CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
There is a high level of maternal motality study has observed that the high maternal mortality ratio (MMR) in Nigeria is attributed to her youth’s sexuality (Harrison, 2009). The latter is characterized by low contraceptive usage by the youth, high incidence of illegal abortion amongst the youths, ignorance of contraception among the youth, and lack of sex education from parents and teachers. The situation in Nigeria is likely to a reflection of the situation in the entire Africa. Such a situation made the World Health Organization Report (2010) to show that Africa’s progress in meeting the number 5 Millennium Development Goals (MDG5), in which the target is 75% reduction in the maternal mortality ratio from the year 2000, to the year 2015 remains a major challenge to health systems worldwide..
Attahir, Sufiyan, Abdukadir and Haruna (2010) found out that the health risk faced by adolescent girls during pregnancy is very high, accounting for 15% of the Global Burden of Disease (GBD) for maternal conditions and 13% of all maternal deaths. The cause of this degenerating health condition of adolescent girls, according to Tien (2006), is lack of knowledge and access to contraception. Consequently, Tayo, Akinola, Babatunde, Adewumi, Osinusi and Shittu (2010) suggested active and intensive promotion of sexuality education, and contraceptive use among the youth in the Sub-Saharan Africa as a way of addressing this anomaly.
Adolescent sexual activity and child bearing has adverse social consequences for premarital fertility, manifested by the disruption of young women’s education; in Kenya, and other African countries, pregnant students are required to drop out of school, and in some areas up to 10% of female students curtail their education each year as a result of pregnancy (Benson, 2010).
Pregnancy is riskier for the very young women than for those who delay their first birth until after age 20. Complications such as obstructed and prolonged labour are leading causes of death among teenage women worldwide. Furthermore, data from around the world show that babies born to teenage mothers are more likely to die than those with their mothers over age 20 (WHO, 2010). Adolescent pregnancy have made many young women to procure abortion which is illegal in many sub-African countries, for it is the main cause of maternal mortality and has also serious health consequences. This is mainly due to the fact that premarital relations tends to be common inmost societies and premarital births are considered undesirable and often result in abortion or infanticide (WHO, 2010).
The consequences of teenage sexual activity transcend pregnancy, because they are often ignorant about their sexual health, yet they are susceptible to sexually transmitted diseases including HIV/AIDS. The adolescents should therefore be provided with services and knowledge of contraception for the protection of their own health and their children. Developing countries like Nigeria, have experienced high rate of development in terms of health and standard of living since independence in 1960. The situation has led to the reduction in mortality rate and rise in fertility rate leading to high population growth and hence putting pressure on social and economic development (WHO, 2010).
One of the major factors is that youth often lack basic reproductive information on the consequences of sexual intercourse (Indongo, 2014). In addition to the above mentioned information, youth also lack skills in negotiating sexual relationship, and knowledge about affordable confidential reproductive health services. Again many do not feel comfortable discussing sexual issues with parents or other key adults with whom they can talk about their reproductive health concerns. Likewise, parents, healthcare workers, and educators frequently are unwilling or unable to provide complete and accurate age-appropriate reproductive health information to young people. This is often due to discomfort in discussing the subject or the false belief that providing the information will encourage increased sexual activity. This is because most youth enter into sexual relationships with very little knowledge on the consequences. The little knowledge they have is either got from their peers or from the media.
Despite the social and cultural importance of child bearing in African society, unwanted pregnancies are a source of concerns within the family. This is more acute for adolescent girls who often fall pregnant out of wedlock. In a bid to avoid facing judgment from their family and community, resulting to abortion is commonly their only choice. Studies in Nigeria indicate high rate of sexual activities as well as limited knowledge and use of condom among secondary school students as well as undergraduates (Iyaniwura and Salako, 2015). The resultant effect is an increased rate of unwanted pregnancy and the attendant unsafe abortion. As unintended pregnancy still poses a major challenge to the reproductive health of young adults in developing countries, there is need to improve on their knowledge and utilization of contraceptives. This study is therefore carried out to examine the knowledge and practice of contraception among students of medical laboratory science, Babcock University.
1.2 Statement of the Problem
Unwanted pregnancy is one of the problems facing adolescent girls.
In Sub Saharan Africa it is estimated that 10% of girls become pregnant at the age of sixteen (WHO, 2008). Teenage girls who get pregnant are likely to drop out from school and are unlikely to have the social and economic means to raise their children. Adolescent pregnancy has been identified as one of the reasons for girls dropping out from school (MoET BEST, 2009). It has been reported that many young people become sexually active at an early age, when most of them have no knowledge on reproductive health. (Reina et al., 2010).
Adolescents remain inconsistent contraceptive users and are thus at high risk of unintended pregnancy and childbearing. Adolescents who do not use contraception or who use contraception inconsistently in their first sexual relationships are less likely to be consistent contraceptive users in later relationship (Ryan, Franzetta and Manlove, 2007).
In Nigeria, it has been observed from several studies that high rate of sexual activities as well as limited knowledge and use of contraceptives exist among adolescents (Nwaorah, Mbamara, Ugboaja,Ogelle and Akabuike, 2009). This usually leads to high rate of unwanted pregnancies, sexually transmitted infection including HIV/AIDS etc. According to Atere, Shokoya, Akinwale and Oyenuga (2010), the increasing number of pregnancies, abortions, and sexually transmitted infections including HIV/AIDS among the adolescents in Sub-Saharan Africa indicates that successive efforts towards preventing the scourge remain inadequate in the continent. This is due to the fact that a lot of sexually active young people use contraceptives at a very low rate, which results into increase in the spread of STD’s and HIV/AIDS among the adolescents. In their study, Ghuman (2005) affirmed this and noted that there is a global existence of increasing sexual activities among the adolescents, with those in developing countries perceived to be at greater risk because of their low level of access to medical facilities. The inadequate contraceptive coverage is multifaceted social, ethical, and cost issues are focused on the consequence of unintended pregnancy; long-term consequences of unintended pregnancy are far reaching.
Many adolescents do engage in sexual activity without the use of contraception, despite exposure to educational programs, which has led investigators to consider the potential predictors of contraceptive use (Chung-Park, 2007). Several factors have been noted to influence contraceptive decision-making, amongst adolescents.
Creel and Perry, (2003) noted that the improvement of reproductive health is keys to improving the situation of youths as well as the world’s future generations. |Even though several reports have shown that there is a decline in adolescents’ pregnancy, maternal mortality and morbidity, yet most of the premarital births still occur among young women aged 15-24 years, the majority of whom are neither economically nor emotionally ready to deal with parental responsibilities.
Aderibigbe(2011) noted from her study that 17% of all sexually active males had impregnated a girl once while the remaining has got a girl pregnant more than once. Aderibigbe (2011) also noted that poor access to contraceptive information contributes to higher infant mortality, increased maternal mortality and morbidity among the youth and the spread of sexually transmitted infections including HIV/AIDS. The foregoing has necessitated the need for this study which is aimed at examining effect of contraceptive patronage and risk involvement on female Senior secondary school students’ academic performance.
1.3 Objectives of the Study
General Objective
The broad objective of this study is to determine the level ofeffect of contraceptive patronage and risk involvement on female Senior secondary school students’ academic performance.
Specific Objective
1. To assess the knowledge of female senior secondary school students in Ilisan High School on contraception.
2. To determine the practice of contraception among female senior secondary school students in Ilisan High School.
3. To assess the factors that influences the use of these contraceptives among female senior secondary school students in Ilisan High School.
4. To evaluate the effect of contraceptive patronage and risk involvement on female Senior secondary school students’ academic performance.
1.4 Research Questions
The following research questions are formulated to guide this study.
1. What is the knowledge of female senior secondary school students in Ilisan High School on contraception?
2. What is the practice of contraception among female senior secondary school students in Ilisan High School?
3. What are the factors that influences the use of these contraceptives among female senior secondary school students in Ilisan High School?
4. What are the effect of contraceptive patronage and risk involvement on female Senior secondary school students’ academic performance?
1.5 Justification of study
Unsafe abortion is a major medical and public health problem in Nigeria. Because she has a high incidence of unwanted pregnancies and unsafe abortions, particularly among adolescents (Hassen, 2000). Teenage girls are particularly prone to unintended pregnancies. Unsafe abortion is one of the top causes identified in the high number of maternal morbidity and mortality in Nigeria.
Thus, understanding of knowledge and practice of contraception is critical for countries like Nigeria with a population policy aimed at reducing unwanted pregnancy. The present study will show the scope of the problem in the study area and information gathered will provide baseline data for further study and for policy makers in developing appropriate evidence-based strategies to promote the use of emergency contraceptive pills in Nigeria.
1.7 Significance of the study
The outcome of this study may be of immense benefits to the respondents and the society to identify the roles of parents in the sexual and contraceptive behavior of their children and to awaken the interest of parents in giving their children sex education at home. It will in behaviour which will assist in the development and implementation of effective, preventive and intervention programs especially issues concerning sexually transmitted disease. It will also help to identify students who either use or misuse contraceptive method, thereby putting them at risk of unwanted pregnancy, AIDS and other sexually transmitted disease. It will also be of importance in educating the undergraduate on the choice of contraceptive methods.
1.8. Scope of study
The study would focus on sexuality and contraception among student. In this case, this study will review the plight of sexuality and use of contraception among students of Babcock University, Ilishan – Remo. The school is located at Ilishan Remo community which is in Ikenne Local Government area of Ogun State. Due to the pattern of lifestyle of the students all over the country, the result of this study can serve as a guide to what the situation could be in other parts of the county.
1.9 Operational definition of terms
Abortion: This is the ending of pregnancy by removing a fetus or embryo before it can survive outside the uterus
Contraception: This is a method or device used to prevent pregnancy
Family planning: The practice of controlling the number of children one has and the intervals between their births, particularly by means of contraception or voluntary sterilization.
Unsafe Sex: Having sex (vaginal, anal or oral) without using a condom. It means you are at risk of HIV as well as sexually transmitted infections (STIs).
Youths: The period between childhood and adult age usually within the age range of 15 and 24 years.