CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND STUDY
Young people's sexual habits are on the rise all over the world, with a trend toward early onset. Many young adults began their first sexual activity while still in adolescence. Up to 6% of all sexually active teenage girls in Nigeria could have become pregnant and had an induced abortion. Sexual behavior has been characterized as any activity that causes sexual arousal, with biology and the degree of sociocultural control exerted on an individual's ability to express sexuality being two major determinants. Individuals' or couples' desire to live a satisfying and healthy sexual life is critical to sexual health. If the Millennium Development Goals (MDGs) for sexual inclusion, maternal health, and HIV/AIDS are to be met, inclusive environments in which healthy sexual activity can occur are critical. Traditionally, public health has concentrated on the negative consequences of sexual behavior. Sexual behaviors contribute significantly to the burden of disease as essential determinants of reproductive patterns and transmission of sexually transmitted infections. Sexual rights have received increased attention in the foreign policy arena over the last decade, and new norms for the development and preservation of a sexually safe community, based on values of integrity, respect, and choice, are being developed. The design and evaluation of strategies to improve sexual health include information about sexual conduct and activity. Importantly, too, empirical evidence is needed to correct myths in public perception of behaviors. Yet despite being scrutinized everywhere, sexual behavior poses challenges for scientific enquiry. In terms of intervention, the same paradox exists: sexual behavior is tightly controlled in almost every country, but changing it to improve sexual wellbeing has proven difficult. In the last two decades, the need to predict and avoid HIV transmission has given a valuable impetus to both sexual activity and intervention studies. Some regions have more data than others, especially those with low HIV prevalence or strict sex prohibitions, or both. African countries, for example, have received much less attention from researchers than Asian countries, resulting in a limited evidence base. Even so, the vast number of developing countries with comparable data (those for which a Demographic and Health Survey (DHS) has been conducted) and other countries with comparable national surveys will provide a fair global impression. Data is also accumulating from evaluations of the effectiveness of programs aimed at improving sexual health.
The research that has resulted offers a once-in-a-lifetime opportunity to assess sexual behavior and attempts to protect sexual health at the dawn of the twenty-first century. Both secular and non-secular social movements have an effect on sexual behavior. Poverty, schooling, and housing have all changed dramatically in recent decades. Seasonal labor, rural-to-urban migration, and social instability due to war and political instabilities have all resulted in demographic shifts in the age structure of populations, the timing of marriage, and the rate of mobility and migration between and within countries. Many countries have changed their attitudes about sexual behavior. Worldwide communications, including the internet, have influenced social norms by transporting sexual images from more liberal to more conservative societies, especially in societies where information technology advancements have been rapid. With advancements in contraceptives, sexual identity is becoming largely free of its reproductive effects. Health-care policy and regulations, as well as public-health policies, have changed; access to family planning services has improved, and attempts to prevent HIV transmission have impacted few areas. We discuss emerging trends and patterns in key sexual behavior variables, as well as their consequences for sexual health and the design of sexual health interventions.
Given the widespread AIDS epidemic that has gripped many countries, as well as a persistently high rate of childbearing at a young age, adolescent sexual and reproductive health is a crucial policy and programmatic problem in Sub-Saharan Africa. At the end of 2005, an estimated 4.3 percent of young women and 1.5 percent of young men in Sub-Saharan Africa were living with HIV, and 9-13 percent of young women had given birth by the age of 16. To minimize their risk of contracting HIV and other sexually transmitted infections (STIs), as well as unwanted pregnancies and very early childbearing, young people clearly need access to preventive knowledge and skills before they become sexually active. The most difficult task is determining what unique information to provide young undergraduates, from what sources, at what ages, and in what ways. Understanding the emerging sexual and reproductive health habits and needs of very young teenagers is one of the first steps in answering these concerns. In Nigeria, contraceptives are given free of charge at government health facilities. Referral hospitals, primary hospitals, main clinics, university clinics, mobile clinics, health posts and the Botswana Family Welfare Association, as well as sexual and reproductive centers, are among the facilities available. The residents' homes are within a 15-kilometer radius of these health centers (UNFPA Case Study 2013). Because of strong cultural and religious values, the use of contraception is not freely debated by young single women or undergraduates in higher education, exposing young women to an increased risk of unwanted/unintended pregnancies. Pregnancy before marriage is also considered an abomination in many African traditional cultures. As a result, many single females who become pregnant unintentionally seek abortion care for fear of social stigma. Since abortion is illegal in Nigeria, it is generally dangerous and is often performed by traditional herbalists, which raises the risk of maternal deaths. Despite engaging in high-risk sexual behaviors, students in Nigeria did not have access to sexual and reproductive health services or HIV/AIDS-related programs, according to two major surveys conducted among university students. The findings also revealed that a quarter of university students (25%) had unmet contraceptive needs, despite having a high degree of contraceptive knowledge. Knowledge, attitudes, and expectations about sexual and reproductive health could influence contraceptive use, implying that interventions may result in fewer unintended pregnancies.
The university community is a miniature world in which various demographic groups interact with an emphasis on information development and dissemination: males, females, teenagers and young adults, adults, elders, teachers, lecturers, administrative staff, and many others. The social structure of most university environments not only brings both sexes together at the point of study, but it also significantly increases interaction between them beyond what is allowed in the pre-university setting. Unrestricted social interaction, such as that found in many public universities, continues to encourage young people to engage in heterosexual behaviors beyond the platonic stage. Pre-marital heterosexual connections among a large proportion of unmarried youth in Nigerian higher institutions, according to studies that examine sexual values among teenagers and the rate of use of contraceptives in preventing pregnancy(Ortese, 2019; Aziken, Okonta and Ande, 2013), Ethiopia (Kibret, 2013) in Nigeria (Chappell, Rule, Dlamini and Nkala, 2014; Hogue and Ghuman, 2011) are high and rising. According to Laah, (2010) Unfortunately, teenagers who engage in such premarital sex do not consider it to be wrong. Indeed, the literature confirms that many of them have unstable sexual lives, frequently involving multiple partners and contraception security or not (Hoque and Ghuman, 2011, Ortese, 2019, Peltzer, Pengpid and Peltzer, 2018). Although risky sexual behavior or sexual experimentation exposes young people to reproductive tract infections such as STIs and unintended pregnancy, there appears to be a low rate of contraceptive use among those who are at risk. Obono and Mohammed (2010) observed that contraceptive knowledge and use among sexually active adolescents in Ibadan is abysmally low. Therefore this study centers on sexual activity and use of contraceptive among undergraduate students in Port Harcourt
1.2 STATEMENT OF THE PROBLEM
The Nigerian Urban and Reproductive Health Initiative (NURHI) had previously conducted a study among women in Nigerian undergraduate institutions aged 24-35 years to assess the potential for increased contraceptive demand, and found a positive response. (NURHI, TOR, 2017). Young people are constantly exposed to unhealthy behaviors and negative health effects due to a lack of education and access to sexual and reproductive health information and services(Aji et al, 2013; NURHI TOR, 2017).
According to the World Health Organization (WHO), the general prevalence of contraceptive usage is higher in Latin American countries (63%) than in African countries (20%), with the rate of non-use highest in Sub-Saharan African countries. The use of contraceptives was estimated to be about 12 percent of the Nigerian population (Monjok, Smesny, Ekabua, and Essien, 2010). Despite high rates of sexual activity and increased knowledge of contraceptive technologies, Nigeria's Population Reference Bureau (PRB) estimated in 2011 that only about 29% of Nigerian youth use contraceptives. (Akani, et al, 2018; Fatusi and Blum, 2018: Cadmus and Owoaje, 2010: Tayo et al, 2011: Osakinle et al, 2013; Adeniji, Tijani and Owonikoko, 2013). These findings show that while young people are generally aware of contraceptive methods and the advantages of using them, they do not find them appealing. Students in Nigerian tertiary institutions had similar results suggesting low contraceptive use, indicating that students are vulnerable to unintended pregnancies and the transmission of STIs. Therefore this study centers on sexual activity and use of contraceptive among undergraduate students in Port Harcourt.
1.3 OBJECTIVES OF THE STUDY
In line with the statement of research problems the objectives of the study is to examine sexual activity and contraceptive utilization among undergraduate’s students in Port Harcourt. The objectives therefore are:
1) To assess the knowledge of under graduates students towards the use of contraceptives in port Harcourt
2) To assess the level of the use of contraceptives by under graduate students in port Harcourt
3) To examine the relationship between the sexual behavior and the use of contractive by under graduate’s students in port Harcourt
4) To examine the influence of social cultural factors on the use of contraceptives by undergraduate students in port Harcourt
5) To examine the factor that influences the use of contraceptives by sexually active undergraduate students
6) To recommend ways of improving the safe use of contraceptives among undergraduate students in port Harcourt
1.4 RESEARCH QUESTIONS
1) What is the knowledge of under graduates students towards the use of contraceptives in port Harcourt?
2) What is the level of the use of contraceptives by sexual active under graduates in port Harcourt?
3) What is the relationship between the sexual behavior and the use of contractive by under graduate’s students in Port Harcourt?
4) What is the Influence of social cultural factors on the use of contraceptives by undergraduate students in Port Harcourt?
5) What are the factors that influence the use of contraceptives by sexually active undergraduate students?
6) What are the ways of improving the safe use of contraceptives among undergraduate students in port Harcourt?
1.5 HYPOTHESIS OF THE STUDY
In line with the statement of research problems and the objectives of this thesis, the following hypothesis will be tested:
HYPOTHESES
Hypothesis 1
HO: socio cultural factors do not have a significant influence on the use of contraceptives by undergraduate students in port Harcourt
H1: socio cultural factors have a significant influence on the use of contraceptives by undergraduate students in Port Harcourt
Hypothesis 2
HO: sexual behaviors of undergraduate students do not have a significant relationship with use of contraceptives in port Harcourt
H1: sexual behaviors of undergraduate students has a significant relationship with use of contraceptives in Port Harcourt
1.6 SIGNIFICANCE OF STUDY
This study would enable the researcher to pass their experience on the subject matter to parents, emerging young adults, Non-Government organization, schools (students) to serve as a medium for further research
1.7 SCOPE OF THE STUDY
The study would cover the experiences of Students Perceived Effect on the Use of Contraceptive Technology in Tertiary Institution. The study would encompass undergraduate students in tertiary institution in Taraba state.
1.8 LIMITATION OF THE STUDY
The researcher was faced with the following constraints in carrying out this study:
Time: The time within the researcher is too short to carry on the detail study on this topic.
Resources: Another constraint of the researcher is financial resources to carry on the detail study of this topic.
Data: Another limitation to this study will be lack of data to make valid study on the research problem.
1.9 OPREATIONAL DEFINITION OF TERMS
CONTRACEPTIVE TECHNOLOGY: (Pharmaceutical: Drugs, Devices) A contraceptive is a device or drug that prevents a woman from becoming pregnant. Some contraceptives prevent pregnancy by preventing ovulation. Women who do not wish to become pregnant might consider using contraceptives.
CONTRACEPTION: the deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse. The major forms of artificial contraception are: barrier methods, of which the commonest is the condom or sheath; the contraceptive pill, which contains synthetic sex hormones which prevent ovulation in the female; intrauterine devices, such as the coil, which prevent the fertilized ovum from implanting in the uterus; and male or female sterilization. “one of the most important methods of contraception"
STUDENTS: A student is primarily a person enrolled in a school or other educational institution and who is under learning with goals of acquiring knowledge, developing professions and achieving employment at desired field. In the broader sense, a student is anyone who applies themselves to the intensive intellectual engagement with some matter necessary to master it as part of some practical affair in which such mastery is basic or decisive.
TERTIARY EDUCATION: Tertiary education, also referred to as third-level, third-stage or post-secondary education, is the educational level following the completion of secondary education. The World Bank, for example, defines tertiary education as including universities as well as trade schools and colleges.
SEXUAL ACTIVITY/BEHVIOUR: Human sexual activity, human sexual practice or human sexual behavior is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone to acts with another person in varying patterns of frequency, for a wide variety of reasons