programmes and tools for reducing stigma and discrimination, including human rights approaches what...
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Programmes and tools for reducing stigma and
discrimination, including human rights approaches
What Works For Reducing Stigma
and Discrimination:
Laura Nyblade, PhDJuly 27, 2012
Human Rights ApproachesKey Principals For S&D reduction
programmingExamples from the healthcare sector
Tools & Resources
Presentation Guide
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A Rights-Based Approach to HIV
Supports govts to realize rights
Supports people to take up/demand rights
Ensures that HIV response addresses vulnerabilities/needs of most affected
Ensures that HIV response is non- discriminatory, inclusive, participatory, and accountable (human rights principles)
Empowers individuals and communities
Promote Programmes That Empower
Know your rights/laws campaigns (“legal literacy”)
Programmes to reduce stigma and discrimination
Human rights education for key service providers (health care workers, police, judges): nondiscrimination, confidentiality, informed consent, ethical partner notification
Programmes to change harmful gender norms, violence against women
Provision of legal aid, community paralegals, working with traditional leaders
Economic empowerment
Address Immediately Actionable Drivers
Raise Awareness:
Close the Intention-Action Gap• Foster understanding and motivation for stigma reduction
Address Transmission Fears and Misconceptions• How it is and is not transmitted• Respond to specific fears related to daily living context
Discuss and Challenge the Shame and Blame• The values and beliefs that underlie stigma and
discrimination: • Where they come from• What they do
Develop & Strengthen networks Empowerment & Capacity Strengthening
Address self-stigmaIdentify & support health & other needs
Build Resiliency
Affected Groups at the Core to Lead Response
Engage a range of groupsOpinion Leaders
– Policymakers
– Service Providers – Religious Leaders– Youth– Media
General Community
Family
“Contact strategies”: Foster interaction between groups experiencing stigma & those perpetrating it.
Model desirable behavior
Hold up & reward role models
Create Alliances and Form New Partnerships for Influence and Expanded Reach
Participatory learningCommunity meetingsCultural MediumsWritten Materials Media ChannelsAdvocacy Campaigns
Employ a Range & Combination of Approaches
Building partnerships with Hospital gatekeepersBaseline dataHospital steering committeeParticipatory Training:
For all hospital staff Refreshers (monitoring visits)
Joint development of “Safe and Friendly” hospital policies
Structural changes supporting universal precautionsEducational materialsEndline data
S&D Hospital Reduction Intervention PackageHorizons, ISDS & ICRW
Training
3 to 4 half-days½ day basic HIV knowledge1 day on Universal Precautions½ day on social stigma (Arm 2 only) co-facilitated by PLHIV Naming stigma through pictures What is the meaning of stigma Naming stigma in hospitals—forms & Causes How it feels to be stigmatized
Each trained group developed their own policy & presented it in plenary to hospital
Steering committee took all comments & combined for final hospital policyAccess to services by PLHIVHIV counseling and testingConfidentialityUniversal PrecautionsTraining on HIV and AIDSDissemination of policy
Posters of policy posted throughout hospitals
Hospital Policy Development
Ashodaya-Samithi, Mysore, IndiaTrained Peer Patient
Advocates, placed in public hospitals
Opportunity for increased contact and understanding
Sex workers found easier to access services
Swathi Mahila Sangha & partners, Bangalore, India
Capacity Strengthening Designed advocacy
campaigns
Rose Campaign Opened space for
dialogue Medical student
rotation
Building Alliances & Advocating for Stigma-Free Health Services
General Tools• Challenging & Addressing
Stigma towards– People living with HIV– Men who have sex with men– Sex workers– People who use drugs
• Guidance Documents– UNAIDS, DfiD
Health Care Specific
• Safe & Friendly Health Facility Trainers Guide (ISDS/ICRW/Horizons tools, Vietnam)
• Reducing Stigma and Discrimination Related to HIV and AIDS: Training for Health Care Workers (Engender Health)
• Reducing HIV Stigma & Gender Based Violence: Toolkit for Health Care Providers in India (ICRW/BPWT/Levi Strauss Foundation)
• Global Stigma-Reduction toolkit for health care settings (Draft)
People Living with HIV Stigma IndexGlobal Stigma and Discrimination Indicator working
groupGlobal working group on S&D measurement for
health facilities
Measures: Three Global Eff orts
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www.stigmaactionnetwork.com– From working in isolation to collective action
• Share and learn from each other• Speak with collective voice• Raise external awareness about existing best practices• Coordinate efforts for efficiency & effectiveness
www.healthpolicyproject.com
Thank You!
The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development (USAID) under Cooperative Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. It is implemented by Futures Group, the Centre for Development and Population Activities (CEDPA), Futures Institute, Partners in Population and Development Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), Research Triangle Institute (RTI) International, and the White Ribbon Alliance for Safe Motherhood (WRA).