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Strategies for Scaling Up Stigma Reduction: Evidence-Based Approaches for Health Services

This presentation guide by Laura Nyblade, PhD, outlines effective strategies for reducing stigma in healthcare settings. It emphasizes building on practice-based evidence and highlights actionable drivers to raise awareness, challenge misconceptions, and empower affected communities. Key approaches include fostering dialogue, engaging diverse stakeholders, and implementing comprehensive advocacy campaigns. The guide provides programmatic examples and emphasizes the necessity of scalable interventions to improve health service access and utilization, ultimately contributing to the well-being of marginalized groups.

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Strategies for Scaling Up Stigma Reduction: Evidence-Based Approaches for Health Services

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  1. Stigma-Reduction Scale Up: It Can Be DoneBuilding on Practice-Based Evidence Laura Nyblade, PhD July 22, 2012

  2. Presentation Guide • Fundamentals for Stigma-Reduction Programing: What we’ve learned from the field • Health Care Setting Programmatic Examples • Scaling up: Foundation & Gaps

  3. Address Immediately Actionable Drivers Interactively in Safe Spaces to: • Raise Awareness: Close the Intention-Action Gap • Foster understanding and motivation for stigma reduction • Address Transmission Fears and Misconceptions • How it is and is not transmitted • Respond to specific fears related to daily living context • Discuss and Challenge the Shame and Blame • The values and beliefs that underlie stigma and discrimination: • Where they come from, What they do

  4. Affected Groups at the Core to Lead Response • Develop & Strengthen networks • Empowerment & Capacity Strengthening • Address self-stigma • Identify & support health & other needs • Build Resiliency

  5. Create Alliances and Form New Partnerships for Influence and Expanded Reach • Break down the ‘us’ vs ‘them’: Foster interaction between groups experiencing stigma & those perpetrating it. • Model desirable behavior • Hold up & reward role models Engage a range of groups • Opinion Leaders • Policymakers • Service Providers • Religious Leaders • Youth • Media • General Community • Family

  6. Employ a Range & Combination of Approaches • Participatory learning • Community meetings • Cultural mediums • Written materials • Media channels • Advocacy campaigns

  7. Stigma & Discrimination-Reduction in Health ServicesSome Examples

  8. S&D Hospital Reduction Intervention Package:Horizons, ISDS & ICRW • Building partnerships with hospital gatekeepers • Baseline data • Hospital steering committee • Participatory Training: • For all hospital staff • Refreshers (monitoring visits) • Joint development of “Safe and Friendly” hospital policies • Structural changes supporting universal precautions • Educational materials • Endline data

  9. Building Alliances & Advocating for Stigma-Free Health Services Ashodaya-Samithi, Mysore, India • Trained Peer Patient Advocates, placed in public hospitals • Opportunity for increased contact and understanding • Improved access & utilization of health services • SwathiMahilaSangha & partners, Bangalore, India • Capacity Strengthening • Designed advocacy campaigns • Rose Campaign • Opened space for dialogue • Medical Student Rotation

  10. ESTABLISH A STRONGER CASE BUILD JOINT ACTION CREATE READINESS FOR SCALE CAPACITY STRENGTHENING EVIDENCE BASE COMMUNICATION & ADVOCACY PROGRAMMING GOAL: SCALE UP STIGMA REDUCTION LAWS AND POLICY

  11. EVIDENCE BASE WHAT WE NEED WHAT WE KNOW SCALING UP S&D REDUCTION WHAT WE HAVE • Causes, manifestations & consequences • Stigma impacts HIV and AIDS Programs • How to measure stigma • How to reduce stigma • What works in different contexts • Inclusion of S&D in national strategies • Implementation • Program Evaluations • Costing and cost effectiveness data

  12. PROGRAMMING WHAT WE NEED WHAT WE HAVE SCALING UP STIGMA REDUCTION • Stigma reduction tools • IEC material • Intervention models • Measures • Stigma Action Network • Standardize program guidance • Validate & global indicators • Institutionalize stigma-reduction • Incorporate stigma-reduction into prevention & treatment programs

  13. If you invest in stigma reduction… …the ripple effect will impact all HIV and AIDS programs and services, reaching more people in a single community Coverage Stigma reduction intervention • Provision of health care • Palliative care • Family support • Community support • Testing • PMTCT • Disclosure • Risk Behaviors • Timely uptake • Adherence Prevention Treatment Care & Support

  14. We Know Enough to ACTWhat will you do? You are part of the solution

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