Unmet Needs for Comprehensive Sexuality Education: A Qualitative Study Among Secondary School Students in Western Kenya

Figures & data

Table 1. Participant characteristics and response rates (n = 936).

Intervention school, n = 440		Control school, n = 496
All students		All students
Age		Age
Min	13	Min	13
Max	21	Max	21
Mean	17.1	Mean	17.3
Median	17	Median	17
Response rate	90% (n = 396)	Response rate	95% (n = 471)
Female (n = 224)		Female (n = 244)
Age		Age
Min	13	Min	13
Max	21	Max	21
Mean	16.9	Mean	17.1
Median	17	Median	17
Response rate	91% (n = 204)	Response rate	96% (n = 234)
Male (n = 216)		Male (n = 252)
Age		Age
Min	14	Min	15
Max	21	Max	21
Mean	17.3	Mean	17.4
Median	17	Median	17
Response rate	89% (n = 192)	Response rate	94% (n = 237)

Table 2. Suggested ways to deliver CSE according to 676 secondary school students (I-school n = 315, C-school n = 361).

Category n (%)	Subcategory	Number of suggestions		Codes
		I-school n = 452 n (%)	C-school n = 473 n (%)
School 316 (34)	Group discussions	79 (17)	106 (22)	Interactive group discussions in school. In a group discussion, everyone can contribute their views.
	Lectures	53 (12)	78 (16)	SRHR should be taught just like other subjects. During lessons, students are free to ask questions.
	Total	132 (29)	184 (39)
Online 266 (29)	Social media, e.g., Facebook, WhatsApp	121 (27)	90 (19)	Chat groups are private and confidential. Social media to get different peoples’ opinions from all over the world. Health services should communicate through social media.
	Internet	34 (8)	21 (4)	The internet is fast and comprehensive. We could use internet resources at the computer lab at school.
	Total	155 (34)	111 (23)
Community 250 (27)	Youth friendly services	76 (17)	62 (13)	Healthcare professionals provide trustworthy information. Confidentiality.
	Mass media	41 (9)	55 (12)	Most people have access to a radio. Television channels and newspapers should raise awareness. Discussions in public places.
	Church	13 (3)	3 (1)	Youths come together at church. The elders at church are trustworthy.
	Total	130 (29)	120 (25)
Trusted individual 93 (10)	Teacher	17 (4)	23 (5)	The counseling teacher can guide and give advice. Students feel free to discuss with their teachers.
	Friend	15 (3)	21 (4)	Friends might go through the same thing. Close friends keep secrets.
	Parent	3 (1)	14 (3)	The parents should be involved. Some issues are better to discuss with your parents.
	Total	35 (8)	58 (12)

In total, 925 suggestions were given.

Note 1. CSE: comprehensive sexuality education; SRHR: sexual and reproductive health and rights.

Note 2. Some respondents had multiple responses, and that the n is always for the number of responses (not the number of respondents).

Table 3. Desired CSE topics by 462 secondary school students (I-school n = 194, C-school n = 268).

Category n (%)		Number of suggestions		Codes
		I-school n = 223 n (%)	C-school n = 346 n (%)
Abortion 152 (27)	Supportive	30 (13)	30 (9)	We need to learn more about safe abortion. Stop discrimination of girls who have an abortion. Abortion can help young girls continue school.
	Against	29 (13)	63 (18)	Abortion is a sin. Some girls have made abortion a habit. Girls who have had an abortion should be taught good morals.
Contraception 140 (25)	Supportive	62 (28)	56 (16)	Contraceptives for prevention of pregnancies and STIs. Misconceptions about contraceptives are common. Contraceptives should be allowed among young people.
	Against	7 (3)	15 (4)	Contraceptives have side effects for young people. Contraceptives promote promiscuity.
Sexual rights 125 (22)		61 (27)	64 (18)	Discuss young peoples’ rights, to avoid stigma. Raise awareness of LGBT rights. SGBV is common in the community.
Abstinence 92 (16)		23 (10)	69 (20)	Young people should abstain from sex until marriage. Abstinence is the safest choice. Students need to know how to control themselves.
STIs incl. HIV 60 (11)		11 (5)	49 (14)	Prevention of STIs. Reduce HIV stigma.

In total, 569 suggestions were given.

Note 1. HIV: human immunodeficiency virus; LGBT: lesbian, gay, bisexual and transgender; SGBV: sexual and gender-based violence; STI: sexually transmitted infection.

Note 2. Some respondents had multiple responses, and that the n is always for the number of responses (not the number of respondents).

Data availability statement

Additional data is available by emailing the last author at [email protected].