References in the content below refer to the PBMEF Guide.
Definitions
TB stigma reduction is included in the National TB Program (NTP) annual plan and/or national strategic plan (NSP) and includes 3 elements: interventions, indicators, and assigned budget line.
The NTP annual plan and/or NSP state that it is illegal to discriminate against anyone with TB, citing law where relevant, and includes interventions aimed at reducing stigma as a barrier to TB services; specifically:
- The NTP/NSP mentions activities to reduce stigma, including stigma against vulnerable populations who may already be stigmatized when accessing the health system
- The NTP/NSP provides data from a stigma assessment
- Appropriate context-specific activities are described to respond to stigma
- Indicators with targets are included to reduce stigma
- A defined budget is allocated for stigma-reduction activities.
Use the following scoring system:
0 = No mention of any of those 3 elements in the NTP annual plan/NSP
1 = 1 element (out of 3 elements) is included in the annual plan/ NSP
2 = 2 elements (out of 3 elements) are included in the annual plan/NSP
3 = All 3 elements are included in the annual plan/NSP
Numerator
Denominator
Ref # |
SN_STGMA_NSP
(Previously SN-32A) |
Tier Level |
Project Level Indicators
|
Category |
Sustain
|
Type |
Output
|
Unit of Measure |
Score 0–3
|
Data Type |
Integer
|
Disaggregations |
N/A |
Reporting Level |
Though this is a project-level indicator, this data should be reported at the national level to reflect the country’s NSP.
|
Reporting Frequency |
Annually
|
The data sources for this indicator may include extracting information from a country’s NSP for TB or NTP annual plan. The Stop TB Partnership also conducts an annual survey and publishes data relevant to this indicator in their report "Governance of TB Programmes: An assessment of practices in 18 countries".
Research highlights that stigma and discrimination limit access to TB services and have a negative impact on the quality of life for people with TB. It is essential for countries to understand the levels and dimensions of TB stigma in order to address the health disparities experienced by people with TB and inform interventions to end TB stigma. The Political Declaration of the United Nations High-Level Meeting (UNHLM) on TB commits to removing legal and social barriers in order to eliminate stigma and discrimination and promote TB responses guided by human rights principles.
Overcoming the legal and policy barriers that exacerbate the stigma associated with TB and the people affected by it will reduce a key barrier to services and will enable access to quality, affordable, and timely TB care, as well as a return to normal life. There is a need to scale up interventions aimed at reducing stigma that promote enabling legal environments, identify and overcome legal barriers to TB services, and build comprehensive social protection systems. In 2021, the Stop TB Partnership assessed practices related to governance of TB programs in 22 countries including policy frameworks to reduce TB stigma. An important next step is the design and implementation of both policy and programmatic interventions to address stigma, along with monitoring of the response to such interventions.
This indicator measures whether TB stigma reduction is featured and measured in the NTP annual plan and/or NSP highlighting the following 3 elements: interventions, indicators, and assigned budget line. This is a companion indicator to 32B. Indicator 32B measures whether a stigma assessment or gap analysis has been conducted that would provide information for critical activities that need to be included and addressed in the NTP annual plan or NSP.
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