Moving Forward: Tackling Stigma in a Tanzanian Community
Council researchers with the Horizons program evaluated a community-based effort to reduce stigma in a peri-urban community and re-tested a set of stigma indicators from a prior field test in Tanzania to see how they performed over time.
Stigma and discrimination pose critical obstacles to curbing the HIV/AIDS epidemic. HIV-related programs are increasingly addressing these issues. Standard indicators that measure stigma and discrimination across sites and over time are needed in order to monitor and evaluate these efforts.
An initial set of stigma indicators was created and reviewed by the US Agency for International Development. These indicators were then field tested in Tanzania.
Indicators were tested in four key domains: avoidance of contact with people living with HIV and fear of casual transmission; values and attitudes; enacted stigma (discrimination); and disclosure. This field test led to refined and validated indicators.
Further field testing and refinement of these indicators was needed. The indicators were initially tested in the Kimara ward of Kinondoni district prior to the introduction of a community based stigma reduction intervention. An endline survey in this community along with qualitative data collection was conducted, to evaluate the intervention and to analyze the indicator’s performance in detecting changes in stigma over time.
Banner photo: © 2008 Bob Msangi, courtesy of Photoshare
Key findings include:
- People recognize stigma.
- Both fear and value drivers of stigma remain high.
- Fear-driven stigma is hard to shift despite high knowledge of HIV.
- Individuals exposed to intervention activities reported less stigmatizing attitudes.
- Community members observed more instances of discrimination/enacted stigma.
- Community leaders are a promising entry point for intervention.
- The intervention did not reduce stigma community wide.
- The stigma indicators performed solidly over time.
The findings of this study present a mixed, but hopeful, picture for a way forward in tackling stigma at the community level.
Moving forward: Tackling stigma in a Tanzanian community
(PDF)
Nyblade,Laura; MacQuarrie,Kerry; Kwesigabo,Gideon; Jain,Aparna; Kajula,Lusajo; Philip,Fausta; Tibesigwa,William Henerico; Mbwambo,Jessie K.
Horizons Final Report
Publication date: 2008
Project Stats
Location: Tanzania (Dar es Salaam, Kinondoni Municipality)
Program(s):
HIV and AIDS
Topic(s):
Stigma and discrimination
Duration: 12/2005 - 5/2007
Non-Council collaborators:
Family Health International (FHI)
Fausta Philip (Muhimbili National Hospital)
Gideon Kwesigabo (Department of Psychiatry and Institute of Public Health, Muhimbili Univ. College of Health Sciences)
Jessie Mbwambo (Muhimbili National Hospital)
Kerry MacQuarrie (International Center for Research on Women)
Kimara Peer Educators and Health Promoters Trust
Laura Nyblade (International Center for Research on Women)
Lisanne Brown (Tulane University School of Public Health and Tropical Medicine)
Lusajo Kajula (Department of Psychiatry and Institute of Public Health Muhimbili Univ.College of Health Sciences)
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