Knowledge of contraceptives - Attitudes towards contraceptive use

6.2. Attitudes towards contraceptive use

6.2.1. Knowledge of contraceptives

Contrary to the findings of earlier studies in universities in Ghana (Appiah-Agyekum & Kayi, 2013); South Africa (Hoque & Ghuman, 2012; Patel & Kooverjee, 2009; Roberts et al., 2004); and Nigeria (Mfono, 1998), in which knowledge of contraceptives and their places of access was low, this study reflects a relatively good awareness of the process of conception, how a contraceptive

works, the right time to use a contraceptive, and sources of contraceptives on campus. The participants knew about methods of contraception such as the male condoms, the female condoms, the contraceptive pill, emergency contraceptives, injectable contraceptives, the rhythm method, withdrawal, abstinence, the loop, and implants. A few male participants at postgraduate level had knowledge of sterilisation which is a permanent method of contraception, although none of them had direct experience of it. This finding is in line with Roux’s (1995) comments that most people of student age might plan to have children at later stages of their lives; therefore, a focus on sterilisation, an irreversible method as an option is not expected. The good awareness of contraceptives and where they could be accessed on campus reflected in this study would be viewed in the theory of planned behaviour as a reflection of intentions to use them. Methods of contraception preferred by students were injectable contraceptives, emergency contraceptives and the male condom, which could suggest intentions to prevent the risk of pregnancy and STIs, but their intentions did not result in consistent use of the methods.

Most of the female participants seemed to have an advanced knowledge about contraceptives such as injectable, implants, the female condoms and the contraceptive pill. This trend is mirrored in the recent research in South Africa which found that 93.4 % of women of reproductive age have heard of at least one effective method of contraception (Lince-Deroche et al., 2016). Knowledge of contraceptives is generally predictable in women because they are directly involved in the use of contraceptives except for a male condom which is worn by a man.

The participants in the study did not know about traditional contraceptive practices like herbal mixtures offered by traditional healers to prevent pregnancy (Department of Health, 2012).

Traditional contraceptive practices may be least known by students because students are at the university full time, and they might not have time to consult traditional healers as their primary source of health care. In addition, traditional practices are least considered by young people due to the availability of modern contraceptives like hormonal contraceptives and the male condoms.

Modern contraceptives have constantly been improved to minimise their side effects and increase their efficacy (Department of Health, 2012), and this may in turn increase their demand. This is an indication that contraceptive behaviour may not remain stable over time hence, lowering the predictive ability of the theory of planned behaviour in contraceptive studies and so it is recommended that such studies should be conducted more often.

The natural contraceptive practices such as ‘counting days’ and withdrawal were well known but less practiced due to perceptions that they do not fully prevent the risk of pregnancy. This finding is similar to the findings reported in studies in Uganda (Kiene et al., 2014), and in the USA (Trussell, 2011) among women of reproductive age also report similar findings. These findings relate to the assumption in the theory of planned behaviour that beliefs about the likely outcomes of performing behaviour influences actual practice (Ajzen, 1991).

The good knowledge of contraceptives and conception in this study could partially reflect the study sample. The university students with an experience of contraceptive use took part in this study and so their level of education and past experiences might have intensified their knowledge. The association between awareness of contraceptives and being educated, for instance, having a tertiary level education is reported in studies in South Africa (McPhail, et al., 2007; Myer, et al., 2007;

Seutlwadi, 2012). Participants also learnt about contraceptives from a variety of sources like awareness education and support programmes received from Pietermaritzburg campus clinic;

content in Biology and Life Orientation subjects; peer interaction; and mass media including internet material. These sources might have increased student’s awareness of contraceptive use. In addition, the majority students are aware of their sexual and reproductive rights like access to contraceptives of their choice, and this may have heightened their understanding of contraceptives.

6.2.1.1. Knowledge of therapeutic effects of contraceptives

A few participants in the study commented on therapeutic effects of contraceptive use, for instance, making a woman's skin soft, smooth, attractive and decrease menstrual cramps. This finding relates to the study of Seidman (2011) at the University of Belgrade in Europe, and the information contained in the contraceptive guidelines circulated by the Department of Health (2012) in South Africa. In these articles, contraceptive use was said to treat dysmenorrhea and dermatological diseases. Although participants did not report on other non-contraceptive benefits such as prevention of medical conditions like endometrial cancer, sickle-cell anaemia, pelvic inflammatory diseases and uterine fibroid (Department of Health, 2012; Seidman, 2011), awareness of these therapeutic effects may heighten the demand for contraceptives in universities.

However, awareness of non-contraceptive benefits of condom use mentioned by a male participant, like prevention of premature ejaculation which could mean having a long period of

sexual pleasure, as well prevention of the soiling of bedding may also heighten their demand. The theory of planned behaviour argues that sufficient information about behaviour may influence the formation of behavioural intentions (Ajzen, 1991). If condom users are given information about non-contraceptive benefits of condom use, they might change their beliefs and attitudes towards condom use, and this may positively influence actual use.

6.2.1.2. The effect of knowledge of contraceptives on actual use

Despite the good awareness of the process of conception, how a contraceptive works, the right time to use a contraceptive, and sources of contraceptives on campus, contraceptive use among the participants was low and inconsistent. This finding relates to the argument raised by Baggozi (1992) that having information about behaviour does not necessarily link to behaviour change; but contrary to the argument in the theory of planned behaviour that having knowledge of the behaviour, for instance, contraceptive use, may guide evaluations of the risks and benefits of performing behaviour and may influence desirable outcomes (Ajzen, 1991). This finding implies that, having knowledge of the risk of pregnancy and STIs may influence intentions to use contraceptives but does not necessarily provide specific guidance about actual contraceptive use.

The theory of planned behaviour argues that individuals who are motivated to perform behaviour may focus more on outcomes of performing behaviour, for instance preventing pregnancy (Ajzen, 1991). The comments indicating low and inconsistent use of contraceptives in this study could suggest a lack of concern over the possibility of pregnancy or STIs. Such arguments have been reported in the past studies in universities in New Zealand (Breheny & Stephens, 2004), South Africa (Hoque & Ghuman, 2012; Maja & Ehlers, 2004; Patel & Kooverjee, 2009; Raselekoane et al., 2016; Roberts et al., 2004), Uganda (Nsubuga et al., 2016), and Tanzania (Somba et al., 2014).

Although the influence of past experience on future behaviour is not considered in the theory of planned behaviour, Armitage and Conner (2001) link the two behaviours. Participants in the study consisted of sexually active students with an experience of contraceptive use, but the low and inconsistencies in their contraceptive use could imply that, having used a contraceptive in the past does not necessarily influence future use.

Dalam dokumen Knowledge of contraceptives, attitudes towards contraceptive use, and perceptions of sexual risk, among university students at a South African university. (Halaman 83-87)