Assessing the impact of the twin track socio-economic intervention on reducing leprosy-related stigma in Cirebon District, Indonesia

Dadun Dadun*, Ruth M.H. Peters, Wim H. van Brakel, Joske G.F. Bunders, Irwanto Irwanto, Barbara J. Regeer

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


The consequences of leprosy go beyond the physical, social and psychological, as leprosy can drive persons affected and their families into poverty, stigmatization and disability. This paper describes the impact of a socio-economic development (SED) intervention that uses a twin-track approach (two micro-credit models) to reduce leprosy-related stigma in Cirebon District, Indonesia. A randomized-controlled mixed-methods study design was used to test the effectiveness of the SED intervention. Three scales were used to measure stigma and participation restrictions among 30 SED clients and 57 controls, 20 in-depth interviews with SED clients and seven Focus Group Discussions (FGDs) with key persons were held and 65 profiles of the clients were written up and analysed. The qualitative data shows the socio-economic status of 44 out of 65 SED clients (67%) improved. The median family income increased by 25%, more clients reported higher self-esteem, better interaction with neighbours and less stigma than before, although disclosure concerns remained an issue. The scales indicate a positive effect of the intervention on reducing stigma (e.g., Stigma Assessment and Reduction of Impact (SARI) stigma scale mean difference total score of pre and post assessment for SED clients versus the control group was 8.5 versus 5.6). A twin track socio-economic intervention, if embedded and integrated, can increase participation, and be constructive in reducing leprosy-related stigma.

Original languageEnglish
Article number349
JournalInternational Journal of Environmental Research and Public Health
Issue number3
Publication statusPublished - 1 Feb 2019


This study was funded by Netherland Leprosy Relief (NLR), Sasakawa Memorial Health Foundation (SMHF), the American Leprosy Missions (ALM), and Effect: Hope.

FundersFunder number
Sasakawa Memorial Health Foundation
Netherlands Leprosy Relief
American Leprosy Missions
Sasakawa Memorial Health Foundation


    • Disability
    • Indonesia
    • Leprosy
    • Socio economic
    • Stigma
    • Twin track approach


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