'Money is the vehicle of interaction': insight into social integration of people affected by leprosy in northern Nigeria.

OBJECTIVE This paper proposes a mechanism by which socio-economic rehabilitation (SER) reduces stigma in northern Nigeria following are-analysis of the transcripts of interviews conducted to evaluate the impact of SER on leprosy-related stigma. DESIGN The evaluation combined quantitative questionnaire (P-scale) with qualitative interviews of 20 individuals affected by leprosy, five focus group discussions and 10 key informant interviews. From our data, we developed a leprosy-related stigma framework by integrating emerging themes with the construct of threat to group functioning to describe stigma processes experienced by people affected by leprosy in northern Nigeria. RESULTS Findings revealed people affected by leprosy are less likely to be stigmatised because of leprosy impairments than for their incapacity to contribute to family/community finances. We also identified micro-credit loans and vocational training as elements of SER for reducing stigma through the mechanism of protecting individuals against the loss of social value, and by facilitating their continued engagement in daily social roles in the family/community. CONCLUSION We propose that SER stimulates attitudinal change towards, and inclusion of people affected by leprosy by protecting individuals against the loss of social value and increasing their contributive capacity. We recommend further empirical testing of the proposed framework to ascertain its utility in other cultures.