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AN ANALYTIC REVIEW OF THE ACQUAINTANCE AND PRACTICE OF CONTRACEPTIVES AMONG FEMALE STUDENTS

Abstract

Introduction

Contraception is regarded as an important preventive measure of unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS), among youths. This study aimed to assess the knowledge, attitude, and practice of contraception among female undergraduates in Dodoma, Tanzania.

Methodology

A cross-sectional study was conducted among 347 female undergraduates of St John’s University, Dodoma. Descriptive statistics were used for data analysis. Statistical analysis was done using Epi-Info version 7.2.2.6 (Centers for Disease Control and Prevention, Atlanta, Georgia. A p-value of less than 0.05 was considered statistically significant.

Results

The mean (±SD) age of participants was 27.4 (± 5.7). The majority (96%) of the participants were aware of contraception. Awareness of contraception was significantly associated with the age (p<0.0001), marital status (p<0.00001), and religion of the participating students (p=0.02). Slightly less than half (47.4%) of the students reported having ever used at least one type of contraception while feeling embarrassed to buy or ask for contraception (64.6%) and differing religious beliefs (32.3%) were among the reasons reported by students for not using contraception.

Conclusion

Despite the relatively low utilization of contraception, the majority of the participants had knowledge of contraception. This calls for efforts to advocate the effective utilization of reproductive and sexual health services among youths.

Keywords: knowledge, attitude, practice, contraception, female university students

Introduction

Almost 20% of the Tanzanian population is between 15 and 24 years of age. This group constitutes the majority of youths who join universities in Tanzania. Although the group is the most sexually active, girls in the group are faced with more challenges in accessing contraceptives than are married women due to the stigma attached to their sexual activities before marriage. This poses the risk of unwanted and teen pregnancies and unsafe abortions [2]. The latter is a significant public health concern in many developing countries, with the most recent publication showing global annual incidence estimates that suggest that 25.1 million women had undergone unsafe abortions between 2010 and 2014 [3].

Despite being freely available at health facilities throughout the country, the utilization of contraception among students, especially females, remains low, with increased rates of unplanned pregnancies being reported [4]. Previous reports in Tanzania have shown the utilization of contraception among secondary school students to be between 11.8% and 40.0% despite students exhibiting a relatively high knowledge of contraception. In the general population, the contraception uptake rate has been reported to vary from 19.0% to 34.4%.

The correct use of contraception can prevent unintended pregnancies, unsafe abortions, and sexually transmitted infections, including HIV [9]. Unwanted pregnancies among students of higher learning institutions create a major public health problem, particularly in developing countries, and may jeopardize students’ learning and potential careers. Globally, several studies have reported on the knowledge, attitude, and practice toward the use of contraception among various groups of students but little is known about the current knowledge, attitude, and practice toward the use of contraception among young females in this study setting.

Most previous studies have concentrated mainly on primary and secondary school girls, and only a few have addressed the problem of the low utilization of contraception among university students. Further, to the best of our knowledge, no study has been conducted in this study area to assess the knowledge, attitude, and practice of methods of contraception among female university students. This study, therefore, aimed to assess the knowledge, attitude, and practice of contraception methods among female undergraduate students in Dodoma, Tanzania.

Materials and methods

Study design, setting, and population

This was a cross-sectional descriptive study conducted among undergraduate university students in Dodoma city, Tanzania. The study population consisted of female undergraduate students at the main campus of St John’s University of Tanzania. This is one of the largest universities in the city and is located about five km from the city center. The university offers both undergraduate and postgraduate programs to about 5000 students.

Sampling and sample size

The study site was randomly selected from a list of universities located in Dodoma. A sample size of 347 students was calculated using the Kish, Leslie formula [15] based on the previous prevalence of users of contraception (34.4%) reported in a study conducted at another university in eastern Tanzania [5], with a 95% confidence interval and a ±5% degree of precision.

Inclusion and exclusion criteria

The study included all first to fourth-year, full-time, registered, female undergraduate students of all age groups. Another inclusion criterion was a willingness to participate in the study. Exclusion criteria included an unwillingness to participate and being a part-time or distance learning student.

Data collection

Students who consented to participate were interviewed using pre-tested, self-administered structured questionnaires. The collected information included socio-demographic characteristics, knowledge of students on modern contraceptives, students’ attitude toward the use of modern contraceptives, and students’ practices toward the use of contraception. Dependent variables included knowledge, attitude, and practice of contraception, whereas independent variables were age, year of study, marital status, program of study, and source of information about contraception.

Data analysis

Statistical analyses were done using Epi-Info version 7.2.2.6 (Centers for Disease Control and Prevention, Atlanta, USA). Continuous data were expressed as means ± standard deviation (SD) and categorical data as percentages. The chi-square tests were used to determine the association between categorical variables. A p-value of less than 0.05 was considered statistically significant.

Ethical considerations

Informed written consent was obtained from each participant. The study protocol was collaboratively approved by the Institutional Review Board of Tongji Medical College, Huazhong University of Science and Technology, and the University Research Internal Ethical Committee of St John’s University of Tanzania.

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