Approaches for assessing stigma change

This will depend on what you’re trying to achieve.

For example, think about which type of stigma you want to assess, or what level of society, and/or if you want to explore how an approach works.

Think about what would work in your context, and also any ethical issues. Stigma can be a sensitive and taboo subject to discuss.

Qualitative approaches, such as in-depth interviews, can help to explore such issues, as they allow you to ask questions openly and sensitively, and sometimes more indirectly.

Combining different data sources (known as ‘triangulation’) can provide more robust evidence about change. For example, when asked in a survey, people often report positive attitude change towards people with disabilities due to ‘social desirability’ bias – which means they want to be seen in a positive light.

To obtain a better picture, for example, you might combine a community survey and conduct interviews with people with disabilities.

Within an inclusive education programme, you are likely to collect routine data on school enrolment (a proxy indicator). But to provide a more complete picture  about whether stigma is reduced, you could adopt participatory approaches to collect data with teachers and parents about stigma, for example.

Again, this needs to link with your theory of change and what makes logical sense. Proxy indicators are very useful, particularly in the absence of more complex measurement approaches.

Examples could include:

1. Changes in school enrolment numbers of learners with disabilities in an inclusive education project, or
2. Numbers of women accessing sexual and reproductive health (SRH) services in an inclusive health project.

These changes are unlikely to be attributable to changes in stigma alone. You will also benefit from gathering some other data to understand the role stigma has played.

Think about what is possible to measure in the timeframe, and what resources (human and budgetary) are available.

For example, monitoring a shift in societal norms around disability will take time. Instead, you might focus on intermediate outcomes that signify progress toward stigma reduction.

For example, if stigmatising language is a key driver of stigma, an intermediate outcome might be a reduction in the use of stigmatising language on the radio. A longer-term outcome could examine changes in community level stigma and increased participation in community life.

Sometimes you may need to adapt your tools.

For example, standard questionnaires often need to be translated and then tested out (piloted) in your setting to ensure they are valid and reliable to use (which means they measure what they are intended to measure). There is usually clear guidance on how best to do this.

Some of the tools may require more expertise or budget to use, so discussions will need to happen early on in the process with relevant monitoring, evaluation and learning (MEL), technical or research teams.