Assessing drug-resistant tuberculosis stigma among healthcare workers in the Philippines

Assessing drug-resistant tuberculosis stigma among healthcare workers in the Philippines

Drug-resistant tuberculosis (DRTB) presents a growing global public health challenge characterised by increasing incidence, treatment complexities, and financial burden, all exacerbated by disease stigma. This research explores the stigma surrounding DRTB among healthcare workers (HCWs) in the Philippines, utilising a two-part approach: a scoping review and quantitative studies. An online survey was conducted among HCWs (n= 258) from the selected geographic locations in the Philippines between February and June 2022 using the recommended questionnaire from the Mental Health Secondary Stigma Scale. The survey was expanded to assess HCW’s awareness of organisational support, confidence in infection control, and the impact of stigma on stress and absenteeism. The data was analysed using a variety of statistical methods, including descriptive statistics to summarise the main characteristics of the data, multivariable linear regressions to examine the relationships between variables, and the Hayes Process Model to explore mediation and moderation effects of stress and organisational support between stigma and absenteeism. Stigma was found to be consistent across HCWs, the highest among Barangay Health Workers and the lowest among midwives. The impact of stigma subtypes varied among healthcare worker groups. BHWs experienced higher levels of concealing, labelling, and negative effects, while medical laboratory technicians experienced higher levels of fear of infection. Stigma was positively correlated with absenteeism and was substantiated by stigma-induced stress. Awareness of organisational support and confidence in infection control may not fully address existing stigma. These findings highlight the need for targeted interventions to address stigma-related challenges, establish inclusive and supportive environments that prioritise the well-being of HCWs and effectively manage stress, and improve policies and practical solutions to mitigate the effects of the stigma. This research recommends creating a more equitable and compassionate healthcare environment to enhance care delivery and support HCWs. More research is needed to identify further and understand the factors contributing to the DRTB stigma and to ultimately develop more effective stigma-reduction strategies for HCWs.

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