Ending Stigma and Discrimination: Addressing mental health challenges among COVID-19 survivors and frontline health care workers in Zambia.

Background: Globally, stigma, defined herein as 'the negative association related to people or a group who have a specific disease in common,' has emerged as a significant barrier to an effective COVID-19 response. The unpredictable nature of the virus, associated deaths and containment measures have generated considerable fear leading to stigma and discrimination, both of which have the potential to persist long after the epidemic has passed. With the country currently recording 55,042 cumulative cases and 349 deaths as of 1st February, 2021, addressing the mental health consequences of discrimination directed toward persons infected with, and affected by, COVID-19 can be important in controlling further disease transmission in the country and region. Objective: To understand COVID-19-related stigma among survivors and frontline health care workers in COVID-19 hotspot communities of Zambia. Method: The research will be conducted in three phases to complete 1) formative research, 2) survey on available services and 3) acceptability and feasibility trial. For the formative research, we shall use interpretive phenomenological analysis to gain insights into the psychological experiences of COVID-19 survivors and frontline health care workers in COVID-19 hotspot communities. A self-administered short survey will be used to assess coverage of mental health services available to COVID-19 survivors and frontline HCWs in Lusaka and Nakonde. The COM-B framework will be used to assess the acceptability and feasibility of providing digital technology methods such as mobile phones, Zoom and Skype to provide mental health services to COVID-19 survivors in Lusaka and Nakonde districts of Zambia. Expected Outputs  Understanding of stigma-related mental health by COVID-19 survivors and front-line health care workers.  Mental health services identified in COVID-19 communities.  Comprehensive mental health package developed  Provision of referral services to COVID-19 survivors and front-line workers experiencing any form of stigma, fear, anxiety, and stigma