Stigma in health facilities

Why it matters and how we can change it

Bibliographic Data

ID23357101
AuthorsLaura Nyblade (0000-0001-8067-4192, RTI International, corresponding author), Melissa A Stockton (0000-0002-0737-7180), Kayla Giger (0000-0001-8066-8606, RTI International), Virginia Bond (0000-0002-6815-4239, London School of Hygiene & Tropical Medicine), Maria L Ekstrand (0000-0001-7587-2899, University of California, San Francisco), Roger Mc Lean (University of the West Indies), Edna M Mitchell (0000-0002-2824-3499), Ellen M H Mitchell, Laron E Nelson (0000-0002-2630-602X, St. Michael's Hospital), La Ron E Nelson, Jaime C Sapag (0000-0003-2227-8233, Centre for Addiction and Mental Health), Taweesap Siraprapasiri (0000-0001-9922-1847, Ministry of Public Health), Janet M Turan (0000-0002-7802-6206, AIDS United), Janet Turan, Edwin Wouters (0000-0003-2268-3829, University of Antwerp)
Year2019
Volume17
Issue1
Pages25-25
Publication date2019-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMC Medicine (JOURNAL)
Journal identifiersISSN: 1741-7015 • E-ISSN: 1741-7015
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s12916-019-1256-2
PMID30764806
OpenAlexW2914761006
LanguageEN
Citations received185
References cited110

Stigma in health facilities undermines diagnosis, treatment, and successful health outcomes. Addressing stigma is fundamental to delivering quality healthcare and achieving optimal health. This correspondence article seeks to assess how developments over the past 5 years have contributed to the state of programmatic knowledge-both approaches and methods-regarding interventions to reduce stigma in health facilities, and explores the potential to concurrently address multiple health condition stigmas. It is supported by findings from a systematic review of published articles indexed in PubMed, Psychinfo and Web of Science, and in the United States Agency for International Development's Development Experience Clearinghouse, which was conducted in February 2018 and restricted to the past 5 years. Forty-two studies met inclusion criteria and provided insight on interventions to reduce HIV, mental illness, or substance abuse stigma. Multiple common approaches to address stigma in health facilities emerged, which were implemented in a variety of ways. The literature search identified key gaps including a dearth of stigma reduction interventions in health facilities that focus on tuberculosis, diabetes, leprosy, or cancer; target multiple cadres of staff or multiple ecological levels; leverage interactive technology; or address stigma experienced by health workers. Preliminary results from ongoing innovative responses to these gaps are also described.The current evidence base of stigma reduction in health facilities provides a solid foundation to develop and implement interventions. However, gaps exist and merit further work. Future investment in health facility stigma reduction should prioritize the involvement of clients living with the stigmatized condition or behavior and health workers living with stigmatized conditions and should address both individual and structural level stigma.

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