Life course perspectives on experiences of and responses to leprosy-related stigma in Western Nigeria

Background: In recent years, there has been a move towards understanding the processes underlying stigmatization of leprosy, a move that has come from programme implementers and researchers alike. Currently, most of what is known about leprosy-related stigma emerges from surveys conducted with health workers, medical and nursing students and the general public. Much of this research employs quantitative questionnaires and/or scales to assess the existence, severity, or both, of stigma in diverse global contexts. Whilst these studies seek evidence-based solutions for ameliorating the negative impacts of stigma, they largely ignore the experiences of persons affected by leprosy and the influence of cultural contexts on stigmatization. Moreover, little attention is given to understanding the political and economic processes which shape stigmatization. Purpose: My research aims to capture the complexity of stigma by investigating the everyday experiences of people affected by leprosy in order to understand how microsocial and macrosocial factors shape stigmatization of leprosy in Yorubaland, western Nigeria. Methods: To establish the sources, severity and persistence of leprosy-related stigma, it. was necessary to trace the global social history of leprosy and how that history has influenced the moral definitions of leprosy and stigmatization in western Nigeria. Fieldwork for the research combined life-history interviews of individuals affected by leprosy with semi-structured interviews of non-affected community members in two Yoruba towns and a sociolinguistic study of the leprosy phenomenon. Theoretical frameworks adopted to deepen my analysis of stigma were: the social model of disability and the concept of structural violelnce. Interpretation: The study provides rich contextual understandings of Yoruba ideas of leprosy and illuminates how culture and macrosocial factors such as colonization, economic/political upheavals and social structures shape people's . diverse experiences and responses to leprosy-related stigma. The study also provides compelling theoretical insights for improving policy and practice.