Knowledge And Utilization Of Contraceptive Services Among Female Students Of Ambrose Alli University

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Knowledge And Utilization Of Contraceptive Services Among Female Students Of Ambrose Alli University


Abstract


Access to contraceptive has become increasingly crucial for adolescents because many are sexually active at earlier ages than in the past. This will further compound overall levels of maternal mortality in Nigeria tertiary institutions. Contraceptives are drugs or device used to prevent a woman from being pregnant and also used to protect men and women from sexually transmitted diseases. How can this be driven home is truth to our adolescences, utilized to reduce our teaming population and to reduce the diseases that are sexually transmitted. The project was done in March – July 2019. The main objective of this study was to examine the knowledge and utilization of contraceptive services among female students of Ambrose Alli University,Ekpoma Edo state. 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 serial structured questionnaire and an observational check list. The mean age of the student respondents was 25 + 5 years.

All the respondents are male adolescent students. The result showed that 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 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 female contraception. The study therefore recommended that the mass media should be effectively used to cover both urban and rural areas in order to stimulate more adolescent to the use of male contraception. Also, 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.


Table Of Contents


Preliminary Page(s)

  • Title
  • Declaration
  • Approval
  • Dedication
  • Acknowledgement
  • Table of Content
  • List Of Figures
  • List Of Tables
  • Abstract

Chapter One

Introduction

  • 1.1 Background Of The Study
  • 1.2 Problem Statement
  • 1.3 Justification For The Study
  • 1.4 General Objective
  • 1.5 Specific Objective
  • 1.6 Research Question
  • 1.7 Scope Of The Study
  • 1.8 Definition Of Terms

Chapter Two:

Literature Review

  • 2.1 Empirical Literature Review
  • 2.1.1 Maternal Mortality In Developed And Developing Nations
  • 2.1.2 Maternal Mortality Ratio In Nigeria
  • 2.1.3 Adolescent Knowledge And Use Of Contraceptive
  • 2.1.4 Trends In Unwanted Pregnancy
  • 2.1.5 Contraception In Nigeria
  • 2.1.6 Factors Affecting Contraception
  • 2.2 Review Of Relevant Theories
  • 2.3 Theoretical Framework

Chapter Three

Methodology

  • 3.1 Study Area
  • 3.2 Study Design
  • 3.3 Study Population
  • 3.4 Selection Criteria
  • 3.5 Duration Of Study
  • 3.6 Sample Size Determination
  • 3.7 Sampling Method
  • 3.8 Method Of Data Collection
  • 3.9 Method Of Data Analysis
  • 3.10 Ethical Consideration
  • 3.11 Limitations

Chapter Four

Results And Discussion

  • 4.1 Results
  • 4.2 Discussion

Chapter Five

Conclusion And Recommendations

  • 5.1 Conclusion
  • 5.2 Recommendations
  • References
  • Appendix
  • Questionnaire

List Of Figures


Figures Pages

  • Figure 1 The distribution of years of schooling of students
  • Figure 2 The distribution of Various courses studied by the students
  • Figure 3 Knowledge of contraception among students
  • Figure 4 Awareness of contraception among students
  • Figure 5 Students’ view in cultural acceptance of contraceptives
  • Figure 6 Students’ knowledge on traditional methods of contraception
  • Figure 7 Parental communication to students on contraception
  • Figure 8 Experience of students during usage of male contraceptive method
  • Figure 9 Continued usage of male contraceptive method by students
  • Figure 10 View of multiple sexual practice among students

List Of Tables


Tables Pages

  • Table 1 Frequency distribution of socio-demographic characteristics of students
  • Table 2 Source of awareness of information on contraception
  • Table 3 Types of contraceptives known to students
  • Table 4 Distribution of students’ parents still alive
  • Table 5 Types of contraceptives used as reputed by students
  • Table 6 Types of male contraceptives known by students
  • Table 7 Usage of male contraceptive methods
  • Table 8 Effects of non-use of male contraceptive method
  • Table 9 Practice of abstinence among students
  • Table 10 Marital status of students and usage of male contraceptive method
  • Table 11 Knowledge of contraception and the usage of male contraceptive methods among students
  • Table 12 Age group of students and usage of male contraceptive methods
  • Table 13 Years of schooling and usage of male contraceptive method
  • Table 14 Subject of study of students and usage of male contraceptive methods
  • Table 15 Cultural acceptance of male contraceptive method and usage of male contraception.
  • Table 16 Parental communication on contraception and usage of male contraceptive method
  • Table 17 Knowledge of traditional contraceptives and usage of male contraceptive method
  • Table 18 View of multiple sexual practice among students and usage of male contraceptive method

Chapter One


Introduction

1.1 Background Of The Study

UNAIDS (2007) estimated that 33.2 million women had HIV infection worldwide. In many regions of the world more women than men are at the risk of HIV infection with not less than 50% of all new daily infections in sub-Saharan Africa being in women.

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. 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 women 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 female contraception (Heinemaan, 2006). 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.
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.

Mini Pill:

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.

Injectable Contraceptives:

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.

Sponge:

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.

Female Sterilization:

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 female contraceptive measures include:

a. Female Condom:

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.

d. Intrauterine device (IUD);

The intrauterine device is a small plastic and copper device known as a ‘coil’ that is put into the uterus by a doctor or nurse. It is a long-acting reversible contraception that does not depend on you taking it daily and is over 99 per cent effective.

It works immediately and can stay in from five to 10 years, though it can be removed at any time by a health professional.

e. Contraceptive patch:

The contraceptive patch is a small patch you stick on to the skin that releases estrogen and progestogen. It stops ovulation and is over 99 per cent effective if used according to instructions – but 91 per cent effective for the average woman.

Emergency Contraception:

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 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:

  • Hormonal Contraception – where synthetic hormones are used to temporarily stop the development of healthy sperm.
  • Non-Hormonal Methods – where other techniques are used to stop healthy sperm from entering a women’s vagina.

1.4 General Objective

The objective of this study was to determine the knowledge and utilization of contraceptive services among female students of Ambrose Alli University, Ekpoma Edo state. 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.


1.5 Specific Objective

  1. To assess the knowledge of female students of Edo state university on female contraception.
  2. To determine the practice of female contraception among the students in Ambrose Alli University, Ekpoma Edo state.
  3. To assess the factors that influence the use of these contraceptives in this age group of students in Ambrose Alli University, Ekpoma Edo state

1.6 Research Question

  1. Are female student aware of female contraceptive in Edo state university?
  2. Is female contraceptive widely used in Ambrose Alli University, Ekpoma Edo state?
  3. What are the factors affecting the use of contraceptive in Ambrose Alli University, Ekpoma Edo state?

1.7 Scope Of The Study

The study is carried out on knowledge and utilization of contraceptive services among female students of Ambrose Alli University, Ekpoma Edo state. The study is limited to Ambrose Alli University, Ekpoma Edo state.


1.8 Definition Of Terms

Sexuality:

The things people do and feel that are connected with their desire or ability to have sex.

Contraception:

The practice of making it possible for a woman to have sex without having baby or the methods for doing this, birth control.

Contraceptive:

A drug, object or method used to make it possible for a woman to have sex without having a baby or contracting an STD.

Undergraduate:

A student who is doing a University course for a first degree

SexEducation:

Education given to students about the physical process and emotions involved in sex.

Pregnancy:

The condition of being pregnant

Sex:

The activity in which a male and female join their sexual organs in order to create babies or for pleasure.

STD:

Sexually Transmitted Disease

STI:

Sexually Transmitted Infection

HIV:

Human Immunodeficiency virus

AIDS:

Acquired immune deficiency syndrome


Chapter Five


Conclusion And Recommendations

5.1 Conclusion

The project has shown that there is a high degree of knowledge of contraception among female students especially those in the age group between 21 – 30 years of age in females. This level of knowledge translated to the regular usage of contraceptive as is typified by their affirmative response of re-use of the female contraceptives; when the need arises.

The knowledge of female contraception is effective through communication with their peer groups and to mass media. Parents of children have a major challenge to discuss sexual activities with them so that they can know the best attitudes in contraception as this project has shown that those who the parents were able to communicate with, readily use the male contraceptive method.

The practice of contraception among females of this age group has been done through the influence of their peer group and the mass media. The condom was the only device that has been generally acknowledged to be of use among the students. Research into other types of devices is ongoing.

Majority of students who have used contraceptives before now will like to continue its usage. In other words, the 70.1% students who have used the contraceptive will continue to use it.

On factors that influence the usage, students affirmed that unwanted pregnancies, fear of sexually transmitted diseases were the factors that made them to use the female contraceptives.


5.2 Recommendations

The outcome of our project has been most fulfilling because our deduction tally with the fact that female contraception in the adolescent age has been down played for too long. The need for adequate education before and during adolescent age is of paramount importance. In this vein all health care providers, all parents, all teachers, all counselors are advised to adequately educate the adolescent males to practice safe contraception.

To this end, the knowledge of all those concerned especially the parents of all children should be increased by use of seminars so that they will be knowledgeable enough to teach their children.

The use of the mass media should be harnessed both in rural and urban areas as a programme to highlight the awareness and practice of contraception and the bad consequences that will arise without their usage. The Ministry of Health at the Federal and State levels should handle this advocacy programme.

The Ministry of Health at Federal and State levels should also educate the public to utilize abstinence as a better way of female contraception than any other method. The more publicity in it the more people will appreciate its use and take to its practice.

The government as a matter of urgency release adequate funds to research in family planning especially of female contraception and also to educate the populace for male participation in family planning practice. This will help to increase the knowledge and practice of family planning in Nigeria.

This above will reduce the incidence of HIV/AIDS pandemic, reduce the no of sexually transmitted disease, reduce the no of unwanted pregnancy and finally reduce the population of Nigeria which is predicted to hit the 200 million ceiling by the year 2020.


Knowledge And Utilization Of Contraceptive Services Among Female Students Of Ambrose Alli University


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