CHAPTER ONE
INTRODUCTION
1.1
Background to the Study
Sexual and reproductive health is an important
issue to every stakeholder in theglobal
health sector particularly with regard to the youth and adolescents (Tien,
2006). A number of factors are responsible for the high level of importance
attached to adolescents/youth’s sexual and reproductive health. Various authors
indicate that adolescent/youth’s sexual and reproductive health for most
countries is in bad shape. Attahir, Sufiyan, Abdukadir and Haruna (2010) found
out that the health risk faced by adolescent girls during pregnancy is very
high, accounting for 15% of the Global Burden of Disease (GBD) for maternal
conditions and 13% of all maternal deaths. The cause of this degenerating
health condition of adolescent girls, according to Tien (2006), is lack of
knowledge and access to contraception. Consequently, Tayo, Akinola, Babatunde,
Adewumi, Osinusi and Shittu (2010) suggested active and intensive promotion of
sexuality education, and contraceptive use among the youth in the Sub-Saharan
Africa as a way of addressing this anomaly.
In Nigeria,
Harrison (2009) observed that the countries high maternal mortality ratio (MMR)
is attributed to her youth’s sexuality. The later is characterized by low
contraceptive usage by the youth, high incidence of illegal abortion amongst
the youth, ignorance of contraception among the youth, and lack of sex
education from parents and teachers. The situation in Nigeria is likely to a
reflection of the situation in the entire
Africa.
Such a situation made the World Health Organization Report (2010) to show that
Africa’s progress in meeting the number 5 Millennium Development Goals (MDG5),
in which the target is 75% reduction in the maternal mortality ratio from the
year 2000, to the year 2015 remains a major challenge to health systems
worldwide.
Moreover, NPC and ICF Macro
Report (2009), indicate that Nigeria is remarkably slow in its progress towards
the MDGs set to be attained in 2015. As we move close to 2015, MMR in Nigeria
is put at over 545 per 100,000 live births, compared with other societies that
have made significant progress towards the MDGs goal 5, such as U.K with about
8 per 100,000 live births, Germany and Spain 7 per 100,000 live births and
France with about 10 per 100,000 live births. Also, NPC and ICF Macro (2009)
have attributed the high MMR in Nigeria to poor contraceptive usage and high
rates of unwanted pregnancies, which invariably give rise to illegal and
clandestine abortions.
World Health Organization Report (2010) on the statistics of
contraceptive prevalence in 53 African countries, shows that Nigeria has 14.1%
contraceptive prevalence rate, unlike other African countries like Mauritius
with 75.8%, Morocco 63.0%, Algeria 61.4%, Cape Verde 61.3%, Egypt 60.3%, South
Africa 60.3%, Tunisia 60.2%, Zimbabwe 60.2%,
Namibia and Swaziland with 55.1% and 50.6% respectively.
The
concern here is that since the MDG were set in 2000, there have been steps
deliberately taken by Nigerian government to reduce incidences of unwanted
pregnancies, particularly among the youth. Promotion of contraceptive practices
has also intensified yet with 14.1% contraceptive prevalence in Nigeria, it
shows low usage of contraceptives among the youth necessitating enquiring into
factors that could explain the trend.
According to Indongo (2007), one of the major factors is that
youth often lack basic reproductive information on the consequences of sexual
intercourse. In addition to the above mentioned information, youth also lack
skills in negotiating sexual relationship, and knowledge about affordable confidential
reproductive health services.
Again many do not feel
comfortable discussing sexual issues with parents or other key
adults with whom they
can talk about their reproductive health concerns. Likewise, parents,
healthcare workers, and educators frequently are unwilling or unable to provide
complete and accurate age-appropriate reproductive health information to young
people.
This is often due to discomfort in
discussing the subject or the false belief that providing the information will
encourage increased sexual activity. This is because most youth enter into
sexual relationships with very little knowledge on the consequences. The little
knowledge they have is either got from their peers or from the media
The question then is why teenage pregnancy, maternal mortality
ratio and premarital childbirth is on the increase in Nigeria despite efforts
made by both private and public agencies in providing youth-friendly centers in
public and private hospitals where contraceptive services could be accessed.
This study is therefore designed to study the knowledge of contraception and
use of contraceptives among sexually active youth in Abuja-Federal Capital
Territory (FCT).
1.2
Statement of the Problem
Despite dramatic declines in the percentage of youth who have
ever had sexual intercourse, and reduced rates of teenage childbearing in
developed societies, Ryan,
Franzetta and Manlove (2007), noted that
the youth remain inconsistent contraceptive users and are thus at high risk of
unintended pregnancy and childbearing in United State of America (Abma,
Martinez, Mosher & Dawson, 2004 cited in Ryan et al., 2007). Estimates of
contraceptive consistency within teens’ first sexual relationships show that
21% of teens use no method and 16% are inconsistent contraceptive users, using
a method only occasionally (Manlove, Ryan & Franzetta, 2003 cited in Ryan
et al., 2007).
Moreover,
youth who do not use contraception or who use contraception inconsistently
in their first sexual relationships are less likely to be
consistent contraceptive users in later relationship (Manlove, Ryan and
Franzelta, 2004 in Ryan et al., 2007).
Studies in Nigeria indicate high rate of sexual activities as
well as limited knowledge and use of contraceptives among secondary school
students/undergraduates (Ogbuji, 2005; Iyaniwura and Salako, 2005 cited in
Nwaorah, Mbamara, Ugboaja, Ogelle and Akabuike, 2009). The resultant effect of
this result is an increased rate of unwanted pregnancy, MMR, STI including
HIV/AIDS etc. The increasing number of pregnancies, abortions, and sexually
transmitted infections including HIV/AIDS among the youth in Sub-Saharan Africa
indicates that successive efforts towards preventing the scourge remain
inadequate in the continent (Atere, Shokoya, Akinwale and Oyenuga, 2010). It is
obvious that many young people are sexually active with low level of
contraceptive use. This is a factor contributing to the increasing spread of
sexually transmitted infections and HIV/AIDS among the youth. Evidence from
different studies continue to confirm the existence of increasing sexual
activities among the youth globally, with those in developing countries
perceived to be at greater risk because of their low level of access to medical
facilities (Nwafor and Madu, 2002; Ghuman, 2005; Atere et al., 2010).
However, the age
at which the youth engage in sexual activities varies considerably depending on
the various socializing influences and the opportunities available for
practicing sexual behaviours (Atere et al., 2010). Studies on adolescent sexual
behaviour in several parts of Nigeria have shown that pre-marital sexual
activities are quite common especially in the urban areas (Araoye and Adegoke,
1996; Atere et al., 2010). As a result, unintended pregnancy arises when
sexually active women do not use contraceptive or use them incorrectly
(Chung-Park, 2007). The tendency for adolescent and young adults to engage in
sexual activity without the use of contraception, despite
exposure to educational programs, has led investigators to
consider the potential predictors of contraceptive use (Chung-Park, 2007).
These studies have indicated that multiple factors influence contraceptive
decision-making, amongst them are perceived risk and benefits, values and
personality factors (Sigman-Grant, 2002 cited in Chung-
Park,
2007).
The inadequate contraceptive coverage is multifaceted social,
ethical, and cost issues are focused on the consequence of unintended
pregnancy; long-term consequences of unintended pregnancy are far reaching. For
example, teenage pregnancy, out-of-wedlock birth, welfare dependency, child
abuse, domestic violence, and abortion are some of the major social
ramifications of unintended pregnancy (Judith and George, 2003). Research in
Latin America has also shown that a relatively high proportion of teenagers are
exposed to the risk of pregnancy (WHO, 2001). In Africa, studies have
demonstrated that a large proportion of young women are exposed to the risk of
conception, receive poor or no sex and contraceptive education and experience a
high incidence of adolescent child birth (Muhwava, 1998; Burgard, 2004).
The Nigerian situation is similar to that prevailing in
developing societies in Africa and Latin America. Although reports indicate a
decline in teenage pregnancy, maternal mortality and morbidity, yet most of the
premarital births still occur among young women aged 15-24 years, the majority
of whom are neither economically nor emotionally ready to deal with parental
responsibilities. Thus, improving reproductive health is keys to improving the
situation of youth as well as the world’s future generations (Creel and Perry,
2003).
for complete material (Chapter One to Chapter Five), visit www.researchshelf.com
No comments:
Post a Comment