Anticipated Stigma Index

The Anticipated Stigma Index is a 5-item tool to measure expectation of discrimination from others among young females. The items are related to fear, worry and embarrassment when accessing family planning (FP) services. The measure was originally tested among young married females in rural Ethiopia to improve youth friendly services.


Geographies Tested: Ethiopia

Populations Included: Female

Age Range: Adolescents, Adults


Suppose that you were planning to get services related to FP next week. Please keep this scenario in mind and tell me if you: strongly disagree, disagree, agree or strongly agree with the following statements.

1. I would feel embarrassed about wanting more information about FP services
2. I would be afraid of being seen by someone I knew at the facility
3. I would be worried about what my parents would say if they found out that I needed FP services
4. I would be worried about what people in my community would say about me if they found out I needed FP
5. I would feel embarrassed talking to a provider about FP

Response Options
4-point Likert scale from ‘strongly agree’ to ‘strongly disagree’.

Scoring Procedures

The five items in the index can be combined to form a composite score ranging from 0 to 5, which can then be dichotomized into 0 =no agreement across all five items and 1 =agreement on at least one item. Mean scores for the anticipated stigma scales can be calculated.

Original Citation

Jain, A., Ismail, H., Tobey, E., & Erulkar, A. (2019). Stigma as a barrier to family planning use among married youth in Ethiopia. Journal of Biosocial Science, 51(4), 505-519.

Psychometric Score

Ease of Use Score

Scoring breakdown

Formative Research

Qualitative Research

Existing Literature/Theoretical Framework

Field Expert Input

Cognitive Interviews / Pilot Testing








Criterion (gold-standard)



Ease of Use


Scoring Clarity


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