P2B210: Lisilojulikana (The Unknown): The Impact of a Community-based Film Intervention in Addressing Stigma Related to Disability in Western Kenya

Background: In Kenya, an estimated 6.6 million children have a disability and stigma remains a major barrier to health and inclusion. Film-based interventions serve as an effective tool for promoting health education in the community, shown to improve health literacy, reduce stigma, and improve attitudes towards seeking care. This study aims to explore the impact of a narrative film on beliefs and attitudes toward disability in western Kenya.

Methods: Six locations were selected for the film intervention in Uasin Gishu County, Kenya, including Kapyemit, Pioneer, Sergoit, Chuiyat, Olare, and Kapsoya. Village elders and chiefs were invited to screen the film and consulted about who in the community may benefit from the film. These community members were then invited to a movie screening. At each screening, all individuals were registered to get basic demographic information. Up to 20 participants per location were randomized for study recruitment and underwent written consent. Focus-group discussion (FGDs) were conducted before and immediately after the film in the local language to understand attitudes and experiences toward disability. FGDs were audio-recorded, transcribed, and translated. Transcriptions were analyzed using rapid qualitative analysis to identify emerging themes.

Results: A total of 506 community members attended the film screening and 114 were randomly selected for FGDs, as shown in Table 1. In the pre-intervention FGDs, while many participants described their own positive views of persons with disabilities, noting they should be “given love,” “prioritized in society,” and “helped,” the community perception of individuals with disabilities was reportedly negative. Participants described the community characterizing those with disabilities as “ignored,” “overlooked,” “feared,” “cursed,” “unworthy,” “burdensome,” and “difficult for caregivers.” Treatment of persons with disabilities was described as discriminatory, citing lack of accessibility, caregiver abandonment, financial exploitation, and various forms of abuse, including physical, verbal, sexual, and neglect.

In the post-intervention FGDs, most agreed that the narrative film aligned with their own experiences. Overall, the responses to the film were primarily positive, with individuals describing the movie changed their view of persons with disabilities as “a blessing,” “important,” “no different than other children,” and “valuable members of families and communities.” There were mixed responses about the role of extended family in having an obligation to take care of an individual with a disability, but collectively, participants described that the family, community, and government should bring their children out, provide educational opportunities, and should support, protect, and love them. Representative excerpts from both pre- and post-intervention groups are highlighted in Table 2.

Conclusion: The use of a narrative film about stigma and discrimination surrounding disability appeared to align with beliefs of community members in western Kenya. Participants expressed an increased desire for family, community, and government support to address ongoing discrimination in their region.