Intervention effectiveness to reduce disability stigma in sub-Saharan Africa: a systematic review

Summary

Background: To reduce stigma effectively, there is a need to understand where stigma exists, how it affects different populations, and what interventions have proven effective in reducing stigma.

Aim: To synthesise evidence on the effectiveness of interventions in reducing disability-related stigma in sub-Saharan Africa.

Methods: A search of nine databases for peer-reviewed literature was supplemented with grey literature, references from relevant studies and expert consultations. Two authors independently screened titles, abstracts and full texts, extracted data and critically appraised the included studies. We synthesised data narratively from studies rated low and medium risk of bias.

Results: The review included 15 studies, six with low risk of bias and nine with medium risk of bias. Among eight studies reporting positive effects of interventions, seven found positive effects of education and training, either alone or in combination with other interventions on stigma-related outcomes. One study observed positive effects of education combined with communication, enablement and persuasion. Out of five studies, with medium risk of bias, showing mixed effects of interventions, four employed education and training alongside other interventions and one combined education with modelling, persuasion, enablement and communication. Two studies with low risk of bias reported null effects when education and service provision were combined with other interventions.

Conclusion: There is a need for increased investment from researchers, implementers and funders to conduct high-quality evaluations. Generating and publishing both positive and negative findings is crucial to advancing our understanding of effective interventions and reducing disability-related stigma.