CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
There has been considerable concern in many countries about the sexual and reproductive health of young people, in part because of their perceived increased vulnerability to the risk of sexually transmitted disease (STI), the potential risk to their health due to early pregnancy and the negative consequences of early non-marital child bearing to young people’s life prospects. Public concern over reproductive health problems among Nigerian youths has drawn attention to researchers, non-governmental organizations (NGOs) and policy makers to examining the driving force behind the upsurge in adolescent sexual activity.
The environment in higher institutions of learning is characterized by high levels of personal freedom and social interaction. This social interaction often translates to sexual interaction (Aras, .S.et al., 2007). Permissive sexual lifestyle in higher educational institution in Nigeria and a number of other African countries have been documented as featuring a high level of risky sexual behaviour such as transactional sex, multiple sexual partners, unprotected casual sex (Ikene, A.C.C; et al 2010). Such reproductive health behaviour is prone to consequences of unwanted pregnancies, unsafe abortion, disruption of education and secondary infertility (Oyedeji, O.A; 2009;Orji, E.O; et al 2012). Given the increase level of sexual activities among young people and decreasing age at first sex in developing countries, the use of contraceptives to prevent unwanted pregnancy and unsafe abortions is especially important (Adedoyin et al., 1995;Okonkwoet al., 2005;Uthaman 2008).
It has been reported by the Nigeria population commission (NPC) that knowledge of contraception is lowest among adults with no education and greatest among people with more than secondary education (NPC and ICF Marco, 2009). This indicates that along the line, there is improvement in contraceptive knowledge though it may not always translate the same level of utilisation. The utilisation gap has been highlighted in some studies among adolescent and out of school women (Abiodun et al., 2001; Idenigie et al., 2011).
The current prevalence rate of contraceptive used in Nigeria is approximately 11% to 13% (NPC and ICF Macro, 2009). This rate is very low despite the high rate of sexual activity and wide spread awareness of the various contraceptive methods among Nigerian youths. There is ample research evidence identifying the various factors that contribute to the low prevalence of contraceptive used in Nigeria institutions with the most common factor been myth about side effects of modern contraceptives.
It has been estimated that the 210million pregnancies that occur annually worldwide, about 80million (38%) are unplanned and 46million (29%) end in abortion (of which undergraduates made a high percentage), (Okonofua and Illunoka, 2000; Akingba 2002). Those undergraduate that do not use any contraceptives may lack access or face barrier. These barriers include lack of awareness, lack of access, cultural factors, religion opposition to be used by partners or family members and fear of health risk and side effect of contraceptives. Among college students, especially the medical students, unintended intercourse is the primary course of unwanted pregnancies and many undergraduates with unwanted pregnancies decide to end them by abortions. The performance of an abortion is illegal under Nigeria constitutional laws, unless the woman’s life is threatened by the pregnancy. As a result, induced abortions are usually obtained in secret and are frequently unsafe (Adedoyin and Adegoke, 2007).
1.2 Statement of Problem
The promotion of effective contraceptive use among Nigeria undergraduates is a major challenge if their reproductive health is to be improved. Given that undergraduates are now marring later and their increasingly interested in further studies and increasingly having premarital sex; it is clear that allowing the existing gap between contraceptive need and contraceptive utilization to be left unfilled will result in dramatic rise in the prevalence of unsafe abortions, disruption of education, future unemployment and secondary infertility.
Identifying the high risk group that are often ignorant of contraception, a comprehensive study of understanding the knowledge, attitude and use of contraceptives of undergraduate students in college of medicine, Ambrose Alli University (A.A.U) Ekpoma is highly needed.
1.3 Objectives of the Study
- To access the students’ knowledge of contraceptive devices.
- To access their attitude towards contraceptive devices.
- To access their utilization of contraceptive devices.
1.4 Significance of Study
The study will help to determine the knowledge, attitude and use of contraceptive among undergraduate student in college of medicine, A.A.U, Ekpoma. This will enable us to know the modalities for further educating the student on different forms of contraceptives, proper use of such contraceptive, side effects and suitability of the different contraceptives on individual basis. The study will help us to know the interventions to put in place, should the knowledge, attitude and usage of contraceptives be poor and will also enable health professionals and the government more accessible, available and affordable for undergraduate students. The research findings will create awareness to the undergraduate students and thus educate then on the factors necessary for contraceptive use there by reducing ignorance and misconception about contraception and reduce sexually transmitted infections.
1.5 Research Questions
- How informed are undergraduates students about contraceptive devices?
- What are their attitude towards contraceptive devices?
- What are the contraceptives used amongst students?
1.6 Research Hypothesis
- There is a significant association between the level of knowledge of contraception and the use of contraceptives by undergraduate students.
- There is no significant association between the level of study of undergraduate students and their knowledge of contraception.
1.7 Scope of Study
The study is delimited to the knowledge, attitude and the use of contraceptives by undergraduate Students in college of medicine, Ambrose Alli University, Ekpoma, Edo state.
1.8 Limitation of Study
Certain limitations to this study, such as using only a university student population as a sample group, might have a negative effect on the validity of the findings. This study was conducted among a higher education population, and therefore, students who were not enrolled at universities, as well as other sexually active groups, were excluded from this study. Therefore, research among a larger variety of students representing all fields of study would be needed to determine whether the study’s findings could apply to all students.
Furthermore, this study was limited in that information was gathered by means of a questionnaire only. The results of this study were dependent on the accuracy and truthfulness of the participants’ responses and due to the sensitive nature of this topic the researcher could not explore issues like self-reported sexual behaviour in more depth. The participants’ disclosure of personal information and their honesty might have affected the data that was obtained. In-depth interviews with some students might help to collaborate and expand the findings in this regard.
The researcher initially intended to include both faculties of basic medical sciences and clinical sciences in the study. However, the researcher was informed to obtain additional consent from faculty of clinical sciences, and due to time constraints, data could not be collected at this faculty.
1.9 operational Definition of Terms
Contraception: The use of a device or procedure to prevent contraception as a result of sexual activity.
Contraceptives: A mechanism or means by which conception as a result of sexual intercourse can be prevented or made less likely.
Knowledge: Awareness of a particular fact or situation, a state of having been informed or made aware of something.
Attitude: The disposition, orientation or state of mind about something.
Use: To employ, to apply or utilize something.
Undergraduate: A student in a university who has not received a degree.
College: A specialized division of a university with its own faculty, department, library etc.
College of medicine: A school with a curriculum leading to a medical degree
University: A high level educational institution in which students study for degree and academic research is done.
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