CONTRACEPTIVE PRACTICES AMONG FEMALE SECONDARY SCHOOL STUDENTS IN IKERE LOCAL GOVERNMENT AREA OF EKITI STATE, NIGERIA.
ABSTRACT
Adolescent girls in developing countries are known to
have inadequate access to reproductive health information which could influence
their attitude towards reproductive health practices. This study therefore
investigated Contraceptive practice among female secondary school students. The
study adopted the descriptive survey research design. A multistage sampling
technique was used to select 100 in-school adolescent girls in Ikere that
constituted the sample. A questionnaire tagged Reproductive Health Information
and Attitude of Adolescents Questionnaire (RHIAQ) complemented with focus group
discussion, observation and oral interview were instruments used to collect
data. Knowledge and prevalence of contraceptive use was found to increase
with age, current use and positive attitude. Female students had better
knowledge on contraception than male students. Good knowledge on contraception
did not translate into increased use, the prevalence of use being only 34% as
compared to 75% of students with average to good knowledge. More students
reported using the male condom for contraception. Most students (69.5%)
mentioned pharmacies and drug stores as their main source of contraceptives.
These findings underscore the need for early education on human sexuality and the
benefits of family planning. Health care providers, including pharmacists, must
be trained to be able to provide adequate basic contraceptive services to
adolescents and the general public. There is need to improve access to
contraceptive services by adolescents.
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CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Adolescents’ sexuality and reproductive health
information needs and services have been a major concern and challenge to the
international community for over a decade. This is as a result of the growing
awareness of young peoples’ relatively high risk of exposure to inaccurate or incomplete
information about reproductive health issues such as sex, HIV and other
sexually transmitted infections (STIs), pregnancy, abortion, maternal
complications, female genital mutilation and so on (World Health Organization,
2002). The advancement in science and technology has restructured and redefine
the way and manner people interact with things that pertains them. For
instance, birth control. A lot of devices have been produced to reduce that
rate at which people especially women reproduce at the detriment of their
health. The issue of pre-marital sex is likening to a burning bush among youths
globally. It is worthy of note, to mention that youths engage in pre-marital
unprotected sex for several reason such as they don’t enjoy sex when
contraceptive is used, contraceptive is too expensive, it is far out of their
reach to mention but few reasons. It is after the exercise that they run from
pole-to-pole to use one thing or the other so that the unprotected does not
result in unwanted pregnancy. Hence, this studies to investigate the practice
of contraceptive among female students in secondary school in Ikere Local
Government Area of Ekiti State.
Unwanted
pregnancy is one of the problems facing adolescent girls. In Sub Saharan Africa
it is estimated that 10% of girls become pregnant at the age of sixteen (WHO,
2008).Teenage girls who get pregnant are likely to drop out from school and are
unlikely to have the social and economic means to raise their children. In
Nigeria, adolescent pregnancy has been identified as one of the reasons for
girls dropping out from school (Olukoya and
Ferguson (2002). It has been reported that many young people become
sexually active at an early age, when most of them have no knowledge on
reproductive health. (Reina et al., 2010). A study on adolescents in the
rural area of Nigeria reported that school children lack credible knowledge
about safe sex (Mushi et al.,2007). Unintended pregnancy is also
associated with increased risk of morbidity for women and with health behaviors
such as delay in prenatal care which may affect the health of the infant.
Educational programs on reproductive health have been conducted in Nigeria,
however knowledge and practice of secondary school girls regarding safe days and
contraceptive use is not well documented.
Adolescents, according to the World Health
Organization (2002), are young people between the age of 10 and19 years, and
they constitute about a fifth of the world’s population. Of these, about
sixteen per cent live in Africa. In fact, in many countries in Africa,
adolescents constitute approximately thirty-three per cent of the population (International
Clinical Epidemiology Network, 2006; Olukoya
and Ferguson, 2002). In Nigeria, thirty-four per cent of the population are
adolescents (Population Reference Bureau, 2006).Adolescence is the transition
from the world of childhood to the world of adulthood. It is a period of
physical and emotional development almost as rapid as the first decade of life.
At this time, the body matures and the mind becomes more questioning and
independent (World Health Organization, 2002).
The physiological changes which take place during this
period of transition from childhood to adulthood result in the formation of
sexuality and present the first challenge to healthy adolescent growth. During
this period adolescents engage in sexual exploration and experimentation
without adequate knowledge of reproductive health issues, information sources
and services that are available (International Clinical Epidemiology
Network, 2006). According to Olukoya and
Ferguson (2002), evidence from World Health Organisation case studies on sexual
relations among adolescence in developing countries indicate that sexual
activity seems to start during adolescence, and among a significant number of
these adolescents much of the activity is often risky, and contraception and
condom use is erratic.
According to Marie Stopes International Worldwide
(2002) the health risks which these adolescents are exposed to include sexually
transmitted infections, unplanned pregnancies, unsafe abortions, and untimely
death. Adolescent mothers are more likely than older women to suffer from
serious complications during delivery, resulting in higher morbidity and
mortality for both mother and infants (National Population Commission, 2000).
Similarly, health statistics show that more than 13% of all maternal deaths
occur among adolescents (ages 10 – 19), representing approximately 69,000
maternal deaths annually. In Africa, maternal mortality among adolescents
account for up to 40% in some countries (Olukoya, 2004).
A community
based study of abortion prevalence among Nigerian women found that one-third of
those who obtained abortions were adolescent girls (Otoide, Oronsaye
and Okonofua 2001). A hospital based studies
also indicated that up to 80% of patients with abortion-related complications
were adolescent girls (Otoide, et al, 2001).
Health reports
indicate that more than a third of all people living with HIV/AIDS are under
the age of 23, and almost two-thirds of them are female. In Sub-Sahara Africa,
among young people aged 15 to 24, two girls are infected for every boy and for
adolescents ages 15 to 19, five or six girls are infected for every boy in
worst affected areas (UNICEF, 2006). In Nigeria, one of the first cases of AIDS
in 1984 was in a sexually active 13 year old girl (Fawole, Asuzu
and Odunta, 1999). Otive-Igbuzor, (2003) stressed
that girls within the age-group 12 – 24 are mostly infected with HIV/AIDS. In
fact, HIV/AIDS increasingly is becoming a disease of the young girls in Africa.
These startling revelations indicate that adolescent girls are more vulnerable
to reproductive and sexual health risks than adolescent boys.
The purpose of
this study therefore was to assess knowledge and use of different contraceptive
methods among adolescent secondary school girls in some selected secondary
schools in Ikere Local Government Area of Ekiti State.
1.2 Statement of the Problem
Access to appropriate reproductive
health information by adolescent girls is crucial to the achievement of the
Millennium Development Goals of reducing maternal and child mortality by 2015
and halting and reversing the spread of HIV among the most vulnerable by 2010.
Yet, literature has shown that secondary
school adolescent girls have inadequate access to reproductive health
information due to socio-cultural values, religious beliefs, economic factors,
inadequate information resources and facilities.
With increasing
adolescent sexual activity and the decreasing age at first coitus in developing
countries, the knowledge and use of contraceptives become imperative to curb
the hazard associated with unplanned pregnancy and its complications especially
in the underdeveloped youths. According to Aziken, Okonta and Ande (2003),
unintended pregnancy poses a major challenge to the reproductive health of most
young adults in developing counties.
The increase in
mortality and mortality among adolescents in the developing countries has
become a focus of research and policy initiatives (Amaego, Silicia and Obiekezi
2007). These problems were associated with adolescent unprotected sexual
activities, low contraceptives awareness and practice and had resulted in
increased pregnancy rates and criminal abortions. These had led to the
development of Nation Policy on Population which specified reduction of teenage
pregnancy by the year 2000. The adolescent pregnancies and sexual embarrassment
are presumably high that knowledge, attitude and practice of contraceptives
among adolescents in selected secondary schools in Akpabuyo should be known and
steps taken in addressing this social menace. It is against this backdrop that this study investigated contraceptive practice
among female secondary school students in Ikere Local Government Area of Ekiti
State.
1.3 Objectives of the study
The major objective of the study is to examine
the extent of practice and use of contraceptives among secondary school female
students. The specific objectives of the study are to:
1. investigate the state of awareness of female students
in secondary school on the contraceptives practices;
2. investigate reproductive health information needs of
the secondary school female students in Ekiti State;
3. determine the level of the secondary school female
students access to reproductive health information sources;
1.4 Research Questions
The study has the following research questions:
1. What is the level of awareness of contraceptives among
secondary school female students in Ikere Local Government Area of Ekiti State?
2. What are the reproductive health information needs of secondary
school female students in Ikere Local Government Area of Ekiti State?
3. What is the degree of secondary school female
students’ access to reproductive health information sources in Ikere Local
Government Area of Ekiti State?
1.5 Scope of the Study
Though adolescents are young people between the ages
of 10 and 19 years the study focuses on young girls (female students) in
secondary school girls ages 13-20. It is believed that adolescent girls in the
senior secondary classes fall mostly within the 13-20 age bracket. The study
will cover access to and use of electronic media, print media, oral and
institutional sources of health information that are relevant to adolescent
girls health needs. The adolescent reproductive health issues that are of
interest in this study include teenage marriage, premarital sex, early and
unwanted pregnancy, unsafe abortion, sexually transmitted diseases, and HIV/AIDS.
All the 9 senior secondary schools made-up of 100 girls from public secondary
schools in Ikere Local Government Area of Ekiti State were involved in the
study.
1.6
Significance of the study
The findings of
this study will help policy makers and stakeholders who are involved in the
provision of reproductive health information and services to adolescents to
understand the relationship between access to reproductive health information
and the attitude of in-school adolescent girls towards reproductive health
practices. This will enable them to
design and adopt more appropriate policies and intervention strategies that
will enhance the general well-being of in- school adolescent girls.
The result of the study will bring to fore
the reproductive health information needs of adolescent girls in Lagos State in
particular and elsewhere especially in Nigeria and the Third World. This is expected to provoke government and
non-governmental agencies to make concerted effort towards meeting these
needs. The outcome of this study may be
a basis for reviewing and improving the quality of existing National Health
Information Policy, National Health Management Information System and National
Sexuality Education Curriculum. Lastly,
this study will contribute to knowledge and literature on adolescent
reproductive health information which no doubt will be of immense benefit to
researchers in the field of adolescent health in Nigeria.
1.8 ASSUMPTIONS
OF THE STUDY
(1)
I assume
that after this research work on contraceptive practice among female secondary
school students in Ikere Local Government, that the ministry of education and
other educational agencies in the arm of secondary school education in Nigeria
will understand the basic needs for adequate sensitization of the students and
the entire public on the need the practice and consequences of contraceptives
among secondary students and other educational institutions to curtain the
negative use and effect of contraceptives on the students in term of academic
output and social life.
(2)
I also
assume that this research work will enlighten the people more and educate them
widely in the need for the sensitization of secondary students against mis-use
of contraceptives.
I
assume that this work will put to an end, the problems of abuse practice of
contraceptive among students.
1.7 Definition of Terms
Adolescents: Adolescents in this study refer to girls between
ages 13 to 20 (the common age bracket for senior secondary schools).
Access: Access refers to the degree of proximity, closeness
or nearness to sources, and ease of locating and obtaining reproductive health
information from the sources.
Attitude: Attitude refers to what adolescent girls think
about, feel about, and their behaviour towards reproductive health practices
Health
Information: This includes information
for staying well, preventing and managing diseases, and making other decision
related to health and health care. It may be in the form of data, text, and/or
video. It may involve enhancement through programming and interactivity.
Information: This refers to news, facts, messages, opinions,
processed data, images that are capable of improving the reproductive health
knowledge of in-school adolescent girls.
Information
Source: The point of origin or a supplier
of information; a point of emanation of information; first hand document;
primary reference work; an individual; institution or media from where a
message originates.
Reproductive
Health: It refers to a state of
complete physical, mental and social well-being and not merely the absence of
disease or infirmity, in all matters related to the reproductive system and to
its functions and processes.
Reproductive
Health Information use: the
application of reproductive health information; that is how in-school
adolescent girls in this study apply reproductive health information received
from various sources for decision making, prevention and curative purposes.
Reproductive Health
practices: It refers to reproductive and
sexual health related actions or behaviours such as early marriage, premarital
sex, early and unwanted pregnancy, abortion, female genital mutilation.
CHAPTER TWO
REVIEW OF
RELATED LITERATURE
2.0.
Introduction
This chapter reviews literature relevant to the study.
The related literature is reviewed under the following sub-headings:
2.1 Academic meaning of
Contraceptives
2.2 General Overview of
Contraceptive
2.3 Adolescent attitudes towards
contraceptives
2.4 Positive attitude towards
contraceptive use
2.5 Benefits of using
contraceptives
2.6 Beliefs and values about
adolescents’ use of contraceptives
2.7 Responsibility to use
contraceptives
2.8 Motivation to use
contraceptives
2.9 Challenges of using
contraceptives
2.10 Beliefs and values that
prevent adolescents’ use of contraceptives
2.11 Appraisal of
literature review
