A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study*
AbstractThis study assessed the effectiveness of a school-based stigma-reduction intervention focusing on stigmatising attitudes towards girls associated with abortion and contraceptive use. In February 2017, two gender-mixed secondary schools (n = 1368) in peri-urban areas of Kisumu County, Kenya,...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-12-01
|
| Series: | Sexual and Reproductive Health Matters |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/26410397.2021.1881208 |
| _version_ | 1797894128644653056 |
|---|---|
| author | Marlene Makenzius Ulrika Rehnström Loi Beatrice Otieno Monica Oguttu |
| author_facet | Marlene Makenzius Ulrika Rehnström Loi Beatrice Otieno Monica Oguttu |
| author_sort | Marlene Makenzius |
| collection | DOAJ |
| description | AbstractThis study assessed the effectiveness of a school-based stigma-reduction intervention focusing on stigmatising attitudes towards girls associated with abortion and contraceptive use. In February 2017, two gender-mixed secondary schools (n = 1368) in peri-urban areas of Kisumu County, Kenya, were assigned to receive either an 8-hour stigma-reduction intervention over four sessions (intervention school: IS) or standard comprehensive sexuality education (control school: CS). A classroom survey entailing two five-point Likert scales – the 18-item Adolescents Stigmatizing Attitudes, Beliefs and Actions (ASABA) scale, which measures abortion stigma, and the seven-item Contraceptive Use Stigma (CUS) scale – was conducted to collect data at baseline, 1-month and 12-months after the intervention. The intervention was to be considered effective if a mean score reduction of 25% was achieved for both the ASABA (primary outcome) and the CUS (secondary outcome) at the IS between baseline and 12-month follow-up. 1207 (IS = 574; CS = 633) students were included in analyses at 1-month follow-up, and 693 (IS = 323; CS = 370) at 12-months (the final-year students had left school). A decrease in mean score on both scales was observed at 1-month at both schools. At 12-months, the score decrease was 30.1% at the IS and 9.0% at the CS for ASABA, and 27.3% at the IS and 7.9% at the CS for CUS. At the IS, the score decrease for ASABA between baseline and 12-months was 23.3% among girls and 31.2% among boys; for CUS, the decrease was 27.3% and 24.3%, respectively. ASABA and CUS were positively correlated (r = 0.543; p < 0.001), implying a broader perspective on reproductive stigma. A four-session, school-based stigma-reduction intervention could lead to transformed values and attitudes towards gender norms among adolescents regarding abortion and contraceptive use. Stigma associated with abortion and contraception should become a priority for high-quality CSE programmes. |
| first_indexed | 2024-04-10T07:05:01Z |
| format | Article |
| id | doaj.art-7960c9548fbb4f84b3171e3e0fcd0055 |
| institution | Directory Open Access Journal |
| issn | 2641-0397 |
| language | English |
| last_indexed | 2024-04-10T07:05:01Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Sexual and Reproductive Health Matters |
| spelling | doaj.art-7960c9548fbb4f84b3171e3e0fcd00552023-02-27T09:51:01ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972023-12-0131110.1080/26410397.2021.1881208A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study*Marlene Makenzius0Ulrika Rehnström Loi1Beatrice Otieno2Monica Oguttu3Researcher, Department of Women’s and Children’s Health, and the Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.Researcher, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, SwedenProject Officer, Kisumu Medical Education Trust (KMET), Kisumu, KenyaExecutive Director, Kisumu Medical Education Trust (KMET), Kisumu, KenyaAbstractThis study assessed the effectiveness of a school-based stigma-reduction intervention focusing on stigmatising attitudes towards girls associated with abortion and contraceptive use. In February 2017, two gender-mixed secondary schools (n = 1368) in peri-urban areas of Kisumu County, Kenya, were assigned to receive either an 8-hour stigma-reduction intervention over four sessions (intervention school: IS) or standard comprehensive sexuality education (control school: CS). A classroom survey entailing two five-point Likert scales – the 18-item Adolescents Stigmatizing Attitudes, Beliefs and Actions (ASABA) scale, which measures abortion stigma, and the seven-item Contraceptive Use Stigma (CUS) scale – was conducted to collect data at baseline, 1-month and 12-months after the intervention. The intervention was to be considered effective if a mean score reduction of 25% was achieved for both the ASABA (primary outcome) and the CUS (secondary outcome) at the IS between baseline and 12-month follow-up. 1207 (IS = 574; CS = 633) students were included in analyses at 1-month follow-up, and 693 (IS = 323; CS = 370) at 12-months (the final-year students had left school). A decrease in mean score on both scales was observed at 1-month at both schools. At 12-months, the score decrease was 30.1% at the IS and 9.0% at the CS for ASABA, and 27.3% at the IS and 7.9% at the CS for CUS. At the IS, the score decrease for ASABA between baseline and 12-months was 23.3% among girls and 31.2% among boys; for CUS, the decrease was 27.3% and 24.3%, respectively. ASABA and CUS were positively correlated (r = 0.543; p < 0.001), implying a broader perspective on reproductive stigma. A four-session, school-based stigma-reduction intervention could lead to transformed values and attitudes towards gender norms among adolescents regarding abortion and contraceptive use. Stigma associated with abortion and contraception should become a priority for high-quality CSE programmes.https://www.tandfonline.com/doi/10.1080/26410397.2021.1881208abortionadolescentscontraceptionKenyasexuality educationstigma |
| spellingShingle | Marlene Makenzius Ulrika Rehnström Loi Beatrice Otieno Monica Oguttu A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study* Sexual and Reproductive Health Matters abortion adolescents contraception Kenya sexuality education stigma |
| title | A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study* |
| title_full | A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study* |
| title_fullStr | A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study* |
| title_full_unstemmed | A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study* |
| title_short | A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study* |
| title_sort | stigma reduction intervention targeting abortion and contraceptive use among adolescents in kisumu county kenya a quasi experimental study |
| topic | abortion adolescents contraception Kenya sexuality education stigma |
| url | https://www.tandfonline.com/doi/10.1080/26410397.2021.1881208 |
| work_keys_str_mv | AT marlenemakenzius astigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy AT ulrikarehnstromloi astigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy AT beatriceotieno astigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy AT monicaoguttu astigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy AT marlenemakenzius stigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy AT ulrikarehnstromloi stigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy AT beatriceotieno stigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy AT monicaoguttu stigmareductioninterventiontargetingabortionandcontraceptiveuseamongadolescentsinkisumucountykenyaaquasiexperimentalstudy |