Intervention effectiveness reducing disability stigma in sub-Saharan Africa: Systematic review

Area of Science:

• Public Health
• Health Services Research
• Social Determinants of Health

Background:

• Stigma reduction requires understanding its presence, impact on diverse populations, and effective interventions.
• Disability-related stigma presents a significant public health challenge in sub-Saharan Africa.
• Evidence synthesis is crucial for informing targeted stigma-reduction strategies.

Purpose of the Study:

• To synthesize existing evidence on the effectiveness of interventions aimed at reducing disability-related stigma in sub-Saharan Africa.
• To identify successful intervention components and approaches within the study region.

Main Methods:

• A comprehensive literature search across nine databases, supplemented by grey literature and expert consultation.
• Two independent reviewers screened, extracted data, and appraised the risk of bias for included studies.
• Interventions were categorized using the Behaviour Change Wheel framework and narratively synthesized.

Main Results:

• Out of 15 studies, eight reported positive effects, with education and training being frequently cited as effective components.
• Interventions combining education with other strategies like communication and persuasion showed varied results.
• Two low-risk-of-bias studies reported null effects for combined interventions, highlighting the complexity of stigma reduction.

Conclusions:

• High-quality research on stigma interventions in sub-Saharan Africa is scarce.
• Challenges include defining stigma, measuring intervention effectiveness, and the heterogeneity of target groups, settings, and metrics.
• There is a critical need for increased methodological rigor, theoretical grounding, and transparent reporting in evaluating stigma-reduction interventions.