trial and errors the final search terms of the study, SH and its types, placed of occurrences as well as perception or knowledge of SH.All sources were searched after May 2023.

Data Selection Process
The systematic review of sexual harassment articles was based on eligibility criteria and searched through different databases.Initial literature was selected using a trial-and-error approach, with paper article selection based on access time, title and contents.Relevant articles were assessed, analyzed, and screened using the PRISMA flow diagram.The overall selection and screening (systematic review) were presented in Figure 1.

RESULTS
This systematic review examines past research articles on sexual harassment in Nepal, revealing gender-based forms as the most common form.Several types of harassment were identified, with perpetrators being male or female in various disciplines.The negative effect of sexual harassment leads many victims to avoid reporting it to specific departments or concerned places/areas.The results of the articles are presented in the different titles, highlighting the long and short-term consequences of such harassment.

Study Selection
There were a total of 51 paper articles identified in the process of the initial study while accessing the database through various search engines.There were records identified through database searches during the time of access (n=51) from Taylor and Francis (n=3), Mind and Society (n=2), Nepjol (n=13), ResearchGate (n=13), and others (n=20).The study search was based on the title, abstract, keywords, and concept of SH.After investigating all those related terms, the systematic review excluded 39 papers due to unsuitability, ineligibility, and duplication of paper articles.12 were selected for full text eligibility, with 10 duplicated and 29 being before-dated, abroad studies, dissertations, reports, and seminars.10 were not eligible due to other than mention database papers.

Study Characteristics
Information regarding to all screened paper articles has been presented in succeeding section of table1, 2, 3 and 4.  (26,7), not to want to make a big issue (14.4), feel not a big problem (11.8), feeling of being shamed (18.6), not response (25.5)

Authors
Results and Conclusion (Bhatta et al., 2021) This study examines the experiences of victims of SH, its impact on health and education, and remedies for its consequences.It covers themes such as characteristics, perception, immediate reaction, and contextual factors.The study also examines the effects of harassment on students' psychological well-being, academic performance, and education.The study develops interpersonal and intrapersonal coping strategies, such as disclosure to friends and family, to demoralize the situation.Although limitations exist in generalizing qualitative research findings, the study has implications for individual, group, society, and policy-making levels in the explanatory debate on sexual issues.(Dawadi et al., 2022) The respondents showed a high level of SH awareness.Only a select few have any experience with SH.Instances of sexual harassment were reported to a police station by 50 percent of those surveyed.The study revealed that, out of 150 respondents, majority of the respondents (82.0%) had a higher level of awareness of SH.According to recommendations of respondent"s for preventing SH, the practice can be stopped by enacting strict rules, regulations, and policies against those who partake in it (85.3%),launching awareness campaigns about it (83.3%),and provide training for how to handle SH (75.3%).The specified socio-demographic factors and the degree of sexual harassment awareness did not have a statistically significant link.The respondents showed a high level of SH awareness.Only a select few have any experience with SH.Instances of sexual harassment were reported to a police station by 50 percent of those surveyed Schools should periodically educate students about sexual harassment through continuing sensitization programs or awareness campaigns, it should be advised.(Gautam et al.,2019)The single women and lived far from the campus have greater chance of sexual harassment than others.Public transportation was found significantly higher change of sexual harassment than other areas.There are strongly associated with sexual harassment and public transpiration facilities in Kathmandu.(Gyawali, 2020) The findings indicated that teachers, neighbors, relatives, and complete strangers all engaged in sexual harassment.Male peers are more likely to engage in verbal or gestural forms of sexual harassment, while teachers and family members are more likely to engage in touching, pinching, or other forms of sexual abuse or assault.In public transportation, sexual harassment is a common occurrence.Parents and students should respect and trust teachers greatly in our culture.They are close to the female students.However, this intimacy and trust resulted in sexual harassment, which increased sexual harassment.Strong rules, awareness campaigns, and victim-friendly judicial procedures are essential to prevent sexual harassment of female students in all spheres of society, especially in public transportation, where anonymity and proximity contribute to high rates of abuse.(Gyawali, 2021) The study found that sexual harassment negatively impacts teenage girl students' mental health, leading to depression, anxiety, stress, and insomnia.The prevalence of these issues is high, with 45% experiencing sadness, 52% experiencing anxiety, and 35% experiencing stress.Schools must implement anti-sexual harassment policies and take action to create a positive learning environment.Teaching assistants' SH is also a significant factor contributing to the poor mental health of female students.Schools must implement anti-sexual harassment policies to create a positive learning environment.(Gyawali& Maharjan, 2022) One of the factors affecting a girl student's learning experience has been identified as sexual harassment.It was determined that this sexual harassment of female students contributed to a decline in their enthusiasm to learn, as evidenced by their lack of focus while studying and self-directed learning.It was found to have a substantial negative impact on girl students' learning motivation, interactions with teachers, self-learning, and class discussion activities.SH was also identified as one of the root causes of the poor learning activity and achievement on the girl students.In order to provide girls with a safe study environment, SH must be prohibited in all academic settings, and all stalkers must be made aware of this fact.(Khanal & Paudel, 2022) The results showed that the highest percentage of respondents had heard about the term "sexual harassment."i.e.Kathmandu (97%), Lalitpur (86%) and lower in Bhaktapur (83%) out of total respondents had heard of SH respectively.
According to the majority of respondents (60%), feel SH at work as a result of men misinterpreting signals from women.However, the majority of respondents (35%) claimed that sexual harassment is most likely to occur on public transit, followed by dark or secluded areas (34%).At the 0.05 level, it was statistically significant that about twothirds of respondents (varying from 62% to 65%) from each district had heard of sexual harassment-related laws, acts, and policies.In a similar vein, respondents 35 and older reported less knowledge than respondents in the younger age group, and their age was substantially associated with this.The majority of respondents (93%) who worked as receptionists knew about the laws and rules pertaining to harassment, followed by managerial supervisors (86%) and unskilled laborers (47%) who knew the least.(Pandey et al., 2022) Overall, 18.5% of nurses reported having encountered sexual harassment at work.More than half (53.8%) of nurses experienced harassment from patients and visitors, 46.2% experienced harassment in the emergency room, general ward, or operating room, 30.8% experienced harassment at the bedside, 38.5% experienced harassment during the overnight shift, and 66.7% experienced harassment when working alone.Similarly, 28.2% reported a sexual harassment incident, 90.9% verbally reported it, and 89.7% thought the hospital should create a policy against it.However, this was not statistically significant.Nurses who worked the night shift (100.0%),had a PCL/Bachelor degree (20.0%), were single (21.8%), staff nurses (20.17%), had a slim build (21.3%), had a strong personality (33.3%), and had attractive looks (29.8%) were more likely to be victims.Nurses working in tertiary hospitals frequently experience workplace sexual harassment.However, due to fear of repercussions and ignorance of where and how to complain, there is a very low reporting rate.To stop sexual harassment of nurses, appropriate policy, law, and reporting mechanisms should be created.(Paudel, 2022) Teachers and lecturers who responded claimed that SH is a major issue in the community, the workplace, and the classroom.The vast majority of women (82%) have been the victim of sexual harassment in some way.Additionally, research demonstrates that the majority of female harassment starts in the early adolescent years.The age group of the respondents was shown to be substantially (P0.01) linked with having encountered sexual harassment at least once.In a similar vein, married women (80%) encountered more sexual harassment than single women (75%), at least once.As a result, the study reveals that online harassment is on the rise and is frequently experienced by educated women in Kathmandu Valley.On the other side, they view it as sexual harassment and do not want to be exposed.Therefore, it is important to handle sexual harassment-related initiatives and policies.(Sharma et al., 2022) Most respondents (73.2%) said they had been subjected to online sexual harassment more than once, with about 66.5% reporting it had happened to them at least once.The 62.8% of total respondents who had experienced online sexual harassment before turning 18 years was little under two thirds (62.8%).The young ladies reported being harassed sexually online on average when they were 18.94 1.79 years old.High school students (10+2 level), those who live in cities, and those who accepting friend requests from strangers on social media were more likely to experience regularly i.e. online sexual harassment (P=0.000,P=0.011, and P=0.013, respectively).Online sexual harassment was prevalent and frequently reported.This demonstrates the urgent necessity to solve the issue; academia and the government must participate.The current academic curricula should be supplemented with a brand-new module on comprehensive sexuality education for online communication.(Thapalia et al., 2019) Just about 76% of the participants had ever been the victim of sexual harassment.Religion and parental occupation were substantially linked to sexual harassment.Most participants who experienced sexual harassment said that the harassers were strangers and that they chose to ignore it or take no action at the time of the incident.The most frequent locations where participants experienced sexual harassment were schools, roadways, and public areas.In Kathmandu, sexual harassment is common among female secondary pupils.However, they lacked a firm understanding of sexual harassment and strategies for dealing with it.To address the issue in Nepalese society, it may be necessary to shift victim-blaming attitudes as well as raise awareness of how to identify and respond to various forms of harassment.(Wagle et al., 2022) The majority of respondents, 82.1%, reported having encountered sexual harassment on public transit, with verbal harassment accounting for 85.1% of these incidents, followed by physical harassment (80.1%) and non-verbal harassment (70.8%).Male passengers accounted for the majority of those who engaged in verbal (75.2%), non-verbal (81.6%), and physical harassment (82.8%).The study also showed that the majority of participants (96.3%) chose not to file a complaint because of fear.Female students were shown to be much more likely to be sexually harassed in public transit.As a result, the government and other relevant authorities must create laws, regulations, and policies that have zero tolerance for any sort of sexual harassment in public areas.

Context
The systematic review analyzed studies on female, girl, and women's experiences, knowledge, and perceptions of SH in various fields and common places.Seven papers focused on SH in traveling, school premises, and common places (Bhatta et al., 2021;Gautam et al., 2019;Gyawali, 2020;Pandey et al., 2022;Sharma et al., 2022;Thapalia et al., 2019;Wagle et al., 2022).Two studies were in the context of mental health issues (Gyawali, 2021) and (Gyawali & Maharjan, 2022).Rest of the remaining studies was in the context of knowledge, awareness and perception of SH.

Types of Sexual Harassment
Regarding the types of sexual harassment, the systematic paper article review identifies the various types of sexual harassment.There were various types of sexual harassment identified in the systematic review.That were previously studied, identified and mention in national and international journal articles before the date of accessing for the review.Those mentioned types of sexual harassment were also listed in the sexual harassment act of Nepal (NLC, 2019).Most of the studies dealt with types of physical, verbal and non-verbal sexual harassment under there were various types of sexual harassment were studies in systematic review.

Types of Perpetrators
Regarding the perpetrator of sexual harassment in Nepal, the systematic studies showed that men or boys were the major predator for sexual harassment.They were different person in terms of situation of sexual harassment occurred.The interesting facts found that whether adult, old people, administrator, common people or responsible person towards the society, everybody is engaged in sexual harassment in Nepal.

Effects of Sexual Harassment
All systematic reviews were explained some kinds of effect of sexual harassment to the victim.The situation of the studies depends upon the effect of sexual harassment for the victims even though there were seen short term and long-term effect, mental problem, fear, frustration, depression, suicide attempt, lack of concentration, moral problem, lack of confidence and many more problems that victims faced after sexual harassment occurred.

Participants
This systematic review study included a total 4,330 persons of participants for study review through the primary sources of data collection and the majority of the population of participants included in the systematic review studies were female/girls rather than male/boys.It covered all participants an average group of age between 12-29 years.Those groups were building up by taking the minimum age of respondents and the maximum age of respondents mentioned in the studies.The four systematic studies were taken the sample more than 29 years of age group for the studies but minimum age group of participants were started from the age of 15.

METHODOLOGICAL APPROACH
This systematic review article identifies that most previous studies used descriptive, cross-sectional, and chi-square tests to examine the relationship between sexual harassment and participants' experiences, perceptions, knowledge, and effects.Data was collected through structured questionnaires, depth interviews, key informant interviews, and focused group discussions, with chi-square tests being the primary analysis method.
Secondary data-based studies were rarely used to analyze knowledge, perception, awareness, and effects of sexual harassment.Two systematic review studies used a mixed methods approach; one is being a thematic study.Most studies did not use validation tools except pretesting questionnaires.

Risk of Bias
Regarding types of bias, there were almost previous studies based on and targeted to the school"s girls and followed non-probability sampling procedures via convenience and purposeful sampling method.Some of previous studies were found sampling biased.They were followed non-probability sampling procedures for collecting their samples.Out of total, only three of the studies have used "Mixed-method" in the form of stratified and random sampling.One of the studies used random sampling as lottery method for collecting data.Besides, there was gender biased in the previous studies because the majority of the previous studies were targeted female/girl"s participant except two of the previous studies involved male participants (Bhatta et al., 2021 andDawadi et al., 2022).

DISCUSSION
The existing systematic review of selected articles, reviews the various types, context, perpetrators, and effects of SH in societies.The systematic review also extracted data by following the PRISMA procedures that included the selection procedure, sample characteristics, context, participants, types of biases, and methodological approach followed the PROSPERO international prospective register of systematic reviews.
Most of the systematic reviews on SH were published and recorded during the year 2022, which indicated the issue has gained importance in recent days.The majority of past studies were primarily focused on non-probability sampling, descriptive, and cross-sectional designs with the use of the Chi-Square test.In particular, due to the subjective nature of SH and the experience and perception of the target population, the prevalence rate varied by SH setting; females reported a higher prevalence of SH than males due to the study of female participants; therefore, it is difficult to draw with conclusion (Huang et al., 2019;Haq et al., 2018;Rotundo et al., 2001).
Most of the studies measured the experience of SH through direct questionnaires.Studies recorded the prevalence of certain behaviors or acts such as unwanted touch, suggestive comments, sexual calls, inappropriate staring, forceful sex, dating, and so on.In this systematic review, when data on perpetrators was available, studies showed that perpetrators of lower status exhibited offensive behavior compared to perpetrators of higher rank.
The most often identified culprits in educational and professional settings were coworkers and students.Furthermore, peer harassment was much more prevalent than harassment by superiors in the research that measured it.The majority of occurrences involve offensive actions by perpetrators who are not typically thought of as sexual harassers (such as peers), which may account for the low level of acknowledgment.The fact that the behaviors they encountered were insulting and undesirable, however, is unaffected by this.
Additionally, in addition to measurement problems being a factor in underreporting, other reasons for low reporting rates in the workplace include concern about a negative impact on jobs, embarrassment, fear of discrimination by coworkers, or fear that their complaint won't be taken seriously (Lu et al., 2020).Underreporting of SH can also occur in school settings due to a variety of factors, including normalization of the behavior, lack of awareness of it, and fear of negative consequences from classmates and teachers.Surprisingly, the studies reveal that a large proportion of people have encountered two or more harassing behaviors (such as unwanted touching or suggestive statements), but a smaller proportion of people recognize that their experience is sexual harassment (Fineran et al., 2003;Mabetha & De Wet, 2018;Tang et al., 1996;Stockdale et al., 1995).
Whether the focus of study is on employees, students, and staff in higher education, organizations, or any institution, there is broad consensus that the effects of sexual harassment are substantial and multifaceted.Studies have demonstrated how sexual harassment affects depressive symptoms.In the systematic review, there is proof that there is a strong correlation between sexual harassment and depressive symptoms.However, there needs to be more empirical research from different settings and various mental health outcomes, such as the risk of anxiety, depression, and post-traumatic stress disorder, as well as decreased levels of self-esteem, self-confidence, and psychological well-being (Bondestam & Lundqvist, 2020;Houle et al., 2011;Ranganathan et al., 2021).

Research Gap Identified
After the systematic review, it was found that the majority of researches are focused on the experiences of women and girls regarding sexual harassment in different fields in Nepal, while there have been relatively few studies that have focused on the experiences of males regarding sexual harassment in Nepal, according to a literature analysis of many journal publications.All review journal papers focus on areas of society where sexual harassment is most likely to occur, yet there is a dearth of study in areas like the armed forces, police departments, governments, and ministerial offices.However, there is little study on inferential research design.It was discovered that descriptive research design using non-probability approaches is employed for data collection.Policy-related reviews and surveys are inadequate.This review has found so many gaps like policy, methodological, theoretical and conceptual gap, and study areas and so on.So, these gaps can be fulfilled by researcher in near future, and their eyes to bridge the gaps found in the previous studies.

Further Research Directions
Sexual harassment remains a global issue, with limited areas of focus in systematic review studies.Future research should explore various departments, including military, police, government, youth and work place.Few studies have been conducted on sexual harassment so, comparing male and female sexual behavior, understanding types, perpetrators, and effects on individuals and society, and focusing on youth, preventive measures, and policy review are essential for addressing this issue.

CONCLUSION
Through the systematic research of exiting search and brief analytical sample, context, and cases, a complete picture has been drawn of a very important field.As a concluding remark, the systematic review studies found that there are common types of sexual harassment which is concentrated on city areas.
The systematic research has found that the occurrence of SH high in workplaces, schools, and public settings revealed that women experience higher levels of harassment than men.The review confirmed that common types of harassment are prevalent, with women experiencing it more frequently than men.It explained that men are free to perform SH (masculinity theory).It is a serious problem involving individuals of all ages, genders, and social groups.Studies show that the effect of it is associated with depression, anxiety, frustration, suicide attempts, fear, and loneliness.
This problem makes socio-cultural impact, values, opinion, knowledge and perception regarding to SH of men.So, this problem that also shines a light on the need for developing and innovative new preventive ideas, relevant support for hierarchical structures, importance of refined, changed legislation, legal practices and inability of every higher education system to address its own shortcomings.

LIMITATIONS
Researchers utilized multiple databases to search for open access journal articles in Nepalese authors which were published into English language, but some important studies may be missed due to the inclusion of only a select few.This systematic review only covered peerreviewed articles published in Nepalese institutional journals, but may overlook articles uploaded before 2019 due to lack of institutional support.To expand research areas, researchers should include more databases and studies published in other languages.

AUTHOR CONTRIBUTIONS
AP and RB conceptualized the topic, while AP worked on PRISMA Modeling, finalizing the manuscript and preparing the abstract.RB reviewed literature and made theoretical analysis and prepared the conclusion part.NBA worked on discussion, presentation of data analysis and study design.RBh prepared Introduction, framing and layout of the manuscript and language edits.SP made the summarization of the manuscript and managed all references.

Table 1
Inclusion Criteria for the Selection of the Articles for Systematic Review

Table 1
Information regarding to Gender Distribution, Place, Context and Target Population