Lesson 7- Stigmatization and Discrimination.pdf

STIGMATIZATION AND DISCRIMINATION LECTURER: DELPHINA ABBEY-AWADZI (MPH, BSCN, RN) QUOTE “Sometimes, later becomes never. So do it now!!” By the end of the lesson, the students should: Define Stigmatization and discrimination Discuss some Stigmatized conditions State the factors leading to...

STIGMATIZATION AND DISCRIMINATION LECTURER: DELPHINA ABBEY-AWADZI (MPH, BSCN, RN) QUOTE “Sometimes, later becomes never. So do it now!!” By the end of the lesson, the students should: Define Stigmatization and discrimination Discuss some Stigmatized conditions State the factors leading to stigmatization Effects and consequences of stigma on clients, relatives, communities, institutions and care providers Highlight the steps to be taken to reduce stigma and discrimination STIGMATIZATION Stigmatization is defined as "a process of discrediting an individual or group in the eyes of others". Stigmatization is a social process of devaluation of people who do not seem to conform to societal standards, such as living with HIV/AIDS. Health condition-related stigma is stigma related to living with a specific disease or health condition. It is noteworthy to know that stigma may be experienced in all spheres of life. DISCRIMINATION Discrimination, as defined by the Joint United Nations Programme on HIV/AIDS (UNAIDS), is the unfair and unjust action towards an individual or group on the basis of real or perceived status or attributes, a medical condition (e.g., HIV), socioeconomic status, gender, race, sexual identity, or age. Discrimination is an unfair treatment of one person or group, usually , because of prejudice about race, ethnicity, age, religion, gender or health conditions. It has also been described as the endpoint of the stigmatization process. Forms of stigma Stigma is divided into four forms namely; physical, social, verbal and institutional stigma. ❖PHYSICAL STIGMA: *Neglecting *Rejecting *Isolating *Separation *Hiding *Staying at a distance *Harassment *Physical violence *Sexual abuse *Being kicked out ❖SOCIAL STIGMA: *Isolated from the community *Loss of social networks *Loss of standing and respect *“Social death” ❖VERBAL STIGMA: *Labeling *Blaming *Judging *Gossiping *Name calling *Finger pointing *Making assumptions *Suspecting ❖INSTITUTIONALIZED STIGMA: *Barred from jobs, scholarships, visas *Denial of rights- kingship titles, health services such as refusing to care for clients who present with symptoms of covid-19 *Police harassment for example drug addicts *Appointing someone as a director or leader of a firm because of his race or colour whiles others are equally qualified. Forms of stigma In health facilities, the manifestations of stigma include: Outright denial of care Provision of sub-standard care Physical and verbal abuse, to more subtle forms, such as making certain people wait longer or passing their care off to junior colleagues Healthcare workers living with stigmatized conditions may also conceal their own health status from colleagues and be reluctant to access and engage in care Causes of Stigma Stigma is brought to bear on individuals or groups. This can be due to: Health (e.g., disease-specific) Non-health e.g., poverty, gender identity, race, language barrier, looks, religious beliefs, etc. Factors leading to stigmatization Several studies show that stigma usually arises from; Lack of awareness Lack of education and quality information to both professionals and the general public Ignorance / misconception- misperceptions about the cause of the disease as a curse from the gods, punishment for one’s sins, witchcraft, etc. Cultural factors / belief system Fear Misleading Media information Stigmatized conditions Examples of stigmatized conditions are; Covid - 19 Mental disorders eg. Schizophrenia, xenophobia, autism etc. HIV / AIDS Venereal diseases eg. Syphilis, gonorrhoea etc. Certain skin diseases eg. Buruli ulcer, elephantiasis etc. Tuberculosis Blindness Deafness Epilepsy Alcoholics Effects and consequences of stigma on…. ❖Clients Loss of self-confidence Low self-esteem Feeling of shame and hopelessness Isolation- Reluctance to ask for help or seek medical attention Rejection by family, friends or others. Divorce suicidal tendencies Loss of job / lack of employment Bullying, physical violence or harassment Financial problems Stigma hinders efficient and effective recovery Difficulty finding a job Effects and consequences of stigma on…. ❖Relatives The most frequently cited effects of stigma on relatives were: Damage to self-esteem Difficulty making and keeping friends Difficulty finding a job Reluctance to admit mental illness Damaged family relationship Conflicts within the family, divorce or separation Heavy burden on the care givers (usually women) A lowered quality of life for all family members Children drop out of school because of lack of money or the need to help care for an infected family member. Children may become orphans Effects and consequences of stigma on…. ❖ Communities Isolation from society and societal activities (affected community will be disassociated from other neighbouring communities) High divorce rate Slow development / low productivity ❖ Institutions Financial problem Lack of support Low self esteem ❖ Care providers Stigma prevent others from seeking care Might bottle it up and ‘explode’ or get angry about everything Insufficient logistics  Actions taken to challenge stigma and discrimination Stigma Talk openly about the condition eg. Mental illness, AIDS, homosexuality Educate yourself and others Be conscious of choice of language used Choose empowerment over shame Let the media know when people are being stigmatized Be honest about treatment, show compassion and acceptance etc. Actions taken to challenge stigma and discrimination Discrimination Do not suffer in silence, report to the right authorities Acknowledge your rights and privileges Be open to surprises about life Introduce friends to each other or form support groups to deal with discrimination Learn to tolerate, accept and understand others way of life etc. Steps in moving into action Identify the causes of fear and stigma Educating the general public Involve the community leaders or heads. Seek to improve attitudes and help-seeking behaviour. Formulate policies and ensure everyone adheres to it. Involve peer services Respect confidentiality Develop a right-base response (anti-stigma committee) Share positive stories and introduce individuals that have been able to handle stigma. Reducing stigma and discrimination in healthcare setting Tackle multiple stigmas at once, while remaining attentive to the needs of individuals with specific health conditions or characteristics Focus on empowerment as an approach for clients or health workers to cope with or challenge stigma, and demand rights to stigma-free health services Recognize and address stigma experienced by health workers, including internalized and secondary stigma Target all levels of health facility staff, both clinical and nonclinical Leverage technology for interactive learning beyond video testimonials Work at a structural level to change the physical or policy aspects of the facility environment Concentrate on simultaneously targeting multiple ecological levels, such as targeting both individual attitudes and practices as well as the health facility policies and environment