Stigma surrounding contraceptive use and abortion among secondary school teachers: A cross-sectional study in Western Kenya

OBJECTIVES: Comprehensive sexual education plays an essential role in adolescent sexual and reproductive health and rights (SRHR). The study aim was to investigate Kenyan secondary school teachers’ attitudes toward girls associated with contraceptive use and abortion. STUDY DESIGN: We conducted a cross-sectional study in January 2018 among school teachers (n = 144) at 4 religiously affiliated suburban secondary schools in Kenya and used 2 validated Likert Scales (1–5) to capture contraception and abortion stigma. RESULTS: Overall, 122 teachers responded (85%) (females, 57%; males 43%; age, 21–70 years [mean, 36]). Respondents associated contraceptive use with a promiscuous lifestyle (43%) that will encourage peers to do the same (51%). Respondents indicated that married women were more deserving of contraception than unmarried women (57%), a girl could not herself decide to use contraceptives (50%), and contraceptive use could impair future fertility (57%). Abortion was considered a sin (74%), shameful for the family (48%), a habit (34%), and a behavior that might encourage peers to do the same (51%). Many believed an abortion will lead to worse health (73%). Male and female teachers gave similarly distributed responses. Younger teachers were more likely to find abortion shameful (<29, 64%; 30–39, 39%; ≥40, 39%; p = 0.046). Contraception stigma and abortion stigma were highly correlated (r = 0.355, p < 0.001). CONCLUSIONS: Stigmatizing attitudes associated with contraceptive use and/or abortion were common among teachers in Western Kenya. IMPLICATIONS: Stigma may hinder the sexual and reproductive health and rights of students. Contraceptive use and abortion stigma need to be addressed in teacher education to ultimately improve health outcomes among adolescents.