CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

Contraceptives can be simply defined as a drug, device of practice used to prevent a woman becoming pregnant. This definition though well encompassing but does not include its effective utilization as a preventive measure against the spread of sexually transmitted diseases or infections. The practice of contraception is as old as man himself. Ancient writings noted on the Leahun Papyrus (1800 BCE) that the old Egyptians effectively practice contraception by using a vaginal pessary of crocodile dung and fermented dough which may create a hostile and unfriendly environment for sperm to be able to fertilize the egg.During the early second century in Rome, Sorunus of Ephesus created a highly acidic concoction of fruits, nuts and wool that was placed at the cervical OS to create a spermicidal barrier (Wikipedia.com, 2010). The act of contraception has been an ancient practice even from our forefathers who designed the timing of mating with their wives or not depending on whether they want to produce babies. They have a mental picture of when the monthly menstrual flow of their wives takes place or how long it would take their wives to breast feed their babies to avoid unwanted pregnancies. Some traditional women even go through the extra-mile of wearing contraceptive waist bands to prevent unwanted pregnancies. Every year, women around the world experience more than 70 million unwanted pregnancies.

Unwanted pregnancy can occur for two main reasons; either the couple was not effectively using contraceptives, or the method they were effectively using failed. There are many reasons why people do not use contraceptives to prevent unwanted pregnancies, including lack of access to family planning information and services; incest or rape; personal or religious beliefs; inadequate knowledge about the risks of pregnancy following unprotected sexual relations; and women’s limited decision-making ability with regard to sexual relations and contraceptive use. Many women are deprived of family planning services. Over the years, issues related to sexuality and contraceptive use, have been taken with great reservation by Nigerians, as a result of increase in sexual expressions and experimentation among adolescents. Studies conducted among female students in Nigeria indicate an overall awareness rate of 71.2%. Among sexually exposed students, there was contraceptive usage rate of 42.1% and an unwanted pregnancy rate of 33.5% (Adinma and Okeke, 1995).

Most adolescents who are sexually active and do not use contraceptive face the increasing risks of unwanted pregnancies and unsafe abortions which could ultimately put their health in grave danger. Induced abortion currently accounts for 20,000 of the estimated 50,000 of maternal mortality occur in Nigeria each year (Akingba, 1977; Okonfua and Liumok, 1992). Many unwanted pregnancies by adolescents arise out of ignorance and bad attitude to contraceptive use, because they receive inadequate education on sexual and reproductive health, and the source of information available on contraception are oen dubious, unreliable and misleading because the information is less motivated by healthcare providers than their peers. The 1990 Demographic and Health Survey indicated that only 11% of sexually active women age 16 – 20 ever used any modern contraceptive methods. this is unfortunately very low as it has increased cases of unwanted pregnancies and abortions which has put their lives in danger. The environment in higher institutions of learning is characterized by high levels of personal freedom and sexual interaction (Alexander et al, 2007).

Permissive sexual lifestyle in higher institutions of learning in Nigeria and a number of other African countries have been documented as featuring a high level of very risky sexual behaviors such as transactional sex, multiple sexual partners, and unprotected casual sex amongst others (Manena-Netshikweta, 2007; Katjaviri and Otaala 2003). Such reproductive health behavior is prone to consequences of unwanted pregnancies, unsafe abortions, disruption of education and secondary infertility amongst other dangers (Malhotra, 2008; Akingba, 2002; Adegoke, 2003). Given the increasing level of sexual activities among young people and decreasing age at first sex in developing countries, the use of contraceptives to prevent unwanted pregnancy and unsafe abortion is especially important (Adedoyin et al, 1995; Okonkwo et al, 2005; Uthman, 2008). It has been reported by the Nigerian Population Commission (NPC) that knowledge of contraception is lowest among women with no education and greatest among women with more than secondary education (NPC and ICF Macro, 2009). This indicates that along the line, there is improvement in contraceptive knowledge though it may not always translate to the same level of utilization.

This utilization gap has been highlighted in some studies among adolescents and out of school women (Idonigie et al, 2011; Abiodun et al, 2001). A high level of knowledge and concomitant utilization of contraception is desirable among adult women, a significant proportion of which is in tertiary institutions. The current contraceptive prevalence rate in Nigeria is about 15% (NPC and ICF Macro, 2009). This low rate underlies the population explosion and other reproductive health challenges being currently experienced in the country. Women in tertiary educational institutions are included in the over 200 million women worldwide who have an unmet contraceptive need (McPhail et al, 2007). This study was to investigate the knowledge, use, and behaviour regarding contraceptives among female undergraduates in University of Port Harcourt.

STATEMENT OF THE GENERAL PROBLEM

The promotion of effective contraceptive use among female students of University of Port Harcourt is very important, if their reproductive health is to be improved, because many female students are oblivious of the adverse health consequences of ineffective contraceptives. It should be noted that despite the wide knowledge and campaign about the use of some contraceptives such as condom, most female students still distaste such use, therefore, exposing themselves to unwanted pregnancies and risky abortions. It is true that sexual education in most of our homes are poor, with the belief that being sexually educated will make the student to be promiscuous or to test what they have learnt.