Nayar Usha S, Stangl Anne L, De Zalduondo Barbara, Brady Laura M
a Tata Institute of Social Sciences , Mumbai , India.
J Health Commun. 2014;19 Suppl 1(sup1):142-63. doi: 10.1080/10810730.2014.930213.
The social processes of stigmatization and discrimination can have complex and devastating effects on the health and welfare of families and communities, and thus on the environments in which children live and grow. The authors conducted a literature review to identify interventions for reducing the stigma and discrimination that impede child health and well-being in low- and middle-income countries, with a focus on nutrition, HIV/AIDS, neonatal survival and infant health, and early child development. Despite broad consensus on the importance of stigma and discrimination as barriers to access and uptake of health information and services, the authors found a dearth of research and program evaluations directly assessing effective interventions in the area of child health except in the area of reducing HIV-related stigma and discrimination. While the literature demonstrates that poverty and social exclusion are often stigma-laden and impede adult access to health information and services, and to education relevant to family planning, child rearing, nutrition, health promotion, and disease prevention, the child health literature does not document direct connections between these known mediators of child health and the stigmatization of either children or their caregivers. The child health field would greatly benefit from more research to understand and address stigma as it relates to child health and well-being. The authors suggest applying a framework, adapted from the HIV stigma field, to direct future research and the adaptation of existing strategies to reduce HIV-related stigma and discrimination to address social and health-related stigmas affecting children and their families.
污名化和歧视的社会过程可能会对家庭和社区的健康与福祉产生复杂且具有破坏性的影响，进而影响儿童生活和成长的环境。作者进行了一项文献综述，以确定在低收入和中等收入国家减少阻碍儿童健康和福祉的污名化与歧视的干预措施，重点关注营养、艾滋病毒/艾滋病、新生儿存活和婴儿健康以及幼儿发育。尽管人们普遍认为污名化和歧视是获取和利用健康信息及服务的障碍，但作者发现，除了减少与艾滋病毒相关的污名化和歧视领域外，直接评估儿童健康领域有效干预措施的研究和项目评估非常匮乏。虽然文献表明，贫困和社会排斥往往充满污名，阻碍成年人获取健康信息和服务，以及获取与计划生育、育儿、营养、健康促进和疾病预防相关的教育，但儿童健康文献并未记录这些已知的儿童健康调解因素与儿童或其照顾者污名化之间的直接联系。儿童健康领域将从更多旨在理解和解决与儿童健康和福祉相关的污名化问题的研究中受益匪浅。作者建议应用一个从艾滋病毒污名领域改编而来的框架，来指导未来的研究，并调整现有的减少与艾滋病毒相关的污名化和歧视的策略，以应对影响儿童及其家庭的社会和健康相关污名。
