Autism in Bangladesh: Window for Stigma Removal

Background: Bangladesh is a South East Asian developing country with moderate literacy rate with three leveled health care delivery system. Most of the citizens of Bangladesh live in rural area and devoid of modern approach of technology and also having stigma on health care seeking attitude. Especially the rural person depends on the traditional and religious healers for their behavioral disturbance like autism and other mental condition. There is a common false belief that the autism and other mental disorders are caused by ill spirits and need some measure other than medication. A study revealed more than 50% rural people have faith on traditional healers. This false belief and stigma act as a barrier to promote scientific management for the mental disorders including autism. Though there are a lot of community clinics in grass root level and structured level wise health centers exist the people are more interested to take treatment from spiritual healers.   

Objectives: To change the health seeking behavior of rural people need to create general awareness and mitigate stigma by the advocacy program. Before create the general awareness we need general education and inclusion of autism related topics in school curriculum. Training for the general physicians and other health professionals is a vital component because they are the first contact for the all people in health service. Mass awareness can be creating by using the mass media and using traditional folk songs and drama. There is very important issue to trained the traditional healers and provide them the scientific knowledge about autism and other neurodevelopmental disabilities. To provide ideal service and increase public awareness and reduce stigma the local opinion leaders and religious leaders also need to be trained. Within a specific interval the process evaluation should be conducted.

Methods: Country will divided into multiple clusters and from each clusters a significant number of primary care physicians, traditional healers, opinion leaders and religious leaders will be included into the training. By using the existing health facilities and the manpower the training will be conducted in tertiary care institutes like National Institute of Mental Health (NIMH) and Center for Neurodevelopment and Autism for Children (CNAC). Training modules and manual should be in native language and folk songs and drama also used for training.

Results: N/A

Conclusions: Social stigma and lack of awareness is the main barrier to provide appropriate service for autism spectrum disorders. By generating public awareness through training, advocacy, cultural activities and using the mass media the current scenario should be changed.  Bangladesh will be create  an example for the low resource countries that how to develop coordinated multidiciplinary services and social inclusion of the people with autism.