Perception of Undergraduate Students Towards the Use of Contraceptives
CHAPTER ONE
Objectives
- To examine the level of undergraduate’s contraceptive use and practice in Lagos State.
- To identify factors responsible for level of undergraduate’s contraceptive use and practice in Abuja.
- To find out how effective contraceptive use and practice among undergraduate in Lagos State are.
- To find out the undergraduate’s level of accessibility to contraceptive methods in Lagos State.
- To know the problems undergraduate’s encounters in accessing contraceptive methods in Lagos State.
CHAPTER TWO
LITERATURE REVIEW
Empirical Literature
In this literature review, efforts will be made to examine some of the previous studies related to the title of this work under the following sub-headings: Maternal mortality in developed and developing countries, maternal mortality in Nigeria, adolescent knowledge and use of contraceptives, trends in unwanted pregnancy, contraception in Nigeria, preventive factors affecting contraception etc.
Maternal Mortality Ratio in Developed and Developing Countries.
Maternal mortality is a public health issue in many countries especially in the developing countries, where an estimated 585000 women die everyday from pregnancy related deaths (Ali, 2009). Similarly, WHO (2010) report shows that, in developed and developing countries, maternal mortality adds up to 600,000 each year. And that every minute, at least one woman dies from complications arising from pregnancy and child birth. The report further shown that maternal mortality represents one of the widest health gaps between developed and developing nations, with 99% of all maternal deaths occurring in developing countries.
Report by United Nations Development Programme [UNDP], (2003) from a study conducted by Charles (2000) on Maternal Deaths in Europe, shown that in developed countries there are approximately 27 maternal deaths per 100,000 live birth each year, while in developing countries, the average is 18 times high, at 480 deaths per 100,000 live births. The majority of pregnancy related deaths occur after delivery is (61%), in comparison to 24% during pregnancy and 16% during delivery (USAID, 2010).
CHAPTER THREE
RESEARCH METHODOLOGY
Research Design.
This study adopted a cross–sectional survey design. May (2001) noted that the application of a cross-sectional survey method is appropriate in obtaining the behavioral pattern of a given population on the basis of their knowledge, opinion, attitude and perception concerning a given phenomenon?
Study Area.
Lagos State University – also known as LASU – was established in 1983 by the enabling Law of Lagos State of Nigeria, for the advancement of learning and establishment of academic excellence. The university caters for a population of over 35,000 students enrolled for full-time. The university also offers courses at Diploma, Undergraduate and Postgraduate levels. Lagos State University is located in Ojo, a town in Lagos State, Nigeria. LASU is the only state university in the former British colony. Lagos State University offers diploma, degree and post graduate programmes including an MBA programme.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
This chapter presents and analyzes the data collected for this study. The entire five hundred (500) questionnaires administered to the respondents in Lagos State, which constituted the representative samples of undergraduate in Lagos State were returned. Therefore, the analyses were based on five hundred (500) returned questionnaires. The analyses were divided into five major sections to include: personal data of respondents: knowledge of contraception, sexual history, barrier to contraceptive use. The hypotheses that guided the execution of this study were tested in the last section of this chapter.
Also included in the present analysis are qualitative data collected through indepth interviews with the school functionaries including religious group leaders as well as traders and artisans in the study area. During the interview sessions, the researcher observed that there two categories of undergraduate on were they spend their leisure time. The first group was referred to as ‘homely group’ that comprises of undergraduate who spend their time reading books, watching television, listening to the radio, playing games with their friends or helping their parents in different kinds of activities.
The second was the group labeled as ‘modern’ who spend most of their leisure time in illegal video houses, dancing halls, in bars, and where prepared beverages are being sold.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of Findings
This study was conducted in Lagos State, among undergraduate between 15 – 25 years old. It covered undergraduate in higher institutions, Secondary schools, and others who are not in school like traders and artisans.
A total sample of five hundred (500) was chosen for this study. The questionnaires were other-administered and were duly completed. In-depth Interview (IDI) was also conducted to revalidate and complement the findings of the survey instruments.
Socio-Demographic Characteristics of Respondents
The respondents for the survey comprised, fifty three percent (53%) males and forty six percent (46%) females. The age range of most of the respondents clustered between 15-19 years. The current level of education of most of the respondents are higher institutions and secondary schools (40%) each respectively and (20%) of traders and artisans who are not privileged to be in school. However, majority of the respondents were Christians (47.4%) and Moslems (45.6%). This shows that populations of those who practices Christianity and Moslem are quite high in Lagos State.
Knowledge and Use of Contraceptives
Since knowledge is an important prerequisite in gaining access to contraceptives, it means that knowledge of contraceptives level could be promising for better future use.
With above 50% of total population of those who have knowledge of contraceptives from this study, it shows that knowledge of contraceptives among undergraduate in Lagos State is quite high. And with 78.8% of undergraduate who have heard about contraceptives, it shows that knowledge of contraceptives is also quite high in Lagos State. And with 62% means of those who lack knowledge of contraception, It shows that undergraduates have limited knowledge and access to contraceptive methods in Lagos State.
Sexual History
The study revealed that 58.2% of respondents were sexually active or have sexual partner. It shows that sexual activity is quite high among undergraduate in Lagos State. The mean age at the sexual debut was 0.83% for males and 0.88% for females. This indicates that females are at higher risk facing consequences of undergraduate sexuality than there male counterparts. Differences in engagements in sexual activity between male and female could be due to various societies in Nigeria’s norms that prohibits undergraduate’s involvements in sexual activity. (Whereby some society considers premarital sexual activity of male as normal but strictly disapprove female involvements in pre-marital sexual activities to avoid unwanted pregnancies). Engagements in sexual activity in this study are quite lower among undergraduate between the ages of 20 years and above.
Contraceptive Use
Majority of the respondents (55.4%) identified that they have not used any contraceptives during their last sexual exercise/intercourse. While the lowest proportion (34.2%) identified that they used contraceptive methods at their last sexual intercourse. Condoms were used by 26.6% of all the respondents at their last intercourse. Shops were identified as the sources of contraception for higher proportion of the respondents at 59.2% while Government Health Centres (42.8%) and private hospital/clinic (33.0%) were the second and third sources of contraceptives used by the respondents at their last sexual intercourse. I know where to get contraceptives, I can afford to buy and I approve use of contraceptives, where the major reasons to get contraceptives from the selected sources for high proportion of the respondents. The main purpose of using contraceptive by the respondents at their last sexual intercourse was to prevent unwanted pregnancy, followed by prevention of sexually transmitted diseases (STDs).
However, for the fact that the rate of use of contraceptive by the respondents at their last sexual intercourse was to prevent unwanted pregnancy, followed by prevention of sexually transmitted diseases (STDs), it shows that undergraduate were more exposed to the risk of unprotected sex. This could also be an indication to give information about unprotected sex before they start to engage in sexual activity is lacking among them.
Barriers to Contraceptive Use
The study found that majority of the respondents who have ever used contraceptives and inconsistent users might reflect the presence of problems that undergraduate face when trying to use contraceptives. Considering the fact that (4.6%) of the female respondents have been pregnant and (4.8%) of male respondents have impregnated a girl, therefore the level of contraceptive use could be even lower and unsatisfactory. In this study most of the respondents identified, embarrassment to buy (60.57%), Religious opposition (59.45%) fear of side effect (63.55%), Afraid of being seen by parents (60.55%) and lack of knowledge (61.30%) means was commonly reported barriers by the respondents.
This is in agreement with qualitative finding that indicted that undergraduate face various barriers both at the level of accessing and using contraceptives considering the reasons for non use especially embarrassment to buy, lack of knowledge, fear of side effect and religious opposition could imply that even undergraduate who have the knowledge and want to use contraceptives, factors like fear of sharing sensitive personal matters and fear of facing side effect could also be a challenge to undergraduate decision to use contraceptives.
The study shows that undergraduate aged 14 – 19 years were less likely to use contraceptives than those aged 20 years and above. And again undergraduate who discuss contraceptives with their friends and those that approve use of contraceptives by undergraduate were more likely to use contraceptives without considering the barriers they may face. This explains why undergraduate at their early stages should need to provide information and guidance. It could also indicate the importance of teachers/parents in providing information about contraceptive use and clearing the negative rumors about contraceptives.
Conclusion
Firstly, the level of knowledge of contraceptives methods was quite high among the undergraduate, but the majority of the respondents ever used any method was quite low. This implies that majority of sexually active undergraduate are highly exposed to consequences of unprotected sex and sexually transmitted diseases.
Secondly, the study found that majority of the undergraduate have who plans to use contraceptives in the future, choose to use modern methods mostly preferred condom and lesser proportion of the respondents identified pills and withdrawals, injectables as their preferred choice.
Thirdly, greater majority of the undergraduate had positive views towards contraceptives and were interested to know more about it especially before the age they are likely to start sexual activity. Some of them identified they were not properly thought and guided on how to lead their sexual life neither from their parents nor from their teachers.
Fourthly, the study found that sizeable proportion of undergraduate prefers to use chemists/pharmacy shops to avoid identifying them sexually active and to avoid embarrassment by health workers at government and private hospitals, who will request for registration before attention could be given to them.
Finally, the study found that undergraduate faced a wide range of barriers to the use of contraceptives both at accessing it and level of use.
Recommendations
Based on the findings, the following recommendations were proffered:
Programs promoting safe sexual behaviour should be encouraged among undergraduate and it should be integrated with other behavioural change intervention.
Provision of information about contraceptive should also include the possible sources of contraceptives, especially where it could be accessed without embarrassment by the providers.
Undergraduate should be provided with basic knowledge of sexuality and contraception before the age they are likely to engage in sexual activities and effective channels of communication should be used to inform and educate undergraduate using health professionals including, the author, trained teachers, and trained peer promoters and media.
Creating public awareness (especially on parents, teachers and service providers to create supportive environment to inform undergraduate abut sexuality, encourage abstinence and reduce barrier’s to use of contraceptive by sexually active undergraduate.
Since Lagos is a modern and developing world class city, undergraduate friendly centers should be encouraged through sensitization of the providers to enhance the function of undergraduate centre which should include recreational, education, income generating activities to reduce fear of undergraduate to utilize the centres.
Areas of Future Research
It will be interesting to conduct further research among undergraduate on the use of contraceptives in various rural communities in Lagos state to identify whether they are facing similar barriers to use contraceptives, parents and teachers on their knowledge about and attitude towards undergraduate contraceptive use and provides of different delivery points on their knowledge about and attitude towards undergraduate sexuality and contraceptive needs and how they feel about undergraduate contraceptive use.
Researchers should also be committed to using the findings of research to improve the reproductive health of the undergraduate by embarking in field works in order to find out those factors which affect undergraduate’s reproductive health; as undergraduate’s reproductive health matters a lot being one of the major contributors of death of undergraduate in their undergraduateful ages, (15-20 years ) through incessant abortions and HIV/AIDS infections.
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