Stigma, marginalization and psychosocial well-being of orphans in Rwanda: exploring the mediation role of social support

Abstract

Stigma and marginalization are one of the major challenges orphans face in their daily lives, particularly in developing countries, but little is known about their impacts on mental health. This study examines how orphan-related characteristics, stigma and marginalization are associated with psychosocial well-being. It further analyses the role of social support in mediating between stigma and marginalization and mental health, indicated by emotional well-being and mental distress. The participants in this study were 430 Rwandan orphans who were 10-25 years of age, and of whom 179 were females and 251 were males. Results showed that high levels of stigma and marginalization were associated with a lower level of emotional well-being and higher levels of mental distress. A mediation analysis indicated that low level of social support due to stigma and marginalization contributed significantly to low level of emotional well-being. Once stigma, marginalization and social support were fully accounted for, AIDS orphans exhibited higher levels of mental distress than those who were orphaned by genocide or other causes. Future interventions designed to reduce stigma and marginalization for orphans and actions that facilitate social support can significantly improve emotional well-being and reduce mental distress among orphans.

Stigma and illness uncertainty: adding to the burden of sickle cell disease

“…Studies are also needed to understand why women face higher levels of illness uncertainty and gender-specific strategies may need to be developed to reduce the same. Higher levels of social support can mitigate against both stigma [66] and illness uncertainty [22] Family and other personal support networks can assist a person to make better sense of their illness; peersupport can assist in coping and undermining their stigma experiences; and structural factors, such as more accessible quality healthcare services can improve patients' healthcare experiences and reduce adverse outcomes.…”

Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health—An integrative review

“…The cumulative outcome of these conditions is increased economic burden that results in increased vulnerability among the marginalized group. That is, the victims of marginalization are deprived of health promoting SDH such as social support and access to care (Caserta, Pirttila-Backman, & Punamaki, 2016). …”

The Relationships of Self-Esteem, Future Time Perspective, Positive Affect, Social Support, and Career Decision: A Longitudinal Multilevel Study

“…Thus, those who perceive their social relations as supportive are very likely to experience good results in life ( Cohen and Wills, 1985 ). On the other hand, the perception of low social support not only lowers emotional well-being but also brings about mental health problems ( Caserta et al, 2016 ).…”