Abstract
Background: Emergency contraception (EC) offers women a second chance to avoid unintended pregnancy after unprotected sexual intercourse. Besides its availability, requisite knowledge and positive attitude of the healthcare works will encourage its utilization by the Internally Displaced Persons (IDP) and host community. Objectives To determine the knowledge, attitude and practice of EC by healthcare workers (HCWs) in IDP camps and host community clinics in Jere and Maiduguri metropolitan local government areas (LGAs) of Borno state, Nigeria. Methodology: Self-administered questionnaires were issued to HCWs attending a workshop on child spacing counselling and service organized by the Society of Gynaecology and Obstetrics of Nigeria, North-East sector (SOGON-NE). The questionnaire inquired about knowledge, attitudes and practice of emergency contraception. Results: Eighty-nine (89.0%) of the respondents were aware of EC and 88.0% have approved of its provision. The most common indication for the EC was unprotected sexual intercourse (91.0%), followed by rape, failed contraception and missed pills. Sixty-five (84.4%) of Nurse/Midwives and CHEWs were willing to provide EC for prospective clients and 59(76.6%) of them had provided EC in the past. The commonest form of EC known to the respondents was Levonorgestrel (Postinor 2), followed by oral contraceptive pills (OCP) and intrauterine device (IUCD). Mifepristone and ulipristal were known to only 23.6% and 11.2% of the respondents respectively. Majority (79.6%) will give EC immediately after intercourse. Only 46.1% of the respondent would institute EC within 7 days of unprotected intercourse and among them, 50% were Nurse/Midwives and 46.4% were CHEWs. Conclusion: Both the knowledge and approval of EC among the HCWs in the IDP camps and host community clinics in Jere and Maiduguri metropolitan LGAs of Borno state are high. This can be harnessed to encourage the wide utilization of the EC by adolescents and other vulnerable womenin the IDP camps and Host communities.
Highlights
Fourty-five (45.0%) of the respondents were Nurses or Midwives, 32 (32.0%) were community health extension workers (CHEWs) and 23 (23.0%) were secondary school leavers that were attached to the Internally Displaced Persons (IDP) camp and host community clinics as Healthcare Mobilizers
Recent studies amongst medical doctors and other health professionals showed an awareness of 100%. 6-8 The Emergency contraception (EC) awareness of 89.0% from this study is an improvement from a previous report by Geidam and colleagues who sampled healthcare workers (HCWs) across three Local government areas (LGAs) in Borno state about 10 years ago.[5]
This improved knowledge and awareness may be because the majority of the HCWs have put in a reasonable number of years in service to be grounded in family planning
Summary
EC has the propensity to reduce the occurrence of unwanted pregnancies following unprotected sex, contraceptive malfunction and sexual assault which are common in the Internally Displaced Person (IDP) camps and host community.[2,3]. It is a safe, effective and relatively inexpensive way to prevent unintended pregnancy.[1]. Their situation further worsens their vulnerability and sparks a cycle of repeated sexual exploitation, unintended pregnancies and unsafe abortions Many of these pregnancies could have been avoided if the ladies were aware of and had access to EC in the camps and the knowledge, attitude and practice of the HCWs in the IDP camps towards EC is an important determinant of the utilization of the services by the clients that might require it. Requisite knowledge and positive attitude of the healthcare works will encourage its utilization by the Internally Displaced Persons (IDP) and host community
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