149 Investigating stigma and discrimination faced by burn patients in health facilities in India

<h3>Background</h3> Burn injuries are a significant global public health concern, particularly in low- and- middle-income countries like India. These patients often encounter economic hardships, vocational limitations, and social exclusion even before sustaining their injuries. The resulting disfigurement, disability, and scarring from burns lead to heightened social stigma and discrimination, exacerbating mental health concerns among survivors. However, no research has been conducted that explores this phenomenon in health facility settings. <h3>Objective</h3> To investigate the occurrence and manifestations of stigma and discrimination experienced by burn survivors within healthcare facilities and social settings in India. Methods- This qualitative inquiry was conducted between February 2023 and January 2024 in Uttar Pradesh, India, and involved 18 face-to-face semi-structured in-depth interviews. Participants were selected through purposive sampling and included burn patients, healthcare providers, and legal professionals advocating for burn survivors. In addition, the body mapping methodology was conducted over five sessions involving eight survivors of burns, complemented by two focus group discussions. The findings were triangulated, and thematic analysis was used to analyze the data. <h3>Results</h3> Analysis revealed three key themes. The first theme, ‘Structural and systemic challenges’ highlights institutional barriers such as staff stress, resource constraints, funding limitations, and the absence of guidelines. The second theme of ‘Interpersonal dynamics between patients and providers’ explores patient-provider interactions, including moral judgment over injury, and instances of physical and mental abuse. Lastly, the third theme, ‘Chronic consequences of burns’ examines the long-term impact of burns on patients seeking follow-up care and their social reintegration into society. <h3>Conclusion</h3> This study provides crucial insights into the multifaceted challenges of stigma and discrimination faced by burn patients within healthcare facilities and post their discharge in India. There is an urgent need for reform within the health systems by the development of policies and guidelines around discrimination-free healthcare, strengthening public-sector burn care, enhancement of rehabilitation services, and greater focus on the social reintegration of burn survivors. Implementation of such welfare and social justice approaches will enable the provision of inclusive and dignified care for burn patients in India.