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      Sexual experiences and emergency contraceptive use among female university students: a cross-sectional study at Wachamo University, Ethiopia

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          Abstract

          Background

          Although unintended pregnancy rate is declining in both developed and developing countries, it remains higher in developing countries. Ethiopia is one country with a high prevalence of unintended pregnancy. In spite of this fact, very little is known about utilization of emergency contraception (EC) among young women. Therefore, this study aims to assess sexual experiences and emergency contraception use among female students at Wachamo University in Ethiopia.

          Methods

          A cross-sectional study was conducted from March to April 2013 at Wachamo University in Ethiopia. A pretested self-administered questionnaire was used to assess sexual experiences and emergency contraception use among female students. The study participants (n = 424) were selected using a multistage sampling procedure. A simple random sampling technique was applied to select the study participants from a list obtained in registrar’s office. Data was entered into EpiInfo and exported to SPSS for analysis. Bivariate and multivariate logistic regression analyses were used to determine factors associated with emergency contraception use.

          Result

          The majority of respondents (62.0%) were 20–24 years old and 31.4% were sexually active. Among sexually active, the mean (standard deviation) age at first sex was 18.22 (SD = 1.69). About one-half participants had high levels of knowledge about EC (49.8%) and positive attitudes towards EC (47.6%). Moreover, 44.4% of sexually active participants used EC at least once after unprotected sexual intercourse. The bivariate logistic regression revealed that age, marital status, religion, previous & current residence, parent’s educational status, knowledge about and attitude towards EC has a significant (P < 0.005) association with EC use. Furthermore, the multivariate analysis indicated that female students who have good knowledge, and ever got married were more likely to use EC than their counterparts (P < 0.05).

          Conclusions

          Emergency Contraception use, knowledge about and attitude on Emergency Contraception were very low among female students. Overall, knowledge on EC and marital status were predictors for EC use. Thus, it is an indication that there is a need for health education and promotion programs in university set-up to improve EC use to prevent unintended pregnancies.

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          Most cited references19

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          The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural Southwestern Ethiopia

          Background Depression in pregnancy has adverse health outcomes for mothers and children. The magnitude and risk factors of maternal depression during pregnancy is less known in developing countries. This study examines the association between pregnancy intention, social support and depressive symptoms in pregnancy in Ethiopia. Methods Data for this study comes from a baseline survey conducted as part of a community- based cohort study that involved 627 pregnant women from a Demographic Surveillance Site (DSS) in Southwestern Ethiopia. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms during pregnancy. Data on depressive symptoms, pregnancy intention, social support and other explanatory variables were gathered using an interviewer-administered structured questionnaire. The association between independent variables and depressive symptom during pregnancy was assessed using multivariable logistic regression. Results The prevalence of depressive symptoms during pregnancy was 19.9% (95% CI, 16.8-23.1), using EPDS cut off point of 13 and above. The mean score on the EPDS was 8, ranging from 0 to 25 (SD ±5.4). Women reporting that the pregnancy was unwanted were almost twice as likely to experience depressive symptoms compared with women with a wanted pregnancy. (Adjusted Odds Ratio (AOR) = 1.96, 95% Confidence Interval (CI) 1.04-3.69) Women who reported moderate (AOR = 0.27; 95% CI 0.14-0.53) and high (AOR = 0.23, 95% CI 0.11-0.47) social support during pregnancy were significantly less likely to report depressive symptoms. Women who experienced household food insecurity and intimate partner physical violence during pregnancy were also more likely to report depressive symptoms. Conclusion About one in five pregnant women in the study area reported symptoms of depression. While unwanted pregnancy increases women’s risk of depression, increased social support plays a buffering role from depression. Thus, identifying women’s pregnancy intention and the extent of social support they receive during antenatal care visits is needed to provide appropriate counseling and improve women’s mental health during pregnancy.
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            Population effect of increased access to emergency contraceptive pills: a systematic review.

            We systematically reviewed data on effects of increased access to emergency contraceptive pills on pregnancy rates and use of the pills. We searched MEDLINE, POPLINE, EMBASE, and LILACS, and we consulted with experts. We included studies that compared the effect of different levels of access to emergency contraceptive pills on pregnancy rates, use of the pills, and other outcomes. Of the 717 articles identified, we selected 23 for review. The studies included randomized trials, cohort studies, and evaluations of community interventions. The quality of these studies varied. In all but one study, increased access to emergency contraceptive pills was associated with greater use. However, no study found an effect on pregnancy or abortion rates. Increased access to emergency contraceptive pills enhances use but has not been shown to reduce unintended pregnancy rates. Further research is needed to explain this finding and to define the best ways to use emergency contraception to produce a public health benefit.
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              The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience.

              Intrauterine devices (IUDs) have been studied for use for emergency contraception for at least 35 years. IUDs are safe and highly effective for emergency contraception and regular contraception, and are extremely cost-effective as an ongoing method. The objective of this study was to evaluate the existing data to estimate the efficacy of IUDs for emergency contraception. The reference list for this study was generated from hand searching the reference lists of relevant articles and our own article archives, and electronic searches of several databases: Medline, Global Health, Clinicaltrials.gov, Popline, Wanfang Data (Chinese) and Weipu Data (Chinese). We included studies published in English or Chinese, with a defined population of women who presented for emergency contraception and were provided with an IUD, and in which the number of pregnancies was ascertained and loss to follow-up was clearly defined. Data from each article were abstracted independently by two reviewers. The 42 studies (of 274 retrieved) that met our inclusion criteria were conducted in six countries between 1979 and 2011 and included eight different types of IUD and 7034 women. The maximum timeframe from intercourse to insertion of the IUD ranged from 2 days to 10 or more days; the majority of insertions (74% of studies) occurred within 5 days of intercourse. The pregnancy rate (excluding one outlier study) was 0.09%. IUDs are a highly effective method of contraception after unprotected intercourse. Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options offered to patients presenting after unprotected intercourse. This review is limited by the fact that the original studies did not provide sufficient data on the delay between intercourse and insertion of the IUD, parity, cycle day of intercourse or IUD type to allow analysis by any of these variables.
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                Author and article information

                Contributors
                tedrigecho@gmail.com
                tame.tesfish@gmail.com
                tedlamelese@gmail.com
                wondimu.al@gmail.com
                yeshialem.k@gamil.com
                yoseflelamo@gmail.com
                tilahunsaol@gmail.com
                canaanb00@gmail.com
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                31 March 2015
                31 March 2015
                2015
                : 8
                : 112
                Affiliations
                [ ]School of Public Health, Wolaita Sodo University, Sodo, Ethiopia
                [ ]School of Nursing & Midwifery, Wolaita Sodo University, Sodo, Ethiopia
                Article
                1070
                10.1186/s13104-015-1070-7
                4381372
                25888876
                1249fa12-2d63-4094-88a1-e606927c71c5
                © Hailemariam et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 30 September 2014
                : 18 March 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Medicine
                sexually active,emergency contraception,female students,ethiopia
                Medicine
                sexually active, emergency contraception, female students, ethiopia

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