Name : Nonkosazana Namba

Student no. : 62268694

Accessqualification
Proposed and use of: Masters
emergency
in Publiccontraception
Health
amongst
College adolescent girls in the Nelson
: Health Sciences
Mandela Bay District,
Department Eastern Cape, South
: Health Studies
Africa.
Research focus area : Health and human rights
Email address : 62268694@mylife.unisa.ac.za

[COMPANY NAME] [Company address]

Table of Contents

Topic Page no.

1. Introduction 2
2. Problem statement 3
3. Literature review. 4
4. Significance of study. 4
5. Aim and objectives. 4
5.1 Aim. 4
5.2. Objectives. 4
6. Research questions. 4
7. Methodology. 4
7.1 Research design. 4
7.1.1 Quantitative research. 5

7.1.2 Descriptive research. 5

7.1.3 Exploratory research. 5

7.2 Research methods. 5

7.2.1 Research population. 5

7.2.2 Sampling and sample. 6

7.2.3 Data collection. 6

7.2.3.1 Data collection instrument. 6

7.2.3.2 Data collection process. 6

7.2.4 Pilot study. 6

8. References. 7

Table 1. 8

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 1. Introduction.

Emergency contraception refers to methods of contraception that can be used to prevent

pregnancy in the first five days after sexual intercourse (WHO, 2010). Its effectiveness is
seen only after few days following intercourse and before the ovum is released from the
ovary and before fertilisation takes place. However, according to WHO, emergency
contraception cannot interrupt an established pregnancy or harm a developing embryo. This
method is safe and effective in preventing unplanned pregnancies.

According to Rammopo and Mokgatle (2016), it is a normal activity among humans to be

involved in sexual activity. However, this activity may result in unwanted pregnancy
especially to adolescent and young girls who are in their child-bearing age. There is high
percentage of teenage pregnancy among this age group. Therefore, this leads to termination
of pregnancy amongst the age group that is between 13-18 years old. This is the group that is
still attending basic schooling, from the higher primary ages to higher learning.

Emergency contraception is not meant to be regular method of birth control (Lelisa,2016). It

can be used once as an emergency treatment in a number of situations following sexual
intercourse which include the following, when no contraceptive has been used, in cases of
rape or coerced sex, when the woman was not protected by an effective contraceptive pills or
when there is contraceptive failure or incorrect use, which can include condom breakage,
spillage, three or more consecutively missed combined oral contraceptive pills (WHO).

In South African public sector clinics, emergency contraception is widely available free of
charge. Even although it is widely available, the rate of teenage pregnancy and unwanted and
unintended pregnancy is high. This give rise to termination of these pregnancies as they are
not planned or unwanted and unintended.

Emergency contraception or `morning after pill ‘as it is normally called, is available in South
Africa over the counter to the public from chemists and also public hospitals. The use of this
method or service is found to be lacking as there is a number of unwanted pregnancies as
seen in the number of termination of pregnancies especially in the public sector or
government clinics and hospitals. There are laws that are available in South Africa that
govern the use of this method of contraception.

Emergency contraception is appropriate for adolescents who engage in sporadic and

occasional sexual intercourse, and especially among those who find regular contraceptives
intolerable or who use them sparingly (Babatunde, Ibirongbe, Omede, Babatunde, Durowade,
Salaudeen and Akande, 2016). This method will prevent unwanted pregnancy and reduce the
termination of pregnancy by the adolescent girls. It will also help to prevent increase in
perinatal and maternal mortality and morbidity,

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 2. Problem statement.

The researcher is an advanced midwife who is working in a public hospital in one of the
urban areas in the Nelson Mandela Bay district hospital. Since working for the department of
health in this district, she has witnessed a high rise of termination of pregnancy by girls
among the age twelve to eighteen years, that is the adolescent stage. In the past year about
12% of the women who were done termination of pregnancy was adolescent girls between
ages 12-18 in the hospital she is working in.

The access and use of emergency contraception is evident that it is not used in a good manner
by this age group. Myths and misconceptions concerning contraceptives are also factors that
affect the usage of emergency contraception (Mamabolo:2017). Some of the adolescent girls
do not use this method as it is not clear to them where to get the service.

3. Literature review.

Sexual intercourse is a normal activity among humans and a hot topic among the youth
(Rammopo & Mokgatle :2016). As it is beneficial to the ones involved in it, it may result in
unwanted pregnancies. Research indicates that many young South Africans engage in sexual
risk-taking, including early initiation of sexual activity, unprotected sex and low levels of
condom and contraceptive use, and often have concurrent partners (Wood & Jewkes: 2006).

In trying to unpack the series of rights associated with the right of access to healthcare, Lelisa
(2016), emphasises that the right to access to health care services cannot only be linked to the
notion of self-determination or autonomy, but also to the rights to equality and human
dignity. Adolescent girls can also use these rights to equality and human dignity to seek
access to emergency contraceptives on the same foot as older women.

One of the major factors responsible for unwanted pregnancies and unsafe abortion is lack of
knowledge of the various methods of contraceptives available ((Babatunde:2016). The
consequences of unprotected sex, such as unintended pregnancy and unsafe abortion can be
prevented by access to contraceptive services (Mamabolo:2016). Contraceptives are easily
available to women of all ages in South Africa.

According to Mamabolo (2016), despite the availability of safe and effective contraceptive
methods, unintended pregnancies and sexually transmitted infections (STIs), continue to be
reproductive health concern for women most often owing to lack of knowledge regarding the
use of contraceptives .A lot of studies has been conducted in South Africa about the
knowledge and use of emergency contraceptives among all age groups of women and it
shows that there is some lack of knowledge and incorrect use of contraceptives.

Several researchers have analysed the profiles of emergency contraception pill users, who are
usually adolescent girls and young women whose main motive in requesting emergency
contraception is an accident with the male condom, although non-use of contraceptive
methods is also indicated by a small percentage of women (Jimenez-Iglesias, Moreno,
Garcia-Moya & Rivera:2018).

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Failure to access emergency contraception debars adolescent girls from exercising their right
to enjoy sex without fear of falling pregnant (Lelisa:2016). This is their right as human being
to make good use of it.

4. Significance of the study

When adolescent girls are educated about various options available for emergency
contraception, it is in all likelihood to have access and will be able to make knowledgeable
decisions about their sexual and reproductive alternatives.

5. Aim and objectives

5.1 Aim

The main aim of the study is to evaluate the accessibility by adolescent girls in the Nelson
Mandela Metropolitan district, without discrimination and whether the adolescents are
furnished with enough information about emergency contraception in order to be able to use
such information effectively when needed.

5.2 Specific objectives

 To improve awareness of emergency contraception in order to decrease unplanned

pregnancies.

 To increase the use of emergency contraceptives among the adolescent girls.

 To reduce the number of termination of pregnancies due to unintended pregnancies.

6. Research questions.

The significance of stating the specific question is to indicate why the study deserves to be
done and what benefits derives, for the development of the scientific knowledge and the
quality of practice from the study`s results (Benner & Ketefian,2008:139). The questions
should be simple, direct and should invite an answer.

This study should be able to answer the following research two questions;

1) What measures are put in place for adolescent girls to use emergency contraceptives
effectively by the public sector?

2) To what extend is the accessibility of emergency contraceptives among adolescent girls in

the Nelson Mandela Bay district?

7. Methodology

7.1 Research design

Research design is the overall plan for gathering data in a research study (Brink, van der Walt
& van Rensburg, 2012:217).

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7.1.1 Quantitative research

According to Brink, van der Walt and van Rensburg (2012:11) a quantitative research focuses
on a relatively small number of concepts which begins with preconceived ideas about how
the concepts are interrelated. The aim is to discover the meaning and unfold realities and
generalisation is normally not a guiding criterion (Benner & Ketefian,2008:141).

Quantitative research in this regard will help to investigate the how accessible is emergency
contraception and the use among the adolescent girls in this district.

7.1.2 Descriptive research

The purpose of descriptive research is to explore and describe phenomena in a real-life

situation (Burns & Grove, 2009:45). These are used in studies where more information is
required in a particular field through the provision of a picture of the phenomenon as it occurs
naturally (Brink, van der Walt & van Rensburg, 2012:112). This research falls into the class
of a non-experimental quantitative design.

To understand the phenomenon being investigated the researchers will use questionnaires to
assess the use and accessibility of emergency contraception among the adolescent.

7.1.3 Exploratory research.

A central objective in Social Science research is to understand the make-up or demographics

of a particular population and build an understanding of that population`s knowledge,
attitudes and practices on a particular topic or issue (O`Leary, 2010:110).

Like the descriptive research, exploratory research begins with the phenomenon of interest,
but rather than simply observing and describing it, exploratory research investigates the full
nature of the phenomenon, the manner in which it is manifested and the other factors to
which it is related (Polit & Beck, 2017:20).

The researcher in this study want to explore the knowledge of emergency contraception by
adolescent girls, use and accessibility of the service to them.

7.2 Research methods

7.2.1 Research population

Brink (2009:123) describes a population as the entire group of persons that is of interest to
the researcher, in other words, that meets the criteria which the researcher is interested in
studying. The population sets boundaries with regard to the elements or subjects.

The research population for this study will be adolescent girls between thirteen to eighteen
years in the Nelson Mandela Bay district.

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7.2.2 Sampling and sample

Sampling is process of selecting subjects, events, behaviours or elements for participating in

a study (Burn & Grove, 2009:37). Samples make the research process manageable allow
exploring of groups that could not be accessed in their totality (O`Leary, 2010:162).

Simple random sampling will be used so that each adolescent girl attending school or health
care will have equal chance of being selected to participate in the study. Numbers, either be
client number form the clinic or registration number from the school will be drawn in a
random way from the sample frame. Different private and public schools and public health
sector are chosen for the study. About 120 adolescent girls will be selected by the simple
random sampling over a period of time.

7.2.3 Data collection.

7.2.3.1 Data collection instrument

There are different data collection instruments: questionnaires, scales and interviews (Brink.
2009:146). The instrument chosen for this research will be an online questionnaire and other
printed questionnaire in which responded will fill it online or either writes down her answers
in response to questions asked on online or printed document.

Questionnaires will be in English and IsiXhosa as some of the areas in the district are not
fluent in English. The questionnaire will comprise of two sections, namely Section A and
Section B to find out about the access and use of emergency contraception among the
adolescent girls.

7.2.3.2 Data collection process.

The researcher will create an online questionnaire for all those adolescent who will be able to
access it and also be responsible contacting the chosen schools and clinics in the district to
get permission to conduct the study. It will also explain the privacy and confidentiality
procedures. There would be a written consent form attached to the form and also an online
consent will be available.

7.2.4 Pilot study

A pilot study is a small-scale, trial run of an actual research study (Brink, 2009:206). This
method is done to test the practical aspects of the research study and to investigate the
feasibility of the proposed study.

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 8. References

Babatunde. A.O., Ibirongbe. D.O., Omede. O., Babatunde. O.O., Durowade, K.A., Salaudeen.
A.G. AND Akande. T.M. 2016. Knowledge and use of emergency contraception among
students of public secondary schools in Ilorin, Nigeria. Pan African Journal. Google Scholar

Benner, P. & Katefien, S. 2009. Nursing Research: Designs and Methods. Philadelphia:
Elsevier.

Burns. N. & Grove. S. 2009. The Practice of Nursing Research: Appraisal, Synthesis, and
Generation of Evidence. 6th Edition. Missouri: Saunders.

Bink. H. 2009. Fundamentals of Research Methodology for Health Care Professionals. Cape
Town: Juta and Co.

Brink. H van der Walt. C and van Rensburg. G. 2012. Fundamentals of Research
Methodology for Healthcare Professionals. 3rd Edition. Cape Town: Juta

Jimenez-Iglesias. A., Moreno. C. and Garcia-Moya. F. 2018. Prevalence of emergency

contraception pill use amongst Spanish adolescent girls and their family and psychological
politics. BMC Women`s Health; 18:67. Google Scholar

Lelisa. N. 2016. Access to emergency contraception among adolescent girls in Lesotho.

South Africa. Google Scholar

Mamabolo. P.R. 2017. Knowledge of emergency contraception among secondary school

learners in the rural area of Moletji-Mashashane, Limpopo Province, South Africa. SAJOB,
23(3):80-84. Google Scholar

O`Leary. Z. 2010. The Essential guide to doing Research project. Los Angeles: Sage

Rammopo. M. & Mokgatle. M. 2016. Knowledge of emergency contraception amongst first

year students at Medunsa Campus of University of Limpopo, Gauteng Province- A short
report. Journal of African Studies, 30(1),174-177. Google Scholar

Polit. E.D. & Beck. C.T. 2017. Nursing Research: Generating and Assessing Evidence for
Nursing Practice, 10th Edition. Philadelphia: Wolters Kluwer.

World Health Organisation (WHO) 2010. Developing sexual health programmes: a

framework for action. Geneva

Wood. K. & Jewkes. R. 2006. Blood blockages and Scolding Nurses: Barriers for Adolescent
contraceptive use in South Africa. Reproductive Health matters, 200614(27):109-118.

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9. Budget

Table 1

Item Price Estimate

A4 Paper and printing R2500

Binding R600

Stationery R500

Travel cost R2500

Telephone R700

Thank you gifts R1500

Researcher R5000

Miscellaneous R1700

Total R14 000