Annual Report: Challenge TB - Core Measurement Stigma

The project employed a two-phased approach over a four-year period, with Phase 1 focusing on consultation and consolidation of existing platforms and USG investments to harvest available insights on TB stigma. During Phase 1, the project built upon existing platforms and USG investments to synthesize available data on TB stigma. Partnerships were established with TB stigma experts and experts from other fields to identify the most promising and innovative tools and strategies to measure TB stigma and reduce it. The project engaged new partners, including academics, to apply their skills to the problem of measuring TB stigma efficiently while ensuring validity and reliability. Significant strides were made in establishing a track record, publication record, technical network, and niche in the arena of TB stigma measurement. Key achievements included the completion of six new studies on TB stigma measurement methods, which were presented internationally. These studies represented a significant advancement in the TB measurement field, answering basic questions that set the stage for correct measurement tools and methods in the future. The studies provided new knowledge on ways to measure TB stigma, as well as the relationship between TB stigma and HIV stigma, the impact of TB stigma on health-seeking behavior, the distribution of TB stigma across settings, and the correlates of stigma at individual, facility, and country levels. These findings are being synthesized in peer-reviewed manuscripts and will establish CTB and USAID as proactive on these issues. The project also supported various activities, including a prevalence survey review, assessment of the distribution and correlates of anticipated stigma in the general population, assessment of the distribution and correlates of enacted stigma in health care settings, and a systematic literature review of stigma reduction strategies. These activities aimed to develop valid, feasible, and efficient methods for measuring TB stigma and reducing it. Key challenges during implementation included the need to refine and test existing stigma measurement tools in Nigeria, which was later decided to be implemented in Ethiopia in 2016. The project also faced workload, pipeline, and competing priorities, which affected the implementation of certain activities. The project's findings and recommendations will inform the development of valid, feasible, and efficient methods for measuring TB stigma and reducing it. The project's achievements will contribute to the global effort to combat TB stigma and improve TB control efforts.