Stigma reduction in a disability and mental health programme in Ghana: Lessons in participation

Maria Zuurmond; Augustina Naami; Lyla Adwan-Kamara; Cathy Stephen; Sapana Basnet; Caroline Vanderick; Mohammed Chantimah; Abigail Nana Asamoah; Daisy Macdonald; Crick Lund

doi:10.4102/ajod.v14i0.1508

Stigma reduction in a disability and mental health programme in Ghana: Lessons in participation

Maria Zuurmond^*, Augustina Naami, Lyla Adwan-Kamara, Cathy Stephen, Sapana Basnet, Caroline Vanderick, Mohammed Chantimah, Abigail Nana Asamoah, Daisy Macdonald, Crick Lund

^*Corresponding author for this work

Health Service & Population Research

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Stigma is a barrier to inclusion for people with disabilities and mental health conditions. There is increasing recognition of the need to address stigma within disability inclusive programmes, but limited research is available on what are effective participatory approaches to stigma reduction interventions. Objectives: (1) To document participatory approaches used in the design and delivery of disability stigma reduction interventions in a disability and mental health programme in Ghana and (2) to understand the experience of programme implementers and participants in these processes, with particular attention to the leadership and involvement of people with disabilities. Method: A mixed-methods study was conducted. The data were drawn from a purposive sample of 20 in-depth interviews (IDIs) with programme staff, partners and key stakeholders, and 12 focus group discussions (FGDs) with self-help group (SHG) members, organisation of people with disabilities (OPD) members, and disability champions. We conducted thematic analysis using deductive and inductive approaches. Results: The programme adopted several approaches to participation at design and implementation stages, with a focus on the leadership of people with disabilities and people with mental health conditions. The process was seen to promote acceptability of stigma reduction approaches. Providing opportunities for building and strengthening relationships with a wide range of stakeholders was key to successful implementation. Understanding, and engaging with, power dynamics in the local context also provided important benefits. Conclusions: Participation of people with disabilities and mental health conditions is essential for the design and delivery of stigma reduction programmes in Ghana. Contribution: This study provided lessons from the field on the value of participation in reducing stigma, and the role of key stakeholders, particularly people with disabilities and mental health conditions.

Original language	English
Article number	a1508
Journal	African Journal of Disability
Volume	14
DOIs	https://doi.org/10.4102/ajod.v14i0.1508
Publication status	Published - 2025

Keywords

discrimination
implementation lessons
inclusion
participation
people with disabilities
people with mental health conditions
stigma

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.4102/ajod.v14i0.1508

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@article{611becdc02c94cd4aae87766ffaf90e6,

title = "Stigma reduction in a disability and mental health programme in Ghana: Lessons in participation",

abstract = "Background: Stigma is a barrier to inclusion for people with disabilities and mental health conditions. There is increasing recognition of the need to address stigma within disability inclusive programmes, but limited research is available on what are effective participatory approaches to stigma reduction interventions. Objectives: (1) To document participatory approaches used in the design and delivery of disability stigma reduction interventions in a disability and mental health programme in Ghana and (2) to understand the experience of programme implementers and participants in these processes, with particular attention to the leadership and involvement of people with disabilities. Method: A mixed-methods study was conducted. The data were drawn from a purposive sample of 20 in-depth interviews (IDIs) with programme staff, partners and key stakeholders, and 12 focus group discussions (FGDs) with self-help group (SHG) members, organisation of people with disabilities (OPD) members, and disability champions. We conducted thematic analysis using deductive and inductive approaches. Results: The programme adopted several approaches to participation at design and implementation stages, with a focus on the leadership of people with disabilities and people with mental health conditions. The process was seen to promote acceptability of stigma reduction approaches. Providing opportunities for building and strengthening relationships with a wide range of stakeholders was key to successful implementation. Understanding, and engaging with, power dynamics in the local context also provided important benefits. Conclusions: Participation of people with disabilities and mental health conditions is essential for the design and delivery of stigma reduction programmes in Ghana. Contribution: This study provided lessons from the field on the value of participation in reducing stigma, and the role of key stakeholders, particularly people with disabilities and mental health conditions.",

keywords = "discrimination, implementation lessons, inclusion, participation, people with disabilities, people with mental health conditions, stigma",

author = "Maria Zuurmond and Augustina Naami and Lyla Adwan-Kamara and Cathy Stephen and Sapana Basnet and Caroline Vanderick and Mohammed Chantimah and Asamoah, {Abigail Nana} and Daisy Macdonald and Crick Lund",

note = "Publisher Copyright: {\textcopyright} 2025. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.",

year = "2025",

doi = "10.4102/ajod.v14i0.1508",

language = "English",

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T1 - Stigma reduction in a disability and mental health programme in Ghana

T2 - Lessons in participation

AU - Zuurmond, Maria

AU - Naami, Augustina

AU - Adwan-Kamara, Lyla

AU - Stephen, Cathy

AU - Basnet, Sapana

AU - Vanderick, Caroline

AU - Chantimah, Mohammed

AU - Asamoah, Abigail Nana

AU - Macdonald, Daisy

AU - Lund, Crick

PY - 2025

Y1 - 2025

N2 - Background: Stigma is a barrier to inclusion for people with disabilities and mental health conditions. There is increasing recognition of the need to address stigma within disability inclusive programmes, but limited research is available on what are effective participatory approaches to stigma reduction interventions. Objectives: (1) To document participatory approaches used in the design and delivery of disability stigma reduction interventions in a disability and mental health programme in Ghana and (2) to understand the experience of programme implementers and participants in these processes, with particular attention to the leadership and involvement of people with disabilities. Method: A mixed-methods study was conducted. The data were drawn from a purposive sample of 20 in-depth interviews (IDIs) with programme staff, partners and key stakeholders, and 12 focus group discussions (FGDs) with self-help group (SHG) members, organisation of people with disabilities (OPD) members, and disability champions. We conducted thematic analysis using deductive and inductive approaches. Results: The programme adopted several approaches to participation at design and implementation stages, with a focus on the leadership of people with disabilities and people with mental health conditions. The process was seen to promote acceptability of stigma reduction approaches. Providing opportunities for building and strengthening relationships with a wide range of stakeholders was key to successful implementation. Understanding, and engaging with, power dynamics in the local context also provided important benefits. Conclusions: Participation of people with disabilities and mental health conditions is essential for the design and delivery of stigma reduction programmes in Ghana. Contribution: This study provided lessons from the field on the value of participation in reducing stigma, and the role of key stakeholders, particularly people with disabilities and mental health conditions.

AB - Background: Stigma is a barrier to inclusion for people with disabilities and mental health conditions. There is increasing recognition of the need to address stigma within disability inclusive programmes, but limited research is available on what are effective participatory approaches to stigma reduction interventions. Objectives: (1) To document participatory approaches used in the design and delivery of disability stigma reduction interventions in a disability and mental health programme in Ghana and (2) to understand the experience of programme implementers and participants in these processes, with particular attention to the leadership and involvement of people with disabilities. Method: A mixed-methods study was conducted. The data were drawn from a purposive sample of 20 in-depth interviews (IDIs) with programme staff, partners and key stakeholders, and 12 focus group discussions (FGDs) with self-help group (SHG) members, organisation of people with disabilities (OPD) members, and disability champions. We conducted thematic analysis using deductive and inductive approaches. Results: The programme adopted several approaches to participation at design and implementation stages, with a focus on the leadership of people with disabilities and people with mental health conditions. The process was seen to promote acceptability of stigma reduction approaches. Providing opportunities for building and strengthening relationships with a wide range of stakeholders was key to successful implementation. Understanding, and engaging with, power dynamics in the local context also provided important benefits. Conclusions: Participation of people with disabilities and mental health conditions is essential for the design and delivery of stigma reduction programmes in Ghana. Contribution: This study provided lessons from the field on the value of participation in reducing stigma, and the role of key stakeholders, particularly people with disabilities and mental health conditions.

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KW - implementation lessons

KW - inclusion

KW - participation

KW - people with disabilities

KW - people with mental health conditions

KW - stigma

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DO - 10.4102/ajod.v14i0.1508

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VL - 14

JO - African Journal of Disability

JF - African Journal of Disability

M1 - a1508

ER -

Stigma reduction in a disability and mental health programme in Ghana: Lessons in participation

Abstract

Keywords

UN SDGs

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