Eliminating stigma and discrimination in sexual and reproductive health care: a public health imperative (original) (raw)
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Cadernos de Saúde Pública, 2012
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Background: 'Intersectional stigma' is a concept that has emerged to characterize the convergence of multiple stigmatized identities within a person or group, and to address their joint effects on health and wellbeing. While enquiry into the intersections of race, class, and gender serves as the historical and theoretical basis for intersectional stigma, there is little consensus on how best to characterize and analyze intersectional stigma, or on how to design interventions to address this complex phenomenon. The purpose of this paper is to highlight existing intersectional stigma literature, identify gaps in our methods for studying and addressing intersectional stigma, provide examples illustrating promising analytical approaches, and elucidate priorities for future health research. Discussion: Evidence from the existing scientific literature, as well as the examples presented here, suggest that people in diverse settings experience intersecting forms of stigma that influence their mental and physical health and corresponding health behaviors. As different stigmas are often correlated and interrelated, the health impact of intersectional stigma is complex, generating a broad range of vulnerabilities and risks. Qualitative, quantitative, and mixed methods approaches are required to reduce the significant knowledge gaps that remain in our understanding of intersectional stigma, shared identity, and their effects on health. Conclusions: Stigmatized identities, while often analyzed in isolation, do not exist in a vacuum. Intersecting forms of stigma are a common reality, yet they remain poorly understood. The development of instruments and methods to better characterize the mechanisms and effects of intersectional stigma in relation to various health conditions around the globe is vital. Only then will healthcare providers, public health officials, and advocates be able to design health interventions that capitalize on the positive aspects of shared identity, while reducing the burden of stigma.
Leprosy review, 2011
In concurrence with the broad body of literature published on healthrelated stigma, there is a need for practical field guidance to contribute to the fight against leprosy-related stigma and discrimination. To this end, much can be gained by considering the accumulated knowledge and learned from experience with different stigmatising conditions; primarily HIV/AIDS, disability, tuberculosis, and mental health. Therefore a Stigma Research Workshop was organised from 11 -14 October in Amsterdam, The Netherlands. The primary aim of the workshop was to produce scientific papers and field guidelines that could be used to target actions against health-related stigma and discrimination. Keynote presentations were offered by scientists and professionals from different health domains who shared their knowledge, experiences and research findings regarding health-related stigma. Group work was subsequently conducted to work towards agreed outputs on four different themes: i.e. research priorities, measurement, interventions, and counselling. The spectrum of expertise present enabled an interdisciplinary and inter-profession sharing of knowledge and practices. This resulted in the commencement of consensus papers and field guidelines related to the four themes. An evaluation by participants concluded that the workshop had been an informative and worthwhile activity that will strengthen the fight against stigma.
Stigma, prejudice and discrimination in global public health
Cadernos de saúde pública, 2012
This article reviews the development of international research on the relationship between discrimination and health. It provides an overview of theoretical and empirical work on stigma and prejudice and their impact on discrimination and health. It argues that the literature on these issues has drawn primarily from social psychology and has focused on the impact of attitudes associated with stigma and prejudice on discriminatory practices and consequently health outcomes. It also identifies a growing trend in recent research towards a reconceptualization of stigma, prejudice and discrimination from the perspective of social inequality and structural violence, highlighting relations of power and exclusion that reinforce vulnerability within a complex social and political process. It concludes by briefly examining the ways in which this reconceptualization of discriminatory practices has generated a growing interest in the linkages between health and human rights and renewed interest...
Social Stigma and its Consequences for the Socially Stigmatized
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Stigma & Health, 2021
Stigmatization is a socially and culturally constructed process, occurring in social interactions, whereby a person is labeled as different and then devalued, resulting in status loss and discrimination. In this article, we present four key arguments as to why qualitative research is imperative to understanding and changing stigma: (a) Stigmatization is complex and qualitative research is well-suited for exploring complex phenomenon; (b) Qualitative research is participatory and offers substantial opportunities for meaningful community engagement, which promotes agency and empowerment, and redresses power imbalances; (c) Qualitative research is imperative to effective stigma reduction; and (d) Qualitative research informs further scientific inquiry and plays an important role in ensuring that we focus on important and relevant aspects of stigma in our research. For each argument, we outline relevant literature and discuss our own experiences with conducting qualitative research on stigmatization. We lean on both theory and practice, paying attention to not only the outcomes of, but also the processes involved, in conducting qualitative research on stigmatization. We then address two criticisms of qualitative research that undermine its legitimacy. We conclude that to better understand stigma, to redress power imbalances, and to inform interventions and further scientific inquiry, we must continue to conduct qualitative research across stigmatized identities and conditions.