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TB Stigma

Stigma and discrimination are recognized as some of the most commonly identified barriers to fight the TB epidemic. Reducing TB stigma is therefore essential because it hinders care seeking, tracing infected contacts, outbreak investigations, treatment initiation, adherence and quality of care. Moreover it degrades social capital; it deprives people with TB of their rights and the respect of others. Ultimately it can also contribute to catastrophic costs when people with TB are pushed out of their community and lose ways of making a living.

KNCV’s philosophy on reducing TB stigma is to build empathy and mutual respect among communities, health care workers and TB patients. It aims to reduce the tendency to label, blame, shame and control by strengthening the awareness of our own judgements.

To do so, KNCV has developed a TB Stigma Measurement Guidance: an overview of best practices, covering the full scope of established methodologies. The guidance can be used for a whole range of stigma measurements: from baseline assessments to end line evaluations. KNCV also developed a self-stigma toolbox: ‘From the Inside Out’; because people with TB sometimes feel unjustly guilty. This toolkit provides tools for addressing and reducing self-stigma in people affected by TB. Then there is the ‘KNCV’s Allies Approach to TB Stigma reduction’, a health care facilities toolbox, which focuses on stigma at the emotional, cognitive, and practical levels. This approach addresses self-stigma in health care workers, stigmatizing behavior of health care workers and the policy in facilities.

Stigma not only harms patients, but also erodes health care workers’ commitment to high quality care. An effective approach must therefore protect everyone’s rights as a cornerstone of patient-centered care.