PhD Defence Anna van ‘t Noordende

In this thesis we studied the perception of leprosy, interventions to change these perceptions, and interventions to reduce the impact of leprosy at individual and family level. We showed that interventions that focus on the entire family and that aim to strengthen resilience or social support and social connection, have the potential to reduce the impact of leprosy at individual and family level. While these interventions can the reduce the impact of leprosy at individual and family level, they do not target the sources of stigma (public perceptions). We also developed two interventions to change public perceptions of leprosy, based on knowledge gaps, misconceptions, beliefs and fears we identified. These two interventions (contextualised posters and community meetings) were effective in increasing knowledge and changing personal and perceived community attitudes. We identified three main drivers of negative attitudes: (1) poor knowledge and misconceptions about leprosy, (2) local beliefs about leprosy, and (3) fear of contagion. Interventions to change the perception of leprosy should target these drivers taking care to adapt these carefully to the local context.