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Tackling TB Stigma

Tackling TB Stigma

Taking a cross sectoral approach, Access Alliance Multicultural Health and Community Services, engaged representatives from primary care, settlement, public health, and community members from three populations to address the issue of stigma and its impact on tuberculosis (TB) care and support.

Our Project Goals and Activities
The overall aim of this initiative was to address the lack of awareness and high levels of stigma attached to TB and increase access to quality resources, support and care for immigrants and refugees in Canada who are living with or who are at risk of acquiring a communicable disease.

Tackling TB Stigma used an inclusive, cross sectoral approach whereby over 150 individuals representing primary care, public health, settlement and newcomers from the three highest risk communities in Toronto were engaged in all phases of the project, especially in the collection and analysis of information and development of the project recommendations. This approach provided the project with many important perspectives and lived experiences to ensure that project recommendations are relevant, evidence-informed and impactful.

A critical aspect of this process was the creation of reference groups who shared experiences, provided direction and feedback, and reviewed information and resources:

  • Three Community Reference Groups (CRGs), composed of newcomers;
  • Two Settlement Agency Reference Groups (SARG), front line staff and managers;
  • A Primary Care Reference Group (PCRG) comprised of nurses, nurse practitioners, physicians from TB Clinics, community health centres (CHCs), a Refugee Health Clinic and Toronto Public Health TB Program;
  • A Project Advisory Committee comprised of representatives from settlement, primary care, public health, education and libraries, as well as academic researchers and policy makers.

What We Found
In our discussions and interactions we found that the current practice and pathway for TB care and support can and must be improved.

The current state of TB care and support does not fully take into account the settlement journey of new populations nor does it consider how stigma and the broader determinants of health impact access to TB care for newcomers. The project confirms that stigma is complex and has a negative impact that can be best understood within a determinants of health framework that takes into consideration the various intersections of stigma in the current state of TB care and support.

The future state would include:

  • newcomers having access to a coordinated continuum of community based resources and interdisciplinary health care that is evidence based, culturally competent and grounded in equity, which requires a system wide intervention composed of education, training, practice, and policy change;
  • supports for newcomers to engage in a stigma free settlement process that includes timely access to interdisciplinary team based primary care and support that addresses health from a holistic model of care. Public health and specialist care would be well connected and accessible within this care and support pathway;
  • emphasizing TB awareness and knowledge among primary care providers, settlement workers, the general public and newcomers from high-incidence countries; enhancing competencies among settlement and health service providers for effectively and equitably working with diverse newcomer populations; and strengthening the relationships and collaboration between IRCC, settlement, primary care, public health and specialists in order to streamline information sharing and referral pathways.

Our Project Team Members
Tackling TB Stigma was led by Access Alliance with a range of partners and participants that included over 21 organizations and 150 people with lived experience from three newcomer populations and professional experience in primary care, public health, specialist care, settlement, education, libraries, research, and policy.

Our Knowledge Translation Activities & Products
For World Tuberculosis Day 2021, we ran a week-long social media campaign to raise awareness of TB and the stigma associated with infectious diseases. This also helped to build interest and momentum for the release of the full report. The report, along with accompanying Fact Sheets and tailored recommendations targeting three stakeholder groups (Health Service Providers, Settlement Service Providers, and Policy Makers), are linked below.

Full report – English

Full report – French 

Fact sheet, Executive Summary – English, French

Fact sheet for Health Service Providers – English, French

Fact sheet for Settlement Service Providers – English, French

Fact sheet for Policy Makers – English, French 

TB Stigma Project Presentation

TB information resources are available in multiple languages at RIOMIX.ca.  Enter as guest and type “tb” in the keyword search field.  New materials are being added each week so please check back in for more TB resources and other health related materials.

Our Funder
This initiative was funded by The Public Health Agency of Canada

For more info contact: TalkToUs@accessalliance.ca