Contraceptive Use Among Female Students Of University Of Uyo

Project and Seminar Material for Public Health

Abstract

Unplanned pregnancies among students at higher educational institutions are a major concern worldwide, including Nigeria. Apart from various social and psychological problems, unplanned pregnancies affect students’ objectives of achieving academic success. Research indicated that around 80 per cent of female students are sexually active. Higher educational students between the ages of 18 and 24 have one of the highest rates of unplanned pregnancies due to the lack of contraceptive use, knowledge and awareness regarding the use of contraceptives.

A cross-sectional, descriptive quantitative survey was used. The survey included 400 female undergraduate students at University of Uyo who were required to respond to a self-administrative questionnaire. Of the 74 per cent sexually active females, 79 per cent reported using contraceptives.

The most common used methods were the oral contraceptives, 38 per cent, and male condoms, 25 per cent. The most commonly known methods were condoms, 84 per cent, and the oral contraceptive, 68 per cent. The level of knowledge of the condom use to prevent sexually transmitted diseases was very high, 91 per cent. The knowledge of the benefits of contraceptives was also high, 97 per cent. A lack of knowledge and awareness on some contraceptives methods was found. Thus educational programmes to increase student’s knowledge on all contraceptive methods, including addressing possible side-effects, and its use, are urgently needed to increase the use of contraceptives and assisting in reducing the rate of unplanned pregnancies.

Chapter One

Introduction

1.1 Background of the Study

Worldwide female students are exposed to the risk of unplanned pregnancies, as a result of ineffective contraceptive use or the non-utilisation thereof (Maja & Ehlers 2004, p. 43). These risks include failure to complete their education, unability to maintain gainful employment and make independent marital decisions (Maja & Ehlers 2004, p. 43). The sexual activities of young students are a communal, municipal and public health concern, as it eventually leads to unplanned pregnancies, and these activities, especially pre-marital sexual activity seems to be increasing among higher educational institution students in countries such as Asia and Africa, as a result of factors like rapid urbanisation and exposure to mass media (Mehra et al. 2012, p. 1).

In several studies it was reported that the lack of adequate knowledge and awareness of effective contraceptive use among female higher educational students, result in the non- utilisation of contraceptives, which eventually contributes to high unplanned pregnancy rates. It is estimated that it contributes to about 8 to 30 million pregnancies worldwide every year (MacPhail et al. 2007, p.5 of 8; Adhikari 2009, p. 2 of 5). This is supported by international research who reported that students between 18 and 24 years have one of the highest rates of unplanned pregnancies, due to the lack of effective knowledge concerning contraceptive use, resulting in an increase in unplanned pregnancies (Trieu et al. 2011, p. 431; Bryant 2009, p. 12). Approximately 210 million pregnancies occur annually across the world, of which 75 million (or about 36 percent) are unplanned or unwanted (Adhikari 2009, p. 2).

In research studies conducted worldwide among university students, several factors were identified as contributing to the non-utilisation of contraceptives, include, among others, lack of knowledge and awareness, age, culture, ethnicity, religion, poor access, peer pressure, sources of information, alcohol and substance abuse and lack of partner support (Ahmed et al. 2012, p. 2 of 9; Golbasi et al. 2012, p. 81). Another study compiled among university students in the USA estimated that regular contraceptive use can prevent about 12.0 million pregnancies every year (Ersek et al. 2011, p. 497).

Approximately 39 per cent unwanted or unplanned pregnancies occur in Africa (Mehra et al. 2012, p. 1). In a study among 15 to 24 year old Nigerian women, it was estimated that only 52. 2 per cent of sexually experienced women are using contraceptives (MacPhail et al. 2007, p. 3 of 8). Due to the fact that 80 per cent of undergraduate students at higher educational institutions are sexually active, it is vital that they have access to safe, accessible and adequate contraceptive services (Bryant 2009, p. 12). Dreyer (2012, p. 6) suggests that the main reasons for women not utilising or discontinuing the use of contraceptives are side effects, lack of knowledge about different methods available, or just lack of interest in utilising it.

In the study among students in Uyo, Nigeria, Roberts et al. (2004, p. 441), suggested that an increase in the use of emergency contraceptives might reduce the number of unplanned pregnancies. However due to the lack of knowledge and awareness thereof, the family planning services were underutilised (Roberts et al. 2004, p. 441).

The study intended to identify factors that contribute to the non-utilisation of contraceptives among students in this higher educational institution. The findings aimed to improve the student‟s knowledge that would enable them to make informed decisions regarding their sexual health. In turn this will enhance students‟ success, general well-being and their academic career as well.

1.2 Problem Statement

Every year the rate of unplanned pregnancies among students at higher educational institutions continue to increase worldwide; despite the availability of free contraceptives, emergency contraceptives and termination of pregnancy services offered by Student Health Centres at higher educational institutions (Maja & Ehlers 2004, p. 43). As a co-ordinator of the student health services, working at a particular higher educational institutional institution, the researcher discovered that the rate of unplanned pregnancies among undergraduate students continue to rise despite the availability of these services.

It is estimated that 54 million unplanned pregnancies could be prevented annually, if all the needs for effective contraception use was satisfied in developing countries (Singh et al. 2010, p. 246). Research conducted among Nigerian females between the ages of 15 and 24 years, indicated that the availability and accessibility of contraceptives are still inadequate (MacPhail et al. 2007, p. 2 of 8).

It is recommended that there should be a drive to change attitudes towards the use of emergency contraception, providing more information and expanding health education in this order, to reduce the rate of unplanned pregnancies (Ahmed et al. 2012, p. 8 of 9). The high rate of unplanned pregnancies causes multiple problems for academic institutions across the world. These problems relate to high dropout rates of students, serious financial losses for academic institutions and an increased drain on public sector funds (Vermaas 2010, p1). According to Roberts et al (2004, p. 445); Abera & Tebeje (2009, p.37), was indicated that there is a need for educational programmes on contraceptive use at Student Health Services of higher educational institutions.

Assessing the use of contraceptives might help in designing a suitable educational programme at higher educational institutions to assist in decreasing the rate of unplanned pregnancies. The assessment of contraceptive use among undergraduate female students determined reasons for the non-utilisation of it (Brunner Huber & Ersek 2009, p.1069). This might have lead to students making informed decisions concerning their sexual and reproductive health. Simultaneously, this might also assist higher educational institutions to address the issue of potential advancement of female students‟ academic career.

1.3 Research Hypothesis

H0; Students at higher educational institutions have inadequate knowledge and awareness of the use of contraceptives that may contribute to increased levels of unplanned pregnancies.

1.4 Aims of the Study

The aim of the study was to assess the use of contraceptives of students at a particular higher educational institution to address the concern of the increased rate of unplanned pregnancies.

1.5 Research Objectives

To determine the use of contraceptives among undergraduate female students
To determine the knowledge of contraceptive use among undergraduate female students
To describe the factors that contributes to the non-utilisation of contraceptives among undergraduate female students.

1.6 Research Questions

What is the use of contraceptives among undergraduate female students?
What is the knowledge of contraceptive use among undergraduate female students?
What are the factors that contributes to the non-utilisation of contraceptives among undergraduate female students?

1.7 Definition of Key Terms

A definition of terms is given to explain to the reader the meaning of some of the concepts in the study (Akintade 2010, p. 13 of 109).

1.7.1 Assessment:

Means to „decide or estimate the value or quality of a person or thing ‟ („Oxford‟ 2004, p. 26). For the purpose of this study, assessing refers to determining the use of contraceptives.

1.7.2. Contraception:

The use of birth control methods to prevent unplanned pregnancies, during sexual intercourse (Bafana 2010, p. 13 of 81, Yunos 2010, p. 14 of 95). In this study the use of contraception refers to the use thereof by female undergraduate students between the age of 18 and 24 years.

1.8 Significance of the Study

This study aimed to assess the use of contraceptives, as well as the knowledge of contraceptive use. In addition, it described the factors that contribute to the non-utilisation of contraceptives. The outcome of the study could be used by professionals and students to reduce the rate of unplanned pregnancies, by means of assisting students in making informed decisions regarding their sexual health. This may include the provision of a platform for effective intervention, and creating opportunities for higher educational institutions to improve their current sexual and reproductive health services.

Students can advance their academic career within a shorter period which would prevent a financial drain on higher educational and public services. Less unwanted pregnancies may lead to substantial cost-saving in terms of social spending by government.

Chapter Five

Implications, Recommendations, Limitations And Conclusion

5.1 Implications

A major responsibility of healthcare providers at campus clinics is to educate students on sexual and reproductive health issues. Educating females about preventing unplanned pregnancies can decrease some psychosocial challenges associated with having an unplanned pregnancy (Bryant 2009, p.16). Healthcare providers should assist females to make informed decisions about contraceptive use by educating them on concerns about side-effects, and reliability of contraceptives to increase the use of contraceptives. Misconceptions about contraceptive methods can be decreased by accurate, appropriate health education on the methods and assisting them in choosing a most appropriate method for their individual needs, can increase the consistent use of contraceptives, and decrease the rate of unplanned pregnancies (Frost et al. 2012, p. 115).

Ersek et al. (2011, p. 497) reported that the regular contraceptive use prevented 12.0 million pregnancies per year and should therefore be promoted by reproductive health care professionals. By reducing unplanned pregnancies the population growth could slow down, thereby reducing the Government‟s need to expand infrastructure at high cost. This may contribute to substantial cost-saving in terms of social spending by Government. Government grants for children could also be reduced. Nurses can improve quality care at community nursing clinics by providing caring, culturally appropriate care which may increase client satisfaction with the clinic. Clients who receive excellent nursing care are more likely to return for further care (Bryant 2009, p.16).

5.2 Recommendations

The results of the study led to the following recommendations which could assist to improve the use of contraceptives to prevent unplanned pregnancies (Maja & Ehlers 2004, p.51). This study could also be replicated using a different sample (Bryant 2009, p.15).

Programmes to increase young female‟s knowledge on all contraceptive methods and the effective use of contraceptives are urgently needed, to improve the consistent use of contraceptives (Frost et al. 2012. p.107).
Healthcare workers should give adequate, accurate and detailed information about the possible side-effects of contraceptives to increase the consistent use of contraceptives (Bafana 2010, p.55 of 81). They could also ask current users about concerns or problems in obtaining their method and work with them to solve problems, and to also stress the importance of consistent contraceptive use to prevent not only unplanned pregnancies but also sexually transmitted diseases. Considering that only 50.3 per cent of females were familiar with emergency contraceptives, healthcare workers could educate females on how to obtain and use the emergency contraceptive to prevent unplanned pregnancies, (Brunner Huber & Ersek 2009, p. 1069.

As the awareness of the availability of the emergency contraceptive has been found to be low among university students, health education programmes should be implemented urgently to increase the awareness and the use of emergency contraceptives, to assist in reducing unplanned pregnancies (Adhikari 2009, p. 5 of 5). As students are vulnerable because of the lack of knowledge and skills to avoid risky behaviour, suitable and effective health education geared towards higher educational students should be strongly recommended (Zhou et al. 2012, p.1157).

5.3 Final Conclusion

Higher educational students form an important high-risk group in the community. The majority of students are sexually active and at risk of an unplanned pregnancy (Roberts et al. 2004, p.445). Despite the availability of free contraceptives at campus clinics, the high rate of unplanned pregnancies remains a major concern. The main aims of the study were to assess the use of contraceptives, assess the knowledge and awareness of contraceptives and to describe factors for the non-utilisation of contraceptives among female undergraduate students at University of Uyo.

The prevalence of contraceptive use under sexually active students in this study was high, namely 79 per cent, however inconsistent use of contraceptives are a major challenge. Females were aware of the benefits of contraceptives in preventing unplanned pregnancies; however they used contraceptives inconsistently due to being afraid of possible side-effects, which could contribute to the high rate of unplanned pregnancies (Yunos 2010, p. 76 of 95).

Some factors were identified for the non-utilisation of contraceptive use, and a number of misconceptions about contraceptives were found which could affect the use. Overall there was limited awareness and use of the emergency contraceptives indicated in this study. There is thus an urgent need for carefully designed educational programmes on emergency contraceptives in existing campus clinics. Use of regular /consistent use of contraceptives as well a regular condom use needs to be stressed as well, to reduce not only unplanned pregnancies but also sexually transmitted diseases (Brunner Huber & Ersek 2009, p. 1069).

In conclusion, this study highlighted the lack of knowledge and awareness on some contraceptive methods, thus educational programmes to increase students‟ knowledge on all contraceptive methods, including addressing possible side-effects, and its use, are urgently needed, to increase the use of contraceptives and assisting in decreasing the rate of unplanned pregnancies (Frost et al. 2012, p. 107).