Understanding correlates and potential causes of mental illness stigma in community-based settings in low- and middle-income countries (LMICs) is important for developing effective interventions to reduce stigma and demand-side barriers for treatment. This study analyzed data from structured questionnaires administered to 178 respondents in the Buyende district in Eastern Uganda to investigate sociodemographic and clinical factors correlated with mental illness stigma. Factor analysis of 33 items revealed a single dominant factor reflecting mental health stigma. Bivariate and multivariate analyses of sociodemographic and clinical correlates were used to identify factors associated with stigma in the entire sample and separately within the subgroups with evidence of mental illness. In the entire sample, female gender was the only independent correlate of stigma. Analysis of the mental illness subgroup also showed that women had high levels of mental illness stigma. These findings suggest that female gender appears to be a more important correlate of mental health stigma than clinical factors. Nevertheless, effective destigmatizing interventions are needed for the entire population, with additional approaches specifically tailored to women.

Mental health conditions represent a major global burden. However, minimally adequate treatment coverage for common mental disorders remains critically low. Task-sharing solutions using non-specialist providers are promising, but successful implementation requires understanding local culture and context. This study explored facilitators and barriers to implementing non-specialist mental health interventions in Senegal. We conducted in-depth qualitative interviews with 53 stakeholders, including social protection program facilitators, beneficiaries and community members. Data were analyzed using thematic analysis. Four primary themes were constructed: (1) implementation barriers, (2) facilitating factors, (3) health-seeking beliefs and practices and (4) community recommendations. Key barriers include strong preferences for family-based problem-solving, stigma and financial constraints. Facilitators included recognition of the therapeutic benefit of interpersonal dialogue, empathetic values towards helping those with mental health conditions and community enthusiasm for mental health interventions. Culturally adapted interventions need to navigate cultural norms and leverage existing community strengths in interpersonal support. The coexistence of stigma and empathy, alongside both resistance and openness to non-specialist services, highlights a dynamic tension that not only challenges implementation but also presents an opportunity for change. These findings contribute essential formative evidence for designing effective, sustainable non-specialist mental health interventions in Senegal and the sub-Saharan African region.

Cervical cancer, primarily caused by human papillomavirus (HPV), is the most common cancer in women in sub-Saharan Africa and the most common cause of cancer fatalities among women on the continent. While both prevention and early detection are possible through HPV vaccination and cervical cancer screening, health system capacity is inadequate for screening and there are pervasive negative attitudes and beliefs. A major, modifiable but understudied barrier is cancer stigma, which underlies suboptimal vaccination efforts as well as cancer screening. Adhering to the PRISMA, ScR guidelines, we conducted a scoping review exploring HPV and cervical cancer stigma in Africa. We included studies that described stigma in relation to HPV or cervical cancer in Africa or among people of African descent. Forty-three studies described HPV and cervical cancer stigma in a dozen countries in sub-Saharan Africa and none in North Africa. Internalized, enacted and anticipated forms of stigma occurred at the individual, family and community levels. The four main themes that emerged include (1) how lack of knowledge and false perception hinders screening and vaccine uptake; (2) stigma in the context of practical barriers to care; (3) acceptability of education and interventions to reduce stigma and (4) stigma as a contributor to psychological distress and treatment outcomes. Only two studies described interventions focused on eliminating stigma through promoting cervical cancer and HPV-related knowledge, targeting misinformation and incorporating patient navigation. Addressing stigma is essential, as it is a key barrier to HPV vaccination, cervical cancer screening and timely treatment. We call for future studies to develop culturally informed interventions to reduce stigma and improve cervical cancer outcomes across all regions in Africa.

Suicide disproportionately burdens low- and middle-income countries. In Uganda, attempt survivors encounter intense stigma, minimal mental-health services and social exclusion, elevating their risk of future attempts. Rural African data on post-attempt experiences are scarce. From June to August 2023, we conducted semi-structured, in-depth interviews in Buyende District with 18 attempt survivors, 17 relatives, 10 healthcare workers and 9 community health workers. Transcripts were translated into English and thematically analyzed using the framework method within a phenomenologically informed qualitative design. Three interlinked themes emerged. (1) Stigma-shaped immediate responses: cultural, religious and legal norms fostered moral judgment, social distancing, bureaucratic delays and occasionally police involvement. (2) Informal, uneven support: survivors relied on family aid, religious counseling and ad-hoc community advocacy; effectiveness varied widely. (3) Conditional reintegration: sustained practical help, employment and communal acceptance promoted recovery, whereas their absence perpetuated economic hardship and marginalization. Post-attempt trajectories in rural Uganda are governed by multilevel stigma and fragile support systems. Priority actions include provider training, family-community psychoeducation, stigma-reduction initiatives, structured follow-up care and decriminalization of suicide to foster compassionate responses and reduce repeat attempts.

People with tuberculosis (TB) and TB survivors are at increased risk for mental health (MH) conditions. Better management of conditions like depression can improve adherence to TB treatment, and integrating MH care into TB treatment may reduce the MH treatment gap and improve outcomes. This qualitative study explored design characteristics for integrated MH-TB care in Pune, India. Data collection involved in-depth interviews (n = 25) with TB survivors with lived experience of MH conditions, their family members, and TB and MH providers. Data collection and analysis were guided by the Consolidated Framework for Implementation Research, and journey maps illustrated patient experiences. Participants shared suggestions for integrated care models, advantages and barriers to integration, intervention delivery agents, and local perceptions of MH conditions. Barriers included limited awareness about MH and perspectives about MH treatment, which were limited to consuming medication. Suggestions for integrated interventions included raising awareness about MH conditions and existing MH services among TB providers, regular MH screening and counseling for people with TB, and engaging TB survivors to share their experiences with patients in group settings. These insights highlight the importance of working with people with lived experience and understanding patient journeys to inform intervention implementation and sustainability.

Millions worldwide face poverty daily. While its effects vary by society, poverty consistently marginalizes individuals, limiting their opportunities and access to societal benefits. Myths about poverty undergird and perpetuate socioeconomic exclusion, being the vehicles for cultural processes, such as stigmatization, racialization, and rationalization. These myths abound in law. They include the conception of poverty as solely concerned with the deprivation of basic material goods; equal opportunities and collective amnesia about the past; stigmatization of people in poverty as irresponsible and lazy; the categorization of aspects and elements of their poverty condition as criminal. This Article argues that judges, as (meta)narrators, have the power to challenge myths and develop new narratives about poverty, through the language of non-discrimination and equality. This could open the way to judicially redress certain troubling situations of misrecognition, social exclusion and inequality. Ultimately, as long as myths about poverty prevail in law any attempt to tackle the issue of socioeconomic exclusion is destined to fail. This article contributes to the law and sociology literature on poverty in judgecraft by addressing the research gap on narratives of poverty within judicial reasoning and practice.

Social contact refers to the facilitation of connection and interactions between people with and without mental health conditions. It can be achieved, for example, through people sharing their lived experience of mental health conditions, which is an effective strategy for stigma reduction. Meaningful involvement of people with lived experience (PWLE) in leading and co-leading anti-stigma interventions can/may promote autonomy and resilience. Our paper aimed to explore how PWLE have been involved in research and anti-stigma interventions to improve effective means of involving PWLE in stigma reduction activities in LMICs. A qualitative collective case study design was adopted. Case studies from four LMICs (China, Ethiopia, India and Nepal) are summarized, briefly reflecting on the background of the work, alongside anticipated and experienced challenges, strategies to overcome these, and recommendations for future work. We found that the involvement of PWLEs in stigma reduction is commonly a new concept in LMIC. Experienced and anticipated challenges were similar, such as identifying suitable persons to engage in the work and sustaining their involvement. Such an approach can be difficult because PWLE might be apprehensive about the negative consequences of disclosure. In many case studies, we found that long-standing professional connectedness, continued encouragement, information sharing, debriefing and support helped the participants’ involvement. We recommend that confidentiality of the individual, cultural norms and family concerns be prioritized and respected during the implementation. Taking into account socio-cultural contextual factors, it is possible to directly involve PWLEs in social contact-based anti-stigma interventions.

Stress is a challenge among non-specialist health workers worldwide, particularly in low-resource settings. Understanding and targeting stress is critical for supporting non-specialists and their patients, as stress negatively affects patient care. Further, stigma toward mental health and substance use conditions also impacts patient care. However, there is little information on the intersection of these factors. This sub-analysis aims to explore how substance use and mental health stigma intersect with provider stress and resource constraints to influence the care of people with HIV/TB. We conducted semi-structured interviews (N=30) with patients (n=15) and providers (n=15, non-specialist health workers) within a low-resource community in Cape Town, South Africa. Data were analyzed using thematic analysis. Three key themes were identified: (1) resource constraints negatively affect patient care and contribute to non-specialist stress; (2) in the context of stress, non-specialists are hesitant to work with patients with mental health or substance use concerns, who they view as more demanding and (3) stress contributes to provider stigma, which negatively impacts patient care. Findings highlight the need for multilevel interventions targeting both provider stress and stigma toward people with mental health and substance use concerns, especially within the context of non-specialist-delivered mental health services in low-resource settings.