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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

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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

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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

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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

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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

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CHARACTERISTICFREQUENCY n=383PERCENTAGE AGE IN YEARS 18-197619.8 20-2118748.8 228020.9 >224010.4 MARITAL STATUS MARRIED102.6 SINGLE34890.9 COHABITING256.5 RELIGION CHRISTIAN37497.7 MUSLIM92.3 6

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CHARACTERISTICSFREQUE NCY n=383 PERCEN TAGE % CHARACTERISTI CS FREQUEN CY n=383 PERCENTAGE % MODULE RESIDENCE GOVT SPONSORED19751.4 WITH PARENTS246.3 PRVT SPONSORED18648.6 WITH RELATIVES 307.8 COLLEGE OFSTUDY IN CAMPUS29376.5 HEALTH SCIENCES379.7 RENTAL HOUSE (INDIVIDUAL) 164.2 HUMAN/SOCIALSCIE NCES 19952.0 RENTAL HOUSE (SHARED) 205.2 AGRIC AND VET205.2MED INSURANCE BIOLOGICAL/PHYSIC AL SCIENCES 307.8YES16142.0 EDUCATION& EXTERNAL STUDIES 7118.5NO22258 7

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VARIABLEFREQU ENCY %VARIABLEFREQUENCY % EVER HEARD OF ECn=383WHEN IS EC TAKEN n=331 YES33186.5AFTER SEX30792.7 NO5213.6BEFORE SEX92.7 EC PROTECTS STI & HIV n=331BEFORE OR AFTER 51.5 NO32798.8DONT KNOW103.1 YES41.2KNOWLEDGE LEVEL n=331 EFFECTIVENESS OF EC n=331HIGH (70%)14142.6 100%19759.5LOW>(70%)19057.4 95%9227.5 50%123.6 50%51.5 DONT KNOW103.0 8

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ATTRIBUTEFREQUENCYPERCENTAGE SEXUALLY ACTIVEn= 383 Yes20353 No18047 EVER USE OF ECn= 203 YES4120.2 NO16279.6 DO YOU STOCK EC FOR FUTURE USE YES37.3 NO3892.7 LAST TIME OF EP USEn=41 3 MONTHS AGO1126.8 > 3 MONTHS AGO3073.2 9

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VARIABLEFREQU ENCY KNOWLEDGE LEVELOR95% C.IP VALUE AGE IN YEARS LOW n=190) HIGH (n=140) UPPE R LOWE R > 2017584 (48 %)91(52%)2.291.46 7 3.596P 2010679(74.527(25.5%)2.0260.9914.1430.050 209783(85.6%)14(14.4%)ref COLLEGE Health science 2415(62.5%)9(37.5%)2.7561.1096.8510.025 others179147(82.1%)32(17.9%)ref KNOWLEDGE LEVEL HIGH9677(80.2%)19(19.8%)0.4740.2101.0720.892 LOW10785(79.4%)22(20.6%)Ref RESIDENCE FAMILY3222(68.8%)10(31.3%)2.0530.8844.7680.090 OTHERS171140(81.9%)31(18.1%)Ref 14

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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

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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

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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

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5. Timothy, C.O., Nelson, W. and Mburu, T. K. Contraceptive Use among Women of Reproductive Age in Kenyas 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

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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

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THANK YOU 20