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21 COUNTRIES

IMPLEMENTING THE TB STIGMA
ASSESSMENT​

10 COUNTRIES

TB STIGMA & CRG ACTION PLANS

23000+​

PEOPLE WITH TB INFORMING
INTERVENTION TO END STIGMA

WHAT IS TB STIGMA & DISCRIMINATION?
HOW DO THEY ACT AS BARRIERS

Stigma refers to a social process where individuals are devalued, discredited, or labelled as undesirable due to a particular characteristic or condition, such as TB. Discrimination is the unfair or unequal treatment of individuals or groups based on perceived or actual characteristics, such as having TB.​​

Global strategic documents​
TB STIGMA ASSESSMENT – STATUS & KEY HIGHLIGHTS​
21 COUNTRIES

Conducting the TB stigma assessment​

10 COUNTRIES​

Completed the assessment analysis​

21%​

Experienced Stigma in communities​​

20%​

Experienced Stigma at Health Facilities​​

19%​​

Experience Self-Stigma​​​

Implementation Handbook​
Data Collection Instruments​
Data Entry and Analysis Workbook​​
Real-Time Data on TB Stigma​

36 COUNTRIES​

IMPLEMENTING THE ONEIMPACT

250000+ PEOPLE​

ENGAGGED ON ONEIMPACT​

79,000+ CHALLENGES​

REPORTED BY TB COMMUNITIES​

28000+ (>33%) STIGMA ​

CHALLENGES INHIBITING ACCESS TO
TB CARE AND SUPPORT SERVICES ​

JOURNEY​

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Launching the TB Stigma Assessment Portal​​

Sharing key insights from countries on assessment findings and interventions to address them ​​​

Developing and Launching the TB Stigma Assessment tools​​

Aligning to understand Stigma levels, its settings and impact on access of TB care and support services​​

Exploring available tools to assess TB Stigma​

Global Consultation with HIV & TB communities, KNCV, WHO and other partners​

KNCV Global Consultation on Stigma measure. Hague, Netherlands, 2017

Union Conference 2017 – Guadalajara, Mexico – Community consultation including KNCV, USAID, WHO, HIV and TB communities

STP TB Stigma Assessment - Implementation Handbook​

STP TB Stigma Assessment – Data Collection Instruments​

STP TB Stigma Assessment – Data Entry and Analysis Workbook​

2017
2019
2021
2023
2025
2027
AIM​

To assess the extent to which TB stigma acts as a barrier to accessing TB care and support services in different settings (self-community-family-healthcare-legal and policy environment) including across gender and among key and vulnerable populations (KVPs).

METHODOLOGY AND FRAMEWORK​
National Orientation​​ :

To build a common understanding of stigma, how it acts as a barriers and the importance of addressing it at all the levels.​

Data Collection & Analysis​​ :​

To gather information on the impact of stigma and to interpret the data collected to uncover patterns, insights, and trends.​

Insights and Validation​​ :

To ensure that the data is accurate, complete, consistent, and reliable before using it to take actions and at levels.​

AIM​

To assess the extent to which TB stigma acts as a barrier to accessing TB care and support services in different settings (self-community-family-healthcare-legal and policy environment) including across gender and among key and vulnerable populations (KVPs).

METHODOLOGY AND FRAMEWORK
National Orientation​​

To build a common understanding of stigma, how it acts as a barriers and the importance of addressing it at all the levels.​ ​​

Data Collection & Analysis​​

To gather information on the impact of stigma and to interpret the data collected to uncover patterns, insights, and trends.​

Insights and Validation​​

To ensure that the data is accurate, complete, consistent, and reliable before using it to take actions and at levels.​

APPROVAL

Once the initial adaptation process is completed, the platform is reviewed and approved by the country implementation partners​.

PILOT

Once the platform has been reviewed by all the stakeholders including the NTP, the platform is piloted by opening up access to a small group of people .

FEEDBACK

Various consultative workshops and meetings are conducted for different stakeholders to get feedback on all components of the OneImpact platform. All these feedbacks are documented and finalized.​

UPGRADE

Once all the feedbacks from the initial pilots are recieved, these feedbacks are incorrpoated in the platform and the overall platform is further upgraded.​

SCALE UP

The platform is then sclaed up to maximise reach across all TB affected community across the nation. Different stratgies like social media promotion, inclusion of access link in TB treatment card, leveraging NTP communication mechineries are leveregd.

INSTITUTIONALISATION

Once all the feedbacks from country stakeholders has been incorproated, the platform is then institutionalised as one of the core intervention within the National program including inclusion into the NSP. ​

INTEGRATION

It is ensured that the platform is fully integrated with the national data ecossytem and hosted and deployed in preferred server.​

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STIGMA ANALYSIS

21 Countries​

TB Stigma Assessment ​
in process​

10 Countries​

TB Stigma Assessment
Completed​

1,092 (PWTB)​

Average number of respondents
across countries​

Completed Assessment Review​

In-Progress Review​​

Azerbaijan

Cambodia​

DRC

Ethiopia

Ghana

India

Indonesia

Kazakhstan​

Kenya

Malawi

Moldova

Mongolia​

Nepal

Nigeria

Pakistan

Peru

Philippines​

South Africa

Tajikistan​

Ukraine

Zambia​

TB STIGMA MEDIA GALLERY​
COUNTRY SNAPSHOTS​
COUNTRY CASE STUDIES

Empowering tribal populations to advocate for improved access to TB services

Implementer :

PRAKRUTHI Social Service Society

Project timeline :

June 2020-September,2021

Reason for intervention :

Low levels of awareness of TB amongst Tribal Populations

Main achievements :

Impact of TB programs and services

Investment :

20’000 USD

Due to remoteness, sparsely spread and hilly habitations, tribal populations are deprived of necessary and timely medical interventions from public health facilities. The absence of transport facilities further triggers the difficulty in reaching services, especially for women and children. There is a basic denial of human rights; tribal women are confronted by all forms of violence. The underlying causes of gender inequality are related to the social and economic structure based on norms and practices.

Culturally the tribal women lack access to resources, opportunities, and participation in the decision-making processes. This is equally pertinent in the case of their health-seeking behaviour. PRAKRUTHI through its TB CRG sensitizations meetings at the community level, health facilities and with political leaders; capacity building workshops and establishment of TB district and sub-national committees increased TB CRG awareness levels and created demand for TB services among tribal populations.

Through the village and Mandal level committees’ people with TB have access to peer support services, especially for TB treatment adherence. Also, District committee representatives participate in TB program review meetings at the district level to ensure tribal populations are prioritized.

KEY LEARNINGS

NTPs must be included in the Core Groups to ensure government buy-in of the assessment process, findings, recommendations and costed action plans.​

Confidentiality/privacy protocol and training should be provided for the entire assessment team (Core Group and research team).. ​

PWTB belong to 2+ KPs should also be analysed to identify KP overlapping patterns and explore if the stigma dynamics in inhibiting TB service access would differ from other non-KP PWTB and PWTB belonging to just 1 KP. ​

More PWTB and women should be included in the Core Groups and research teams (interviewers, field supervisor, project managers) to reflect the TB situation of the country (minimum a third should be women reflecting the global average). ​

PWTB who had not started treatment and KPs identified in literature review (e.g., CRG assessments, legal environment human rights scorecard) to face more stigma than other KPs should be over-sampled (minimum of 50) to ensure drill down analysis for them​.

PWTB belong to 2+ KPs should also be analysed to identify KP overlapping patterns and explore if the stigma dynamics in inhibiting TB service access would differ from other non-KP PWTB and PWTB belonging to just 1 KP. ​

RECOMMEDATIONS​
More PWTB

More PWTB and women should be included in the Core Groups and research teams (interviewers, field supervisor, project managers) to reflect the TB situation of the country (minimum a third should be women reflecting the global average). ​

More PWTB

More PWTB and women should be included in the Core Groups and research teams (interviewers, field supervisor, project managers) to reflect the TB situation of the country (minimum a third should be women reflecting the global average). ​

More PWTB

More PWTB and women should be included in the Core Groups and research teams (interviewers, field supervisor, project managers) to reflect the TB situation of the country (minimum a third should be women reflecting the global average). ​

More PWTB

More PWTB and women should be included in the Core Groups and research teams (interviewers, field supervisor, project managers) to reflect the TB situation of the country (minimum a third should be women reflecting the global average). ​