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Our objective was to investigate the knowledge, use and attitude towards emergency contraceptive pills among female undergraduates. This was done using a randomly selected sample of female undergraduate students at three tertiary institutions in Enugu, Nigeria. The majority of the respondents (95%) were aware of contraception. However, 61% of the female undergraduates had heard of emergency contraception but only 31% had actually used it. The most common source of information about emergency contraceptive pills was from friends and teachers. Most respondents (19%) used Postinor rather than other types. While using emergency contraception, 16% got pregnant, of whom 9% carried the pregnancy to term and delivered the baby while (10%) procured an illegal abortion. Increased utilization of emergency contraception is plagued with fear of infertility, anovulation, ill health and sexually transmitted infection. Though 40% of the female undergraduates accepted it when informed and would recommend it to other female students, more information dissemination is required to further create awareness and enhance wider acceptance. Awareness programmes should address the barriers to effective use of ECP preferably using peer educators and the media.

The relationship between the socio-economic status (SES) of a household and its sources of malaria diagnosis and treatment was explored in south-eastern Nigeria. One aim was to see if, as seems likely, the poorest people generally seek care from 'low-level' providers, such as traditional healers and community-based healthworkers, because of their severe budget constraints. Interviewer-administered questionnaires were used to collect information from 1197 randomly selected respondents from four villages where malaria is holo-endemic. An index was used to categorize the study households into SES quartiles. The self-diagnosis of presumptive malaria and the use of patent-medicine dealers for treatment were very common among all the SES groupings. Compared with the other interviewees, however, the least-poor were significantly more likely to rely on laboratory tests for diagnosis and to visit hospitals when seeking treatment for presumptive malaria. The most-poor, in contrast, were significantly more likely to seek treatment from traditional healers or community-based healthworkers. Thus, even though the use of low-level providers was so common, there was still evidence of wealth-related inequity--in terms of the probabilities of the good diagnosis and treatment of malaria. Improvements in the quality of malaria diagnosis and treatment by the providers patronised by the most-poor villagers would help to redress this inequity, at least in the short- to medium-term.

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