To be able to design the right intervention, you first have to identify the sources of stigma in a particular situation, as described in chapter 2, ‘Identifying the sources of stigma’.
The next step will be to assess what you would like to change with your intervention, and how you can try to bring about this change:
- What are your desired outcomes? What change in ideas, attitudes and behaviour would you like to see?
- Who or what do you have to influence to make this change happen? Who are the stakeholders in this process?
- What methods and tools can you use to practise this influence?
Example of targeting a stigma-reduction intervention (after thorough analysis of the problem, causes, desired outcomes, and influencing factors/actors for these outcomes) in a specific community
Dream: leprosy-affected children can attend school just like any other children.
Problem: leprosy-affected children are being excluded from education.
Causes: they are sent away from school as soon as it is known that they belong to a leprosy-affected family. In this case, the parents of the other children push the teachers and director of the school to block the leprosy-affected children from attending class. They have misconceptions of the causes of leprosy and are afraid of being infected. The children of these parents start behaving unfriendly towards their leprosy-affected classmates.
Desired outcomes (the change we would like to see):
- The parents of non-leprosy affected children have accurate knowledge about leprosy and understand that there is nothing to fear. They behave in a non-discriminatory manner towards the leprosy-affected children and their families.
- The non-leprosy-affected children stop their discriminating behaviour and accept the leprosy-affected children as their classmates, behaving as they would with any other classmate.
A so-called contact intervention approach is suitable here:
- Information provision and discussions with teachers and directors.
- Discussions with the leprosy-affected children, their families, the school and the parents.
- Information and discussion sessions organised by the school with the parents of non-leprosy-affected children, including leprosy-affected parents in the meetings.
- Sessions with role-playing and discussions on discrimination with all children in class.
- Activities for inclusion with all children in class.
When designing your intervention plan, you need to identify how you think the intervention will help to achieve the desired change in behaviour. This is very important, because we can never just assume that a certain intervention will have the desired effect. It is always relevant to explain how you expect the intervention to work and why you think it will work.
Continuing from the example in the box above, it will be important, for example, to answer the question ‘How will the activity on role-playing and discussions in class influence the acceptance of children affected by leprosy in class?’