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Qualitative Health Research
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Power Brokering, Empowering, and Educating: The Role of Home-Based Care Professionals in the Reduction of HIV-Related Stigma in Kenya

Heather Waterman

University of Manchester

Jane Griffiths

University of Manchester

Len Gellard

University of Manchester

Catherine O'Keefe

Mildmay International

Grace Olang

Mildmay International-Kenya

James Ayuyo

Mildmay International-Kenya

Elly Obwanda

Nyanza Provincial Medical Office

Vitalis Ogwethe

Nyanza Provincial Medical Office

Joshua Ondiege

Nyanza Provincial Medical Office

In this article the authors report on how home-based care (HBC) professionals reduce stigmatizing behavior in Kenya. This study was part of an action research project that evaluated the introduction of HBC. HBC professionals coordinate the delivery of HIV/AIDS services at a district level and educate community-based health workers in HBC. Understanding how HBC professionals reduce stigma is crucial to reduce, prevent, and treat HIV/AIDS. Fifty HBC professionals participated in 27 focus group interviews over 18 months. Stigma featured strongly when they discussed barriers to the introduction of HBC. Using sociological theory, the authors organized the data into five themes: Power broking and mobilization, Stigma as a social construction, Community and structural interventions, Educating and training people, and Historical context. The HBC professionals appear to operate at mostly individual and community levels in their efforts to challenge stigma, and in spite of the difficulties they appear to be having some impact.

Key Words: HIV/AIDS • primary care • social inequalities • home-based care • nursing • stigma

Qualitative Health Research, Vol. 17, No. 8, 1028-1039 (2007)
DOI: 10.1177/1049732307307524
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