Experiences of Gender-Based Stigma and Health Care-Related Outcomes in the African Region: A Scoping Review

Gender-based stigma (GBS) occurs across the globe and harms health and well-being, particularly among women. Yet, there remains a need for synthesized literature to better understand the impact of GBS on health care-related outcomes. Addressing this gap, this scoping review summarizes what is known about GBS and health care-related outcomes among cisgender persons in Africa. We followed Preferred Reporting Items for Systematic Reviews and Meta Analysis extension for Scoping Reviews guidelines to examine the state of evidence related to GBS and health care-related outcomes in African countries. We searched two online electronic databases (PubMed, PsychINFO) for articles published on/before April 20th, 2023. Articles were included if they (a) were published in the English language, (b) reported primary research in Africa, (c) examined GBS at the individual level among cisgender persons, and (d) examined health care-related outcomes. We identified 24 articles for inclusion spanning 14 countries, including 18 qualitative, three quantitative, and three mixed-methods studies. Thematic analyses of qualitative articles identified four overarching themes: GBS is intersectional; differential treatment from societal gender norms and gender role expectations; gendered loss of autonomy and human rights violations in health care; and gender-based violence (GBV). Quantitative findings included that GBV experiences are widespread and may shape health care access, and there are linkages between GBV and HIV. Findings underscore that intersectional, multilevel experiences of GBS impede health care access and rights in the African region across diverse contexts, populations, and health issues. Future research can include additional GBS dimensions and marginalized communities.