The pill: perceptions and usage among Nigerian students

Influence of discipline of study on contraceptive usage among undergraduates in Southwest Nigeria

OBJECTIVE

To determine the influence of discipline of study on contraceptive usage among undergraduates in southwest Nigeria.

METHODS

A comparative cross-sectional study of students from medical and nonmedical disciplines was carried out.

RESULTS

A total of 387 undergraduates were investigated, out of which 198 (55.8%) were from medical disciplines (MD), and 189 (44.2%) were from nonmedical discipline (NMD). Out of the total number of respondents (387), 229 (59.2%), were sexually active, out of which 26.2% had been sexually active without contraception with a greater proportion of students of NMD being affected (p < 0.05). Students from MD had a better knowledge (71.9%) of contraception than those from NMD (28.1%). However, more students from NMD use contraceptives (62%) compared to those from MD (54%) (p < 0.05). Despite this, more students from NMD became pregnant despite contraceptive use (11%) compared to those from MD (5.1%) (p < 0.05). The condom was the most commonly used contraceptive among both disciplines. The peer group was the commonest source of information on contraception.

CONCLUSION

Discipline of study has an important influence on contraceptive usage. This is a pointer to the absolute need for adequate contraceptive education for every student, irrespective of the discipline of study.

Barriers to use of oral contraceptives in ethnic Chinese women presenting for abortion

The purpose of this study was to identify barriers to the use of oral contraceptives by ethnic Chinese women presenting for abortion. Using a qualitative descriptive study design, 40 ethnic Chinese women presenting for abortion were recruited. Data were collected in semi-structured interviews by one interviewer who is fluent in English, Mandarin, and Cantonese. Transcribed interviews were systematically analyzed to identify salient themes. The attitudes toward oral contraceptives were mostly negative. The most common fears were about weight gain, permanent infertility, and being considered "bad" (promiscuous). These mostly negative attitudes toward oral contraceptives appear to be barriers to their use.

Adolescent girls with illegally induced abortion in Dar es Salaam: the discrepancy between sexual behaviour and lack of access to contraception

This article reports on a study of induced abortion among adolescent girls in Dar es Salaam, Tanzania, who were admitted to a district hospital in Dar es Salaam because of an illegally induced abortion in 1997. In the quantitative part of the study, 197 teenage girls (aged 14-19) were asked for socio-economic details, contraceptive knowledge/use, age at first intercourse and number of sexual partners. In the qualitative part, 51 teenage girls were interviewed in-depth about their relationships with their partners, sexual behaviour, contraceptive use and reasons for non-use, and why they became pregnant. The girls were sexually active at an early age and having sex mainly with men older than themselves. Although most of the girls were in love with and enjoyed sex with their partners, they also entered these relationships to obtain money or gifts in exchange for sex. Most were not using contraception or condoms though they were also at risk of STDs and HIV. These girls were getting pregnant expecting their boyfriends to marry them, or because they did not think they could become pregnant or failed to use contraception correctly. Most adolescent girls are not aware of the 1994 Tanzanian policy that gave them the right to seek family planning services and in practice these services are not being provided. There is a need for youth-friendly family planning services and to make abortion safe and legal, in order to reduce unwanted pregnancies and abortion-related complications and deaths among adolescent girls.

Emergency contraception: a review of the programmatic and social science literature

Many biomedical aspects of emergency contraception have been investigated and documented for >30 years now. A large number of social science questions, however, remain to be answered. In this article, we review the rapidly growing but geographically lopsided literature on this topic. Using computer database searches supplemented by reference reviews and professional correspondence with those active in the field, we gathered literature on the social science and service delivery aspects of emergency contraception published in English up through December 1998, as well as a few unpublished papers from the same time and slightly later, representing regions where published material is practically nonexistent. Methodologically acceptable papers are summarized in our tables and text, and form the basis for suggested improvements in existing emergency contraceptive services. The review also offers ideas for designing new emergency contraception services where they do not yet exist. We conclude by proposing an agenda for further social science research in this area.

Contraceptive continuation and its determinants in Benin

To understand better the rates of continuation of different contraceptive methods, a study in 12 family planning centers in Cotonou and Porto Novo, the two largest cities in Benin, was conducted. From January 1 to December 31, 1993, 944 questionnaires completed by new women acceptors of one of three methods of contraception (oral contraceptive, injection, or IUD) were analyzed. For all methods of contraception, the average length of follow-up was 9.5 months. From the start of the analysis, 44.4% (n = 419) of the women were regularly followed, 49.5% (n = 467) were not regularly followed, and 6.1% (n = 58) reported discontinuation of the method. One year after beginning the use of contraception, the cumulative proportion of women at risk of becoming pregnant, for all the methods together, was 42.0% (38.6-45.4%). Age was associated with the probability of abandoning oral contraception (p = 0.01). Three months after the start, the cumulative proportion of drop-out women having chosen oral contraceptive was 37.2% (22.8-51.6%) of the less than 20-year-olds, 19.0% (14.3-23.7%) of the 20- to 30-year-olds, and 23.4% (15.6-31.2%) of the over 30-year-olds. In contrast, drop-out was not associated with age for women using injection (p = 0.96) or the IUD (p = 0.47). Our results indicate a relatively high and rapid rate of discontinuation for modern contraceptive methods, particularly for young women having chosen oral contraceptive. This finding should incite the family planning educators to give more emphasis to the counseling programs, especially during the first three months.

Family planning knowledge and practice among Nigerian women attending an antenatal clinic

This study investigates family planning activity in 308 Nigerian women attending an antenatal clinic. Family planning awareness was present in 234 women (76%) and practice occurred in 168 (54.5%). Proposal to practice family planning occurred in 66 of 137 women who had never used contraception while 69 (22.4%) had no intention to practice family planning. The best-known type of contraception was the condom, 182 (59.1%); the most common used, the safe period (rhythm), 73 women (23.7%); while Billings' contraception was the most commonly proposed type, 72 women (23.4%). Knowledge of the beneficial effects of the chosen method of contraception was claimed by 102 women (43.6%) while 33 (14.2%) conceded ignorance of this. Similarly, 81 women (34.6%) claimed to know the adverse effects of their chosen method of contraception, while 119 (50.9%) admitted ignorance of it. The most common source of information on contraception was the printed media, 112 (47.9%), while the least common was lecture/sex instruction, 27 (11.5%). Lack of adequate information and ignorance are key factors militating against family planning practice in Nigeria. Family planning activity in Nigeria would be improved by wider dissemination of information on family planning through public lectures and the electronic media; training of family planning counselors to facilitate grass-roots coverage; universal entrenchment of family planning counseling into routine antenatal clinic activities; and integration of private medical centers into the national family planning service.

Sexual behavior and pregnancy among Nigerian students

The sexual behavior of 539 Nigerian female students comprising 387 adults and 152 teenagers was studied. The overall incidence of sexual activity among the students was 51.2%. The incidence of sexual intercourse was significantly higher among adult students (61.0%) compared with teenagers (26.3%) (p < 0.0005). There was no significant difference in the mean age at sexual debut for the adult students (18.7 +/- 3.2) compared with the teenage population (16.1 +/- 1.7). The frequency of sexual exposure was also not significantly different in the two groups (4.1 +/- 6.1 times per month for the adult students and 3.6 +/- 5.9 times per month for the teenage students). However, pregnancy occurred more often among the adult students (38.1%) than among the teenagers (15.0%) (p < 0.005). This article looks at the psychosocial implications of adolescent sexuality and the overall relevance of adequate reproductive health education in encouraging responsible attitudes regarding sexuality among teenagers.