Awareness Of Contraception Research Articles

Knowledge and Usage of Emergency Contraceptives among University Students in Ghana

This study examines the knowledge and usage of emergency contraceptives (ECs) among university students in the Republic of Ghana. Data from 1,871 students at the University of Ghana were collected using a structured questionnaire. The results show that the majority (87.9 percent) of students were aware of some regular contraceptives and ECs. Results also reveal that despite the knowledge of these contraceptives among students, the majority (70.4 percent) had never used a contraceptive. The authors recommend that the university should use social media to facilitate student awareness and knowledge of contraceptives, including ECs.

Breaking the silence: Correlates of awareness and usage of emergency contraception amongst youth

Breaking the silence: Correlates of awareness and usage of emergency contraception amongst youth

Contraceptive Method Preferences, Use and Satisfaction among Women of Reproductive Age (15-49 Years) in Umuahia, Abia State, Nigeria

Background: Low contraceptive practice is a major contributory factor to expansive population growth, high risk pregnancies, unsafe abortions, and sexually transmitted diseases. The study determined the pattern of use of contraceptive methods and associated factors among 232 women aged 15-49 years in Umuahia, Nigeria. Methods: A community-based cross sectional study using multistage sampling technique to select 232 participants was conducted. Data were collected by interviewer administered questionnaire. The Chi square test and binary logistic regression were used to assess association between contraceptive use and related factors. The knowledge of the women on contraceptives was assessed using 26 tested and scored questions. Results: The mean age of the women was 25.05 ± 5.33 years. Awareness of contraceptive was very high (96.6%), but their in-depth knowledge was low as only 12.5% had good knowledge about contraceptives. The Media (Radio/TV) was the main source of information (37.6%), followed by relatives/friends (31.4%). Ever use of contraceptives was 39.2%, while only 18.5% were currently using contraceptives. The most preferred and used contraceptive was condom (45.5%) which was considered satisfactory by the women. Fear of side effects (41.1%) was the main reason for non-use of any contraceptive method. Current use of contraceptives was associated with higher odds of being married (OR=3.280; P=0.025). Conclusion: Despite high contraceptive awareness, knowledge and current contraceptive use among the study population were low. Therefore, there is need to design more effective reproductive health programmes, including education targeted at these group of women, but especially the unmarried.

Gender differences in knowledge and attitudes concerning induced abortion in Sri Lanka: a community based study in the Colombo City

Abortion is legally permitted in Sri Lanka, only if it is performed to save the mother’s life. However, it is estimated that 125,000 to 175,000 induced abortions take place annually (De Silva, 1997). Knowledge and attitudes towards induced abortion in society can influence individual decision-making on the outcome of unwanted pregnancies and the health sector policy response. This study aims to understand the gender differences in knowledge and attitudes of adults towards induced abortion in Sri Lanka. Six Grama Niladhari Divisions (GNDs) and 50 households in the Colombo City were systematically selected using multi stage cluster sampling. An interview schedule was administrated among 743 residents between 19 to 49 years of age after receiving their written informed consent. Around 31 percent of females and 57 percent of males do not know that there are specific days in the menstrual cycle in which the chance of becoming pregnant is relatively high. Female respondents’ awareness (48 percent) of emergency contraception was significantly lower than that of males (60 percent). Only 11 percent of the respondents knew the situations in which abortion is legal in Sri Lanka. Around, 93 percent of females and 70 percent of males (X2=56.27, P<0.001) believed that induced abortion is against cultural and moral values. A majority of the respondents agreed to legalise abortion under rape (65 percent), incest (55 percent) and lethal fetal abnormality conditions (53 percent). A very small percentage of respondents agreed to legalise induced abortions in the situation of economic problems (7 percent), contraceptive failure (6 percent), at the request of the couple (5 percent) and at the request of the woman (4 percent). In conclusion, female respondents demonstrate a moderate to low level of knowledge and conservative attitudes towards induced abortion, which highlights the need for more focused interventions to address the issue.

Contraceptive choices following first childbirth among working women in Udupi taluk

IntroductionBirth control is an important determinant of maternal survival. Contraceptive use helps the couple to have the desired number of children in the family as well as to practice the desired birth interval between pregnancies. Objectives(1) To study the choices of contraceptive method by working women following the first childbirth. (2) To study the factors influencing the decision making for the contraception by these working women. Materials and methodsA community-based cross sectional study of 178 women from urban and rural parts was done using a semi-structured questionnaire at Udupi taluk, Karnataka. 30×7 cluster sampling technique was followed. Systematic random sampling was done to select total 30 clusters from urban and rural areas. ResultsIt was shown that mean age of women was 29±3.516 years, husbands’ mean age was 33±4.711. Majority (74.7%) of the women were from rural area. Majority (99.4%) had knowledge of contraceptives but only 43% were practicing contraception. Majority (44.9%) were using copper T. Health concern (60.7%) was the major factor influencing decision making about family planning services. Majority (91.6%) couples took joint decision about contraception. ConclusionAlthough the awareness of contraceptives among working women was high, less than half of the women were practicing contraception. Copper T was used by the majority of working women. Fear of side-effects was the major concern among non-users of contraceptives. Decision making was based on the mutual discussion between the couple.

Assessment of male involvement in emergency contraception in the University of Benin, Benin City, Edo State

Background : Emergency contraception (EC) refers to the use of drugs or a device as an emergency measure to prevent pregnancy. Lack of awareness and appropriate use of emergency contraception after unprotected sexual intercourse can lead to unwanted pregnancies and unsafe abortions. Male involvement in contraceptive practices could help reduce these sequelae. This study assessed the knowledge, attitude and practice of emergency contraception and extent of partners’ communication with each other on pregnancy prevention among male students in the University of Benin, Benin City. Methods : A descriptive cross-sectional study was carried out on 400 male students of the University of Benin selected by multistage sampling technique. Data was obtained with pretested interviewer administered questionnaire. Data was analyzed with SPSS version 20 and statistical significance was determined using Chi square and Fishers exact with p value set at < 0.05. Results : Three hundred and thirty-four (95.4%) of the respondents, had incorrect knowledge of Emergency Contraception (EC) while 293 (83.7%) respondents had a good attitude toward EC. One hundred and seventy-five (80.3%) of the respondents’ partners have used emergency contraception and only 93 (43.1%) respondents discussed pregnancy prevention with their partners. Conclusion : The knowledge of emergency contraception among respondents was poor. However, most respondents had positive attitude towards its use and majority of their partners had used EC. Therefore, health education program on pregnancy prevention methods is recommended to improve respondents’ knowledge. Keywords : Emergency contraception, Male involvement, Knowledge, Attitude, Pregnancy prevention

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers’ perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces—Zhejiang, Hubei and Yunnan—were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.

Awareness and practice of contraception among female secondary school students in Uyo, Nigeria

Background:Adolescent sexual activity is very prevalent in many countries. Unprotected premature sexual intercourse results in a high incidence of induced abortion, unwanted pregnancy and sexually transmitted infections. Objective: The aim of this study was to determine the degree of awareness of contraception and its practice among female secondary school students in Itu, Akwa-Ibom State, Nigeria.Method: A descriptive cross sectional study design was used to recruit 378 consenting female students selected by simple random sampling. Semi-structured, self-administered questionnaires were administered after explanation of the study and assurance of confidentiality. Three hundred and twelve forms were properly filled and analysis was done manually on these using simple proportions and percentages.Results: Majority of the respondents were Ibibio 220 (70.5%) and between 13 and 17 yrs old (89.6%). Two hundred and thirty six (75.6%) were aware of contraception. Twenty nine (16.0%) of those who were sexually active had ever practice any form of contraception. The three common forms of contraception known were the male condom (36.0%), the calendar method (34.0%) and the oral contraceptive pills (25%). The foremost sources of information about contraception were from TV/radio (36.0%), parents (25.0%) and female friends (14.8%). Of those who were sexually active 116(64.8%) had sexual debut at 11-15years of age.Conclusion: This study demonstrated that the level of awareness of contraception was high but the practice of contraception was comparatively low. It also demonstrated that the age at sexual debut was early and the rate of sexual intercourse high. This emphasizes the need for provision of timely and accurate contraceptive information through sex education in secondary schools in our environment.

Unintended pregnancy in Palestinian women living in Ramallah District, occupied Palestinian territory: a qualitative study

BackgroundAbout 39% of pregnancies in Palestinian women are unintended. So far, the determinants and results of unintended pregnancy are poorly understood. This study explores the determinants of unintended pregnancy of women in the Ramallah District, occupied Palestinian territory. MethodsA qualitative design used included five focus groups, which all contained five to six married women from the Ramallah district, occupied Palestinian territory, between May 1, 2013, and Sept 30, 2013. Participants were married, of reproductive age (about 24–28 years), and had a history of at least one unintended pregnancy. Convenience purposive sampling was used to achieve a diversity of Palestinian context. Participants were from rural (nine women), urban (12 women), and refugee camps (six women). Verbal consent was obtained from all participants. Focus groups were taped and transcribed to explore sociocultural, emotional, and economical circumstances. Furthermore, some resulting effects of unintended pregnancy on both the mothers and their infants were also investigated. Thematic analysis was done on the basis of research objectives. FindingsPoor health status and poverty were reported by participants who considered their pregnancy as unintended. Recurrent unintended pregnancies were mainly associated with coitus interruptus, calendar method, and breastfeeding as contraceptive methods. Barriers to use of modern contraceptives (eg, condoms and intrauterine contraceptive devices) included sociocultural factors (such as in-laws or husband forbidding use of contraception), fear of side-effects of modern contraceptives, and refusal of condom by husband. Participants had no awareness of emergency contraceptives, with most women having considered abortion, but did not complete the procedure because of religious beliefs and a scarcity of medical support. Participants referred to disappointment with unintended pregnancy as musiba (calamity), and zomba (letdown). Most participants had exacerbated physical symptoms during pregnancy, delays in receiving antenatal care, and some reported post-partum depression and post-partum haemorrhage. Participants did not report any effect of unintended pregnancy on their infant's weight or breast feeding duration. InterpretationThe social context of Palestinian women seems to determine unintended pregnancy rather than availability and accessibility of family planning services. These results could be used to formulate a framework to study unintended pregnancy in Palestinian women and to inform policies in reproductive health services. FundingNone.

Effectiveness of Contraceptive Counseling on Women Knowledge and Practice in Saudi Arabia

Background: Contraceptive counseling that emphasises effective and safe contraception plays a significant role in women’s health. It can help women select contraceptive methods appropriate to their health needs. The study of contraceptive counseling has not been adequately explored in Saudi Arabia (SA). This study aimed to evaluate whether contraceptive counseling was effective at improving women’s overall knowledge and use of contraceptive methods at King Abdulaziz University Hospital (KAUH).Objectives: (1) Assess women’s knowledge of contraceptive methods before and after counseling. (2) Explore which contraceptive methods were used before and after counselingMethods: This study used quantitative, quasi-experimental design. A questionnaire was administered to women who had delivered and been admitted to the postnatal unit at KAUH. The tools used in this study were a pre-test questionnaire, a counseling evaluation sheet, and a post-test questionnaire. Purposive sampling was undertaken. Ethical approval was granted from KAUH. Data collection was conducted for four months.Results: A total of 65 women consented to participate in this study. The mean age of the women was 30.1 (SD = 0.77). The majority of women (78%) had poor knowledge scores about contraception before counseling. The most frequently used contraceptive methods before counseling were lactational amenorrhea (breastfeeding), which was used by 60%, followed by withdrawal and minipill, which were each used by 50.8%. Male condom, combined oral contraceptive (COC) pills, fertility awareness and intrauterine devices (IUDs) were used by 46.2%, 43.1%, 27.7% and 18.5% of women, respectively. After counseling, the mean knowledge score increased significantly, from 49.94 to 86.35 points (p < 0.001). After counseling, the actual methods used by study participants were lactational amenorrhea, IUD, COC, minipill, withdrawal, fertility awareness and male condom. The majority of women (91%) were very satisfied with the counseling provided.Conclusions and recommendations: Contraceptive counseling significantly improves women’s knowledge about and use of birth control methods. As a result, this study recommends sustained efforts to encourage women, their husbands and the community to improve contraceptive knowledge and use. Moreover, healthcare providers, especially nurses, should participate in the education of women.

Barriers to Contraceptive Uptake among Women of Reproductive Age in a Semi-Urban Community of Ekiti State, Southwest Nigeria.

Globally, unplanned pregnancy and sexually transmitted infections (STIs) persist as a significant threat to women's reproductive health. In Nigeria, despite huge resources committed to family planning programs by stakeholders, contraceptive use has been very low. This study aimed at unraveling the barriers to the use of modern contraceptives among women of reproductive age (15-49 years) in Ise-Ekiti community, Ekiti State, Southwest Nigeria. This study was a cross sectional study among women aged 15-49 years. A multi-stage sampling technique was used in the recruitment of respondents from the community. An interviewer-administered questionnaire was used to collect data. Data were analyzed using SPSS version 15. Although contraceptive awareness among respondents was high 496(98.6%), only 254 of the 503 respondents were using modern contraceptive methods giving a Contraceptive Prevalence Rate (CPR) of 50.5%. Among those not using any form of contraceptives, some identifiable barriers to contraceptive use includes desire for more children, 62(39.5%), partner disapproval, 40(25.5%), and fear of side-effects, 23(14.6%). Factors associated with contraceptive uptake include marital status (p=0.028), educational level (p=0.041) and religion (p=0.043) with traditional worshippers having the least uptake. This study showed that awareness to modern forms of contraceptives does translate into use. The identified barriers to contraceptive uptake suggest the need to improve uptake of contraceptives through a community-based and culturally acceptable intervention as doing this will go a long way in addressing some of these barriers.

Knowledge, Attitude and Practice of Contraception among Postpartum Women Attending Kathmandu Medical College Teaching Hospital.

Background Failure to plan a pregnancy can adversely affect the health of the family as a whole. High parity is related to increased maternal, perinatal and infant deaths and is associated with nutritional problems of both mother and child. Hence, good knowledge, attitude and practice of family planning among women are important. This study is aimed to determine the knowledge, attitude and practice of contraception among the postpartum women attending Kathmandu Medical College Teaching Hospital. Objective To determine the knowledge, attitude and the practice of various contraceptive methods among the postpartum women. Method A cross-sectional observational study was conducted in the department of Obstetrics and Gynecology on 400 postpartum women (within 42 days of delivery) who delivered and came for follow-up in this institution. All the postnatal women were interviewed with pre-designed questionnaire and information on sociodemographic variable, awareness and knowledge of various contraceptive methods, previous and current use of family planning methods, source of information, utilization and reasons for use/non-use of family planning methods were obtained. Data collected were entered and analyzed using SPSS 20. The results were presented as percentages, means, tables and charts. Result Majority of the participants 363 (90.8%) were aware of contraceptive usage. Amongst 60.5% of women who had previously used contraception, OCPs were the commonest one. Maximum number of participants (60.35%) had used modern contraceptives in the past. The most common source of information on contraception was media (55.7%). The reason of using contraception was spacing between the subsequent pregnancies, while the most common reason of discontinuation or not willing to use family planning methods was husband being abroad, fear of side effects and not knowing which contraceptives to use. Conclusion The contraceptive awareness and knowledge among the postpartum women was high but their usage was low. Hence, efforts should be made to educate the public about safety and convenience of modern methods of contraceptives. Health care personnels should also counsel the clients for adopting the contraceptives according to their need.

The observational study of selected sexual behaviour issues in female organ transplant recipients

ObjectiveTo investigate sexual behaviour in women following solid organ transplantation. Study designA cross-sectional single-centre survey study of 230 female organ transplant recipients, aged 18–45years. Main outcome measuresSexual behaviour, contraceptive awareness and methods of birth control. Results205 females declared to be post their sexual initiation. The mean age at sexual initiation in our study population was 20.3±3.3years (range: 14–32). Fifty-three percent (122/230) of the patients declared that they had only one sexual partner at enrolment. After transplantation female organ recipients became more sexually active (71% vs. 83%; p=0.018). The frequency of sexual intercourse decreased significantly in the post-transplant period (p=0.004). In the group of sexually active females before transplantation the frequency of sexual intercourses decreased significantly in the post-transplant period (mean Δ −0.16±0.79; p=0.004). An increase or lack of change in the frequency of sexual intercourse was noted amongst younger transplant-recipients (OR: 0.91; 95%CI 0.86–0.97) and women with effective birth control methods post-transplantation (OR: 3.68; 95%CI 1.60–8.49). ConclusionSexual education of organ transplant recipients is necessary, mainly in younger patients, who present to be more sexually active, thus they need to be taught about effective family planning.

Assessing the Efficacy of an App-Based Method of Family Planning: The Dot Study Protocol.

BackgroundSome 222 million women worldwide have unmet needs for contraception; they want to avoid pregnancy, but are not using a contraceptive method, primarily because of concerns about side effects associated with most available methods. Expanding contraceptive options—particularly fertility awareness options that provide women with information about which days during their menstrual cycles they are likely to become pregnant if they have unprotected intercourse—has the potential to reduce unmet need. Making these methods available to women through their mobile phones can facilitate access. Indeed, many fertility awareness applications have been developed for smartphones, some of which are digital platforms for existing methods, requiring women to enter information about fertility signs such as basal body temperature and cervical secretions. Others are algorithms based on (unexplained) calculations of the fertile period of the menstrual cycle. Considering particularly this latter (largely untested) group, it is critical that these apps be subject to the same rigorous research as other contraceptive methods. Dynamic Optimal Timing, available via the Dot app as a free download for iPhone and Android devices, is one such method and the only one that has published the algorithm that forms its basis. It combines historical cycle data with a woman’s own personal cycle history, continuing to accrue this information over time to identify her fertile period. While Dot has a theoretical failure rate of only 3 in 100 for preventing pregnancy with perfect use, its effectiveness in typical use has yet to be determined.ObjectiveThe study objective is to assess both perfect and typical use to determine the efficacy of the Dot app for pregnancy prevention.MethodsTo determine actual use efficacy, the Institute for Reproductive Health is partnering with Cycle Technologies, which developed the Dot app, to conduct a prospective efficacy trial, following 1200 women over the course of 13 menstrual cycles to assess pregnancy status over time. This paper outlines the protocol for this efficacy trial, following the Standard Protocol Items: Recommendations for Intervention Trials checklist, to provide an overview of the rationale, methodology, and analysis plan. Participants will be asked to provide daily sexual history data and periodically answer surveys administered through a call center or directly on their phone.ResultsFunding for the study was provided in 2013 under the United States Agency for International Development Fertility Awareness for Community Transformation project. Recruitment for the study will begin in January of 2017. The study is expected to last approximately 18 months, depending on recruitment. Findings on the study’s primary outcomes are expected to be finalized by September 2018.ConclusionsReproducibility and transparency, important aspects of all research, are particularly critical in developing new approaches to research design. This protocol outlines the first study to prospectively test both the efficacy (correct use) and effectiveness (actual use) of a pregnancy prevention app. This protocol and the processes it describes reflect the dynamic integration of mobile technologies, a call center, and Health Insurance Portability and Accountability Act–compliant study procedures. Future fertility app studies can build on our approaches to develop methodologies that can contribute to the evidence base around app-based methods of contraception.ClinicalTrialClinicalTrials.gov NCT02833922; https://clinicaltrials.gov/ct2/show/NCT02833922 (Archived be WebCite at http://www.webcitation.org/6nDkr0e76)

Awareness and Acceptance of Contraception in Postpartum Women in Our Tertiary Hospital in Central India

ABSTRACT Introduction Contraception is an important intervention to reduce unwanted pregnancy and promote healthy and better living among women. As the population continues to rise, there will be overcrowding, a limiting of resources, and the quality of life will decline. India, as the first country in the world, initiated the National Family Planning program in the year 1951 with the objective of “reducing the birth rate to the extent necessary to stabilize the population at a level consistent with requirement of national economy.” Objectives (1) To study awareness, acceptance, and preferred method of contraception among postpartum women. (2) To identify the reasons for rejection of contraceptive methods. (3) To contribute to the development of knowledge in the area of family planning. Materials and methods The study is a community-based cross-sectional observational study. The study was conducted among postpartum women in reproductive age group who delivered in our hospital in the Department of Obstetrics and Gynecology of Netaji Subhash Chandra Bose Medical College &amp; Hospital, Jabalpur, Madhya Pradesh, India. A total of 480 married women were interviewed in the local language using a pretested questionnaire. Their level of awareness, acceptance, and reason for acceptance/refusal was assessed. Results A total of 65.2% of women were aware of at least one method of contraception; 73.9% women were using a contraceptive at the time of study; 34.8% women were unaware of any health care facility providing contraceptives in the vicinity. Maximum number of women preferred intrauterine contraceptive device (IUCD; 38.8%) as their first choice. Knowledge and practice of emergency contraceptive was very low. Main reason for nonacceptance of contraceptive was lack of knowledge and fear of side effects. Health professionals were the main source of knowledge. Conclusion There is till date lack of awareness of contraception in some postpartum women. Regular counseling is a must to all pregnant women from every health care center in a village to superspeciality centers in cities. Information should be provided about various methods of contraception and patient should be able to choose a method of her choice. How to cite this article Sahu B, Tiwari P, Uikey V, Badkur P. Awareness and Acceptance of Contraception in Postpartum Women in Our Tertiary Hospital in Central India. J South Asian Feder Obst Gynae 2017;9(4):327-330.

Awareness, perceptions, and use of contraception among married women residing in a village in rural South India

Awareness, perceptions, and use of contraception among married women residing in a village in rural South India

Awareness and Perceptions of Emergency Contraceptive Pills Among Women in Kinshasa, Democratic Republic of the Congo.

Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives. After facilitators explained emergency contraceptive pills' mechanism of action and other characteristics, participants were asked about the potential benefits and risks of making the method more widely available. Transcripts were analyzed using an iterative approach. Women reported employing a wide range of postcoital contraceptive behaviors, albeit often using inappropriate products, and generally agreed that emergency contraceptive pills seemed to be a potentially effective solution to their family planning needs. Perceived benefits and limitations of the method were almost always framed in reference to other, better-known contraceptives, and women expressed strong preferences for pharmacy-based provision that aligned with their usual behaviors for obtaining contraceptives. Participants were reluctant to see the method available for free. Emergency contraceptive pills have the potential to address gaps in the family planning method mix in the DRC. Assessing whether women have incomplete or erroneous information about family planning methods can provide better understanding of women's contraceptive choices in low-income countries.

Assessment of the Attitude of Female Post-Secondary Students and Service Providers’ Towards Emergency Contraception in Hawassa, Ethiopia

Background: Changes in the total fertility rate-lifetime births per woman have dramatic effects on population size. More than 100 million women in developing countries, or about 17 present of all married women would prefer to avoid a pregnancy but are not using any form of family planning. Method: Cross-sectional study including both quantitative and qualitative surveys. Multistage stratified sampling was employed considering all governmental and private non health post-secondary institutions. Result: Mothers level of education has a significant gross effect on awareness of emergency contraception (OR=0.848, P<0.01). Respondents who had no experience of communicating with their respective mother was lower by 62.6% as compared with those who had experience of discussion about reproductive health issues with their mothers (OR=0.374, P<0.001). Those who had no experience of communicating with their respective partner was less by 71.2 (OR=0.288, P<0.01) as compared to those who had no experience. Female students who never had sexual intercourse was less by 71.4% as compared with their counter parts (OR=0.286, P<0.05). Those who had no experience of discussion with their respective mothers and who had no experience of discussion with sexual partner were found less by 59.1% (OR=0.409, P<0.01) and 64.8% (OR=0.352, P<0.001) respectively. Respondents who have no intention to use modern contraceptives and who had poor knowledge of EC was less by (OR=0.272, P<0.05) and OR=0.194, P<0.01) respectively. Conclusion: Building providers’ capacity through in-service and pre- service trainings with emphasis on methods regimen available for different products and method of teaching and counseling of clients according to the method guideline became very vital.

Grandmultiparity: The Reasons Women Give for High Parity in South-South Nigeria

Background: The Total Fertility Rates have declined below the replacement rates globally and in the industrialized countries. The rates are still high in Nigeria and most other poorer countries. Too much childbirth is associated with increased adverse obstetric outcomes and socioeconomic implications. There has been profuse literature on high parity but limited data on the reasons for high parity. We set out to explore the reasons the women have for high parity in Nigeria. Aim: To investigate the reasons women have for high parity in order to improve reproductive health services. Methods: This was a cross-sectional descriptive study on 288 grandmultiparas (para≥5) in South-south Nigeria between 2012 and 2016. EPI INFO software was used for analysis with statistical significance set at P&lt;.05. Results: The mean age of respondents was 35.3±4.2 years. About 85% and 12% were in first marriage and remarried relationship respectively. The mean parity was 5.95±1.3 and ranged 5-11births. Respondents leading reasons for high parity were mistake (unplanned) 30.9%, desire for specific gender 22% (male child 15.6%) and personal desire for more children 15.3%. Over 90% was aware of contraception, only 29.2% ever used any method. The younger (OR=4.9, P=0.02), less educated (OR=0.39, P=0.01) and employed (OR=0.23, P=0.02) and (OR=6.9, P= 0.04) respondents significantly cited spouse desire, desire of male child, child loss and contraception failure for high parity respectively. Conclusion: Mistake, desire for male child and large family were the leading reasons women gave for high parity. Maternal age, education and employment significantly influenced the reasons for high parity. There was high contraceptive awareness but poor utilization among the respondents; a huge unmet need of contraception in this population.

Knowledge and Utilisation of Emergency Contraception Pills among Female Undergraduate Students at the University of Nairobi, Kenya

Background: Emergency Contraception (EC) is used after unprotected sexual intercourse, following sexual abuse, misuse of regular contraception or non-use of contraception. Seventeen percent of pregnancies in Kenya are unintended, potentially leading to unsafe abortion that contributes to the high maternal mortality rate in Country. According to 2016 Kenya Demographic and Health Survey (KDHS), the maternal mortality ratio was 362 maternal deaths per 100,000 live births. Female students in University or College are vulnerable to unplanned pregnancies and illegal abortions resulting in mortality, morbidity and psychosocial problems. Knowledge on EC is very important for students as they are not in stable relationships and not using regular contraception. Therefore, the aim of this study was to determine the knowledge and use of Emergency Contraception among female undergraduate students in the University of Nairobi. Materials and Methods: We used an institution-based cross sectional, quantitative study to sample was employed among 383 female undergraduate students at the University of Nairobi. The University of Nairobi has six colleges and systematic random sampling was used to select study participants from each college. Data were collected using self-administered questionnaires and analysed using SPSS Version 16. Bivariate analysis and logistic regression were used to determine sample characteristics significantly associated with knowledge and utilisation of Emergency Contraception. Results: Most (53%) of the respondents were sexually active, and only 20% of the sexually active female students had ever used Emergency Contraception. Emergency Contraception awareness was high at 86.4%. However, based on a predefined criterion, accurate knowledge of Emergency Contraception was low at 42.6%.The majority (82.5%) of the respondents depended on mass media as a source of information on Emergency Contraception. Factors associated with Emergency Contraception knowledge on bivariate analysis were: age 20 years and above (p = 0.001), enrolment in college of health science (p = 0.001), being in year three of study and above (p = 0.0001) and having an insurance cover (p = 0.021). Ever use of Emergency Contraception was associated with enrolment in the College of health science (p = 0.025) and age 20 years and above (p = 0.050). In multivariate analysis, older age (Aor 1.885 p = 0.003) as well as being in the College of health science (Aor < 0.001) were significantly associated with increased probability of being knowledgeable about Emergency Contraception. Conclusion: Although University of Nairobi female undergraduate students are aware of the existence of Emergency Contraception, their specific knowledge on correct timing of taking EC after unprotected sex and on effectiveness is poor. EC use is also low, compounded by underutilisation of public facilities as a source of the EC and underutilisation of health workers as a source of EC information. Therefore, an educative forum may be needed to improve the knowledge of EC among University of Nairobi female students. Health education on the availability of EC in public facilities needs to be addressed. Possible use of informal sources of information such as peer education could be an area to explore in client education on EC knowledge and use. Further research is recommended to establish factors that influence utilisation of public health workers as a source of EC information.