Pattern, Types and Predictors of Contraception among Female In-School and Out-of-School Adolescents in Onitsha, Anambra State, Nigeria

Abstract

Introduction: The consequences of unsafe sex are suffered mostly by adolescent girls in Nigeria despite efforts to improve accessibility to the reproductive and sexual health of this group. This study elucidates the pattern of contraceptive use, the key socio-demographic factors, sexual beliefs and practices associated with its use amongst adolescent girls in Nnewi, Nigeria. Methods: It was a descriptive cross-sectional comparative study of in-school and out-of-school female adolescents. Data were collected using questionnaires and Focus Group Discussion (FGD), then analyzed by selecting socio-demographic and other variables to assess their interaction with contraceptive use and result compared between the two groups. Data were presented in tables and charts and multivariate and chi-square analyses were performed. Result: Higher proportion of sexually active out-of-school girls than their in-school counterparts had ever used contraception-used it in their first and last sexual exposures, while condom was the commonest contraceptive employed by both groups. Age (older adolescents; F = 0.041), belief in condom use (P = 0.05), willingness to get condom for partner (P = 0.001) and regular sexual practice (P = 0.003) were the most important predictors of contraceptive use among the sexually active adolescents. Generally, the out-of-school girls are more likely to use contraceptives than their in-school counterparts. Some misconceptions about pregnancy prevention and unscientific contraceptive methods were mentioned by the subjects during the FGD. Recommendation: Access to reproductive health services needs to be improved especially among the in-school female adolescents. There is need to incorporate the right * Corresponding author. P. Adogu et al. 34contraceptive information in the school curriculum, and the out-of-school adolescents should receive periodic dissemination of appropriate Behavior Change Communication (BCC) on the relevance of contraception.

Contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania

“…We also found that the most common reasons for not using any contraceptive were fear of side effects and religious beliefs. Our findings differ from the study done in Nigeria where female adolescents were not using contraceptives due to inadequate money, fearing that the use of contraceptive would render them infertile, or for fear of losing their lovers 22 as also indicated in a study done in Bahir Dar University in Ethiopia which reported that the use of contraceptives, especially condoms, decreases sexual pleasure. 23 …”

Predictors of young people’s use of sexual and reproductive health services in Nigeria: a mixed-method approach

“…Age, level of education, location, income, psychocultural and health system (p=<0.001) are signi cantly associated with the utilization of post abortion care, while income (p=0.02), psychocultural (p=0.00) and health system (p=0.00) are signi cantly associated with the utilization of services for the prevention and management of STI, HIV, and AIDS. Table 4 shows that socio-demographic factors of gender; male (AOR = 0.64; CI = 0.43-0.95), age; [17][18][19][20][21][22] (AOR = 0.23; CI = 0.14-0.38), and lower income; <1000 (AOR = 0.84; CI = 0.72-0.99) were signi cantly associated with lower odds of SRHS utilization, while tertiary education (AOR = 2.93; CI = 1.93-4.46) and living in school (AOR = 1.40; CI = 1.13-1.73), were signi cantly associated with higher odds of SRHS utilization. Similarly, psycho-cultural (AOR = 2.40; CI = 1.50-3.84) and health system factors (AOR = 7.47; CI = 4.66-12.01) were signi cantly associated with higher odds SRHS utilization.…”

Overview of HIV Risk Reduction Interventions among Adolescents - A Call to Evaluate the HIV Education Curriculum in Nigeria

“…Worldwide, almost half of studies that measured program impact on condom use found increased condom use with none of them finding decreased condom use [21,[24][25][26]. The proportion of effective programs in developing countries was similar to the proportion in the developed countries in both school and community settings, irrespective of gender and age of populations [21].…”

“…However, sexual risk behaviours were more difficult to change. A 'Sex and HIV Education Programs for Youth' study [25] revealed that the intervention effect of peer education at the individual level was significant. The students who received peer education had a significantly higher attitudewhich influences behaviour compared with those who were not targeted.…”