Stigma and discrimination reduction programmes
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Stigma and discrimination reduction programmes reduce violations and promote access to health care services for vulnerable and key populations.
Stigma and discrimination reduction programmes work to reduce stigma and discrimination towards vulnerable and key populations that act as barriers to universal health coverage. They are an equally vital part of strengthened legal and policy frameworks and are based on an understanding that law and policy review alone cannot reduce human rights violations, harmful gender norms and gender-based violence.
Stigma and discrimination reduction programmes may include:
- Education campaigns and use of media to promote non-stigmatising messages towards vulnerable and key populations
- Engagement with and sensitization of political, religious and community leaders
- Inclusion of non-discrimination and education campaigns in workplaces, schools or other settings
- Measuring stigma and discrimination against vulnerable and key populations, particularly in the context of access to health care, and
- Peer mobilization, advocacy, education and support.
Lesbian, gay, bisexual, transgender and intersex people in El Salvador report stigma, discrimination and even violence in accessing basic health services, education and employment. The police and healthcare workers are said to be particular offenders. Discrimination is linked to high levels of violence against lesbian, gay, bisexual, transgender and intersex communities more generally.
Atlacatl (an organization of people living with HIV representing HIV and human rights issues for key populations in El Salvador) took various actions to reduce HIV-related stigma and discrimination. They held workshops with partner organizations representing sex workers, transgender women, women living with HIV, gay men and men who have sex with men to identify the nature and extent of stigma and discrimination, to discover which service providers discriminated, and to find out what key populations wanted to do about it. They ran stigma and discrimination workshops with key populations, service providers, law enforcers and the broader community, to reduce stigma and discrimination in service delivery, and to build the capacity of key populations to participate in decision-making and advocate for change.
The project worked to improve relationships between key populations and service providers and to improve access to non-discriminatory services. It also supported organizations to gain the experience, visibility and confidence to participate in policymaking bodies and advocate for the rights of key populations.
AUA, the ARV Users Association, is one of a few community-based HIV organizations in Cambodia whose staff work directly alongside health-care providers. While the organization provides a range of services, such as counselling on treatment adherence and HIV prevention, it places a particular focus on preventing stigma and discrimination in the hospitals in which it works.
Eighty-five per cent of AUA’s 40 staff members are people living with HIV and so they know first-hand how discrimination can lead to social isolation and negatively affect a person’s health and well-being. The group facilitates connections between clients and health-care providers and holds regular meetings with hospital staff to provide feedback.
In 2015, AUA was trained by Asia Catalyst to document human rights violations in health-care settings. The cooperation was part of a study that Asia Catalyst conducted in four countries in Asia, which found discrimination evident in many areas, from denial of services and segregation to arbitrary additional fees for health services. When AUA receives a discrimination case, it acts as a mediator, trying to find a solution that is acceptable to both health-care workers and clients.
AUA also holds counselling sessions with clients that aim to give them accurate information, as well as empower them to advocate for their rights and negotiate with health-care providers.