Knowledge regarding emergency contraception among college students

INTRODUCTION

Worldwide 70,000 women aged 15 to 19 years die each year due to pregnancy and childbirth related causes, more than 18 million young women give birth to a baby each year and 9 in 10 of them are in developing countries.¹ With the current scenario of rising premarital sex among adolescents, there is increase in unintended pregnancies, unsafe abortions and sexual transmitted diseases.^2,3 Illegal abortions are direct results of unwanted pregnancies coupled with hesitancy to go to a doctor, thus carrying a major risk for maternal mortality. It is well established that many unintended pregnancies occur as a result of unprotected intercourse, inadequate contraceptive measures and failure of contraceptive methods.Emergency contraception(WHO 1998) refers to contraceptive methods that can be used by women in the first few days following unprotected intercourse to prevent unwanted pregnancy⁴ . The principal goal is the provision of emergency contraception to prevent unwanted pregnancy which might have resulted from method failure, sexual assaults and lack of knowledge or asses to contraception, thereby reducing need for abortions and negative maternal health consequence associated with them.

Knowledge of emergency contraception among adolescents is particularly important because of high rates of unwanted and teenage pregnancy among them. This knowledge will help them to plan proper intervention methods. Hence, this study was initiated to assess the knowledge on emergency contraceptive methods among college going students and to also briefly educate the students about the same.

Materials and methods:

Study setting: The study was undertaken in Bagalkot city, Bagalkot district, Karnataka. Being one of the major towns in north Karnataka, Bagalkot has many educational institution saffiliated to different universities like Karnataka university, Dharwad university and RGUHS. Thousands of students every year come to study here in various colleges and thus it has become educational hub of north Karnataka

Study Design: Cross sectional Study

Study population: Third year students belonging to colleges of different faculty. The colleges include medical (100 students), Nursing (99 students), B.sc (93 students), B.com (100 students)

Sample size: All the students studying in the 4 streams of select colleges. By universal sampling method, a total of 592 students were enrolled for the study.

Study duration: 2 Months from July 2012 to August 2012.

Data collection: Ethical clearance was obtained from the institution and written consent was taken from the study participants. The data collection was carried out by Structured, self-administered, pre tested questionnaire. Data was entered and analysed in openEpi software.

Results

600 students were approached and accepted to participate in the study. 592 students completed and returned the questionnaire, giving a total participation rate of 98.66%

Among 592 students 286 (48.3%) were males and 306 (51.7%) were females.

Out of 592 students, 280 (47.3%) had knowledge about different types of contraception.

Medical (100%), nursing (82%) and B.Sc. (71%) students had better knowledge about different types of contraception than others. Only 7% of polytechnic and B.A students had the knowledge.

Out of 592 students, 181 (30.6%) had knowledge about emergency contraceptive pills.

Medical (96%) students had better knowledge than others. Half of the nursing students (46%) and quarter of B.Sc. students (24.7%) had reported that they were aware of E.C pills. Least knowledge was found in B. Com (6%). B.A (7%) and polytechnic (3%)

Out of 592 students, only 186 (31.4%) had knowledge about time frame of emergency contraception. In the 186 correct answers, predominant were Medical (98%) and nursing (61%). B.Sc. (14%), B. Com (6%), polytechnic (3%) had poor knowledge about emergency contraceptive pill time frame. 

There is a significant improvement in knowledge about emergency contraception before and after the lecture given.

Discussion

In India, where rates of unplanned pregnancies and illegal abortions are high, and it is estimated that 78% of pregnancies are unplanned and 25% are unwanted.⁵ Despite a National Family Welfare programme and legalization of abortions in India through MTP act of 1972, the number of unsafe abortions has been increasing. However, the morbidity associated with abortions is preventable to a great extent through the use of suitable contraception methods. The awareness of different types of contraception methods among students in our study was 47.3%. This level of awareness was higher when compared to the university students in Ghana (43.2%)⁶ and on the other hand it was low when compared to students in Nagpur (92.7%)⁷ , Kathmandu (66.5%).⁸

Only 30.6% of students knew about emergency contraceptive pills which was lower than the study from Ethiopia (82.8%).9 About 20.6% of students mentioned intrauterine device can be used as emergency contraception which was lower than study from Ethiopia (34.1%)⁹ Knowledge about timing of emergency contraception after an unprotected sexual intercourse was 31.4%, these findings were higher thanthat reported in Ghana(11.3%).⁶ Almost three fourth of respondents (72.8%) thought emergency contraception is a form of abortion which was higher than the students of Nagpur (54.6%)⁷ and Ghana (25.4%).⁶ Only 25.2% of students answered that emergency contraceptive pills interrupts ongoing pregnancy which was lesser than the study carried out in Nagpur.⁷ And 33% students mentioned that they knew about side effects of emergency contraceptive pills which was much higher than students from Nagpur.⁷

As our study consists of six different faculties (Medical, nursing, B.sc, B.com, B.A, polytechnic), amongst all, Medical and nursing students had better knowledge about emergency contraception as they were from medical background. However, amongst the others B.Sc students had better knowledge compared to B.A, B.com and polytechnic students as they were from science background.There was a significant improvement in the overall knowledge on emergency contraception frompre-test to post test.

The strength of our study lies in the fact that it is focused on college students rather that only on adult married females. Many studies have been done on married females but not on college students, who also, are in greater need of awareness aboutemergency contraception

Conclusion

The use of contraceptives among college students are significantly influenced by educational, developmental and social factors. The study highlights that knowledge about emergency contraception was good in science stream students. As overall knowledge on emergency contraception increased from pre-test to post test, this indicates that education is an easier and important way to increase the awareness on emergency contraception.