TITLE:
Knowledge and Utilisation of Emergency Contraception Pills among Female Undergraduate Students at the University of Nairobi, Kenya
AUTHORS:
Mwaniki Grace Nyambura, James N. Kiarie, Omenge Orang’o, Okubatsion Tekeste Okube
KEYWORDS:
Emergency Contraception, Knowledge, Utilisation
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.9,
September
28,
2017
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 to sample was employed
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%) of the respondents were sexually
active, and only 20% of the sexually active female students had ever used
Emergency Contraception. Emergency Contraception awareness was high at 86.4%. However, based on a
predefined criterion, accurate knowledge of Emergency Contraception was low at
42.6%.The majority (82.5%) of the respondents depended on mass media as a
source of information on Emergency Contraception. Factors
associated with Emergency 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.