KNOWLEDGE AND UTILISATION OF EMERGENCY CONTRACEPTION AMONG UNIVERSITY STUDENTS: A CASE STUDY OF THE UNIVERSITY OF NAIROBI FEMALE UNDERGRADUATE STUDENTS Grace Mwaniki, MPH student; Moi University, Professor James Kiarie; The University of Nairobi; Dr. Elkanah Omenge, Moi University 1 Various family planning methods have been used to meet the dire need for control of the high population growth (5). Emergency contraception (EC) prevents unwanted pregnancy after unprotected sexual intercourse in the absence, or failure to use regular family planning methods. 2 The rate of unwanted pregnancies in Kenya is high at 17 percent (7). Consequently induced abortions arise that contribute to high maternal mortality rate in (7). The deficit in prevention of unwanted pregnancies even in the existence of regular family planning methods and availability of emergency contraceptives is evident. 3 BROAD OBJECTIVE To establish the knowledge and utilisation of emergency contraceptives among female undergraduate students in the University of Nairobi. SPECIFIC OBJECTIVES 1) To find out the knowledge level of emergency contraceptive among University of Nairobi female undergraduate students. 2) Establish the sources of information about emergency contraceptive among female undergraduate students. 3) To establish practice of emergency contraception among University of Nairobi female undergraduate students. 4) To examine the sample characteristics associated with the knowledge and use of emergency contraceptives among University of Nairobi female undergraduate 4 A cross sectional quantitative design among 383 female undergraduate students. Conducted in the six colleges at University of Nairobi using self-administered questionnaires. Proportionate simple random sampling was used to select the study participants. Data was analysed using SPSS version 16. Descriptive statistics and bivariate analysis was used to determine significant factors associated with knowledge and utilisation of EC. 5 CHARACTERISTIC FREQUENCY n=383 PERCENTAGE 18-19 76 19.8 20-21 187 48.8 22 80 20.9 >22 40 10.4 MARRIED 10 2.6 SINGLE 348 90.9 COHABITING 25 6.5 CHRISTIAN 374 97.7 MUSLIM 9 2.3 AGE IN YEARS MARITAL STATUS RELIGION 6 CHARACTERISTICS FREQUE NCY n=383 PERCEN CHARACTERISTI TAGE % CS FREQUEN CY n=383 PERCENTAGE % RESIDENCE MODULE GOVT SPONSORED 197 51.4 WITH PARENTS 24 6.3 PRVT SPONSORED 186 48.6 WITH RELATIVES 30 7.8 IN CAMPUS 293 76.5 COLLEGE OFSTUDY HEALTH SCIENCES 37 9.7 RENTAL HOUSE 16 (INDIVIDUAL) 4.2 HUMAN/SOCIALSCIE NCES 199 52.0 RENTAL HOUSE 20 (SHARED) 5.2 AGRIC AND VET 20 5.2 MED INSURANCE BIOLOGICAL/PHYSIC AL SCIENCES 30 7.8 YES 161 42.0 EDUCATION& 71 18.5 NO 222 58 7 VARIABLE FREQU ENCY % VARIABLE FREQUENCY EVER HEARD OF EC n=383 YES 331 NO 52 EC PROTECTS STI & HIV n=331 NO 327 YES 4 EFFECTIVENESS OF EC n=331 100% 197 59.5 95% 92 27.5 50% 12 3.6 % WHEN IS EC TAKEN n=331 86.5 AFTER SEX 307 92.7 13.6 BEFORE SEX 9 2.7 BEFORE OR AFTER 5 1.5 98.8 DON’T KNOW 10 3.1 1.2 KNOWLEDGE LEVEL n=331 HIGH ≥(70%) 141 42.6 LOW>(70%) 190 57.4 8 ATTRIBUTE FREQUENCY PERCENTAGE SEXUALLY ACTIVE n= 383 Yes 203 53 No 180 47 EVER USE OF EC n= 203 YES 41 20.2 NO 162 79.6 YES 3 7.3 NO 38 92.7 LAST TIME OF EP USE n=41 ≤3 MONTHS AGO 11 26.8 > 3 MONTHS AGO 30 73.2 DO YOU STOCK EC FOR FUTURE USE 9 90 80 70 PERCENTAGE 60 50 40 30 20 10 0 SOURCES 10 11 VARIABLE FREQU ENCY AGE IN YEARS KNOWLEDGE LEVEL LOW n=190) OR 95% C.I P VALUE HIGH (n=140) UPPE R LOWE R 2.29 1.46 7 3.596 P<0.001 3.312 P<0.001 2.86 P<0.145 > 20 175 84 (48 %) 91(52%) <20 156 106(67%) 50(32.1%) REF >YEAR 2 120 55(45.8% 65(54.2%) 2.09 1.33 ) 1 YEAR 1&2 211 135(64%) 76(36.0%) REF WITH RELATIVE 50 24(48%) OTHERS 281 166(59%) 115(40.9 YR OFSTUDY RESIDENCE 26(52%) 1.56 0.85 5 REF 12 VARIABLE FRE QUE NCY COLLEGE KNOWLEDGE LEVEL LOW (n=190) HIGH (n=141) OR HEALTH SCIENCE 33 10(30.3%) 23(69.7) 3.50 OTHERS 298 180(60.4%) 118(39.6%) REF YES 122 60(49.2%) 62(50.8%) 1.70 NO 209 130(62.2%) 79(37.8%) REF 95% C.I P VALUE UPPER LOWER 1.612 7.637 P<0.001 1.082 2.672 P<0.021 INSURANCE (MEDICAL) 13 VARIABLE FREQ UENC Y AGE EVER USE OR 95% C.I NO(n=162) YES(n=41) UPPER > 20 106 79(74.5 27(25.5%) 2.026 0.991 ≤ 20 97 83(85.6%) 14(14.4%) ref Health science 24 15(62.5%) 9(37.5%) 2.756 1.109 others 179 147(82.1%) 32(17.9%) ref HIGH 96 77(80.2%) 19(19.8%) 0.474 0.210 LOW RESIDENCE 107 85(79.4%) 22(20.6%) Ref FAMILY 32 22(68.8%) 10(31.3%) 2.053 0.884 OTHERS 171 140(81.9%) 31(18.1%) Ref P VALUE LOWER 4.143 0.050 6.851 0.025 1.072 0.892 4.768 0.090 COLLEGE KNOWLEDGE LEVEL 14 The study revealed a high level of awareness of EC including its limitation to protect against sexually transmitted diseases, consistent with Kingston Jamaican study . Probably the higher level of learning of the study participants exposes the students to more information about matters appertaining to their sexuality. Misinformation on EC efficacy levels , appropriate timing of taking the pill and safely repeating the EC intake are worrying concerns that could affect the effectiveness of the EC in preventing unwanted pregnancy. 15 Actual EC knowledge level according to the criterion set was low and was associated with age, college of study and having an insurance cover (depicts a health conscious mind-set ) Popularity of friends as a source of information compared to health workers similar to a Nigerian study (24),lower than Nepal (16) and South Africa(6). Users of EC do not store the EC pill for future use, however there is paucity of research done to give more information on this. 16 Despite there being high level of awareness of EC there is low level of actual specific EC knowledge. There is also low EC use. Continuous public health education is needed to improve knowledge beyond awareness on EC. Health education about the availability of EC in public facilities needs to be provided. 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. 17 5. Timothy, C.O., Nelson, W. and Mburu, T. K. Contraceptive Use among Women of Reproductive Age in Kenya’s City Slums. International Journal of busisess. 2011, Vol. 2, 1. 6. Me, Hoque and Ghuman, S. Knowledge, practices and attitudes of emergency contracetives among female students in Kwazulu, Natal, South AFrica. 2012. 7. Kichamu, G. and H., OSORO. Fertility preferences. Kenya Demorgraphic and Health Survey 2008-2009. 2010 11. Chris, P. Adolescents and Emergency Contraceptive Pills in Developing Countries. s.l. : Family Health International , 2005 16. Adhikari , R. . Factors affecting awareness of emergency contraceptives among college students in Kathmandu , Nepal. Bmc Womens health. 2009. 24. Ebuehi..O.M, Ekanem.E.E. and Ebuhei T.A.O. Knowlege and Practice of emergency contraception among female undergraduates in the University of Lagos, Nigeria. East A frican Medical Journal. 2006, Vol. 83, 3, p. 92. 18 Institutional Ethical And Research Committee- Moi University , for the ethical approval. The University Of Nairobi for allowing me to conduct this research using it as a study area. Moi University, School of Public Health for the academic guidance in carrying out this research. 19 THANK YOU 20