Survey Of Adolescent Sexual And Reproductive Health Practices Among Students

Survey Of Adolescent Sexual And Reproductive Health Practices Among Students
Abstract
This study focused was on the Survey Of Adolescent Sexual And Reproductive Health Practices Among Students using undergraduate students in University of Abuja as case study. The study is was specifically focused on exploring the knowledge about sexual and reproductive health, To examine the common sexual and reproductive health issues and associated socio-cultural factors faced by the adolescents and to understand the perceptions of adolescents regarding existing sexual and reproductive health services and barriers to its utilization. The study adopted the survey research design and randomly enrolled participants in the study. A total of 100 responses were validated from the enrolled participants where all respondent are undergraduate students in University of Abuja.
Table of Content
- Title Page
- Certification
- Dedication
- Acknowledgement
- Table of Content
- List of Tables
- Abstract
Chapter One:
Introduction
- 1.1 Background of the Study
- 1.2 Statement of the Problem
- 1.3 Objective of the Study
- 1.4 Research Questions
- 1.5 Significance of the Study
- 1.6 Scope of the Study
- 1.7 Limitation of the Study
- 1.8 Definition of Terms
- 1.9 Organisations of the Study
Chapter Two:
Review of Literature
- 2.1 Conceptual Framework
- 2.2 Theoretical Framework
- 2.3 Empirical Review
Chapter Three:
Research Methodology
- 3.1 Research Design
- 3.2 Population of the Study
- 3.3 Sample Size Determination
- 3.4 Sample Size Selection Technique and Procedure
- 3.5 Research Instrument and Administration
- 3.6 Method of Data Collection
- 3.7 Method of Data Analysis
- 3.8 Validity of the Study
- 3.9 Reliability of the Study
- 3.10 Ethical Consideration
Chapter Four:
Data Presentation and Analysis
- 4.1 Data Presentation
- 4.2 Analysis of Data
- 4.3 Answering Research Questions
Chapter Five:
Summary, Conclusion and Recommendation
- 5.1 Summary
- 5.2 Conclusion
- 5.3 Recommendation
- References
- APPENDIX
- QUESTIONNAIRE
Chapter One
Introduction
1.1 Background to the Study
Adolescent Sexual and Reproductive Health (ASRH) is a critical component of public health that profoundly impacts the well-being of young individuals. The perceptions of students regarding ASRH practices play a pivotal role in shaping their understanding, attitudes, and behaviors concerning this vital aspect of their lives. This introduction provides an overview of the evolving landscape of ASRH education and practices, highlighting the importance of understanding the perceptions of students and the implications for comprehensive healthcare policies.
As the World Health Organization (WHO) defines it, ASRH encompasses a wide range of issues, including access to sexual education, contraception, safe sexual practices, and reproductive healthcare services (WHO, 2019). The dynamic nature of ASRH, coupled with societal and cultural variations, has made it a subject of extensive research and debate. In this context, the perspectives of students, who are directly affected by ASRH practices, offer valuable insights into the effectiveness of current educational programs, access to services, and the overall impact on their health and well-being.
Adolescent sexual and reproductive health (ASRH) is a global public health concern. This is due to the fact that adolescent sexual activity has been on the increase in many countries around the world (Wellings, 2006). The World Health Organization (WHO) defines adolescents as young people between the age of 10 and 19 years, and they constitute about a fifth of the world‟s population (WHO, 2010a). Adolescence has been described as a time when young people engage in increasing risk-taking behaviour that exposes them to many health risks (Hale & Viner, 2016; WHO, 2014). Worldwide, the highest rates of sexually transmitted diseases (STD) occur among 20-24 year olds, followed by 15-19 year olds (CDC, 2014). Out of an estimated 22 million unsafe abortions that occur yearly, 15% occur among young women aged 15–19 years (WHO, 2011a). In developing countries, more than half of new cases of Human Immunodeficiency Virus (HIV) infections are among young people aged 15-24 years (WHO, 2015). Furthermore, STD rates have been seen to be the highest in Africa with sub-Saharan Africa (SSA) having 110 million new cases per year (WHO, 2011b).
The International Conference on Population and Development (ICPD) (1999) emphasized ASRH with the need to offer sexual and reproductive information and services to adolescents. Reproductive health services (RHS) that are adolescent-friendly have been found to be effective in addressing ASRH needs (UNFPA, 2003). However, according to the WHO, “most SSA countries have a dearth of adolescent-friendly health services and inadequate policies to address adolescent health needs” (WHO, 2010b). Nigeria showed its commitment to improving ASRH by developing the National Adolescent Health Policy based on the ICPD recommendations (ICPD, 1999). The specific ICPD recommendations were:-
- Respecting, protecting and fulfilling sexual and reproductive rights for all through enabling public education and legal and policy reforms
- Achieving access to universal, comprehensive and integrated sexual and reproductive health information, education and services
- Ensuring universal access to comprehensive sexuality education for all young people
- Eliminating violence against women and girls and securing universal access to critical services for all victims/survivors of gender-based violence (ICPD, 1999).
A national action plan for advancing young people‟s health and development in Nigeria was also developed (FMOH, 2010a). This plan focused on important actions that should be taken to improve the health of adolescents and youth in Nigeria.
Many adolescents below the age of 20 are already sexually active, but many face difficulties in obtaining reproductive health care (WHO, 2003). In addition, adolescents are typically poorly informed about how to protect themselves from pregnancies and STD (WHO, 2003). Globally adolescents access health services less frequently than expected (Cassidy, Herceg-Baron, Hock Long & Whitaker, 2003). Although adolescents in both developed and developing countries face challenges in accessing RHS, regional differences exist with adolescents in developing countries facing greater challenges. Research has shown that in many countries in SSA, young people face significant barriers to receiving SRH services resulting in the under-utilization of the service (Boonstra, 2007). A national representative survey conducted by Biddlecom, Munthali, Singh & Woog (2007) in four African countries found that young people aged 12-19 years old underutilized services such as contraception, STD prevention and treatment including HIV testing. Poor access and low use of RHS by adolescents have been attributed to lack of availability of services, lack of knowledge of adolescents about the available services, and social and cultural norms forbidding their access to sexual and reproductive services (Kamau, 2006; Biddlecom et al, 2007).
In Nigeria, a considerable population of adolescents is sexually active and are involved in unprotected sexual activities with multiple partners which expose them to a host of reproductive health problems (Bankole, Okonofua, Imarhiagbe, Hussain, & Wulf, 2009; FMOH, 2003; Okereke, 2010). Nigerian adolescents are also faced with cultural and social contexts which likely affect their access to and use of RHS (FMOH, 2009). Sexuality matters are looked upon as taboo for adolescents because sex is regarded sacred and seen as a topic for the married only (Ogundipe & Ojo, 2015). In addition, though the Federal government of Nigeria decided that sexuality education was integrated into the national school curriculum in 1999, the significant challenge that continues to threaten its implementation is the opposition from religious organizations and conservative political interest groups. These groups have the belief that sexuality and HIV education encourages children and young people to experiment with sexual activity (UNESCO, 2010). These cultural and religious contexts result in adolescents being inadequately informed about sexuality matters, as they rely on their peers for information and often are exposed to incorrect information and myths (Ahlberg, Jylkäs & Krant, 2001).
Early marriage is a common feature of adolescent girls in Nigeria, particularly northern Nigeria which has some of the highest rates of adolescents involved in early marriage in the world (Bello & Erulkar, 2007). In Nigeria, 43% of girls are married off before their 18th birthday. 17% are married before they turn 15.The prevalence of child marriage varies widely in Nigeria with figures as high as 76% in the North West region and as low as 10% in the South East (UNFPA, 2012a). In some countries including Nigeria, barriers to contraceptive use at the community level depend on adolescents‟ marital status. For adolescents who are not married, community attitudes toward contraception stem from the stigma around sexual activity before marriage (Morris & Rushwan, 2015). As such adolescents who are not married are less likely to use reproductive health services.
Reproductive health services are provided mainly by the Nigerian government through maternal and child health programs. These services are usually not targeted to the needs of adolescents and there are also issues of inadequate skills among health workers regarding ASRH services (FMOH, 2009). Adolescent-friendly RHS have been largely lacking in the country, especially in rural areas (WHO, 2011c). Statistics in Nigeria have shown that RHS coverage rates are low, new HIV infection rates are high, contraception usage low and pregnancy rates are high among adolescents (Sedgh et al. 2009; UNFPA, 2013a).
Clearly, adolescents need SRHS, and access to needed services is vital in helping prevent adverse sexual and reproductive health outcomes.
It is also necessary for protecting future generations from negative health consequences. Examples of specific successful youth-friendly service (YFS) implementation programs in Africa that have shown increased utilization, demand for and use of such youth-friendly services include: the National Adolescent-Friendly Clinic Initiative in South Africa (Ashton, Dickson & Pleaner, 2009); the Youth-Friendly Service Component of the African Youth Alliance (AYA) project (Daniels, 2007) and the Innovate Youth-Friendly initiative in Ghana (Moya, 2002). Therefore, further exploring factors affecting ASRH service access and utilization among Nigerian adolescents is important to improve ASRH service utilization and thereby reduce the burden of adolescent disease, disabilities and other negative consequences associated with ASRH.
This study seeks to explore and analyze the perceptions of students towards ASRH practices. By examining their views, knowledge, attitudes, and experiences, we aim to gain a deeper understanding of how students perceive the role of ASRH in their lives and the challenges they may encounter in accessing relevant information and services.
1.2 Statement of the Problem
In Nigeria, 34% of the population is made up of adolescents (National Population Commission, 2006). Over 30 million Nigerians are between the ages of 10-19 years and nearly one-third of Nigeria‟s total population is between the ages of 10-24 years with nearly half (48.6%) of adolescents aged 15-19 sexually active (FMOH, 2009; NPC and ICF Macro, 2009 ). The median age for first sexual intercourse in Nigeria has been reported to be 15 years for adolescent girls and 16 years for boys (NPC and ICF Macro, 2014). A survey conducted by National Agency for the Control of Aids (NACA) in Nigeria, showed that the percentage of young men and women aged 15-24 who have had sexual intercourse before the age of 15 increased from 9.8% in 2005 to 11.9% in 2007 and to 15.5% in 2012; indicating a continuous increase in the number of young people who engage in early sex (NACA, 2014). Another survey in Nigeria reported that 56.4% of sexually active boys and 39.6% of sexually active girls had unprotected sex with non-marital sexual partners 12 months prior to the survey (FMOH, 2013). A study conducted in Nigeria to determine the prevalence of abortion among women reported that one-third of those that had abortions were adolescent girls (Otoide, Oronsaye & Okonofua, 2001).
Two of the Northern regions of the country (North-east and North-west) account for 42% of the nation‟s 15 to 19 year old girls. Many of these girls are among the least educated in the country and account for 71% of annual births occurring in this age group (Singh, Audam & Wulf, 2004). These adolescents also have a fertility rate two points higher than Nigeria‟s average fertility rate of 5.2 (NPC & ICF Macro, 2009). Adolescent marriage and parenthood are common occurrences in both rural and urban communities in Northern Nigeria. The HIV prevalence rate among adolescents aged 15-19 years in the Northwest zone (3.3%) is higher compared to the national prevalence rate of 2.9% (FMOH, 2013). Furthermore, Kaduna has a low contraceptive rate (3%) among adolescents aged 15-19 years (FMOH, 2010b).
Evidence of unmet reproductive health needs among adolescents is reflected in research in Nigeria (Bankole et al, 2009; FMOH, 2003; Godswill, 2014). In order to provide appropriate ASRH services to meet these needs, it is necessary to understand the challenges encountered by the adolescents in accessing and utilizing RHS in their specific contexts and hence the purpose of this study.
1.3 Objective of the Study
The main objective of this study is to examine the Survey Of Adolescent Sexual And Reproductive Health Practices Among Students. specifically, the study aims to
- To explore the knowledge about sexual and reproductive health
- To examine the common sexual and reproductive health issues and associated socio-cultural factors faced by the adolescents.
- To understand the perceptions of adolescents regarding existing sexual and reproductive health services and barriers to its utilization.
1.4 Research Question
- What is the level of knowledge about sexual and reproductive health ?
- Are there common sexual and reproductive health practices and associated socio-cultural factors faced by the adolescents ?
- What is the perceptions of adolescents regarding existing sexual and reproductive health services and barriers to its utilization ?
1.5 Significance of the Study
Research focused on understanding the perceptions of students towards Adolescent Sexual and Reproductive Health (ASRH) practices is of great significance for several reasons:
By comprehending the perceptions of students, educators, healthcare providers, and policymakers can gain valuable insights into how young individuals make decisions related to their sexual and reproductive health. This knowledge can inform the development of educational programs and policies that align with the needs and preferences of students.
ASRH education is a critical component of empowering young people to make informed choices about their health. Understanding student perceptions helps in tailoring educational programs to address their concerns, misconceptions, and information gaps. This, in turn, can lead to more effective and engaging educational initiatives.
The perception of students about the accessibility of reproductive healthcare services is essential for identifying barriers and facilitating greater access. Addressing issues such as stigma, cost, and confidentiality, as perceived by students, can lead to improved access to contraceptives, regular check-ups, and other crucial services.
1.7 Scope of the Study
The study will analyze the Survey Of Adolescent Sexual And Reproductive Health Practices Among Students in University of Abuja. The study is limited to students of university of Abuja. Hence, the respondents for this study will be obtained from and among undergraduate students in the study area.
1.8 Limitation of the Study
In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.
1.9 Definition of Terms
- Adolescence is a transitional stage of physical and psychological development that generally occurs during the period from puberty to adulthood. Adolescence is usually associated with the teenage years, but its physical, psychological or cultural expressions may begin earlier or end later.
- Adolescent sexual and reproductive health refers to the physical and emotional wellbeing of adolescents and includes their ability to remain free from unwanted pregnancy, unsafe abortion, STIs (including HIV/AIDS), and all forms of sexual violence and coercion.
Motivation: this the process through which individual are charged to increase their action or performance either by internal or external factors. - Academic Performance: this is used in the study to refers to students’ attitude to competition for excellent in their attitude toward participating in classroom activities and home work. It also used to students’ interest in learning.
1.10 Organization of the Study
This research work is organized in five chapters, for easy understanding, as follows.
- Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
- Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
- Chapter three deals on the research design and methodology adopted in the study.
- Chapter four concentrate on the data collection and analysis and presentation of finding.
- Chapter five gives summary, conclusion, and recommendations made of the study.
Chapter Five
Summary, Conclusions and Recommendations:
5.1 Introduction
This chapter summarizes the findings on the Survey Of Adolescent Sexual And Reproductive Health Practices Among Students using undergraduate students in University of Abuja as case study. The chapter consists of summary of the study, conclusions, and recommendations.
5.2 Summary of the Study
In this study, our focus was on the Survey Of Adolescent Sexual And Reproductive Health Practices Among Students using undergraduate students in University of Abuja as case study. The study is was specifically focused on exploring the knowledge about sexual and reproductive health, To examine the common sexual and reproductive health issues and associated socio-cultural factors faced by the adolescents and to understand the perceptions of adolescents regarding existing sexual and reproductive health services and barriers to its utilization.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 100 responses were validated from the enrolled participants where all respondent are undergraduate students in University of Abuja.
5.3 Conclusions
With respect to the analysis and the findings of this study, the following conclusions emerged;
The present study explored adolescent’s perspective on the sexual and reproductive health and services. It revealed that the adolescents in both Aagrakhanchi and Kapilvastu disctricts have moderate level of knowledge about sexual and reproductive health. In general adolescents from both districts were aware about some of the common SRH problems like HIV/AIDS, Syphilis and Gonorrhea. Underlying issues like early marriage, teenage pregnancy and gender inequality were also mentioned. The commonly reported sources of SRH information were course book, mass media (TV, radio and FMs) and peers. The culture of communicating SRH problems with parents was almost non-existing except girls getting information from mothers regarding menstruation. This study identified the gap in the implementation of government ASRH programs. The most important reasons noted for not utilizing the services were social stigma, lack of information, service quality, confidentiality and service provider’s behavior. Having known that adolescents moderate knowledge and awareness about SRH and its services, this study emphasized the need of promotional activities at the community level, mostly involving peer groups and youth members
5.4 Recommendation
Based on the findings the researcher recommends that;
- Reaching adolescents with information and education about ARHS.
- Fostering supportive environments for positive ASRH development.
- Improving the quality of adolescent health service delivery.
- Enhancing participation of adolescents in addressing their sexual and reproductive health needs.

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