Community-based anti-stigma intervention for children with disabilities in Zambia.

Abstract

Children with disabilities (CWD) experience greater obstacles than those without disabilities, including increased poverty, reduced healthcare opportunities, minimal educational resources, and stigma. This research explored the impact of community interventions on reducing stigma and discrimination toward children with disabilities. A repeated cross-sectional survey design (2019/2021) was implemented with community members in three low-resource compounds in Lusaka, Zambia, regarding stigma related to disability and participation in sensitization events <i>via</i> Kusumala+, a community-based intervention designed to improve quality of life for households with CWD. The analysis included descriptive statistics and linear regression assessing group mean change over time. Participants included <i>N</i> = 259 (2019) and <i>N</i> = 1037 (2021). Subscales of stigma were identified: attitudes (<i>t</i> = 9.7, <i>p</i> < 0.001) and discrimination (<i>t</i> = 4.1, <i>p</i> < 0.001), which both significantly changed from baseline to follow-up. The effect size for the change in discrimination was <i>d</i> = 0.28 (95% CI 0.15-0.42) (weak to moderate effect) and for attitudes was <i>d</i> = 0.67(95% CI 0.53-0.81) (strong effect). Attitudes improved if event attendance occurred and increased with each additional event. In contrast, discrimination improved only when one event attendance occurred, not with each additional event change, in adjusted or unadjusted models. Sensitization activities and events show promise as targeted interventions to reduce stigma and discrimination and create supportive community environments for CWD and their families.