ABSTRACT
The study sought to investigate the knowledge of use of contraceptives among adolescents in Lagos state. In so doing, the study was guided by five objectives; to establish the prevalence of pregnancy among adolescents in Lagos state, to assess the level of contraceptives knowledge among adolescents in Lagos state. To establish the aims of using contraceptives among adolescents in Lagos state, to investigate the factors influencing the usage of contraceptives among adolescents in Lagos state, to establish the relationship between pregnancy and contraceptives among adolescents in Lagos state and to establish the aims of using contraceptives among adolescents in Lagos state. The study employed a descriptive research design. A total of 138 adolescents were sampled using stratified and random sampling procedure and their views, which were collected by use of questionnaires, analysed descriptively with the help of SPSS software. The findings of the study reveals that high pregnancy rates were as result of peer pressure, poverty levels of the families of adolescent girls which push the girls to look for security and they get lured in relationships, risky sexual behavior and lack of sexual awareness among the adolescent girls, the finding also reveals that the unintended pregnancies were associated with the rate of knowledge of use of contraceptives by adolescents. The study concludes that the pregnancy rates among adolescent girls in Lagos state are high. The study concludes that there is high knowledge of use of contraceptives among adolescent in Lagos state. The study recommends that there is need to come up with policies or programmes that address the contraceptive needs of adolescents and remove barriers to services. Channels should be created where adolescents can get accurate information on the knowledge of use of contraceptives. This should be coupled with provision of adolescent-friendly health care services.
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
In the recent years the number of adolescents using contraceptives has increased significantly. For instance, between 1991 and 2005 high school students that were sexually active used a condom the last sexual intercourse increased from 46.2% to 62.8% in 2005. Regardless, Potts & Fotso (2007) states that the consistent use of modern family planning is still a challenge for most adolescents. Informing teenagers about modern family planning use does not lead to increased sexual activity rates, higher number of partners or earlier age of first intercourse.
Based on the World Health Organization (WHO), adolescents between ten to nineteen years. This age bracket concurs with WHO’s definition of young people, which focuses on persons between 10 and 24 years. In this research, the term adolescent and teenagers will be used interchangeably. This is because in most societies adolescence is often equated with puberty; which is characterized by physical changes that result in reproductive maturity. As such, adolescence can refer to the period between 12 and 20 years. Sexual activity among this group of males and females, especially in urban areas, is becoming increasingly common. The upsurge of interest in pursuing higher education on the part of the adolescent and the decline in the age of reproductive maturity has created a large bio- social gap. The adolescents are biologically mature much before they are socially mature. At the same time adolescents begin having sexual experiences much earlier: with more sexual partners and at a high frequency (Liran et al., 2012). These liberal and sexual lifestyles have contributed to the increase and spread of adolescent pregnancies among other problems.
These adolescents barely use any method of contraception. The choice of contraceptives is often determined by age, education, marital status, income, ethnicity, age, race, fertility intentions and requirements for confidential care. Condoms and oral contraceptive pills are some of the modern family planning methods that have gained popularity among teenagers in the past twenty years. Based on recent research, the number of adolescents using OCPs has remained stable at around 18% to 20%. The number of teenagers between 15 and 19 years using injectable contraception has increased from 0% to 13% from 1988 to 1995.
Adolescents are sexually active; hence, it’s necessary for them to be informed about contraceptives. Notably, teenagers must obtain insights on the different family planning methods, the pros and cons of using specific methods and where to obtain the contraceptives. To raise the comfort levels of adolescents with contraceptives, it’s necessary for the media and peers to support them. Notably, teenagers must have total access to safe, convenient and confidential family planning services. According to Shah and Ahman (2004) parents, health practitioners, pharmacy staff and educators can officially enable adolescents to obtain, learn about and use family planning methods effectively.
Internationally, some countries are making slow but steady progress in terms of minimizing the unmet need using modern family planning methods. For example, Bangladesh recently registered a rise in knowledge of use of contraceptives among married women between 10 and 49 years from 49% in 1996/97 to 61% in 2011. Nonetheless, the rise was slightly smaller among married adolescents; from around 33% in 1996/97 to 47% in 2011.
Adolescents face numerous barriers in accessing and using contraceptives. Cost, legal factors, erratic availability and policies hinder unmarried teenagers in emerging economies from getting contraceptives. In the absence of legal restrictions, unmarried adolescents still cannot access contraceptives because most health workers cannot approve premarital sex. In situations where the contraceptives are provided, unmarried teenagers can only obtain condoms with the health workers presuming that intra-uterine devices and long-acting hormonal methods are unsuitable among childless young women (Shah & Ahman, 2004).
In recent years, stakeholders and scholars have recognized the necessity of preventing early pregnancy among Sub-Saharan region adolescents. According to Phillips & Mbizvo (2016) the highest rates of teenage pregnancies are registered in African countries. From the Nigeria Demographic Health Survey of 1989 at least 90.1% of adolescent participants had knowledge about on birth control method and women that were never married were more informed about at least one contraceptive in comparison to the ones that are currently married. Sex education programs were initiated to inform members of the public about available contraceptives (Murigi, 2015).
Issues linked to adolescent development including the presumption that one is immune from the consequences or problems associated with pregnancy or sexual intercourse and failure to accept one’s sexual activity are some of the factors leading to inconsistent or lack of contraceptive use among adolescents. Misunderstandings about FP methods and low information on contraceptive methods lack contribute to low contraceptive use. Nonetheless, the level of knowledge among adolescents on contraceptive use does not correlate with consistent use. Despite having the knowledge, most teenagers are likely to delay or fail to use contraceptives because of various reasons including fear of parents, lack of parental guidance and ambivalence and the perception that birth control is perilous and can lead to negative effects like weight gain (Tsui, McDonald-Mosley & Burke, 2010).
Several researchers have conducted comprehensive research on the impact of low knowledge of use of contraceptives and the unmet unintended births needs and pregnancies extensively researched on (Tsui et al., 2010). One of the significant issues among young women and adolescents is discontinuation because their access to birth control methods is more limited in comparison to older women. Equally, have more irregular and sexual activities that are less predictable and little information on FP method use. Based on a research done in six emerging nations, women that were less than 25 years were more likely to stop using contraceptives after twenty four months in comparison to others (Shah & Ahman, 2004).
Most adolescents still experience unplanned pregnancies in spite of the best intentions on contraceptive use and the effectiveness of prevention of pregnancy programs among adolescents is still below the desired levels. The success of teenagers in avoiding pregnancies still depends on availability of information focusing on contraceptives services and methods (Tsui et al., 2010). Based on estimates from 2000, around 25% or more than eleven million married women between fifteen and nineteen years the former USSR and the developing world have unmet contraception need. Notably, the persons have desire to delay or avoid pregnancies but are not using any family planning methods. However, the statistics do not capture unmet need among women that are sexually active but are never married. There is also sufficient evidence on the adverse effects of unplanned fertility and pregnancy on teenager’s health (Moreland & Talbird, 2006).
Like most sub-Saharan countries, Nigeria is witnessing an urban explosion. While rural to urban migration is persistent, available data indicates that around 75% of growth in urban centres in Sub-Sahara Africa is caused by natural population growth while migration accounts for around 25% of urban growth (Singh, Sedgh & Hussain, 2010). Another dominant trend among adolescents in Nigeria is the deteriorating health outcomes because of rising urban poverty. In Lagos city, for example, around 60% of the population lives in informal settlements and slums (Central Bureau of Statistics, 2005), which are predominated by early sexual debut among other behaviors that are sexually risky (Zulu, Dodoo & Ezeh, 2002). Admittedly, a critical aspect of urban fertility dynamics that is often neglected is reproductive outomes of teenagers living in poverty (Ezeh et al., 2010).
1.2 Problem Statement
(Yakubu & Salisu, 2018) points out that high levels of unwanted pregnancy are common in Sub-Saharan Africa. Unwanted and mistimed pregnancy is relatively high among young women in comparison to older women (Ochako et al., 2015). The risk of sexually transmitted diseases and unplanned pregnancy including AIDS is high. At younger ages, most adolescents are involved with higher probability of numerous sexual partners and unprotected sex, which exposes the teenagers with the high risk of being infected with STD/HIV/AIDS. The period of exposure in early sexual activity initiation is often prolongs yje exposure period of the pregnancy risk in the adolescents reproductive span. Teenagers are exposed to early child bearing and marriage, which in turn makes children and mothers vulnerable to substantial health risks. Young parents are vulnerable to pregnancy complications and are unable to deal with them; hence, they are exposed to maternal death (Fotso, 2006).
The extent to which improved knowledge and information can unplanned pregnancies is uncertain. Given the youths knowledge on the level of prevention and control risks of unwanted pregnancies, there is concern about teenagers associated morbidity and continued unsafe sexual practices. While a variety of programs are quite effective at increasing youths ‘level of knowledge of contraceptives and contraception, they have little impact on their behavior. The relationship between what youths know and how they behave is perhaps the most salient issue.
Concerning this issue, little is known about the extent of contraceptive use and its effect in averting adolescent pregnancies in Lagos state of Africa in general, and Nigeria in particular.
1.3 Research Questions
The study sought to answer the following research questions:
i. What is the prevalence of pregnancy among adolescents in Yaba, Lagos state?
ii. What is the level of contraceptives knowledge among adolescents in Yaba, Lagos state?
iii. What are the aims of using contraceptives among adolescents in Yaba, Lagos state?
iv. Which factors influence the usage of contraceptives among adolescents in Yaba, Lagos state?
v. What is the relationship between pregnancy and contraceptives among adolescents in Yaba, Lagos state?
1.4 Objectives of the Study
1.4.1 General Objective
The main objective of this study was to examine the knowledge of contraceptives use among adolescents in among Yaba, Lagos state in Nigeria
1.4.2 Specific Objectives
The study was guided by the following specific objectives
i. To establish the prevalence of pregnancy among adolescents in Yaba, Lagos state
ii. To assess the level of contraceptives knowledge among adolescents in Yaba, Lagos state
iii. To establish the aims of using contraceptives among adolescents in Yaba, Lagos state.
iv. To investigate the factors influencing the usage of contraceptives among adolescents in Yaba, Lagos state.
v. To establish the relationship between pregnancy and contraceptives among adolescents in Yaba, Lagos state.
1.5 Significance of the Study
These study findings may be significant to adolescence as they may be able to know the factors that hinder them from the knowledge of use of contraceptives. Also, the findings from the study may be of great importance to other teenagers aspiring to undertake contraceptive methods as they might be able to know the factors that influence uptake of contraceptives.
The study findings may be of great significance to family planning specialists. This is because they may be able to know the factors that hinder that hinder people from the knowledge of use of contraceptives and contraceptive methods especially among the youth. Also they may obtain information on how to overcome barriers to uptake of contraceptives by poor urban residents.
Moreover, the study findings may be of great significance to the government as they may have relevant information to be used in enhancing high uptake of contraceptives among teenagers in an effort to reduce unwanted pregnancies among them.
1.6 Scope and Limitations of the Study
The study was conducted in Yaba of Lagos state. This slum is characterized by high poverty levels, low levels of education, large household sizes that affect access to basic health services including family planning services. The target population was adolescent girls in Yaba. The unit of analysis will be households of adolescent girls in Yaba, Lagos state, while the unit of observation were adolescent girls who have ever conceived at age 18-24 years. This study took a duration of six months.
According to Best (2008) limitations are conditions beyond the control of the research that may place restrictions on the conclusion of the study and their application. One of the main limitations is brought about by the topic of the research itself. Pregnancy is about sexual behavior and due to secretive nature of people’s sexual behavior it may be challenging and threatening to ask people questions touching on their sexuality which is a very private affair. The researcher did everything possible to make informants at ease and ensured that the researcher creates a rapport before asking questions. Another limitation of the study was that it was difficult to get valid responses about the sexual lives of the respondents/ informants.
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