Project Materials

FACTORS INFLUENCING THE USE OF CONTRACEPTIVES AMONG SENIOR HIGH SCHOOL STUDENTS

Chapter one

INTRODUCTION

Background of the Study

Family planning and contraception are two important concerns that have been explored around the world. In the beginning, human cultures prioritised the birth of as many children as possible.

Today, however, few countries can afford this approach, leading in greater efforts to limit and manage their families’ birth rates, with Ghana being no different.

The detrimental effects of high reproduction rates on mothers and their children, as well as the benefits of fertility control, are widely documented (Dona et al., 2008). The condition in Africa is as low as 25%, the lowest among developing regions worldwide (RAND, 1998; UNFPA, 2001).

In West Africa, around 36% of women use contraception, with rates ranging from 22% in Mali to 26% in Togo, 32% in Burkina Faso, and 33% in Ghana (Dona et al., 2008; UNDP, 2008).

In Ghana, a country with numerous ethnic and religious groups, efforts by the Ministry of Health (MOH) and other organisations to promote contraceptive usage have resulted in a general increase over the previous two decades (Ann et al 2002; UNDP, 2008).

The fertility rate has similarly decreased, from 6.4 percent in the 1970s to 4.4 percent in 2005 (UNDP, 2008). Currently, it is estimated that 33% of married women in the country utilise contraception, despite the fact that 43% want to space their children and another 24% need to limit births.

The gap in the usage of family planning methods between urban and rural, as well as rich and poor, disadvantages many women in the most deprived areas (GSS, 2003).

Since 1960, the use of contraceptives has helped women worldwide avert around 400 million pregnancies, saving women’s lives from high-risk births. Again, contraceptive methods serve as great prophylactics (disease preventers), with latex rubber and polyethylene condoms providing a barrier against STIs and HIV/AIDS infection, which are on the rise in the country (Harvey, 2000).

The main interest here is the factors that influence teenagers’ use of contraception. Despite the fact that contraception has emerged to avoid undesired births and, in certain cases, sexually transmitted infections, the community has not entirely accepted teenagers’ use of it.

Other considerations include the age of the teenage boy or girl; the younger the youngster, the less likely he or she is to utilise contraception.

Another element is the teenager’s decision to abstain from sex for a variety of reasons, including a desire not to become pregnant in violation of religious or moral principles (Linda-lowen, 2011).

Becoming a parent as a teen can have a severe impact on young people’s capacity to pursue scholastic and personal goals. In underdeveloped nations, complications from pregnancy, such as childbirth and unsafe abortion, are the primary cause of mortality for young women aged 15 to 19.

Teenagers all across the world require contraception education before becoming sexually active. They must understand how various forms of birth control operate, the pros and drawbacks of using specific methods, and where to obtain them. They require help and encouragement from their peers, adults, and the media in order to feel more comfortable using condoms and birth control.

Importantly, they require complete access to confidential, secure, and convenient family planning services. Parents, educators, health care providers, and pharmacy staff can all play an important role in assisting teens to learn about, get, and use contraception effectively (Wind, 2005).

Meeting women’s contraceptive requirements has been critical in countries that have accomplished Millennium Development Goal 5, which is to improve mother health.

MDG 5a seeks to reduce maternal mortality by three-quarters between 1990 and 2015, while MDG 5b seeks universal access to reproductive health, including family planning (United Nations, 2012).

According to the World Health Organisation in 2012, meeting the unmet need for family planning alone might reduce maternal mortality by about one-third.

However, an estimated 215 million women who want to postpone or avoid pregnancy still lack access to safe and effective contraception (WHO 2012). Thus, in addition to providing quality mother care, family planning is critical to reducing maternal mortality.

Although many United Nations member countries, particularly those in the developed world, have robust family planning programs, this is not the case in Sub-Saharan Africa, where, despite an increase in contraceptive prevalence, many women continue to have unmet contraception needs (UNFPA 2012; Cleland et al. 2006).

The resulting high fertility is connected with high maternal death rates, particularly in the poorest populations. The global maternal mortality ratio remains high, with 287 maternal deaths per 100,000 births; a disproportionate proportion of these deaths occur in young women (WHO et al. 2010).

Approximately one-third of women giving birth in underdeveloped countries are under the age of 20, putting them at a higher risk of sickness and death from maternal causes (WHO 2010).

Women’s age, education level, and socioeconomic status are all significant predictors of contraception use. Women with higher levels of education and wealth are more likely to utilise contraception than illiterate and lower-income women (UBOS and Macro International 2007).

Similarly, women who utilise contraception report a higher quality of life, a higher social position, and more liberty. This link was underlined in a study conducted in Nigeria by Osemwenkha, who emphasised that contraceptive use has the potential to significantly lower fertility and, as a result, enhance maternal and child health.

According to Blanc et al. (2009), young women in underdeveloped nations, whether married or unmarried, utilise contraception with a lot of experimentation and uneven results.

Furthermore, young women encounter numerous challenges to using family planning services, including fear, humiliation, cost, and a lack of information (Blanc et al. 2009).

In Uganda, just 10% of all women and 14% of married women aged 15-24 use any kind of contraception (UBOS and Macro International 2007).

While the age at first marriage has typically increased around the world, certain places of Sub-Saharan Africa continue to see a large number of girls marry before the age of 18 (UNICEF 2005).

Early marriage exposes these women to frequent and unprotected sexual encounters, which might result in an early and dangerous first birth (Mensch 1998; Haberland 2005).

In Uganda, the typical age at first marriage is 17.9 years, and young women are expected to demonstrate their fertility shortly after marriage (UBOS and ICF International 2012).

Furthermore, because contraception is not anticipated upon marriage, these women have little options for spacing their pregnancies.

Many academics have investigated the factors that influence contraceptive use, from the viewpoints of both physicians and clients (Cleland et al. 2006).

The customised conceptual framework expands on current research to examine the socioeconomic and demographic characteristics related with contraceptive use among young married women in Uganda as opposed to older women.

While the paradigm used is generalisable to both young and older women, we hypothesise that the factors associated with contraceptive use may operate differently in each age group due to changes in empowerment, education, and desire for children.

This hypothesis is based on the fact that, like in many other LDCs, health services and policies in Uganda are not explicitly streamlined to address the unique requirements of young women (Healthy Action 2011).

Since individuals act and react within a society and culture, the analysis considers that these factors operate through intermediate factors that generally act as catalysts to increase or decrease contraceptive use among women. These elements are both social and behavioural in character.

Factors assessed include exposure to family planning messages in the media, women’s empowerment, residency (rural or urban), affluence, and country area. To assess women’s empowerment, the DHS poll queried women about their decision-making as a proxy.

Women were asked who makes decisions about visiting family members, significant family purchases, daily household purchases, and personal health care.

According to Harvey (2000), laws that limit teens’ access to contraceptive services and information do not lower sexual activity and instead raise the chance of unwanted pregnancy and sexually transmitted diseases.

Statement of the Problem

Adoption of contraceptives among Ghanaian teenagers remains low, at 10%, owing to poor access to contraceptive services, particularly in increasing metropolitan areas.

National strategies and guidelines for sexual and reproductive health encourage the employment of health workers within Health Teams to deliver contraception, including injectables, as a crucial intervention to enhance access among underserved populations, particularly teens.

Even though trends in family planning indicators, total fertility rate, and contraceptive use in Ghana have improved, there is still a problem in extending access to many teenagers in school who want to limit or avoid pregnancy.

These youngsters’ non-use of contraception has a direct impact on their overall well-being, as well as their professional and educational advancement.

The increase in maternal death rate from 210/100,000 live births in the 1990s to a projected 560 in 2005 (UNDP, 2008) demonstrates the consequences of complications that result in unplanned and undesired pregnancies. Furthermore, there is a high risk of HIV and sexually transmitted infections (STIs).

This trend is especially strong in communities with inadequate access to quality care. Over the years, the New Juaben municipal region has continuously had one of the lowest rates of contraception use in Ghana. The district, which is largely urban, scored lower than the area average of 24.9 percent (Eastern area Health Report, 2007).

However, Ford et al. (2001) believe that teenagers use contraception because of peer pressure and curiosity. They also utilise contraception to avoid undesired pregnancy and its complications, such as school dropout, sexually transmitted infections (STIs), and abortion.

In light of this, the current study aims to identify the factors impacting teenage contraceptive use among students at Koforidua Senior High Technical School.

Objectives of the Study

The study’s overall goal is to identify the factors that influence contraceptive use among teenagers attending Senior High Schools in Koforidua, Eastern Region. The study aims to measure teens’ understanding about contraception use at Senior High Schools in Koforidua.

2) Determine teens’ perceptions of contraceptive use in Koforidua Senior High Schools.

3) Determine the availability of contraception among teenagers in Senior High Schools in Koforidua.

4) Determine the barriers to contraceptive usage among teenagers in Koforidua’s Senior High Schools.

Research Questions

1) What do teens know about the usage of contraception?

2) What are teenagers’ attitudes about the usage of contraception?

3) How do teenagers in Koforidua’s Senior High Schools access contraception?

4) What are the impediments to contraceptive use among teens in Koforidua’s senior high schools?

Justification for the Study

Unplanned and unplanned pregnancies contribute significantly to poor health outcomes for women and children in most developing countries.

Women’s ability to govern their own and their children’s health is hampered by social and environmental variables that limit their ability to make independent and fully informed reproductive and sexual decisions.

Second, there are still unsolved questions based on local contexts that have not been exposed, which exacerbates the predicament of these vulnerable groups in terms of decision-making and choices for managing childbirth.

This study will provide local and contextual expressions by impoverished women, which can be incorporated into the design, administration, and implementation of contraceptive usage initiatives in Ghanaian districts and other metropolitan areas.

It would also tell policymakers and program administrators about missing opportunities that should be considered when implementing programmes. Furthermore, it would produce data that would contribute to existing knowledge in research, the field of contraceptive use, and associated topics.

Organisation of the Study

The study will be divided into five chapters, as follows. The first chapter is an introduction to the study. This chapter’s subtopics cover the study’s background, problem statement, research questions, study aims, importance, and study limitations.

The second chapter will include a review of the literature relevant to the inquiry. Chapter 3 will deal with the study technique. The study’s results will be discussed in Chapter Four, and the key conclusions will be summarised in Chapter Five, along with recommendations.