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 Knowledge Mobilization 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.

TB information resources are available in multiple languages at RIOMIX.caEnter 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.

Activities & Presentations

September 2021 – The Tackling TB Stigma project was presented as a virtual poster presentation at the North American Refugee Health Conference. That presentation can be viewed here: TB Stigma Project Presentation (YouTube video)

The project was also featured in an episode of Tenfold, a podcast about community engagement and health, an initiative of the National Collaborating Centre for Determinants of Health. Here, the focus of discussion was hearing from Project Leads (Jessica Kwan and Shafeeq Armstrong) and the Knowledge Mobilization & Social Action Coordinator (Miranda Saroli) around how the community was engaged in the process, and what was learned from it. The episode, Engaging Communities in Research: the Tackling TB Stigma project, is available on Spotify or at

October 2021 – This work was featured as part of a broader panel discussion around the relationship between stigma and health (examined from the perspectives of TB, HIV/AIDS, addictions, cervical cancer, and trans care) during Community Health & Wellbeing Week 2021 (October 4-11). Panelists working in each of these areas (including one Project lead from our own Tackling TB Project team – Tujuanna Austin) discussed the impact/effects of stigma on clients and communities, as well as strategies and practices that can address stigma: Tackling Stigma, the Unresolved Barrier to Good Health: A Panel DiscussionYouTube video, slide deck

June 2022 – Featured in Panel discussion at Alliance for Healthier Communities Conference – ‘Challenging Stigma as a Multifaceted Barrier to Health’, where panelists discussed concrete strategies to address stigma within and across health issues. The goal of the session was to raise awareness of the impact of stigma on health, and explore actions to challenge it. Panelists included: Tujuanna Austin (Hub and Satellite Manager, Unison Health and Community Services), Nadine Sookermany (Executive Director, Fife House Foundation), Amrita Daftary (Associate Professor, School of Global Health, York University); moderated by Cliff Ledwos (Associate ED, Director of Primary Care at Access Alliance).

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 Funder

This initiative was funded by The Public Health Agency of Canada

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