Knowledge, attitude and use of emergency contraceptives among adolescent girls in secondary schools in Nairobi
Unwanted pregnancy and unsafe abortions among young women are major problems in Africa accounting for an estimated 13% of all maternal deaths in the region Emergency contraceptives have been described as having the potential to reduce the number of unwanted pregnancies and consequently reduce the abortion-related morbidity and mortality. The purpose of this study was to examine knowledge, attitudes, and use of emergency contraception in girls in secondary schools in Nairobi. A randomly selected sample of two-hundred and eighty (280) girls from five secondary schools in Nairobi was studied. Their demographic information, sexual history, knowledge, attitude and use of emergency contraceptives, sources of information about emergency contraceptives and their perceptions on adolescent sexual activity and risk of pregnancy were studied. Overall, 57% (n=280) of respondents knew about emergency contraceptives. Of these, only 18% knew of the correct timing of use. The most common sources of information about emergency contraceptives were friends (81%) and magazines/newspapers (66.9%). Misconceptions were found to exist in respondents responses, mostly centered around perceived adverse effects of ECs. Positive attitude towards emergency contraceptives (would ever use EC and would recommend EC to friends) was found to be associated with previous use of ECs (:l= 6.47, p<0.05), currently having a boyfriend (:x2 =11.44, p<0.05), knowledge on ECs (:x2= 6.65, p<0.05) and being in a higher class - Form 3 & 4- (:x2 = 10.06, p<0.05). Cost of ECs and health worker/pharmacists attitude were perceived as barriers to access to ECs by for young girls. Of the 280 respondents, 22 (8%) had ever engaged in sexual activity and of these, 73% had used a form of contraception. 11 (50%) of those who had engaged in sex, had used an emergency Contraceptive Ever use of ECs was not significantly associated with accurate information regarding ECs (p=0.16). 9 of the 11 users of EC had gotten them from pharmacies. 70% of respondents knew of pharmacies as the main source of ECs while almost all users of ECs had sourced them from pharmacies. 48% (n=133) knew of at least one friend who had used ECs with 21% knowing of more than six (6) friends who had used ECs. These findings reflect a lack of accurate information on emergency contraceptives by young girls. Despite low reported engagement in sexual activity, the proportion of EC use among those who have engaged in sex is high. In conclusion, use of and accurate knowledge about ECs among secondary school girls is low. Most common sources of information about ECs are friends and media. There is a need by the Ministry of Health and its partners to educate adolescents about emergency contraceptives, with emphasis on available methods and correct timing of use. Strategies to promote correct use of emergency contraception when necessary, should be focused on spreading accurate information through medical and informational sources, which have been found to be reliable and associated with good knowledge on emergency contraceptive pills.