Stigma in health facilities: Laura Nyblade and colleagues, published in BMC Medicine

If your organisation wants to reduce stigma but isn't sure where to start, this paper offers one of the clearest roadmaps available.

Drawing on 42 stigma reduction interventions from around the world, the authors identified six common approaches used to tackle stigma in healthcare settings:

  • Providing information about stigma and its impact on health

  • Building staff skills and confidence

  • Participatory learning and reflection

  • Meaningful contact with people who have lived experience

  • Empowerment approaches that help people challenge stigma

  • Structural and policy change within organisations


Perhaps most importantly, the review found that effective interventions rarely relied on a single strategy. Most combined multiple approaches, recognising that stigma is shaped not only by individual attitudes, but also by workplace culture, organisational systems and healthcare environments.

The authors also identified major gaps in the field. Few interventions targeted all staff within a facility, worked across multiple organisational levels, or addressed the policies, procedures and physical environments that can unintentionally reinforce stigma.

Why this matters

Many stigma reduction efforts still focus on education alone. This review suggests that lasting change requires a whole-of-facility approach that combines training, lived experience involvement, organisational leadership, policy change and supportive systems.

Action to take

  • Target all staff, including clinical and non-clinical workers

  • Work at both individual and structural levels

  • Involve people with lived and living experience as partners

  • Address multiple forms of stigma rather than tackling conditions in isolation

  • Review policies, procedures and physical spaces that may contribute to stigma

  • Build stigma reduction into routine quality improvement processes rather than treating it as a one-off project

 

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