Reducing stigma impacting children and adolescents in low- and middle-income countries: The development of a common multi-component stigma reduction intervention

Kim Hartog; Ruth M H Peters; Racheal Kisakye Tukahiirwa; Mark J D Jordans

doi:10.1371/journal.pone.0292064

Reducing stigma impacting children and adolescents in low- and middle-income countries: The development of a common multi-component stigma reduction intervention

PLoS One. 2023 Oct 31;18(10):e0292064. doi: 10.1371/journal.pone.0292064. eCollection 2023.

Authors

Kim Hartog^{1

2}, Ruth M H Peters³, Racheal Kisakye Tukahiirwa⁴, Mark J D Jordans^{1

2}

Affiliations

¹ Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Amsterdam, The Netherlands.
² Research and Development Department, War Child, Amsterdam, The Netherlands.
³ Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁴ Mental Health and Psychosocial Support Department, TPO Uganda, Kampala, Uganda.

Abstract

Introduction: Stigmatisation impedes health and quality of life. Evidence regarding stigma reduction interventions is, albeit growing, limited. There is a gap in the availability and evidence of interventions for reducing stigma among children and adolescents, especially in low- and middle-income countries. This paper describes the process that led to a stigma reduction intervention impacting children and adolescents in low- and middle-income countries, following previously conducted formative research.

Methods: In this study, we conducted (i) online stakeholder consultations (FGD) (n = 43), including a survey assessing intervention acceptability, appropriateness, feasibility and scalability (n = 16); and (ii) preliminary field-testing of intervention content online and in a refugee settlement in Uganda.

Findings: Stakeholder consultation showed the initial version of STRETCH (Stigma Reduction to Trigger Change for Children), albeit positively received, required adaptations. We made adjustments to i) take into account implementation duration, intervention flexibility and intersectionality; (ii) strengthen the involvement of individuals, including adolescents/youth, with lived stigma experience; (iii) target people close to individuals with lived stigma experience; and (iv) address feasibility and sustainability concerns. Preliminary field-testing simplified STRETCH while adding a community outreach component and revisiting the intervention setup, to ensure STRETCH can also be applied from a modular perspective.

Conclusion: We conducted a process to develop a child-focused multi-component stigma reduction intervention, with intended applicability across stigmas and settings. This paper provides an overview of the intervention development process, generating intervention-specific learnings with generic value. STRETCH aims to reduce stigmatisation at the implementing organisation, create community-wide reflection and stigma reduction demand, and reduce stigmatisation among various target groups.

Copyright: © 2023 Hartog et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Developing Countries*
Humans
Quality of Life*
Referral and Consultation
Social Stigma
Stereotyping

Grants and funding

The Dutch Relief Alliance (DRA) funded part of the STRETCH development process. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.