The study aims to develop and test the effectiveness of a replicable stigma-reduction intervention to improve leprosy knowledge and to reduce negative perceptions and stigmatising behaviours towards Leprosy patients among HCWs in endemic communities in Niger.
Understanding & Reducing Leprosy-Related Stigma Among Healthcare Workers in Niger
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Project summary
Neglected Tropical Diseases (NTDs) are endemic in Niger Republic. These diseases and their consequences are especially common among rural populations. Leprosy is a NTD that persists in Niger, despite efforts to increase access to care. In 2019, 333 new cases of leprosy were diagnosed nationally, of which 23% had advanced disability, an indicator of late case detection. This is partly due to the stigma associated with the infection and its physical sequalae even after the disease has been treated successfully. Stigma caused by leprosy is deeply rooted in history and permeates every aspect of society, including the healthcare system. Preliminary evidence of stigma directed at patients by healthcare workers (HCWs) and lack of knowledge of leprosy among HCWs indicate the need to identify leprosy-stigma reduction activities if the disease is to be eradicated through access to early screening, treatment and rehabilitation.
The goal of this study is to utilize a community-based participatory approach to develop and test a leprosy-stigma training programme among health workers in 16 regional health centres in Niger. The study has two phases. First, using the WHO stigma framework, it aims to identify the local and contextual reasons behind stigma directed at patients by HCWs, and the resulting impact on people affected by leprosy. An understanding of these elements is necessary to develop and invest in effective leprosy stigma-reduction strategies and will contribute to the Zero Transmission / Zero Disability agenda.
A second phase of the study aims to develop and test the feasibility, acceptability and effectiveness of a training programme to reduce stigmatizing attitudes and behaviours among HCWs. Results will provide a contextual, yet replicable model for Leprosy stigma-reduction programme.
This study will be conducted collaboratively with active involvement of all stakeholders, including the national and international study team, healthcare providers, leaders and members of communities of persons affected by leprosy. The study will use a mixed method design to identify the elements of leprosy-related stigma perpetrated by HCWs, the impact on people affected by leprosy, and the development and testing of a leprosy stigma-reduction program targeting HCWs.