Main Article Content
Abstract
Emergency contraceptive (EC) is a family planning method that can be used after the failure of barrier contraceptive methods, sexual assault, and/or missed oral contraceptive pills to prevent pregnancy. Improving access and use of modern contraceptives such as EC has been suggested, among another healthcare continuum, as the solution to the global population dilemma. However, there is a paucity of data on modern contraceptive use and associated factors in Ghana’s impoverished and low-resource settings. If this continues into the future, the effective planning and implementation of sexual and reproductive programs in these regions could be hampered. This study, therefore, sought to examine the level of knowledge on EC, attitude towards EC, utilization, and barriers to EC among reproductive-age women between 15 and 24 years in the East-Gonja Municipality of Ghana. The study was conducted in Salaga, the administrative capital of the East-Gonja Municipality, using a school-based, descriptive cross-sectional study design. The study population comprised 295 female students from Salaga Senior High School (SHS). Data were collected using structured, self-administered questionnaires, and descriptive analyses were performed to determine respondents’ level of knowledge, attitude, utilization, and barriers to EC. Statistical Package for Social Sciences (SPSS) version 25 was used to analyze the data. About 62% of the respondents had inadequate knowledge about EC. More than half (56.5%) of the sample who reported prior awareness of EC showed a negative attitude toward EC. Less than half (48.5%) of the respondents who indicated had ever engaged in vaginal intercourse with a man reported ever-use of EC. The major reason for EC non-use was fear of stigma (62.0%). Although the majority of the respondents were aware of EC, most of them demonstrated inadequate knowledge and poor attitude toward EC, the former being a major reason for EC non-use. Our findings suggest the need for comprehensive Sexual and Reproductive Health (SRH) education and improved access to modern contraceptives among adolescents and youth in the East-Gonja municipality.
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References
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- Ahinkorah, B. O., Seidu, A., Appiah, F., Budu, E., Adu, C., Boahemaa, Y., Aderoju, G., Adoboi, F. & Ajayi, A.I. (2020). Individual and community-level factors associated with modern contraceptive use among adolescent girls and young women in Mali: a mixed effects multilevel analysis of the 2018 Mali demographic and health survey. Contraception and Reproductive Medicine, 7, 1–12. https://doi.org/10.1186/s40834-020-00132-7
- Asamoah, B. O. & Agardh, A. (2018). Individual- and family-level determinants of risky sexual behavior among Swedish- and foreign-born young adults 18–30 years of age, residing in Skane, Sweden. Archives of Sexual Behavior, 47 (2), 517–528.
- Babatunde, O. A., Ibirongbe, D. O., Omede, O., Babatunde, O. O., Durowade, K. A., Salaudeen, A. G. & Akande, T. M. (2016). Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria. Pan African Medical Journal, 23, 1–7. https://doi.org/10.11604/pamj.2016.23.74.8688
- Bajpai, R. (2015). Emergency contraception: a study to assess knowledge, attitude and practice among female college students in Delhi. National Journal of Community Medicine, 4, 281–285.
- Bamiwuye, S. O., Wet, N. De. & Adedini, S.A. (2013). Linkages between autonomy, poverty and contraceptive use in two sub-Saharan African countries. African Population Studies, 27, 164–173. https://doi.org/10.11564/27-2-438
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- Duran, C. P., Dabalen, A., Narayan, A., Lucas, A. & Menéndez, C. (2016). Inequalities in women’s and girls’ health opportunities and outcomes: A report from sub-Saharan Africa.
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- Ndayizigiye, M., Fawzi, M. C. S., Lively, C. T. & Ware, N. C. (2017). Understanding low uptake of contraceptives in resource-limited settings: a mixed-methods study in rural Burundi. BMC Health Services Research, 17, 1–12. https://doi.org/10.1186/s12913-017-2144-0
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- Pradhan, M., Pokharel, B. & Karki, A. (2020). Knowledge and practice regarding emergency contraception among higher secondary students of selected Government schools of Godawari Municipality. International Journal of Health Sciences and Research, 10, 95–102.
- Relwani, N., Saoji, A., Kasturwar, N. B., Nayse, J., Junaid, M., & Dhatrak, P. (2012). Emergency contraception: exploring the knowledge, attitude and practices of engineering college girls in Nagpur District of Central India. National Journal of Community Medicine, 3, 3–8.
- Seglah, P. A., Wang, Y., Wang, H., Apelike, K., Neglo, W., Gao, C., & Bi, Y. (2022). Energy potential and sustainability of straw resources in three regions of Ghana. Sustainability, 14, 1–22. https://doi.org/10.3390/su14031434
- Semero, S., Town, J., Tesfa, A., Bizuneh, A. D., Tesfaye, T., Gebru, A. A., Ayene, Y. Y., & Tamene, B. A. (2015). Assessment of knowledge, attitude and practice towards emergency contraceptive methods among female West Ethiopia. Science Journal of Public Health, 3, 478–486. https://doi.org/10.11648/j.sjph.20150304.15
- Shakya, V., & Ghimire, N. (2020). Knowledge and attitude on emergency contraception among adolescent students of an urban school. Journal of Patan Academy of Health Sciences, 7, 146–155. https://doi.org/10.3126/jpahs. v7i1.28892
- Staveteig, S., Gebreselassie, T., & Kampa, K. T. (2018). Absolute poverty, fertility preferences, and family planning use in FP2020 focus countries. (DHS comparative reports No. 48).
- Thapa, S., Lopchan, M. & Mehta, R. K. (2015). Knowledge and attitude regarding emergency contraception among higher secondary students. IOSR Journal of Nursing and Health Science, 4, 46–49. https://doi.org/10.9790/1959-04334649
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- Yamane, T. (1967). Statistics; an introductory analysis (2nd ed.). New York: Harper & Row.
- Yeboah, D. S., Appiah, M. A. & Kampitib, G. B. (2022). Factors influencing the use of emergency contraceptives among reproductive age women in the Kwadaso Municipality, Ghana. PLoS ONE, 17, e0264619. https://doi.org/10.1371/journal.pone.0264619
References
Abrha, S., Zeratsion, F., Molla, F., Eticha, T., Assen, A, & Melkam, W. (2014). Assessment of knowledge, attitude and practice among regular female preparatory school students towards emergency contraceptives in Mekelle, Northern Ethiopia. International Journal of Pharma Sciences and Research, 5, 856–864.
Ahinkorah, B. O., Seidu, A., Appiah, F., Budu, E., Adu, C., Boahemaa, Y., Aderoju, G., Adoboi, F. & Ajayi, A.I. (2020). Individual and community-level factors associated with modern contraceptive use among adolescent girls and young women in Mali: a mixed effects multilevel analysis of the 2018 Mali demographic and health survey. Contraception and Reproductive Medicine, 7, 1–12. https://doi.org/10.1186/s40834-020-00132-7
Asamoah, B. O. & Agardh, A. (2018). Individual- and family-level determinants of risky sexual behavior among Swedish- and foreign-born young adults 18–30 years of age, residing in Skane, Sweden. Archives of Sexual Behavior, 47 (2), 517–528.
Babatunde, O. A., Ibirongbe, D. O., Omede, O., Babatunde, O. O., Durowade, K. A., Salaudeen, A. G. & Akande, T. M. (2016). Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria. Pan African Medical Journal, 23, 1–7. https://doi.org/10.11604/pamj.2016.23.74.8688
Bajpai, R. (2015). Emergency contraception: a study to assess knowledge, attitude and practice among female college students in Delhi. National Journal of Community Medicine, 4, 281–285.
Bamiwuye, S. O., Wet, N. De. & Adedini, S.A. (2013). Linkages between autonomy, poverty and contraceptive use in two sub-Saharan African countries. African Population Studies, 27, 164–173. https://doi.org/10.11564/27-2-438
Dangat, C. M., & Njau, B. (2013). Knowledge, attitude and practices on family planning services among adolescents in secondary schools in Hai District, northern Tanzania. Tanzania Journal of Health Research, 15, 1–8. https://doi.org/10.4314/thrb.v15i1.3
Deressa, J. T., & Yang, L. (2021). Knowledge, attitude and practice of emergency contraceptive among undergraduate female college students: a cross-sectional study. Austin Journal of Obstetrics and Gynecology, 8, 1182.
Duran, C. P., Dabalen, A., Narayan, A., Lucas, A. & Menéndez, C. (2016). Inequalities in women’s and girls’ health opportunities and outcomes: A report from sub-Saharan Africa.
East Gonja Municipal Health Directorate. (2022). East Gonja sub municipals & communities. Salaga.
Ghana Health Service. (2016). Adolescent health service policy and strategy (2016-2020). Accra, Ghana.
Ghana Statistical Service. (2021). Ghana 2021 Population and Housing Census. General Report (V. 3). Accra
Hellwig, F., Coll, C. V. N., Blumenberg, C., Ewerling, F., Kabiru, C. W. & Barros, A. J. D. (2021). Assessing wealth-related inequalities in demand for family planning satisfied in 43 African countries. Front. Glob. Womens Health, 2, 674227. https://doi.org/10.3389/fgwh.2021.674227
Hussain, R., & Kavanaugh, M. L. (2021). Changes in use of emergency contraceptive pills in the United States from 2008 to 2015. Contraception: X, 3, 100065. https://doi.org/10.1016/j.conx.2021.100065
Jko, O., Pavlova, M. & Groot, W. (2020). Socioeconomic inequalities in reproductive health care services across Sub-Saharan Africa. A systematic review and meta-analysis. Sexual & Reproductive Healthcare, 25, 100536. https://doi.org/10.1016/j.srhc.2020.100536
Kaba, A.J. (2020). Explaining Africa’s rapid population growth, 1950 to 2020: trends, factors, implications, and recommendation. Sociology Mind, 10, 226–268. https://doi.org/10.4236/sm.2020.104015
Kwame, K. A., Bain, L. E., Manu, E. & Tarkang, E. E. (2022). Use and awareness of emergency contraceptives among women of reproductive age in sub-Saharan Africa: a scoping review. Contraception and Reproductive Medicine, 7, 1–14. https://doi.org/10.1186/s40834-022-00167-y
Lartey, N. L. (2021). Teenage pregnancies in Ghana hit 555, 575 in five years. Citinews. https://citinewsroom.com/2021/06/teenage-pregnancies-in-ghana-hit-555575-in-five-years/amp/
Laari, P. (2021, June). Ghana National Household Registry (GNHR) and Data Dissemination. Damango, Savannah region.
Mamuye, S. A., Wudineh, K. G., Belay, A. N., & Gizachew, K. D. (2021). Assessment of knowledge, attitudes, and practices regarding emergency-contraception methods among female Dangila Hidase high school students, Northwest Ethiopia, 2019. Open Access Journal of Contraception, 12, 1–5. https://doi.org/10.2147/OAJC.S288029
Menene, A., Getachew, A., Kediro, A., & Gutema, B. (2020). Assessment of knowledge, attitude and practice toward emergency contraceptive among female students at Unity University, Adama Town, Oromia Regional State, Ethiopia. International Journal of Clinical and Experimental Medical Sciences, 6, 96–103. https://doi.org/10.11648/j.ijcems.20200605.13
Mesfin, D. (2020). Emergency contraceptive knowledge, utilization and associated factors among secondary school students in Wolkite town, southern Ethiopia, cross sectional study. Contraception and Reproductive Medicine, 5, 1–10. https://doi.org/10.1186/s40834-020-00119-4
Milkowski, C. M., Ziller, E. C., & Ahrens, K. A. (2021). Rural-urban residence and emergency contraception use, access, and counseling in the United States, 2006-2017. Contraception: X, 3, 100061. https://doi.org/10.1016/j.conx.2021.100061
Ministry of Finance - Ghana. 2021 PBB Estimates for East Gonja Municipal. Accra.
Mishore, K. M., Woldemariam, A. D. & Huluka, S. A. (2019). Emergency contraceptives: Knowledge and practice towards its use among Ethiopian female college graduating students. International Journal of Reproductive Medicine, 2019, 9397876. https://doi.org/10.1155/2019/9397876
Ndayizigiye, M., Fawzi, M. C. S., Lively, C. T. & Ware, N. C. (2017). Understanding low uptake of contraceptives in resource-limited settings: a mixed-methods study in rural Burundi. BMC Health Services Research, 17, 1–12. https://doi.org/10.1186/s12913-017-2144-0
Planned Parenthood Association of Ghana [PPAG]. (2016). Five-year strategic plan. Planned Parenthood Association of Ghana. Accra, Ghana.
Pradhan, M., Pokharel, B. & Karki, A. (2020). Knowledge and practice regarding emergency contraception among higher secondary students of selected Government schools of Godawari Municipality. International Journal of Health Sciences and Research, 10, 95–102.
Relwani, N., Saoji, A., Kasturwar, N. B., Nayse, J., Junaid, M., & Dhatrak, P. (2012). Emergency contraception: exploring the knowledge, attitude and practices of engineering college girls in Nagpur District of Central India. National Journal of Community Medicine, 3, 3–8.
Seglah, P. A., Wang, Y., Wang, H., Apelike, K., Neglo, W., Gao, C., & Bi, Y. (2022). Energy potential and sustainability of straw resources in three regions of Ghana. Sustainability, 14, 1–22. https://doi.org/10.3390/su14031434
Semero, S., Town, J., Tesfa, A., Bizuneh, A. D., Tesfaye, T., Gebru, A. A., Ayene, Y. Y., & Tamene, B. A. (2015). Assessment of knowledge, attitude and practice towards emergency contraceptive methods among female West Ethiopia. Science Journal of Public Health, 3, 478–486. https://doi.org/10.11648/j.sjph.20150304.15
Shakya, V., & Ghimire, N. (2020). Knowledge and attitude on emergency contraception among adolescent students of an urban school. Journal of Patan Academy of Health Sciences, 7, 146–155. https://doi.org/10.3126/jpahs. v7i1.28892
Staveteig, S., Gebreselassie, T., & Kampa, K. T. (2018). Absolute poverty, fertility preferences, and family planning use in FP2020 focus countries. (DHS comparative reports No. 48).
Thapa, S., Lopchan, M. & Mehta, R. K. (2015). Knowledge and attitude regarding emergency contraception among higher secondary students. IOSR Journal of Nursing and Health Science, 4, 46–49. https://doi.org/10.9790/1959-04334649
United Nations Population Fund. (2010). How Universal is Access to Reproductive Health? New York, United States.
Wilmoth, J., Menozzi, C., & Bassarsky, L. (2022). Why population growth matters for sustainable development. New York, United States: UNESCO.
Yamane, T. (1967). Statistics; an introductory analysis (2nd ed.). New York: Harper & Row.
Yeboah, D. S., Appiah, M. A. & Kampitib, G. B. (2022). Factors influencing the use of emergency contraceptives among reproductive age women in the Kwadaso Municipality, Ghana. PLoS ONE, 17, e0264619. https://doi.org/10.1371/journal.pone.0264619