Leprosy stigma in the healthcare setting: Lived experiences of persons affected by leprosy in Niger

Leprosy-related stigma is deeply rooted in history and permeates every aspect of society, and stigmatization by healthcare professionals is no exception. This paper explores the experiences of persons affected by leprosy with stigma in the healthcare setting throughout their treatment-seeking journey. We conducted one-on-one interviews with 112 individuals who experienced a leprosy diagnosis and underwent treatment. Data was collected in July and August 2022, in nine villages and one urban neighborhood in the region of Maradi, Niger. Over two-thirds of participants experienced some form of visible impairment due to leprosy. Throughout their treatment-seeking journey, healthcare providers were reported to have stigmatized patients by using hurtful language, isolating patients, physically distancing from patients, or refusing to treat. The extent of the stigmatization depended on, first, whether leprosy was recognized or not. Unfortunately, many healthcare providers did not detect the early signs of leprosy, therefore, patients were then not able to obtain treatment prior to physical impairment. Second, the level of stigmatization varied based on the degree and type of visible physical impairments (e.g., missing fingers or toes, limbs, blindness). These negative experiences with healthcare workers made treatment-seeking and adherence to treatment regimen less likely for patients. Our findings confirm the presence of leprosy stigma in the healthcare context in Niger. Increasing leprosy knowledge and addressing stigma among healthcare professionals is key to early diagnosis and treatment of leprosy.