The Knowledge And Practice Of Contraception Among Male Adolescent Students
The objective of this study was to assess the knowledge and improve the practice of this knowledge in our teaming adolescent population bearing in mind that a good beginning will eventually grow to a good end. A descriptive cross-sectional study was done using quantitative and qualitative methods of data collection. Though sample size was calculated for a finite population, the total population of student respondents was used for the study. Data collection was by use of a seria structured questionnaire and an observational check list. The result showed that the mean age of the student respondents was 25 + 5 years. All the respondents are male adolescent students. The knowledge of contraception in this group was 86.1% as against those who had as knowledge of 13.9%; the practice of contraceptive use has 77% while abstinence ws 6.6% and withdrawal 5.5% respectively.
The subject of study of the students did not influence the knowledge and practice of contraception so also is their year of study. The mass media and peer group were found to be their main sources of information that contraceptives and their parents’ being alive or dead did not also influence their practice. The study concluded that the students who had good knowledge of contraception affirmed that they will continue to practice it. The cultural values of students did not influence their practice of male contraception. The mass media a veritable means of communication should be effectively used to cover both urban and rural areas in order to stimulate more adolescent to the use of male contraception.Parents, teachers, health practitioners should do more to give adolescents such advice to help in their proactive ability and the need to adequate control of sexuality related activities.
1.1 Background Of The Study
The Oxford Advanced Learners’ Dictionary of Current English defines “Contraceptives as a drug, device of practice used to prevent a woman becoming pregnant.”1 This definition though well embracing but does not include its utilization as a preventive measure against the spread of sexually transmitted diseases; such as AIDS/HIV. The act of contraception has been an old practice even from our forefathers who designed the timing of mating with their wives or not depending on whether they want to make babies. They have a mental picture of when the monthly menstrual flow of their wives takes place or how long their wives have to breast feed their babies to avoid unwanted pregnancies. Some traditional women even go through the extra-mile of wearing contraceptive bands on their waist to prevent unwanted pregnancies.
Each year, women around the world experience 75 million unwanted pregnancies. Unwanted pregnancy can occur for two main reasons; either the couple was not using contraceptives, or the method they were using failed. There are many reasons why people do not use contraceptives to prevent unwanted pregnancy, including lack of access to family planning information and services; incest or rape; personal or religious beliefs; inadequate knowledge about the risks of pregnancy following unprotected sexual relations; and women’s limited decision-making ability with regard to sexual relations and contraceptive use.2 Many women are deprived of family planning services.
The use of contraceptives by both males and females has been accepted and widely practiced in the developed world. This has not been the case in the developing world where the male chauvinistic cultural belief that women should protect themselves from unwanted pregnancies; instead of the men also making it possible to use contraceptives. The act of child bearing is the combined effort of both males and females, but in the developing world; it is seen as a primary function of the female gender. This is the reason why the usage of contraceptives among men in these areas has not been encouraged as the female contraceptives. The patriarchal nature of the African society does not seem to help or encourage male contraception rather it makes men to believe that they do not have any role to play in reproductive health.
In the developed world, the populace has overgrown the persistent myths and negative attitude of men towards contraception. However, the fact that male contraception in the underdeveloped countries has not been encouraged has led to the paucity of information about it and also reduced the quest for knowledge in this area. Studies show that men want access to better contraceptives. In a recent study of British men, 80% placed a hypothetical male pill as one of their top three contraceptive choices (Brooks, 1988)3. Another study found that over 60% of men in Germany, Spain, Brazil and Mexico were willing to use a new method of male contraception (Heinemaan, 2006).4 In another study on “why Nigeria adolescent seek abortion rather than contraception: Evidence from focus group discussions” where youths were asked about contraceptive availability, perceived advantages of method used, side effects and young people’s reasons for using or not using contraceptives? It was found that the fear of future infertility was an overriding factor in adolescent decisions to rely on induced abortion rather than contraception.5
Methods of Contraception – are more in the female gender than the male.
Those of the female include:
The Combined Pill:
These are oral contraceptives which are eniphasic and biphasic pills, Everyday /Ed pills. They are 99% effective when properly taken. They contain two hormones – estrogen and progistogen, and acts by preventing ovulation when taken regularly.
Progestogen pill only. Its 98% effective when taken properly and regularly any day at the same time. It causes changes in the womb which makes it difficult for the sperm to enter the womb.
They include Depo-provera and Noristerat. Its effective to 99% of cases. It also stops ovulation by acting in a similar way to the mini pill. It provides protection for up to 3 months longer. It may cause irregularity in her periods and break through bleeding.
Intra Uterine Device:
Its 96 – 99% effective. It’s a plastic device or with copper inserted into the womb by the doctor and it prevents the ovum or egg from settling in the womb.
Diaphragm or Cap:
Its 85-97% effective with careful use. It is a soft rubber device put into the vagina before intercourse, to cover the cervix, and form a barrier which prevents sperm from meeting the egg. It must be used with a spermicide and left in place for six hours after intercourse.
It is 75 – 91% effective, with careful use. It’s a soft circular polyenthrane foam sponge, put into the vagina up to 24 hours before intercourse, to cover the cervix. It already contains a spermicide.
It’s a permanent method of birth control in which the fallopian tubes are closed so that the egg cannot travel down than to meet the sperm. Its effective for life but has occasional failure rate of 1:300 where the tube rejion and fertility returns.
Natural Methods (‘Safe Period’ ‘Rhythm method’). Its 85 – 95% effective. It aims to predict ovulation when the woman is most fertile intercourse is avoided at this time. This symptom-thermal method requires daily recording of body temperature, noting changes in vaginal nuclear and other signs of ovulation.
The male contraceptive measures include:
It is effective in 85 – 98% of cases with careful use. Its made up of a thin rubber and worn on an erect penis. It prevents sperm from entering the woman. It protects both partners against sexually transmitted diseases and also protects the woman against cancer of the cervix.
b. Male Sterilization (Vasectomy):
It’s a permanent method which involves the cutting or blocking of the tubes that carry sperm from the testes (vas deferens) to the penis. It is a permanent method of contraception like the tubal ligation in females. Another method of contraception needs to be used for about 3 months after vasectomy so as to clear the whole sperm from the tube. Occasional failure of this method occurs in 1:100 cases.
c. Withdrawal Method:
This method is usually not effective but its practiced by some own. They withdraw the penis before ejaculation takes place during orgasm. Its not effective because it does not take care of sperm which are passed into the vagina before orgasm takes place.
This is method of preventing pregnancy after having unprotected sexual intercourse or if you had a contraceptive accident or misuse (such as condom breakage, failed coitus interruptus) and in case of rape. There are two common methods which can be used in emergency contraception:
- Emergency contraceptive pills (ECPs)
- Copper intra-uterine device (IUDs).
These two methods must be used within few days of unprotected sexual intercourse. They are safe for most women. The ECPs contain the same hormones used in family planning pills but are used differently. They either stop the release of the egg or prevent fertilization of an egg. The IUDs immobilize sperms, slow down sperm movement, prevent fertilization of the egg and cause changes in the uterine lining which prevent pregnancy.
1.2 Problem Statement
It is true that sexual education in most of our homes are poor, with the belief that being sexually educated will make the student to be promiscuous or to test what they have learnt. But we all know that our society have overgrown such belief, and they will always have coitus, whether they are educated or not. They will always be influenced by their peer groups and those who are not yet exposed will learn the act in a negative way. This being the case, the onus now rests on adults to educate the teenage or early adult group on what the reproductive organs stand for, the usage of contraceptives to reduce the incidence of unwanted pregnancies or even infections in the reproductive system.
The need for this study is to stimulate parents and school authorities to educate our younger generations to be well equipped with the knowledge of family planning. Failure of this taking place will lead to an increase in the number of unwanted pregnancies, sexually transmitted diseases and undue population rise in the society.
1.3 Research Questions
- What is the extent of sexual activity among male students in federal college of education?
- What is the extent and nature of contraceptive use among sexually active male students?
- How accessible are contraceptives for sexually active male students, here considering in particular availability, cost and the attitudes of federal college health workers and other relevant staff towards students seeking access to contraception.
1.4 General Objective
The objective of this study was to determine the level of awareness of male on contraceptive measures with a view to improving this knowledge and increasing their compliance to the usage. This will help us in educating them on how to prevent early pregnancies and its negative effects and or infections to their young reproductive organs which may lead to secondary infertility in later life.
1.4.1 Specific Objective
- To assess the knowledge of male students of Federal College of Education Technical Asaba on male contraception.
- To determine the practice of male contraception among the students.
- To assess the factors that influence the use of these contraceptives in this age group of students
1.5 Justification For The Study
Over the years, especially in Africa, the need for contraception and control of population using female methods of the pill, injectables etc have been adapted. Before now only the condom and withdrawal method has been used by men.
The increasing need for male contraception cannot be over-emphasized as humans are more aware of the fact that, there need to be a greater co-operation between spouses for family and reproductive health to grow and blossom; with greater understanding that everyone involved will contribute their quota to the success of the family.
To this extent therefore, there is the dire need for the study of this nature to identify the contraceptive devices possibly of use now, the knowledge of their use, how well adolescent comply with their use, in order to educate them so that they could have a good beginning in their understanding of choosing when to have children and when not to. This is done with the wisdom that a good beginning when well nurtured will bring about a good end.
This study will give us an overview of the perception or knowledge, the usage or practice of contraception among these adolescent which will again enable us to educate them on what good practice of family or reproductive health should be. This will translate into a better moral upbringing of the society around us.
On-Going Research: There are many ongoing research projects into different methods of male contraception. Researchers are optimistic that a safe, effective method of male contraceptive will eventually become a reality, although this is still several years away.6
The two main areas of research into male contraception include:
a. Hormonal Contraception
Where synthetic hormones are used to temporarily stop the development of healthy sperm.
b. Non-Hormonal Methods
Where other techniques are used to stop healthy sperm from entering a women’s vagina.
1.6 Scope And Limitations Of The Study
Scope refers to the dimension of coverage of this work. This research work restricted to a number of male students in the college of education, Asaba. In carrying out this research work, the researcher was faced with certain problems which includes;
Time constraints, as a student trying to keep up with lectures and at the same time running around for the collection of necessary information for completion of this research work.
collecting data from different sources cost a lot of money; from internet subscription to transportation to libraries. This posed a certain limitation on the research
1.7 Organization of study
This research consists of five chapters and references
- Chapter 1 discusses the background, various definitions, measurement, Problem Statement, misconceptions, and facts related to contraception.
- Chapter 2 discusses previous studies for knowledge and practice of contraception among male adolescents. It also lists various factors affecting contraception and further identifies the possible factors responsible for pre marital sex among youths.
- Chapter 3 discusses the research methodology used, including a discussion of the survey approach.
- Chapter 4 discusses the analysis method and Statistical Method utilized for the study as well as the results obtained from the web survey.
- Chapter 5 discuses conclusions, Recommendations, and suggestions for future research. Figure 1.1 shows the flow-chart describing various stages in research and its structure.
Recommendations And Conclusion
5.1 Recommendations with regards to findings
Various interventions are required for contraceptive use to be improved, thereby decreasing the risk associated with unwanted pregnancy and the spread of STIs among students in Kaduna polytechnic and by extension students of tertiary institutions in other parts of Nigeria and especially the northern region. The following recommendations are made in line with the findings of my study.
Firstly, due to the low level of contraceptive knowledge, there is a need to improve contraceptive knowledge among students. Accurate and detailed information should be passed to students with the aim of correcting the misperceptions they have about contraceptive methods and creating more positive attitudes in them towards contraception. Intervention programs should be put in place to ensure that students as well as the general public get adequate and correct information on contraceptives. This could be achieved, as suggested by students, if sex education were introduced as part of the institution’s academic programme. Public campaigns should also be organised by the institution through the media (both electronic and print media), seminars and workshops organised for students with regards to educating them about contraception.
Also, religious and cultural beliefs, which were found to influence students’ contraceptive practices by prohibiting contraceptive use, need to be changed to begin seeing youths as sexually active beings and so embrace the inevitability of sexual practices among them. These teachings should be more concerned about promoting safe sexual behaviours among sexually active youths while still encouraging abstinence among the young and those who have not yet made their sexual debut. Cultural beliefs that discourage discussions of sex and contraception among youths should be changed to rather encourage a cordial relationship between adults and youths, parents and children. These relationships should be established on mutual trust and should seek to educate youths and children on issues of reproductive health so as to give them accurate information and develop in them positive attitudes which will eventually help them in making sound decisions in future with regards to contraception and thereby enable them to prevent the devastating dangers of unprotected sex.
Secondly, to ensure the success of these interventions, there is also the need to educate health workers, both within and outside the polytechnic environment, to ensure not only that they have correct information about contraception, but also to change their widely negative perceptions of students who seek contraceptives from them. Health workers should be encouraged (if possible under supervision from relevant authorities) to disseminate such information to students who come to seek for contraceptives from them, and should be given the responsibility of anchoring programmes both in the media and during seminars and workshops with regards to contraception.
Thirdly, given the home as the primary agent of socialization, there is the need for parents to educate their children on issues of reproductive health and contraception. To achieve this, parents need to be encouraged through a general public education programme organised by relevant authorities, using the media, community leaders as well as religious leaders to educate parents on the need for such.
Fourthly, intervention programmes should seek to discuss the dangers of risky sexual behaviours among students and the need for the individual student to prioritise safety above material gains especially in transactional sexual relationships. Unequal gender power relations must also be discouraged; rather, the egalitarian view found among many students about gender and contraception in sexual relationships should be encouraged and propagated at all levels to ensure that a partner should have the capacity to carter for his/her reproductive health needs without being compelled or restricted by the other partner.
Lastly, other factors discouraging students from using contraceptives also need to be addressed. Of great importance is that, contraceptives should be made easily accessible to students at low cost, if not free, and at convenient places where students can access them with ease. I recommend that condoms should be placed in secure boxes in public places such as toilets and other convenient corners where students can access them without the fear of being seen by others. Other methods should also be made available in the polytechnic clinic and its availability be effectively communicated to all students irrespective of their marital status and/or age. Health care providers must also be encouraged to be friendly to students seeking for contraceptives and educate them on the correct ways of using them to prevent against unwanted pregnancies and STIs.
My research attempted to explore contraceptive knowledge and practices among students of Kaduna Polytechnic with reference to the extent of sexual activities, contraceptive use, as well as contraceptive accessibility and influences of social factors on students’ contraceptive practices.
Despite students’ high awareness of the existence of contraceptive methods and continuous engagement in sexual activity, the level of actual contraceptive knowledge as well as the rate of contraceptive use among students was found to be low. Friends and the media were found to be the major sources of contraceptive information for students; this makes it likely that incorrect or incomplete information is conveyed to students, which could lead to them developing negative attitudes towards contraceptive use or being exposed to the dangers of contraceptive accidents.
Patterns of students’ sexual behaviours were found to influence the students’ attitude towards the use or non-use of contraceptives. While having multiple sexual partners was found to encourage students to use contraceptives, other forms of sexual activity, such as transactional sex and engaging in sexual relationships with partners of older ages, tends to limit the students’ capacity to use contraceptives.
Contraceptive use, including emergency contraception, was low among sexually active students. However, the condom and oral pills were found to be the most commonly used methods of contraception among students. .
Contraceptives were not easily available for students in the polytechnic. Negative and unfriendly attitudes of health care providers towards students seeking for contraceptives was also found to limit contraceptive use among students in the polytechnic, thereby exposing them to the dangers of unprotected sex. Traditional and religious beliefs and practices were also found to influence the individuals’ attitude towards contraception, while there was evidence to suggest that gender attitudes are shifting and women’s rights to negotiate contraceptive use in sexual relationships is gaining recognition, although unequal power relations still are significant, especially when the woman is significantly younger and economically more vulnerable than the man.
Finally, students at the polytechnic were eager to talk about their concerns and showed a willingness to find out more which is encouraging and should be worked with by the polytechnic authorities.
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