Response of unmarried adolescents to contraceptive advice and service in Nigeria

Residential Spaces and Timing of First Sexual Intercourse Among Never-Married Youths in Nigeria

Youths in sub-Saharan Africa who initiate sex at an early age tend to be more vulnerable to HIV/AIDS and other sexually transmitted diseases because of the lack of accurate knowledge of preventive behaviors. Although sociocultural and economic factors associated with sexual initiation among youths have been studied extensively in Nigeria, little is known about the effect of place-based factors. Rural and urban disparities remain high in Nigeria, and these disparities are reinforced by stark regional inequalities between the north and south. Considering these underlying inequalities, we examined the extent to which rural and urban youths in northern and southern Nigeria differ with regard to the timing of sexual initiation using the 2013 Nigerian Demographic and Health Survey. Results from our event history analyses suggest that never-married male and female youths who lived in the urban north delayed their first sexual intercourse compared with their counterparts in the rural north, but those who lived in the rural south had their first sex earlier. Young males who lived in the urban south also experienced their first sex earlier than their counterparts in the rural north. Surprisingly, educated youths and those who had accurate knowledge about HIV/AIDS transmission experienced their first sex early. Clearly, the timing of sexual initiation among youths varies across different spatial and cultural contexts. Therefore, interventions aimed at discouraging early sexual initiation among young people in Nigeria may need to go beyond merely providing health information and services to addressing the livelihood needs of youths, especially those in rural settings.

Sexual Behaviors and Attitudes of High School Students in the Kingdom of Swaziland

This study examined sexual behaviors and attitudes of high school students, with a steady partner, in the Kingdom of Swaziland, southern Africa. Questions asked were: What proportion of adolescents with a steady partner is coitally active and with what frequency? How do adolescents feel about multiple partners? What are adolescents' contraceptive practices? What gender differences emerge regarding demands and expectations of coitally active adolescents? Multiple methods of data collection were employed. The results showed that most respondents had become coitally active by the time they were 16 years of age. Genderdifferences emerged regarding (a) attitudes about multiple partners and (b) demonstrating affection. Growing consumerism is beginning to have some effect on adolescent sexuality. There is no school policy on teachingfamily life education. Pregnancy is a problem as well as are septic abortions. Parental guidance is less influential than in the past, yet traditional values attached to gender roles are still intact among the adolescents interviewedfor this study.

Perinatal outcome in unbooked teenage pregnancies in the university of calabar teaching hospital, calabar, Nigeria

Background. Teenage pregnancy being a high risk condition requires skilled attention for good outcome. Objectives. To determine the influence of antenatal care on perinatal outcome in teenage pregnancies in Calabar. Materials and Methods. A review of patient records in Calabar was conducted between 1st January, 2006 and 31st December, 2010, to determine perinatal outcome in teenage pregnancy. Results. Teenage pregnancy accounted for 644 (6.5%) of the total deliveries with 245 (38.0%) booked while 399 (62.0%) were unbooked. Teenage mothers contributed significantly to the proportion of women who were delivered without prior antenatal care (χ(2) = 6.360; P < 0.05). The mean duration of labour in booked teenagers was 10.85 ± 4.2 hours, while unbooked teenagers was 23.31 ± 3.6 hours (t-value = 77.1039; P < 0.05). There was statistically more caesarean sections among unbooked teenage pregnancies than booked (χ(2) = 36.75; P < 0.05). Stillbirth was statistically significant (χ(2) = 27.096; P < 0.05) among unbooked teenagers than booked. However, early neonatal death was not significantly different between booked and unbooked teenage pregnancies(χ(2) = 0.512; P < 0.05). Conclusion. Unbooked teenage pregnancies were significantly associated with increased operative intervention and poor perinatal outcome.

Reasons for delaying or engaging in early sexual initiation among adolescents in Nigeria

Background

Annually, over 1 million births in Nigeria are to teenage mothers. Many of these pregnancies are unwanted and these mothers are also exposed to the risk of human immunodeficiency virus (HIV) infection. Sexual abstinence is a critical preventative health strategy. Several quantitative studies in Nigeria have identified the correlates and determinants of early sex, yet few have explored in depth the underlying reasons for early sex. This paper explores both the key factors that motivate some unmarried young people to engage in early sex and reasons why some delay.

Methods

This qualitative study was based on data from 30 focus group discussions held with unmarried 14- to 19-year-olds in four geographically and culturally dispersed Nigerian states. Focus groups were stratified by sexual experience to capture variations among different subgroups.

Results

Several reasons for early premarital sex were identified. The “push” factors included situations where parents exposed young female adolescents to street trading. “Pull” factors, particularly for males, included the pervasive viewing of locally produced movies, peer pressure and, for females, transactional sex (where adolescent girls exchange sex for gifts, cash, or other favors). Also noted were overtly coercive factors, including rape. There were also myths and misconceptions that “justified” early sexual initiation. Reasons cited for delay included religious injunction against premarital sex; disease prevention (especially HIV/acquired immunodeficiency syndrome); fear of pregnancy, and linked to this, the fear of dropping out of school; and, for females, the fear of bringing shame to the family, which could lead to their inability to get a “good” husband in the future.

Conclusion

The differences observed between sexually active and abstinent adolescents were that the latter were more confident, had greater determination, and, most important, deployed refusal skills to delay first sex. Health promoters need to focus attention on educating adolescents in the skills needed to delay sexual debut.

Impact of post-abortion counselling in a semi-urban town of Western Nigeria

This study is designed to evaluate the impact of post-abortion counselling in bringing about changes in sexual behaviour among patients who had treatment for an induced abortion and/or its complication in the department of gynaecology and obstetrics of Wesley Guild Hospital Ilesa and Folasola Specialist Hospital between January 1999 and December 2001. A structured questionnaire designed to evaluate the impact of counselling was administered to 108 patients, who formed part of 238 patients who had undergone induced abortion and who benefitted from the behavioural contract counselling technique. The results showed that the percentage of women using contraception increased from 30 (27.8%) to 53 (49.1%) at the time of interview. The number of subjects with multiple sexual partners fell from about 62 (58%) to 12 (11%). About 24 (45%) found access to contraception difficult. Major factors influencing contraceptive usage and change in behaviour include suffering experienced at the time of termination 26 (49%) and knowledge of contraception 19 (36%). The study advocates post-abortion counselling as a tool to increasing contraceptive usage in women and influencing behavioural changes positively towards health promotives measures.

Reproductive Knowledge, Attitudes and Behaviour of Secondary School Students in Akure, Nigeria

Adolescents are subject to many life changes as their secondary sexual characteristics emerge. Contrary to parents' and society's wishes, these young people are more sexually active then previous generations and thus at greater risk of unwanted pregnancies, sexually transmitted diseases, and related problems. Adolescents enrolled in school have the potential opportunity to learn ways to prevent these reproductive and sexual health problems, but there is concern whether schools are living up to this challenge. Therefore, this study was designed to learn whether adolescents in secondary school in the Ondo State capital of Akure have reproductive health education and are practicing healthy sexual behaviors. The study was based on a sample of six of the twenty-eight secondary schools in Akure that fell under the jurisdiction of the Ondo State Post-Primary Schools' Management Board. Focus was placed on pupils in the final years of both Junior Secondary School (JSS 3) and Senior Secondary School (SSS 3). Overall, 30 percent of the young people reported having sexual intercourse: 21 percent of females and 38 percent of males. Also 39 percent in SSS 3 reported having had sex compared to 21 percent in JSS 3. Forty percent of students in coeducational school compared to 19 percent in boy's school and 8 percent in girl's school had sex. Respondents averaged only 11 points on a 33-point scale of reproductive health knowledge. Students in the senior classes and those in single sex schools scored higher. The mass media was stated to be the major source of reproductive health knowledge; only one-third reported that they had actually talked with someone about their reproductive health concerns. Attitudes toward pre-marital sex were more favorable among male students, pupils in mixed sex schools and those whose parents had lower levels of education. These findings suggest not only that the schools must take a more active role in providing reproductive health education, but that this should be done in the junior secondary years before most pupils become sexually active.

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.

The pill: perceptions and usage among Nigerian students

The knowledge and use of oral contraception were investigated in 498 students from 5 tertiary institutions in south-eastern Nigeria. Awareness of the pill was high (92.2%) but usage was comparatively low (17.5%). Post-coital oral contraception was more often used (11.5%) than the other types. Perceptions about the risks of the pill were variable: 46.4% of the students believed that it could damage the uterus, and 41% said it could cause infertility; 31.7% believed that it caused amenorrhea, while only 14.9% of the students admitted ignorance of the risks of the pill. There was a lack of desire to use the pill in 72.3% of the respondents. Only 18.7% desired to do so, including students already using the pill. The most common source of information on contraception was peer groups (43.6%), while lectures and sex instructions constituted the least common source (11.2%). Poor information on the pill and ignorance were identified as the major factors militating against pill usage. Accordingly, the role of early and adequate sex and contraceptive education in improving pill usage in this population and developing countries in general is highlighted.

Family planning practice among Nigerian student midwives

An analysis of the various contraceptive methods practiced by a total of 462 student midwives from the Northern and Southern parts of Nigeria over a 3-years period is presented. The differences in age distribution, the type of contraceptive agents used, the reasons for using them, and the side effects in the two groups are statistically significant. The need to provide acceptable contraceptive advice to the rural communities by the midwives is discussed.

Sexual behavior and contraceptive use by adolescent pupils in the republic of bophuthatswana

Cluster sampling was used to identify thirty clusters from which a total random sample of 210 pupils aged thirteen to eighteen were drawn to assess their sexual and contraceptive behavior. The mean age of the sample was 15.2 with a mean age at menarche of 13.8, a mean age at first coital experience of 14.9 and a mean age at commencement of contraception of 15.6. One hundred and seventy-four (82.9%) of the respondents reported general knowledge about contraceptives that was obtained from a variety of sources, 101 (48.1%) reported to be sexually active and thirty-one (14.8%) to be using contraceptives. Although no statistically significant relationship was found between age and contraceptive use, a statistically significant correlation (p < .001) was found between age and age at first coitus.

Contraception among female students in the University of Benin

QESTIONNAIRES WERE distributed amongst a randomly selected sample of 400 female under graduates of the University of Benin, Benin City, Nigeria with the aim of finding out their degree of aware ness of, attitude to, and use of contraceptives.

The mean age of the studied population was 19.6 years. 360 (90%) were single. 372 of them (93%) were aware of contraception, 192 (48%) had used one form of contracep tion or the other, and 104 (26%) had had one or more abortions at the time of the study. Of these 104, 62 (or 60.8% of them) had used no form of contraception prior to the pregnancy.

The most dreaded side effect of contraception among the population studied was infertility.