The Impact of Stigma on Access to Addiction Treatment Services in Iringa Municipality: A Case Study of Iringa Sober House

Vollständiger Abstract

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Stigma is widely recognized as a barrier to accessing addiction treatment, yet how internal and external forms of stigma jointly constrain treatment access within community-based rehabilitation settings in Tanzania remains underexplored. This study examined the impact of stigma on access to addiction treatment services in Iringa Municipality, using Iringa Sober House as a case study, guided by two objectives: to examine the impact of internal stigma on treatment access, and to examine the impact of external stigma on treatment access. A qualitative case study design was adopted, drawing on semi-structured interviews, documentary review and focus group discussions with thirty purposively selected participants, comprising fifteen residents, five family members, eight healthcare providers and support staff, and two community leaders. Data were analyzed thematically. Findings showed that internal stigma operated through shame, guilt and self-blame that inhibited disclosure, delayed help-seeking and reduced motivation to sustain treatment. External stigma operated through social rejection, fear of public labelling, institutional barriers within the health system, and continued stigmatization that disrupted recovery and reintegration after discharge. The study concludes that stigma functions as a multi-dimensional barrier constraining access to addiction treatment at every stage, from initial recognition of need to sustained recovery, and that interventions addressing only internal or only external stigma are unlikely to be sufficient without coordinated action across family, community, healthcare and policy domains.