Coronavirus (1382) COVID-19 and stigma in Ghana

19 October, 2021

Interesting new study in the Ghana Medical Journal. Citation, abstract and a comment from me below.

CITATION: Community acceptance of COVID-19 and demystifying stigma in a severely affected population in Ghana

Delia A. Bandoh et al.

Ghana Med J 2021; 55(2) supplement: 2-9 doi: http://dx.doi.org/10.4314/gmj.v55i2s.2

SUMMARY

Objective: We assessed the level of community acceptance of COVID-19, identified and implemented strategies to demystifying stigma in a severely affected population in Tema.

Design and Setting: We conducted a cross-sectional study to assess stigma among the Tema community, then identified and implemented interventions to demystify COVID-19 stigma. We interviewed positive cases, their contacts, contact tracers, case management team members, and community members who shared their first hand experiences and knowledge on the current pandemic.

Intervention: Based on the information received, we came up with ways of reducing stigma and implemented them in their community.

Main Outcome: Stigma demystified

Results: Cases and contacts reported being avoided, discriminated against, insulted or had derogatory words used on them by family, friends, work colleagues or the community. Cases and their contacts stated that stigmatisation was fueled by the presence of COVID-19 branded vehicles and security officials at their homes or workplaces. Stakeholder engagement, education and extensive sensitisation of community members were implemented to reduce stigma.

Conclusion: We observed deeply entrenched stigma to COVID-19 positive patients and their contacts in the community. Health care response mechanisms such as the presence of security personnel with contact tracers and case managers and the use of COVID-19 branded vehicles fueled stigma. A multifaceted approach through the engagement of key stakeholders, training of health workers and extensive education and community sensitisation was essential in reducing stigma.

SELECTED EXTRACTS

'Some contacts refused to quarantine and refused contact tracers to follow them up for fear that neighbours, community members and colleague workers would get to know their status and not allow them to use the same facilities or discriminate against them. Contacts felt that being singled out in a compound house where they live communally and shared amenities caused the other house members to see them as a threat to their lives and livelihoods'

'Most community members have limited information on COVID-19 and therefore end up stigmatising others out of ignorance.'

Comment (Neil): It would be helpful to understand better the reasons for stigmatisation. Are they due to fear of contracting the infection or perhaps other factors? Is this fear exaggerated as compared with the actual risk, and could stigmatisation be reduced through a better understanding of risk and ways to reduce risk?

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org