Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual framework
Background: Widows in sub-Saharan Africa experience stigma linked to their social identity of widowhood. Despite the known significant impacts of stigma on health and wellbeing, widowhood stigma is less conceptualized and studied and its effects on widows' mental, sexual and reproductive health...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | SSM - Mental Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666560325000192 |
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| author | Jackline A. Odhiambo Louisa N. Ndunyu Erick O. Nyambedha Ushma Upadhyay Janet M. Turan Elizabeth Bukusi Nicodemus O. Agumba Craig R. Cohen Sheri D. Weiser |
| author_facet | Jackline A. Odhiambo Louisa N. Ndunyu Erick O. Nyambedha Ushma Upadhyay Janet M. Turan Elizabeth Bukusi Nicodemus O. Agumba Craig R. Cohen Sheri D. Weiser |
| author_sort | Jackline A. Odhiambo |
| collection | DOAJ |
| description | Background: Widows in sub-Saharan Africa experience stigma linked to their social identity of widowhood. Despite the known significant impacts of stigma on health and wellbeing, widowhood stigma is less conceptualized and studied and its effects on widows' mental, sexual and reproductive health are not delineated. Methods: We thematically reviewed literature mentioning widowhood stigma and its effects in Africa. Applying the fundamental cause theory to this literature, we developed a widowhood stigma conceptual framework to highlight the domains of widowhood stigma and the pathways through which widowhood stigma impacts mental, sexual and reproductive health outcomes for widows. Results: We identified five domains of widowhood stigma: discriminatory socio-cultural and institutional norms, rituals, policies and laws, negative labelling and stereotyping, loss of social status, social isolation, and perceived, anticipated and internalized stigma. We show how widowhood stigma is a fundamental cause of poor mental, sexual and reproductive health outcomes through multiple pathways: distally through loss of material and social resources such as land disinheritance and lack of social support. Proximal pathways include health risk situations such as sexual exploitation and gender-based violence, maladaptive health and coping behaviors, and reduced access to health care. While several factors, such as a widows' age and educational level, might offer widows resources to resist stigma, other factors, such as intersectional stigma, might worsen the impact of widowhood stigma. Conclusion: Ours is likely the first framework focused on widowhood stigma in sub-Saharan Africa. This framework should assist in research on widowhood stigma and its health impacts, and in designing and evaluating interventions for reducing widowhood stigma and improving widows' health outcomes. |
| format | Article |
| id | doaj-art-9aec2a03ae654225814307c2077bde4e |
| institution | OA Journals |
| issn | 2666-5603 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM - Mental Health |
| spelling | doaj-art-9aec2a03ae654225814307c2077bde4e2025-08-20T02:33:51ZengElsevierSSM - Mental Health2666-56032025-06-01710040710.1016/j.ssmmh.2025.100407Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual frameworkJackline A. Odhiambo0Louisa N. Ndunyu1Erick O. Nyambedha2Ushma Upadhyay3Janet M. Turan4Elizabeth Bukusi5Nicodemus O. Agumba6Craig R. Cohen7Sheri D. Weiser8School of Public Health and Community Development, Maseno University, Kenya; Nyanam Widows Rising, Kisumu, Kenya; Corresponding author. School of Public Health and Community Development, Maseno University, Private Bag, Maseno, Kenya.School of Public Health and Community Development, Maseno University, KenyaDepartment of Sociology and Anthropology, Maseno University, KenyaDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, CA, USADepartment of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, AL, USACentre for Microbiology Research, Kenya Medical Research Institute, KenyaNyanam Widows Rising, Kisumu, KenyaDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, CA, USADivision of HIV, Infectious Disease and Global Medicine, University of California San Francisco, CA, USABackground: Widows in sub-Saharan Africa experience stigma linked to their social identity of widowhood. Despite the known significant impacts of stigma on health and wellbeing, widowhood stigma is less conceptualized and studied and its effects on widows' mental, sexual and reproductive health are not delineated. Methods: We thematically reviewed literature mentioning widowhood stigma and its effects in Africa. Applying the fundamental cause theory to this literature, we developed a widowhood stigma conceptual framework to highlight the domains of widowhood stigma and the pathways through which widowhood stigma impacts mental, sexual and reproductive health outcomes for widows. Results: We identified five domains of widowhood stigma: discriminatory socio-cultural and institutional norms, rituals, policies and laws, negative labelling and stereotyping, loss of social status, social isolation, and perceived, anticipated and internalized stigma. We show how widowhood stigma is a fundamental cause of poor mental, sexual and reproductive health outcomes through multiple pathways: distally through loss of material and social resources such as land disinheritance and lack of social support. Proximal pathways include health risk situations such as sexual exploitation and gender-based violence, maladaptive health and coping behaviors, and reduced access to health care. While several factors, such as a widows' age and educational level, might offer widows resources to resist stigma, other factors, such as intersectional stigma, might worsen the impact of widowhood stigma. Conclusion: Ours is likely the first framework focused on widowhood stigma in sub-Saharan Africa. This framework should assist in research on widowhood stigma and its health impacts, and in designing and evaluating interventions for reducing widowhood stigma and improving widows' health outcomes.http://www.sciencedirect.com/science/article/pii/S2666560325000192Widowhood ritesProperty rightsRemarriageHealth disparitiesHIV/AIDSSocial isolation |
| spellingShingle | Jackline A. Odhiambo Louisa N. Ndunyu Erick O. Nyambedha Ushma Upadhyay Janet M. Turan Elizabeth Bukusi Nicodemus O. Agumba Craig R. Cohen Sheri D. Weiser Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual framework SSM - Mental Health Widowhood rites Property rights Remarriage Health disparities HIV/AIDS Social isolation |
| title | Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual framework |
| title_full | Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual framework |
| title_fullStr | Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual framework |
| title_full_unstemmed | Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual framework |
| title_short | Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa: A conceptual framework |
| title_sort | widowhood stigma as a fundamental cause of poor mental sexual and reproductive health outcomes in sub saharan africa a conceptual framework |
| topic | Widowhood rites Property rights Remarriage Health disparities HIV/AIDS Social isolation |
| url | http://www.sciencedirect.com/science/article/pii/S2666560325000192 |
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