Knowledge and Utilisation of Emergency Contraception Pills among Female Undergraduate Students at the University of Nairobi, Kenya

Abstract

Background: Emergency Contraception (EC) is used after unprotected sexual intercourse, following sexual abuse, misuse of regular contraception or non-use of contraception. Seventeen percent of pregnancies in Kenya are unintended, potentially leading to unsafe abortion that contributes to the high maternal mortality rate in Country. According to 2016 Kenya Demographic and Health Survey (KDHS), the maternal mortality ratio was 362 maternal deaths per 100,000 live births. Female students in University or College are vulnerable to unplanned pregnancies and illegal abortions resulting in mortality, morbidity and psychosocial problems. Knowledge on EC is very important for students as they are not in stable relationships and not using regular contraception. Therefore, the aim of this study was to determine the knowledge and use of Emergency Contraception among female undergraduate students in the University of Nairobi. Materials and Methods: We used an institution-based cross sectional, quantitative study among 383 female undergraduate students at the University of Nairobi. The University of Nairobi has six colleges and systematic random sampling was used to select study participants from each college. Data were collected using self-administered questionnaires and analysed using SPSS Version 16. Bivariate analysis and logistic regression were used to determine sample characteristics significantly associated with knowledge and utilisation of Emergency Contraception. Results: Most (53%) Contraception knowledge on bivariate analysis were: age 20 years and above (p = 0.001), enrolment in college of health science (p = 0.001), being in year three of study and above (p = 0.0001) and having an insurance cover (p = 0.021). Ever use of Emergency Contraception was associated with enrolment in the College of health science (p = 0.025) and age 20 years and above (p = 0.050). In multivariate analysis, older age (Aor 1.885 p = 0.003) as well as being in the College of health science (Aor < 0.001) were significantly associated with increased probability of being knowledgeable about Emergency Contraception. Conclusion: Although University of Nairobi female undergraduate students are aware of the existence of Emergency Contraception, their specific knowledge on correct timing of taking EC after unprotected sex and on effectiveness is poor. EC use is also low, compounded by underutilisation of public facilities as a source of the EC and underutilisation of health workers as a source of EC information. Therefore, an educative forum may be needed to improve the knowledge of EC among University of Nairobi female students. Health education on the availability of EC in public facilities needs to be addressed. Possible use of informal sources of information such as peer education could be an area to explore in client education on EC knowledge and use. Further research is recommended to establish factors that influence utilisation of public health workers as a source of EC information.

Determinant of emergency contraceptive practice among female university students in Ethiopia: systematic review and meta-analysis

“…The review revealed that students age less than 20 were less likely to practice emergency contraceptives [ 19 – 22 , 27 ]. This finding was consistent with the finding of a study conducted in Kenya [ 28 ]. This might be related to, less exposure for sexual experience due to less adaptiveness for the environment and less sexual experience of their peer.…”

“…This systematic and meta-analysis revealed that the overall prevalence of emergency contraceptive practice during the period studied in Ethiopia was 34.5% [95% CI [20.8, 48.2%]. This study is higher than findings from South African university students, 28% [ 10 ], Cameroon, 7.4% [ 11 ] Kenya, 20.2% [ 28 ], Kampala, 7.4% [ 29 ] Hong Kong, 12.9% [ 30 ]. The variation could be due to easy availability of the drug without prescriptions but lower than a study conducted in Federal Polytechnic Kaduna, Nigeria 38% [ 12 ], Ghana 41% [ 31 ].…”

Emergency Contraceptive Pill Use and its Impact on Condom Utilization Among University Students: A Cross-Sectional Study

“…In this study, more than half (51.4%; 95% CI, 45.1–57.7%) of the respondents had awareness of ECP. This is lower than the reports of previous studies conducted in different universities of Ethiopia (67% to 95.9%) 26–28 , 30 , 31 and Kenya (86.4%) 12 but much higher than that of a Nigerian university (14.6%). 13 It is consistent with results from a South African university (49.8%).…”

“…2–4 , 9 For instance, certain multinational analysis of ECP use indicated that the proportions of ECP use varies from below 0.1% in Chad to 12% in Colombia. 10 Other studies also reported that the magnitude of ECP practice among female university students varies across countries in Africa: 21.2% in South Africa, 11 20% in Kenya 12 and 15.2% in Nigeria. 13 The Ethiopian Demographic Health Survey of 2016 (EDHS 2016) reports showed that practice and knowledge of emergency contraception was 4% and 19%, respectively among Ethiopian women aged 15–49.…”

Knowledge, Practice and Barrier Towards Emergence Contraceptive Usage Among Female University Students at Kilimanjaro Region in Tanzania.

“…Different studies identi ed different sources providing information on emergence contraceptive. Accordingly, the most commonly stated sources of information included mass media, books/magazine and friend/partner (10,11) These evidences clearly show that method mix (formal education, combination of mass media and internet) has to be used to make emergence contraceptive information as widely disseminated as possible so as to increase awareness of youth and adolescence in universities as well as community at large.…”