Marked yet invisible Child-centred stigma research in low- and middle-income countries and the case for a common approach to stigma reduction

This dissertation focuses on stigmatisation impacting children and adolescents in low- and middle-income countries, including conflict-affected settings. Stigmatisation, a form of structural violence of labelling, prejudice, separation and harmful treatment, is engrained in society. Decades of research demonstrated stigmatisation’s impact on multiple aspects of life, including health and educational outcomes, to name just a few. Based on recent recommendations calling for a stigma lens ‘beyond the silos’, this dissertation approached stigmatisation irrespective of the stigmatised label(s). Across seven chapters, after an introduction in conflict, stigmatisation as well as this dissertation, Chapters 2 and 3 describe systematic reviews with a child-centred lens analysing the existence, application and impact of stigma reduction interventions as well as assessing the application and content of stigma measures. Chapter 4 discusses primary qualitative research exploring stigmatisation dynamics concerning three populations in a village in South Kivu in the Democratic Republic of Congo from adolescent and adult perspectives and people with and without specific stigmatised labels. Chapter 5 portrays, through primary quantitative research, the stigma experiences, predicting labels of stigmatisation, and correlates of stigmatisation experience with mental health, educational and social outcomes of primary school learners in a Ugandan refugee settlement. Chapter 6 synthesis the development process of a generic stigma reduction intervention called STRETCH. Chapter 7 concludes on the underrepresentation of children and adolescents in stigma research, describes the need and possibility to stretch beyond the stigma silos, and provides reflections about stigma reduction research. This chapter ends with recommendations on a way forward.