Infectious Diseases related stigma among Health Care Workers in Zambia- A Mixed Methods Analysis

Abstract

Background: Infectious diseases such as cholera and COVID-19 have had significant global consequences, straining healthcare systems, disrupting daily life, and causing substantial socio-economic challenges. Beyond their direct health effects, stigmatization of patients, their contacts, and healthcare workers has emerged as a critical issue. Healthcare workers, often perceived as sources of infection, face stigma that can lead to severe psychological and social consequences. While stigma during infectious disease outbreaks has been studied in other contexts, this study examines its impact on healthcare workers in Zambia. The objective was to assess the extent of infectious disease-related stigma experienced by healthcare workers and its effects on their psychological and social well-being.

Methods: A mixed-methods study utilizing a descriptive cross-sectional design was conducted. A total of 384 participants were conveniently sampled from purposively selected health facilities. Quantitative data were collected through structured, self-administered questionnaires, while qualitative data were obtained through in-depth interviews guided by a structured interview protocol. Quantitative analysis was performed using SPSS version 27, employing chi-square and logistic regression at a significance level of 5 percent. Qualitative data were analysed thematically.

Results: The study found that 70.2 percent of healthcare workers experienced infectious disease-related stigma, with 20.1 percent reporting severe stigma. The department in which healthcare workers were stationed significantly influenced the level of stigma encountered (p < 0.05). The primary sources of stigma were the community (60%), family (25%), and self-perception (15%). Healthcare workers adopted coping mechanisms such as faith in God (65%), positive thinking (50%), and the belief that increased public sensitization and education on cholera and COVID-19 would improve attitudes.

Conclusion: Infectious disease-related stigma substantially affects healthcare workers, particularly those assigned to cholera and COVID-19 isolation centres. This stigma contributes to psychological distress, increased stress levels, and reduced job satisfaction. The findings highlight the need for targeted interventions to mitigate stigma, enhance public knowledge of disease prevention, and provide emotional and social support for healthcare workers.