ABSTRACT

 This study assessed knowledge and prevention of the risk of contraceptives use among women in Kwara State, Nigeria. A proportional sampling procedure was used for the selection of 378 respondents between the ages 20 – 44 in the selected local government areas in Kwara State. Questionnaire was used to collect data for this study. The demographic variables were analyzed using frequency and percentage distributions. The mean and standard deviation were used to answer the research questions. The inferential statistic of Chi-square were used to test hypotheses one and two, whereas hypotheses three, four, five and six, which sought for differences among age groups and marital status on their knowledge and prevention of contraceptive risk were tested using the Analysis of Variance (ANOVA) all at 0.05 level of significance. This gave rise to six (6) major findings. The study found that, knowledge of contraceptive risks among women in Kwara State is significant with high mean score (X) of 3.76 which is greater than the decision mean of 3.00. Also, the preventive measures of contraceptive risks exists due to the knowledge possessed by women who uses contraceptives in Kwara State is highly significant with the mean score (X) of 4.00, which is also greater than the decision mean of 3.00. This led to the conclusion that women in Kwara State are knowledgeable about the risk of contraceptives and as well possessed the knowledge of its preventive measures. To this therefore, the researcher recommends that health talks about the prevention of contraceptives risk should be in continuum during antenatal and postnatal care in respective clinics. Women should also consider their health status and understand the risk involved in each method of contraceptive chosen to avoid further complications.

CHAPTER ONE

1.0         INTRODUCTION

1.1         Background of the Study

Contraception is concerned about the procedure intentionally used to interfere with the normal sequence of events in the process of reproduction to prevent unwanted pregnancies. Contraceptive use among sexually active women in Nigeria is critical to reduce unwanted pregnancy and unsafe abortion. However, there are potential risks of some serious side effects when you use particular methods of contraception. According to National Health Insurance Scheme (2014), there are lots of contraceptive methods to choose from. Hormonal Contraceptive, Intrauterine Contraceptive, Voluntary surgical Contraceptive, Barrier Contraceptive and Natural Family planning method.

Planned Parenthood Federation of America, (2012) reported that not all contraceptive methods are appropriate for all situations, and the most appropriate method of birth control depends on a woman's overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases. Individuals should consult their health care providers to determine which method of birth control is best for them.

Although all forms of contraception are available to couples where the female partner is still active, certain methods may be more suitable for women of different age group and marital status on medical grounds, while other methods may have no medical advantage but may simply be more convenient or more acceptable. There are available types of family planning and contraceptive methods in Nigeria with their potential risks to help women make an informed decision. Heinemann (2014) reported that uterine

perforation is a potentially serious complication of Intrauterine Device (IUD). Voluntary Surgical Contraception has risks of ectopic pregnancy, client may regret later and success of reversal surgery cannot be guaranteed, there is also risks associated with surgical procedures, risks and side effects of local anesthesia, delayed effectiveness once the procedure has been performed and risk of complications. Another potential risk is failure. Vasectomy is not guaranteed to be 100% effective. Even when the operation is performed perfectly, it is possible in rare cases for sperm to find its way across the void between the two blocked ends of the vas deferens. The situation, called recanalization, is highly unusual but does occur (Snyder, 2015).

American College of Obstetricians and Gynecology (2015) reported that Barrier Birth Control Methods that need spermicides to be effective should only be used if you are at low risk of HIV infection. Frequent use of spermicides can increase the risk of getting HIV from an infected partner. To avoid an increased risk of infection, including toxic shock syndrome, the cervical cap should not be used during your menstrual period and use of a cervical cap, sponge, diaphragm and spermicidal may increase the risk of urinary tract infection. There is also an increased risk of toxic shock syndrome if the diaphragm is left in for more than 24 hours. Most women in Nigeria do not know how effective various forms of contraceptive are, nor are they able to judge the absolute or relative risks of different methods, (Edwards, 2000).

Other serious potential risks that accompany contraceptives are: increased risks of cervical and breast cancer, increased risk of heart attack and stroke, migraines, higher blood pressure, gall bladder disease, benign liver tumors, decreased bone density, yeast overgrowth and infection, increased risk of blood clotting and infertility, yeast infection

(Candida) is another major distressing condition brought on by the consumption of contraceptive pills However, stopping the pill means you will have to come up with alternative methods of family planning, the most common alternatives to contraceptive pills include: condoms, contraceptive sponge, diaphragm, cervical cap, IUD, female condom, spermicidal foam, calendar method, withdrawal method, abstinence and sterilization (Okon, 2013). Anna, (2013) reported that people who use hormonal contraception, such as the contraceptive patch, are at a slightly increased risk of being diagnosed with breast cancer compared with people who do not use hormonal contraception. World Health Organization, (2000) concluded that, women over the age of 35 who suffer from migraines cannot use oral contraceptives because the risks outweigh the benefit. Therefore, due to the above mentioned issues, a research on knowledge and prevention of the risks of contraceptives uses among women in Kwara State became necessary.

1.2         Statement of the problem

Contraceptives risks in Nigeria in the contemporary time have become an issue that casts a gloomy shadow to the entire society especially among women in Kwara State. The researcher witness cases of high blood pressure, urinary tract infection, blood clotting, migrains, gall bladder disease, delay in pregnancy and infertility in women, especially among friends and relatives and all were as a result of contraceptives uses. Today, Nigeria has one of the highest maternal mortality rates in the world and this has largely been attributed to lack of knowledge of contraceptives use to prevent the potential risks (Stover& Rose 2009). Gbolahan, (2008) however, reported that married women in Ilorin, Nigeria, who are in their prime childbearing ages, have contraceptive knowledge and more than 95 percent of all the women believe that too frequent birth could endange

the health of the mother and her children. However, only the women with risks of contraceptive knowledge will be able to take preventive measures. Acquiring knowledge about contraceptives is the best way to prevent potential risk since women are not fully protected from an unplanned pregnancy and which makes contraceptives necessary until they have reached menopause. Women therefore need knowledge to prevent the risks of contraceptive uses and be able to consider their health status in order to choose an appropriate and suitable contraceptives (Bruce & Rymer, 2009). While Deborah, Ikhena,

&   Julia (2012), observed that the necessity for contraceptives options for women start as early as 18. Regrettably, the prevalence of potential risk of some contraceptives is related to lack of knowledge to prevent potential risks of contraceptives.

Majority of women in Kwara State are facing some health challenges due to some types of contraceptives or after using it especially if women lack knowledge of choosing the right method that is suitable for their body. Some contraceptives increase the risk of developing blood clots, which can result into stroke. If a woman has high blood pressure, she needs to take this into consideration before using contraceptives. Other serious potential risks that accompany contraceptives are increased risk of cervical and breast cancer, increased risk of heart attack and stroke, migraines, high blood pressure, gall bladder disease, benign liver tumors, decreased bone density, yeast overgrowth and infection, increased risk of blood clotting and infertility. The dangers for use of oral contraceptives in women above age of 35 includes Smoking, Hypertension, History of thromboembolism, or Stroke (Rebecca, Charles &Norris 2012). Inadequate knowledge and lack of relevant information and education on preventive measure is a major barrier

to women of reproductive age. Women often are not fully aware of their contraceptive choices.

According to Guttmacher (2008), women may not use contraception consistently because of problem they are facing such as lack of knowledge of their chosen method, infrequent sexual activity, and ambivalence about pregnancy, misperceptions about pregnancy risk, wrong information from friends and family members and lastly, self medication. Addressing these and other barriers to the use of effective contraception through health talks is key to helping women prevent contraceptives risks (Lee, Parisi, Akers, Borrero, & Schwarz, 2011). Currently, there are several entities that want to include health talks on knowledge and prevention of contraceptive risk, despite that contraceptives are used for child spacing, they also have their own significant risks, such as increase in cardiovascular event especially in older women and smokers, increase in human papillomavirus (HPV) infection , breast cancer and an increase in cervical cancer, which is the second most common cancer worldwide (Harper, Brown, Foster-Rosales & Raine, 2010). Therefore, oral contraceptives fail the most important test of preventive medicine: they increase the risk of disease instead of decreasing it. Based on the above discoveries, the researcher is motivated to conduct a research among others to assess the knowledge and prevention on the risks of contraceptives uses among women in Kwara State.

1.3         Purpose of the study

The purposes of this study are to:-

1. To examine the knowledge of the risks of contraceptives use among women in Kwara State;

1. To investigate the preventive measures of contraceptives uses among women in Kwara State;

1. To evaluate the difference between women of different age groups in their knowledge of the risks of contraceptive use among women in Kwara State;

1. To evaluate the difference between women of different age groups in their preventive measures of the risks of contraceptive use among women in Kwara State;

1. To examine the difference between women of different marital status in their knowledge of the risks of contraceptive use among women in Kwara State;

1. To examine the difference between women of different marital status in their preventive measure of the risks of contraceptive use among women in Kwara State;

1.4         Research Questions

1. Will women have knowledge of the risks of contraceptives use in Kwara State?

1. Will women have knowledge of preventive measures of the risks of contraceptives use in Kwara State?

1. What is the difference between women of different age groups in their knowledge of risks of contraceptive use among women in Kwara State?
2. What is the difference between women of different age groups in their preventive measures of risks of contraceptive use among women in Kwara State?

1. What is the difference between women of different marital status in their knowledge of risks of contraceptive use among women in Kwara State?

1. What is the difference between women of different marital status in the preventive measures of the risks of contraceptive use among women in Kwara State?

1.5         Significance of the Study

The finding of the study will be significant in the following ways:

1. Women in Kwara State will have knowledge on the risks of contraceptives due to regular health talks during antenatal and postnatal clinics.

1. It will help women in Kwara State to understand ways of preventing contraceptives risks after it has been discussed by heath care providers.

1. It will benefit women of different age groups in Kwara State when nongovernmental organizations address the risks involved in contraceptives uses.

1. It will motivate women of different age groups in Kwara State to take preventive measure while using contraceptives after attending health talks by health care providers and nongovernmental organizations.

1. It will allow women of different marital status in Kwara State to gain more knowledge on contraceptives risks through Medias such as radio and televisions.
2. It will encourage women of different marital status in Kwara State to take preventive measure and choose the natural method of contraceptives to prevent all health hazards associated with other artificial contraceptives.

1.6         Basic Assumption

On the basis of available research evidence, the following assumptions were made for the purpose of this study.

1. Knowledge of contraceptives use would help women in Kwara State understand the risks.

1. Prevention of contraceptives risks will become a regular practice among women in Kwara State.

1. Women of different age groups in Kwara State will be more knowledgeable on contraceptives risks.

1. Women of different age groups in Kwara State will take preventive measures while using contraceptives.

1. Women of different marital status in Kwara State will be more knowledgeable on contraceptives risks.

1. Women of different marital status in Kwara State will take preventive measures while using contraceptives.

1.7         Hypotheses

Based on the research questions, the following hypotheses were formulated for the purpose of this study.

1. Women will not significantly have knowledge on the risk of contraceptives use in Kwara State.

1. Women will not significantly take preventive measure of contraceptives risks in Kwara State.

1. Women of different age group will not significantly have knowledge on the risks of contraceptive use in Kwara State.

1. Women of different age group will not significantly take preventive measure on the risks of contraceptive use in Kwara State.

1. Women of different marital status will not significantly have knowledge on the risks of contraceptive use in Kwara State.

1. Women of different marital status will not significantly take preventive measure on the risks of contraceptive use in Kwara State.

1.8         Delimitation of the Study

The study was delimited to the knowledge and prevention of the risk of contraceptives use among women in Kwara State. It was delimited to six local governments in Kwara State. Women between the age groups of 20-44 who uses contraceptives from hospitals in the selected local government Areas served as respondents to this study.