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Contraceptive Use Among Female Undergraduates: A Case Study of a Nigerian

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IJP International Journal of Pharmagenesis
1(2), July-December 2010, pp. 147-152

Original Research Article

Contraceptive Use Among Female Undergraduates:

A Case Study of a Nigerian University

*Pharm Adibe Maxwell Ogochukwu; Pharm (Dr) Okonta Jegberime Mathew and
Pharm Ubaka Chukwuemeka Michael
Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences
University of Nigeria, Nsukka

Abstract: There has been proliferation of the use of various types of contraceptives particularly among the young
women. This informed the aims of this study which are to assess behavours and attitudes that underlie the use
of contraceptives among female student in University of Nigeria, Nsukka. A total of 3,480 self-completed
questionnaires were distributed to the respondents in all the 9 faculties of University of Nigeria, Nsukka campus.
The study showed that the main aim of contraceptive use was to prevent pregnancy. This was more among the
married than the singles, 67.8% and 50.2% respectively. Condoms use between single and married female students
differed greatly (43.7% vs. 28.4%), unlike traditional methods which were almost similar (41.2% vs. 44.7%) for
both groups. The study revealed that the prevalence of contraceptive use was high and that the purpose of its
use was majorly to prevent pregnancy for both married and unmarried respondents.

Introduction Most of our teenage male and female have their

Contraception is the deliberate prevention of
conception or impregnation through the use of
contraceptives [1] . The approach is often
employed for economic, demographic and /or
medical purposes so as to reduce maternal
mortality, teenage pregnancy, over population
and sexually transmitted infections prevalence[2].
One third of Nigeria’s total population is youth
between the ages of ten and twenty-four[3]. By
2025, the number of Nigerian youth is estimated
to exceed 57 million [4]. Lack of sexual health
information and services places these young
people at risk for pregnancy, abortion, sexually
transmitted infections (STI), and HIV/AIDS. In
addition, early marriage and childbearing limit
youth’s educational and employment
opportunities.
Corresponding Author: Pharm Adibe Maxwell
E-mail: maxolpharmacia@yahoo.com;
maxwell.ogochukwu@unn.edu.ng
Received on: 06-05-09, Accepted on: 28-11-09
first sexual intercourse before the age of eighteen[5].
Therefore, effective and innovative programs that
can provide youth with sound sexual health
information and services are needed.
Proliferation of the use of various types of
contraceptives particularly among the young
female has been observed, [6,7,8] even when the
effectiveness, safety, side effects,
contraindications and availability of these
methods vary. With such an array of methods to
influence the choice of the medical experts, special
precaution should be taken with respect to patient
suitability and adverse effects of each method. It
is therefore the responsibility of health
professionals to ascertain that each person who
obtains a family planning method has sufficient
information on the proposed method and that this
person is competent to make a choice. The choice
of contraceptive method is often individualized
based on a patient’s age, profile or need. Thus an
opportunity should be given to individuals or
couples to make their choices.
148
A perfect contraceptive would be 100%
effective, totally safe, available to everyone,
completely without side effects, instantly
reversible and easy to use. It would not interfere
with intercourse in any way and would require
no advice or care from the clinician. However, the
choice in recent years have been affected
particularly by the emergence of Acquired
Immune Deficiency Syndrome (AIDS) and a
consequent increase in the awareness of the need
for the protection from sexual transmitted
infections (STIs). The aims of this study were to
assess behavours and attitudes that underlie the
use of contraceptives among female student in
University of Nigeria, Nsukka. Also to identify
barriers that militate against correct and
consistent use of contraceptives, particular
attention is given to importance of pregnancy
prevention and sexually transmitted infections
including HIV/AIDS prevention.
Methods
Study area / Population
The study was conducted among the female
undergraduate students of University of Nigeria,
Nsukka campus, Eastern Nigeria. The university
has two campuses: Enugu campus and Nsukka
campus. The Nsukka campus accommodates
about 23,000 of total students distributed in 9 out
of 14 faculties of the university, with about 16,000
female students’ population. The university admit
student from 11 states in South-East and South-
South of Nigeria and it provides a common
ground to study the behavour and attitude of
students from these geo-political regions
Research Instrument
The questionnaire was divided into three sections.
Section A consisted of demographic data of the
respondents, section B consisted of questions
regarding contraceptive usage and section C
consisted of contraceptive methods used by the
respondents. Condom methods include condoms,
Spermicides, Diaphragm and Cervical cap. Non-
barrier methods include combined oral
contraceptives, Progestin-only oral
contraceptives, Injectable contraceptives and
Norplant Implants. Traditional methods include
periodic abstinence (rhythm), withdrawal,
International Journal of Pharmagenesis, 1(2) 2010
Lactational Amenorrhea methods and folk
methods.
Validity and Reliability of the Research
Instrument
Items in the questionnaire were suggested by the
literature and expert opinions.
A pilot study was conducted using 50
students to ascertain the validity and reliability
of the instrument. After the pre-test, the
instrument was slightly modified and reliability
analysis performed on data.
Data Collection
A total of 3,480 self-completed questionnaires
were distributed to the respondents in all the 9
faculties of Nsukka campus. The questionnaires
were distributed at the end of lectures, with
permission of the lecturer, for self-completion.
Respondents were briefed about the purpose of
the study and oral consent was obtained from
them. All respondents were assured of
confidentiality and anonymity. They were asked
to put the questionnaire in the envelope provided
and hand it to researcher. It took about 10-15
minutes per respondent to complete a
questionnaire.
Data Analysis
The completed questionnaires were sorted and
entered into version 14 of Statistical Package for
the Social Sciences (SPSS Inc. Chicago) for
analysis. Questionnaires with scanty information
were rejected. The methods of contraceptive use
were grouped into four categories: condom
method, non-barrier methods, traditional
methods and other methods. Descriptive analysis
was conducted to identify differences in attitudes
and behavours between single and married
female students towards contraceptive use. Chi
square tests were applied to determine statistical
significance.
Results
A total of 3,101 out of 3,480 questionnaires were
retrieved giving a response rate of 89.11% and 76
of which were discarded due to scanty or
incomplete information. Thus a total of 3025
Contraceptive use among Female Undergraduates: A Case Study of a Nigerian University 149

respondents’ information was analyzed. The or during the use and 27.6% vs. 53.2% knew the
reliability analysis of the instrument showed the side effects of their contraceptives. Many of them
Cronbach Alpha to be 0.867. agreed that pregnancies had resulted from
contraceptive failure, consequently, the
Table 1 prevalence of abortion was higher among the
Demographic Data of the Respondents
single (63.3%) than married (4.8%). About two-
Demographic data Percentages third of single female and one-third of the married
Age (Years) had changed their contraceptives at least once due
15-20 11.4 to reasons ranging from unpopularity (46.1%)
21-25 42.1 among the single females to ineffectiveness (30%)
26-30 37.3
among the married females. See Table 2.
Above 30 9.2
Table 2
Marital status The Attitude of Single and Married Towards
Single 67.8 Contraceptives Use
Married 32.2
Items Single (%) Married(%)
Years of study n = 2051 n = 974
One 14.4
Contraceptive use 72 79.1
Two 17.6
Sources of information
Three 26.2
Mass media 36.4 31.4*
Four 15.5
Five 18.2 Doctors 0.6 29.2
Six 8.1 Pharmacists 1.2 11.3
Peer group 57 19.0*
Attitude Towards Contraceptive Use Parents 3.6 1.2
Purpose of contraceptive use
The prevalence of contraceptive use was high
Prevent pregnancy 50.2 67.8*
among the single and married undergraduate
Prevent sexually transmitted 25.1 22.3
female students of the studied university and
infections
53.5% of them were between 15-25 years. Friends
Prevent both 24.7 9.9*
recommended more than half of contraceptives
Onset of contraceptive use
used by single female students while about one-
third of the married females indulged in self Before my admission 32.4 45.2*
recommendation. The study showed that the After my admission 67.6 54.8
main aim of contraceptive use was to prevent Counselling before/during use 12.7 63.0*
pregnancy this was more among the married than Knowledge of side effects 27.6 53.2
the singles, 67.8% and 50.2% respectively. Pregnancy due to failure 47.9 39.0
Although about one quarter of both groups used Abortion 68.3 4.8*
contraceptives for prevention of sexually Birth 31.7 95.2
transmitted infections but only 10% of married Change of contraceptives at 76.4 33.5*
females used them for both pregnancy and least once
sexually transmitted infections preventions Reasons for change
compared with 24.7% for the single female. Most Unsafe 20.8 30.0
of the studied females started using contraceptive Unpopularity 46.1 20.5
after being admitted into university, 67.6% and Inconvenience 10.2 14.5
54.8% for single and married respectively. And Non-affordability 7.2 9.3
also 50.4% and 30.2% of single and married
Inaccessibility 7.3 8.6
females respectively, had used contraceptives
Uneasy administration 4.1 5.0
between one and three years. About 13% and 63%
Side effects 4.3 13.1
for single and married female undergraduate
students respectively, received counseling before *statistically significant difference (p= 0.05)
150
Contraceptive Methods Used
Condoms use between single and married female
students differed greatly (43.7% vs. 28.4%), unlike
traditional methods which were almost similar
(41.2% vs. 44.7%) for both groups. Non-barrier
methods received greater attention by the married
(21.8%) than the single females (7.5%). See
Table 3.
Table 3
Contraceptive Methods Used by Respondents
Methods Single (%)
n= 2051
Condoms 43.7
Non-barrier methods 7.5
Traditional methods 41.2
Other methods 7.6
*statistically significant difference (p = 0.05)
Discussion
As with nearly all studies of sexual behaviour,
the value of this study depends on the veracity
of reported attitude. The survey was in the form
of an anonymous questionnaire, which hopefully
encourages accurate disclosure of attitude.
This study revealed that contraceptive use
among female undergraduate students was high.
This is consistent with some similar work done
in Nigeria which observed that in southern
Nigerian modern contraception was a relatively
recent phenomenon. It also showed that
traditional contraception was widely used but
modern contraception was more wide spread
among the educated and sexually active youth in
Nigeria[9]. Education has played some vital roles
in behavour of woman towards contraceptive use
and family life in general. Educated and working
women are presumed to have closer conjugal ties
with their husbands compared to non-educated
and unemployed women [10,11]. The educated
woman is therefore, expected to have similar
reproductive attitudes as their husbands. On the
other hand education and employment tend to
give greater freedom and power within the
household[12]. It may then be argued that educated
and non working wives are more likely to have
reproductive preferences that are independent of
their husbands. For instance, it was found that
spousal agreement about contraceptive use to be
International Journal of Pharmagenesis, 1(2) 2010
positively related to education, [10] while
agreement about desired number of children was
negatively associated with education [13]. This
study challenges a work which found low
contraceptives use among Nigerian adolescents
[14]
.
The study showed that friends and media
played an important role in influencing single and
married female students respectively. This is in
agreement with another study [9] which
demonstrated a high correlation between peer
Married (%) group influence (r = 0.80) and use of the pill and
n=974
barrier methods such as the condom. The study
28.4* further stated that peer group, films and sexual
21.8* partners tended to have a strong influence on the
44.7 user. This also depended on the degree of
5.1 exposure of the user, her religious conviction as
well as partner’s socio-economic status.
Majority of the students considered one factor
or the other as reasons for changing their
contraceptives at least once. The variables range
from unpopularity (as result of peer group
influence) of the methods among the singles with
a high percentage of 46.1%, and non-safety of
contraceptive among married female students
(30%). Most women consider safety (r = 0.95) of
their contraceptives before using them 9. Cost,
inaccessibility, non-availability and
inconvenience had minor effects on change of
contraceptives.
The major purpose of contraceptives use was
to prevent pregnancy. This is supported by work
which was based on demographic and health
survey data of 18 African countries[15].
The findings of this study showed that
abortion was high among single undergraduate
students. Seeking or performing an abortion is
illegal in Nigeria, except to save a woman’s life.
Yet, experts estimate that more than 600,000
Nigerian women obtain abortions each year[16].
One study found that one-third of women
obtaining abortions were adolescents and also
showed that up to 80 percent of Nigerian patients
with abortion-related complications were
adolescents[14]. The issue of abortion therefore
should not be taken lightly. This high prevalence
of abortion may be attributed to the fact that
pregnancy spells disaster for progress through
Contraceptive use among Female Undergraduates: A Case Study of a Nigerian University 151

college and hopes of a well-paid job [17]. This was which showed that as education increased, so did
supported by a work which stated that the major the use of traditional contraception in all nine
reasons given for why adolescents seek countries. It also showed that education did not
termination of pregnancy were (in order of affect traditional method use when factors such
frequency): the need not to interfere with as age, rural residence, and wanting another child
schooling; not being old enough to get married; were controlled for[23].
fear of family members knowing; not planning
It is imperative to stage programs and
to marry the partner; being jilted by a fiancé;
campaigns in the secondary schools on the
following rape or incest; and not knowing the
contraceptive use. This is important because
actual father. It mentioned that less-common
many of the respondents started using
reasons were the need to test fertility and, in some
contraceptives even before getting admission into
cases, as a means of making financial demands
university.
on male partners. It further noted that this last
reason was often mentioned by the less-educated
participants, although it was also given by more- Conclusion
educated respondents14. The study revealed that the prevalence of
contraceptive use was very high and that the
There was obvious disparity in condoms use
purpose of its use was majorly to prevent
between single and married female students.
pregnancy for both married and unmarried
Several factors might have contributed to high
respondents. It was obvious that about one-
acceptability and uptake of condom among single
quarter of both groups also used contraceptive for
female students. Firstly, pregnancy avoidance
prevention of STDIs/HIV. The study showed that
was the top priority, particularly for unmarried
condom was the most used method
women, for whom pregnancy spells disaster for
notwithstanding its limitations. There is need to
progress through college and hopes of a well-paid
improve education and awareness strategies
job [17] . Secondly, non-barrier methods are
among the undergraduate in universities to
unpopular because of fears of side effects and
reduce the ever increasing STDs/HIV infections
unwarranted but common fears that future
among them. This is necessary because over 40%
childbearing might be jeopardized by use
of studied single and married female students
hormonal methods [18,19]. Although non-barrier
were still using traditional methods despite their
contraceptive use has become a global norm,
levels of education. There is need to organize
unprotected sex in relation to sexually transmitted
undergraduate peers training programs in all the
infections remains the norm almost everywhere.
higher institutions in Nigeria. This will help the
Condoms offer dual protections from unwanted
trained peers to train other undergraduate since
pregnancy, HIV and other sexually transmitted
the peer group influence contributed much in
infections [20] . When used correctly and
behaviour and attitude of female undergraduate
consistently, they keep sperm and any disease
students towards contraceptive use. There is need
organisms in semen out of the vagina. Condoms
for provision of condoms in the guest houses and
also stop any disease organisms in the vagina
hotels on the campuses and also in the toilet ends
from entering the penis [21] . Condoms
of eve.
notwithstanding have their limitations such as
breakage, leakage and it can also slip off during Acknowledgement
intercourse. However, no contraceptive method
We are grateful to entire staff of Department of Clinical
is completely efficacious and safe. Pharmacy and Pharmacy Management, University of
Use of traditional methods, mainly periodic Nigeria, Nsukka for their support during the data collection
and analysis.
abstinence were high (41.2% vs. 44.7%) in both
single and married female students, this situation References
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