Ebola-related stigma in Ghana: Individual and community level determinants

•Ebola-related stigma exists and undermines efforts towards re-integrating survivors.•Very few studies have explored what contributes to such stigmatizing behaviors.•We examine individual- and community-level factors affecting Ebola-related stigma.•Individual- and community-level factors are significant predictors of stigma in Ghana.•Multi-level interventions are needed in addressing Ebola-related stigma in Ghana.

RationaleAlthough Ebola-related stigmatization continues to undermine efforts to re-integrate survivors, few studies have examined what influences such stigmatizing attitudes.ObjectiveThis paper explores the effects of both individual- and community-level factors on Ebola-related stigma in Ghana.MethodsData were collected from a cross-section of 800 respondents, nested within 40 communities in the Greater Accra Region of Ghana. Multi-level modelling was employed for analysis.ResultsBoth individual- and community-level factors were significant determinants of stigma. Respondents who endorsed myths about Ebola were significantly more likely to also endorse Ebola-related stigma. Similarly, those who were worried about a potential outbreak of Ebola in the future, had moderate risk perceptions of contracting Ebola, had primary and secondary education, and were not confident of the quality of health care in the event of an outbreak, were more likely to endorse Ebola-related stigma. Knowledge of Ebola was significant at the community level, but not at the individual level. Communities with more knowledge were less likely to endorse Ebola-related stigma.ConclusionsThese findings underscore the need to increase the knowledge base while countering myths that undermine preventive behaviours to fight Ebola-related stigma. It is equally important to adopt multi-level interventions that emphasize community-based strategies.