Building stigma into your results framework

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Good monitoring, evaluation and learning (MEL) starts with effective planning and a clear theory of change (ToC), as detailed in section 3 of this guidance.

You can then build on your ToC to consider how stigma reduction should be monitored in your logframe, or through the project’s learning questions or evaluation approach. There are different approaches to measurement, and this needs to be clearly articulated in your approach to MEL.

The guidance here is in line with good practice for any MEL, but we highlight specific examples for understanding and capturing changes in stigma and discrimination.

Monitoring and evaluating stigma can be conducted at different times in the project process, and for different purposes.

Note for Sightsavers staff

When planning a project, please ensure that the measurement approach is documented in the MEL plan. The plan will include key documents related to the project’s monitoring, evaluation and learning approach, and it outlines what data will be collected, why, when, how and by whom.

Some data collection approaches may need more expertise and/or budget allocation, so will require early discussions to build this into your plan and budget.

You can consider integrating stigma into project learning questions. Additional data collection or a research may be considered, in which case this needs to be discussed with the relevant teams and adequate resources allocated. When considering logframe indicators, please consult with the MEL project lead, and link back to the indicator reference guide (Sightsavers staff only).

What elements of stigma can be recorded and monitored?

Monitoring and evaluating stigma can be conducted at different times in the project process, and for different purposes.

Level of stigma

This details changes in frequency and nature of stigmatising behaviours at certain points in a project (ie at baseline, midline, endline or afterwards). It can be useful to consider which types of stigma are most relevant for your project.

Coverage of stigma reduction activities

This captures who is exposed to the stigma reduction activities, and can detail the frequency of exposure (for example, how often home visits are made or how frequently a radio play is aired).

Individual change

This details the impact of stigma on the lives of individuals, which may include measuring internalised stigma (ie changes in a person’s confidence over a project lifetime). It can be valuable to explore what contributed to change and how that links to the ToC. What you want to explore will need to be unpacked, depending on the context and ToC.

Social stigma in the family/community

This captures changes in social stigma in communities and families. This can look at changes in knowledge and attitudes but importantly should also capture any changes in behaviour and practice. For example, assessing changes levels of representation and participation of people with disabilities in community structures.

Structural stigma

This will capture changes at an institutional and/or policy level. Examples might include adopting a new workplace policy, or changing the level of resourcing to improve public services for people affected by disability related stigma,

Additional considerations

In some project contexts it may also be important to consider stigma by association, for example, assessing stigma experienced by a caregiver, and whether that changes over time.

Building stigma into a results framework

Below we provide examples of change areas and indicators that you can be built into your results framework, logframe or MEL plan.

The aim of this information is to give you a flavour of how to embed stigma, and illustrative examples are given for different thematic areas. This is not a blueprint, as this will vary widely by project and context. Project indicators are not the only place to measure stigma, so you should consider alternatives such as embedding stigma in your approach to evaluation (mid or end term) or in project learning questions.

The examples below are illustrations, and you will always need to unpack change statements, outcomes and indicators so they are tailored to your project.

Thematic areas

Economic empowerment

Example of areas of change

Change in stigma in the workplace or in vocational training.

Example indicators

Quantitative: Number and % of employers who address stigma in the workplace with actions taken: ie changes to workplace policies.
The number and percentage of project participants with disabilities who report feeling supported by their families to undertake vocational training.
Assesses changes in social and structural stigma.
Examples of data sources: Employer assessment tools, ie workplace survey, which includes questions on stigma and discrimination.

Qualitative: People with disabilities report improvements in inclusion, including reduction in experiences of stigma in the workplace.
Examples of data sources: In-depth interviews or focus group discussions with people with disabilities.

Inclusive health

Example of areas of change 1

Barriers (including stigma) are reduced for people with disabilities, especially women, accessing family planning services.

Example indicators

Quantitative: Number of people with disabilities who are accessing family planning services.
Examples of data sources: Health service records.

Qualitative: Reported change in quality of services, including a reduction in stigmatising health worker attitudes experienced.
Assesses changes in structural, social and internalised stigma, and the views of different stakeholders on what has contributed to that.
Examples of data sources: In-depth interviews and focus group discussions with health service providers and people with disabilities.

Example of areas of change 2

Change in stigma around spectacle wearing in girls (social and internalised stigma with a gendered dimension).

Example indicators

Quantitative: The number and % of school age girls who feel comfortable wearing spectacles at school.
Examples of data sources: Survey.

Qualitative: Reported changes in how comfortable school age girls are to wear spectacles at school.
Examples of data sources: Key informant interviews, focus group discussions, vignettes, storytelling.

Inclusive education

Example of areas of change

Changes in stigma related to the right to access inclusive education.

Example indicators

Quantitative: Number and % of parents who believe in the right of children with disabilities to access education.
Number and % of children with disabilities who report experiences of bullying at school (boys, girls).
Examples of data sources: Survey to parents, teachers and learners.

Qualitative: Children report changes in level of support from parents and caregivers.
Children with disabilities report changes in enjoying school (boy, girls).
Explores changes in social stigma, stigma by association and internalised stigma.
Examples of data sources: Quality of life/wellbeing tool; in-depth interviews or participatory tools (such as vignettes, storytelling etc).

Note: Attention to ethical issues is required when conducting MEL/research with children.

Inclusive citizenship

Example of areas of change

Local governance and development processes are more inclusive and accessible to people with disabilities. Men and women with disabilities feel able to meaningfully participate in governance systems and development processes.

Example indicators

Quantitative: Number of local government organisations with people with disabilities in leadership positions.
Number and % of OPDs demonstrating an increase in the participation of men, women and young people with disabilities in national and regional decision-making processes.
Assesses changes in social and structural stigma.
Examples of data sources: Tools that assess levels of participation in relation to inclusive local development (ILD).

Qualitative: Change in the confidence of project participants to take up leadership positions.
Explores changes in social stigma, internalised stigma and structural stigma.
Examples of data sources: Most Significant Change stories with community leadership and people with disabilities; participation tool (measurement of level of participation).