Developing and evaluating a community-based stigma reduction strategy in Mbarara, Uganda
Awarded 2015
Large Research Grants
Kristen Shellenberg, PhD, MPH

In Uganda, as in many other countries around the world, social stigma plays a critical role in the social, medical, and legal marginalization of abortion care. Stigma may ultimately determine whether a woman seeks a safe versus unsafe abortion or pursues life-saving medical care when suffering postabortion complications. Effective stigma reduction interventions need to be developed, implemented, and evaluated to create lasting, positive change around safe abortion locally, regionally, and globally. The proposed research aims to evaluate a stigma reduction strategy in Mbarara, Uganda, using a pre/post intervention quasi-experimental design. A small, randomized household survey will measure individual and community-level abortion stigma at baseline and endline. Ipas will partner with two local community-based organizations, one mass media partner, and the Ugandan Private Midwives Association to develop and implement stigma reduction interventions. Participatory interpersonal communication strategies such as community dialogues, household visits, and peer-to-peer education, supported by a mass media campaign (which may include radio talk shows, mini-street dramas, and other “edutainment activities”) will be used to facilitate dialogue around abortion, and address negative norms, values, and stigmatizing attitudes about abortion. It is anticipated that findings from this research will provide insight into the development and implementation of stigma reduction strategies at the community level in a legally restrictive setting, and provide evidence on which interventions are most effective in reducing stigma, as well as the level of exposure required to initiate positive change.