Interventions for Stigma Reduction – Part 2: Practical Applications

Hugh Alistair Cross, Miriam Heijnders, Ajit Dalal, Silatham Sermrittirong, Stephanie Mak


This paper reports the endeavours of the Working Group assigned to develop guidelines for interventions to reduce stigma. The group was comprised of academics and experienced field personnel, all of whom had either investigated stigma, implemented actions to address stigma, and/or had experienced stigma. The group’s mandate was to develop an intervention to reduce the stigma of leprosy, but while accepting that there are commonalities relating to stigma that cut across different health conditions, it was hoped that a generic intervention might be developed.


This goal proved to be unattainable in the time given: condition-specific peculiarities and the diversity of cultural contexts presented significant challenges. The group agreed, however, that a considerable body of theory and expert opinion does exist, and that general strategies might be developed from this. The Working Group discussed a systematic review of such material. It also discussed other material that was considered to be important but had not met the criteria for the systematic review. One conclusion of the group’s deliberations was that a “Stigma Intervention Matrix” could be a useful guide for cross-checking the development of situation-specific stigma interventions. The Stigma Intervention Matrix is presented in this paper.

DOI: 10.5463/dcid.v22i3.72


Labelling; Stereotyping; Status; Discrimination; Intra-personal; Inter-personal

Full Text:



Angermeyer MC (2002). From intuition to evidence-based anti-stigma interventions. World Psychiatry; 1: 21-22. PMid:16946809 PMCid:1489815.

Bos AE, Schaalma HP, Pryor JB (2008). Reducing AIDS-related stigma in developing countries: the importance of theory- and evidence-based interventions. Psychol.Health Med.; 13: 450-460.

Bozkaya IO, Arhan E, Serdaroglu A, Soysal AS, Ozkan S, Gucuyener K (2010) Knowledge of, perception of, and attitudes toward epilepsy of schoolchildren in Ankara and the effect of an educational programme. Epilepsy Behav.; 17: 56-63.

Brown L, Macintyre K, Trujillo L (2003). Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ.Prev.; 15: 49-69. PMid:12627743.

Chan KY, Yang Y, Zhang KL, Reidpath DD (2007). Disentangling the stigma of HIV/AIDS from the stigmas of drugs use, commercial sex and commercial blood donation - a factorial survey of medical students in China. BMC Public Health; 7: 280. PMid:17919317 PMCid:2180176.

Corrigan P, Gelb B (2006). Three programmes that use mass approaches to challenge the stigma of mental illness. Psychiatr.Serv.; 57: 393-398. PMid:16524999.

Cross H, Choudhary R (2005a). STEP: an intervention to address the issue of stigma related to leprosy in Southern Nepal. Lepr.Rev.; 76: 316-324. PMid:16411511.

Cross H, Choudhary R (2005b). Self Care: A catalyst for community development. The Asia Pacific Disability Rehabilitation Journal; 16.

Gussow Z, Tracy GS (1970). Stigma and the leprosy phenomenon: the social history of a disease in the nineteenth and twentieth centuries. Bull Hist Med; 44: 425-449. PMid:4919121.

Heijnders M, Van Der Meij S (2006). The fight against stigma: an overview of stigmareduction strategies and interventions. Psychol.Health Med.; 11: 353-363.

Holmes EP, Corrigan PW, Williams P, Canar J, Kubiak MA (1999). Changing attitudes about schizophrenia. Schizophr.Bull.; 25: 447-56. PMid:10478780.

Hyland J (2000). Leprosy and social exclusion in Nepal: the continuing conflict between medical and socio-cultural beliefs and practices. In J Hubert (ed) Madness, Disability and Social Exclusion; 168-179. London: Routledge

Ignatieff M (1999). Less race please. Prospect.

Lapshin O, Wasserman E, Finkelstein J (2006). Computer intervention to decrease level of psychiatric stigma among medical students. AMIA Annu Symp Proc; 998. PMid:17238617 PMCid:1839289.

Link BG, Phelan JC (2001). Conceptualising Stigma. Annual Review of Sociology; 27.

Mak S (2011). Fighting Health Related Stigma: What Works? A systematic overview of successful stigma-reduction strategies and interventions. (unpublished work).

Martiniuk AL, Speechley KN, Secco M, Campbell MK, Donner A (2007). Evaluation of an epilepsy education programme for Grade 5 students: a cluster randomised trial. Epilepsy Behav.; 10: 604-10.

McLeroy KR, Bibeau D, Steckler A, Glanz K (1988). An ecological perspective on health promotion programmes. Health Educ Q; 15: 351-377.

Penn DL, Guynan K, Daily T, Spaulding WD, Garbin CP, Sullivan M (1994). Dispelling the stigma of schizophrenia: what sort of information is best? Schizophr Bull; 20: 567-78. PMid:7973472.

Raju MS, Rao PS, Mutatkar RK (2008). A study on community-based approaches to reduce leprosy stigma in India. Indian J Lepr; 80: 267-273. PMid:19432357.

Sartorius N (2002). Fighting stigma: theory and practice. World Psychiatry; 1: 26-27. PMid:16946814. PMCid:1489837.

Secker J, Armstrong C, Hill M (1999). Young people’s understanding of mental illness. Health Educ Res; 14: 729-739. PMid:10585381.

Smith M (2002). Stigma. Advances in Psychiatric Treatment; 8: 317-323.

Thornicroft G, Brohan E, Kassam A, Lewis-Holmes E (2008). Reducing stigma and discrimination: Candidate interventions. Int J Ment Health Syst, 2, 3. PMid:18405393. PMCid:2365928.

Uys L, Chirwa M, Kohi T, Greeff M, Naidoo J, Makoae L et al (2009). Evaluation of a health setting-based stigma intervention in five African countries. AIDS Patient Care STDS; 23: 1059-66. PMid:20025515. PMCid:2832642.

Valencia LB (1989). Social science research on social dimensions of leprosy: Where are we going from here? International Journal of Leprosy; 57: 847-863.

Watson AC, Otey E, Westbrook AL, Gardner AL, Lamb TA, Corrigan PW et al (2004). Changing middle schoolers’ attitudes about mental illness through education. Schizophr Bull; 30: 563-72. PMid:15631245.

Weinrich NK (1999). Hands-on social marketing: a step by step guide. Thousand Oaks, California 91320: Sage Publications inc.

Weiss MG (2008). Stigma and the social burden of neglected tropical diseases. PLoS Negl Trop Dis; 2, e237. PMid:18478049. PMCid:2359851.

Weiss MG, Ramakrishna J (2006). Stigma interventions and research for international health. Lancet; 367: 536-538.

Weiss MG, Ramakrishna J, Somma D (2006). Health-related stigma: rethinking concepts and interventions. Psychol Health Med; 11: 277-287.


Copyright (c) 2015 Hugh Alistair Cross, Miriam Heijnders, Ajit Dalal, Silatham Sermrittirong, Stephanie Mak

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Supported by:


© Disability, CBR & Inclusive Development