‘ Stigma is a tough beast… we need all the allies’ : A qualitative study on prospects for an integrated approach to reduce health-related stigma from civil society organisations' perspective

In line with global efforts to reduce health-related stigma to 'zero' by 2030, researchers propose integrating disease-specific stigma reduction programs into a united approach. This study explored civil society organisations' (CSOs) perspectives on using an integrated approach across diverse health conditions to mitigate stigma and its associated implications. A qualitative methodology was employed, involving 15 in-depth interviews and one focus group discussion (FGD). Participants, purposively selected as staff from CSOs working with stigmatised health conditions, represented diverse contexts, organisations and health issues, offering a broad narrative. Findings highlight the potential of an integrated approach to amplify stigma reduction by addressing multiple and intersecting stigmas, presenting it as a context-relevant and sustainable strategy. However, participants noted significant challenges, including cross-stigmatising attitudes among group members, stigma by association exacerbating marginalisation and practical barriers like differing agendas, cultures and values among organisations. Additionally, participants emphasised the critical importance of community involvement, warning that its absence could undermine the approach's effectiveness. The FGD allowed for deeper exploration of these challenges and generated potential solutions to address them. While exploratory in scope, this study sheds light on organisational perspectives that may help guide the development of more comprehensive stigma reduction interventions.