CHILALO HEALTH SCIENCE AND TECHNOLOGY COLLEGE

DEPARTMENT OF NURSING

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE

TOWARDS ON EMERGENCY CONTRACEPTIVE METHODS
AMONG FEMALE HIGH SCHOOL(9-12) STUDENTS IN
ASSELA TOWN,ARSI ZONE, OROMIYA REGION, SOUTH
EAST,ETHIOPIA,2024

By: Group 1

1. Jewar Hussein

2. Abay Kedir

3. Bedria Gena

4. Kenenisa Bayisa

5. Melese Teshome

6. Kiya Shiferaw

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 A RESEARCH PROPOSAL SUBMITTED TO THE DEPARTMENT OF PUBLIC

HEALTH IN FULFILLMENT OF THE REQUIRMENT FOR AN

INTERN IN MEDICINE

DECEMBER,
2012/13

Iteya

Ethiopia

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE

TOWARDS EMERGENCY CONTRACEPTIVE METHODS
AMONG FEMALE HIGH SCHOOL(9-12) STUDENTS IN ITEYA
TOWN,ARSI ZONE, OROMIYA REGION, ETHIOPIA

BY:-

Adama University Clinical -2

Medical Students

ESUBALEW GASHAW

GOITOM BRHANE

HABTAMU TILAHUN

ii
 HIWOT FENTAHUN

LAMESGIN DAGNE

MELKAMU SEFERIH

ADVISORS:-

ATO ABAY BURRUSIE (MPH)

ATO AMDE ……. (MPH)

DECEMBER 2012/13
ITEYA
ETHIOPIA

iii
 ABSTRUCT (SUMMARY)

BACKGROUND: - High school students' unwanted pregnancies pose a major public health problems in
the developed and developing countries including Ethiopia and are associated with far reaching effects
such as jeopardizing students' educational progress and future careers, due to lack of KAP about
possible EC methods. It is thus expected that an assessment and improvement of KAP of high school
female students towards utilization of EC methods when necessary & having good awareness about
other RH issues could enhance prevention of un wanted pregnancy rates &improve school performance.

OBJECTIVES: - The aim of the study is to assess the KAP of high school female students in Oromia
region, taking Iteya sec. & prep. School as a sampling population towards EC methods.

Associated with assessing the KAP of the students towards EC methods, awareness creation about safe
sex practice will be done. The magnitude of school discontinuation due to unwanted pregnancy & the
issue of STIs & HIV AIDS will be discussed with the students & reported to the Woreda health office &
the school of health.

METHOD: - A Descriptive cross-sectional study will be used towards assessment of KAP of EC methods
among female high school students in Iteya, Arsi, Oromia, Ethiopia.

Around 289 Samples will be selected using proportional stratified sampling technique & systematic
sampling technique used for each strata. From December 2012 – January 2013 is the sampling period.

Data will be collected by using structured questionnaires & data collection will be done by the
researchers.

The data will be analyzed by using SPSS 20 & presented by tables, graphs & charts based on the reliable
& the objective of the study.

The result of the study is expected to show gap that exists in KAP of female high school students &
enhance creation of awareness towards RH issues & EC methods.

Finally the study will lead to appropriate conclusion & recommendations that can be implemented by
the town health center, up to the level of regional & national blue print for other projects that will be
done in the future in this issue.

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 ACKNOWLEGDMENT

We would like to spell our heart full gratitude to AUSOHH

department of public health stuffs, especially to our advisors Ato
Abay
Burrisa and Ato Amde & to our previous group medical students.

TABLE OF CONTENTS

Contents
ABSTRACT……………………………………………………………………..і

ACKNOWLEDGEMENT…………………………………………………ii

TABLE OF CONTENTS…………………………………………………..ii

LIST OF DUMMY TABLES……………………………………………..v

ACRONYMS……………………………………………………………………v

CHAPTER ONE…………………………………………………………….1

INTRODUCTION………………………………………………………1

1.1 Background…………………………………………………………..1

1.2 Statement of the problem………………………………………….2

1.3 Significance of the study……………………………………………2

CHAPTER TWO……………………………………………………………..3

LITERATURE REVIEW…………………………………………………3

CHAPTER – THREE……………………………………………………….4

OBJECTIVE…………………………………………………………..4

3.1 General objectives……………………………………4

3.2 Specific objectives…………………………………………………….4

CHAPTER – FOUR……………………………………………………………5

METHODOLOGY…………………………………………………………5

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 4.1 Study design……………………………………………………………..5

4.2 Study area and period…………………………………………………5

4.2.1 Study area…………………………………………………………5

4.2.2 Study period……………………………………………………5

4.3 Determination of population………………………………………5

4.3.1 Reference/source/Target population……………………..5

4.3.2 Sampling population ………………………………………..5

4.3.3 Study population (sample)…………………………………6

4.3.4 Sampling unit……………………………………………………6

4.3.5 Study unit………………………………………………………6

4.4 Sample size and sampling technique…………………………….6

4.4.1 Sample size determination………………………………6

4.4.2 Sampling technique/ procedure……………………….7

4.4.3 Exclusion and inclusion criteria……………………..8

4.5 Data collection and measurements………………………….8

4.5.1 Data collection instruments…………………………….8

4.5.2 Data collection technique and data collectors……9

4.6 Data processing…………………………………………………………9

4.6.1 Data handling…………………………………………………..9

4.6.2 Data analysis……………………………………………………9

4.6.3 Data presentation……………………………………………….9

4.7 Quality control measure………………………………………………..9

4.8 Ethical consideration: ………………………………………………….10

4.9 Dissemination of result………………………………………………10

4.10 Limitation of the study……………………………………………….10

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4.11 Operational definitions……………………………………………….10

4.12 Study variables…………………………………………………………11

4.12.1 Dependent variables…………………………………………..11

4.12.2 Independent variables…………………………………………11

CHAPTER FIVE………………………………………………………………..11

WORK PLAN, DUMMY TABLES AND ANNEX……………………11

5.1 project work plan……………………………………………………………….11

5.2 Budget section………………………………………………………………..13

5.3 Budget summary………………………………………………………………13

5.4 Dummy tables………………………………………………………………….13

ANNEXS……………………………………………………………………………………22

Annex one (Reference)…………………………………………………………………22

Annex two…………………………………………………………………………………..25

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 DUMMY TABLES

Table – 1:- Socio – demographic characteristics of study population Iteya sec. & prep. School,
December 2012/13…………………………………13, 14, 15

Table – 2:- family background factors of the study population, Iteya sec. & prep school Dec
2012 /13…………………………………15, 16

Table – 3: - respondents’ response towards sexual practice, Iteya sec. & prep school, Dec
2012/13 ………………………………16, 17, 18

Table - 4: -peer & partner related characteristics of the study population, Iteya sec. & prep
school Iteya, Dec 2012/13 ……………………18

Table -5:- habits of the study population, Iteya sec. & prep school , Dec 2012/13

…………………………………………….18, 19

Table -6: -assessment of knowledge & attitude towards EC & other RH issues of the study
population, Iteya sec. & prep school, Dec 2012/13

…………………………………………………….19, 20, 21, 22

ACRONYMS

A.A………………………………..Addis Ababa

AIDS……………………………….Acquired Immune Deficiency Syndrome

AUSOHH…………………….Adama University School Of Health & Hospital

B/n…………………………………Between

EC…………………………………..Emergency Contraception

ECPs………………………………Emergency Contraception

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 ESOG………………………………Ethiopian society of obstetricians & gynecologists

Etc. …………………………….. Excreta

HIV……………………………….Human Immune Deficiency Virus

IUCDs………………………………Intra Uterine Contraceptive Devices

IUDs………………………………….Intra Uterine Devices

KAP…………………………………Knowledge, Attitude, Practice

Km……………………………………Kilo meter

OCP…………………………………Oral Contraceptive Pills

PREP. …………………………….Preparatory

RH…………………………………...Reproductive Health

RT………………………………......Research team

R/ship…………………………………..Relationship

SEC. …………………………………Secondary

SPSS…………………………………...

STIs…………………………………..Sexually Transmitted Infections

WHO…………………………….World Health Organization

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1
 CHAPTER ONE

INTRODUCTION

Emergency contraception (EC), or emergency postcoital contraception, is birth control measures

that, if taken after sexual intercourse, may prevent pregnancy.

Forms of EC include:

Emergency contraceptive pills (ECPs)—sometimes simply referred to as emergency contraceptives (ECs)

or the "morning-after pill"—are drugs intended to disrupt ovulation or fertilization, which are steps
necessary for pregnancy (contraceptives).

Intrauterine devices (IUDs)—usually used as a primary contraceptive method, but sometimes used as
emergency contraception

And Others’ like progestin-only products & mifepristone.

1.1 Background information

Unwanted pregnancy leading to unsafe abortion is one of the most important causes of maternal
morbidity and mortality. Unsafe abortion is a major medical and public health problem in Ethiopia (1-3).
Ethiopia has a high incidence of unwanted pregnancies and incomplete and unsafe/septic abortions,
particularly among adolescents. Several studies in the country have revealed that women who tend to
undergo induced abortion are below the age of 30 years and are literate; many of whom being above
the secondary educational level. (4).

Consequences of unprotected sex, such as unintended pregnancy and unsafe abortion, can be
prevented by access to contraceptive services including emergency contraception. Emergency
contraception is a method used to avoid pregnancy after unprotected sexual intercourse unlike the
regular methods of contraception that are taken before sexual contact. It has the potential, as the last
resort, to avoid unwanted pregnancy and therefore abortion; a desirable goal especially when abortion
is illegal.

Oral contraceptive pills and intrauterine contraceptive devices (IUCDs) are mainly used as emergency
contraceptives. When used within 72 hours after sexual contact pills have the capacity to prevent
pregnancy by 75-85% and with the use of IUCDs unwanted pregnancy can be prevented by as much as
99%. This is especially significant for those young couples that opt not to use a long-term regular
contraceptive method and their sexual behavior is rather unplanned, erratic and irregular (9-11).

Knowledge and practice on emergency contraception are particularly important because of high rates of
unwanted and teenage pregnancy and soaring STI and HIV/AIDS rates. Different studies, however, have
shown that the knowledge and practice in relation to emergency contraception are limited among
women (12-15). The practice of emergency contraceptives is almost inexistent in Ethiopia, as the
method is not presented with other methods of contraceptives.

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Literature is also scarce in this area. Recently a survey has been conducted in the country for the
purpose of expanding coital dependent and contraception methods and the findings showed that young
people opt not to use long-term regular contraceptive methods as their sexual practices are unplanned
and irregular. The aim of this study is therefore to assess the level of knowledge, attitude and practice of
emergency contraception among young students at higher institutes.

1.2 statement of the problem

High school students' unwanted pregnancies pose a major public health problems in the developed
and developing countries including Ethiopia and are associated with far reaching effects such as
jeopardizing students' educational progress and future careers. These pregnancies are mostly
unplanned and unintended, and many are terminated either legally or illegally. Around 30%–50% of
women presenting for choice on termination of pregnancy were not using contraceptives at the
time of contraception, and similar numbers of pregnancies were unplanned and unwanted (6, 7).

Unwanted pregnancy is a big problem in Ethiopia; more than 60% of the pregnancies in adolescents
are unwanted which is an alarming figure, and most of these pregnancies particularly in adolescents
end up with unsafe abortion. According to the survey conducted in 2000 by ESOG in nine
administrative regions, 25.6% abortion cases were induced abortions. Among abortion cases, 60%
were unplanned, and 50% were unwanted. Abortion related mortality was 1,209 per 100,000 live
births (8.13).

In about half of all unwanted pregnancies, conception occurs due to inadequate guidance to use
contraception effectively, including the users' inability to address their feelings, poor attitudes
towards contraceptives, and lack of motivations. Despite the Ethiopian government's effort to
prevent unwanted pregnancies and abortion among youths of age less than 24 years, the number of
youths requesting termination of pregnancy is increasing annually. Despite the availability of
contraceptives with affordable costs, there is a large number youths' with unwanted pregnancies
and unsafe abortion (13).

1.3 Significance of the study

The Oromia regional state is one of the largest regions of the Federal Democratic Republic of Ethiopia.
Iteya, one of the districts found in this region, is a high risk environment in many aspects. Thus, this
survey is therefore essential and well-timed as reproductive health issues like family planning
(emergency contraception) are crucial in such environments especially among female high school
students

Finally, In line with the above attributes and defined objectives, this study has multifaceted benefits to
the concerned bodies, stakeholders and communities at large. For the first thing it helps to identify the
gaps (of what?) that exist; helps to probe the grounds for the threat; helps to set and develop programs
and strategies based on the study area’s setup. It can also be used as a reference tool and base for
further study.

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 CHAPTER TWO

LITREATURE REVIEW

The World Health Organization estimates that 84 million unwanted pregnancies occur annually
worldwide [15]. A world wide study conducted by the WHO to assess the reproductive needs of the
population found unexpected discrepancy between the young peoples’ familiarity with modern
contraception and on the other hand the high levels of unwanted pregnancy and unsafe abortion
experienced. Averagely, 46 million abortions take place every year, out of which 20 million are
performed under unsafe conditions [15, 16]. Seventy thousand women die yearly as a consequence of
unsafe abortion, while five million suffer permanent or temporary disability [15,-17]. Approximately 13%
of pregnancy-related mortality worldwide is due to unsafe abortions and the majority of these deaths
(and morbidity) occur in low-and-middle income countries [ 19]. An important proportion of maternal
deaths worldwide are attributable to induced unsafe abortion [ 18, 19]. Millions of women who could
benefit from emergency contraception have never hearted of it (20, 21).

In several African countries, survey among University students showed that only three quarter of youth
had heard about EC, and minimal accurate knowledge about its use (22, 23). In 2003, 650 deaths per
100,000 unsafe abortions occurred in Africa (23).

East Africa is highest. The maternal mortality ratio, due to unsafe abortions in this region outnumbers
any part of the world; 160 deaths per 100,000 live births. (24)

Unsafe abortion is a major medical and public health problem in Ethiopia. Ethiopia has a high incidence
of unwanted pregnancies and unsafe abortions, particularly among adolescents (25). Teen age girls are
particularly prone to unintended pregnancies as studies revealed that a relatively high percentage
(16.3%) of teenage women were already pregnant or have given birth previously (26). Unsafe abortion is
one of the top causes incriminated in the high number of maternal morbidity and mortality in Ethiopia
(27). In case of our country, although inclusive research is not yet done in high school students’
knowledge, attitude & practice of emergency contraception, we do have lots of researches in the
country’s different universities, collages, and other institutions.
In one study performed at Jimma University graduating female students on knowledge, attitude &
practice of emergency contraceptives; Three hundred eighty nine (389) were included in the study giving
a responses rate of 96.5%. Most of the respondents 267 (68.64%) were within age group of 20–24 years.
Regarding to respondents knowledge about emergency contraception (EC), 163 (41.9%) ever heard or
knew EC; their common sources of information were friends for 60 (36.5%), radio for 37 (22.8%) and
television for 20 (12.3%). Of those respondents who had heard of emergency contraceptives, only 11
(6.8%) used ECs. General awareness about ECs was significantly associated with faculty of respondents
and origin of residence; unlike other faculties, most of the health science students are aware of it. It was
also found that students from towns have a better awareness than those from rural areas. (28)

3
 On another study done to assess knowledge, attitude and practice of emergency contraceptives among
female university students in Addis Ababa; Full response was obtained from a total of 774 students (614
from AAU and 160 from UUC) making the response rate 91%. The age of study participants ranged from
a minimum of 17 years to a maximum of 41 years. The mean age was 21±2.7 years. Most of the
respondents, 66.1%, were followers of Orthodox Christianity followed by Protestants who account for
18.6%. Majority (92.7%) of students were not married. At the time of the survey about 151 (19.5%)
respondents have ever had sex in the past. Of those who are sexually active, about 6% started sex
before the age of 15 and 16% started sex between 15 to 19 years of age. Ten percent of the respondents
claimed to have used contraceptive methods other than male condoms by their partners. The most
commonly used contraceptive method was pills (44%) followed by injectables (21%) (29).

A total of 53 respondents replied that they had been pregnant at least once previously. This represents
6.8% of the total respondents and 35.1% of those who are sexually active. Almost half of those who
were pregnant were below the age of 20 years and two of whom below the age of 15 years. Similarly
50% of those who were pregnant reported that their pregnancy was unwanted, two of them reported
that they were raped. About 13% of respondents reported that as they got pregnant while using a
contraceptive method (29).
About 53% (95% CI 49.1-56.1%) of the students have positive attitude towards emergency
contraceptives. A considerable proportion (about 30%) of the respondents, however, did not know or
did not respond to the question concerning attitude towards emergency contraception. only 4.9% (95%
CI 3.4-6.4%) respondents reported that they had used emergency contraceptive methods previously(29).
Generally, almost all of the previous studies done on this issue have somewhat similar results.

CHAPTER THREE

OBJECTIVE

3.1 General objective

3.1.1 To assess knowledge, attitude & practice of emergency contraceptive among Iteya high school
female students, 2005 E.C

3.2 specific objectives

3.2.1 To assess EC methods knowledge among Iteya high school female students

3.2.2 To assess the attitude towards EC methods among Iteya high school female students

3.2.3 To assess EC methods practice among Iteya high school female students

3.2.4 To measure the association b/n knowledge of students towards EC methods & independent factors

3.2.5 To compute the r/ship b/n students attitude to EC methods utilization & independent factors

3.2.6 To work out the r/ship b/n students practice towards utilization of EC methods & independent
factors

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 4. Methodology
4.1 Study design

Institutional (high school) based descriptive cross-sectional study design will be used

4.2.1 Study area

Iteya is a town in southeastern Ethiopia. Located in the Arsi Zone of the Oromia Region east of
Lake Zeway, it has a latitude and longitude of 08°08′N 39°14′ECoordinates: 08°08′N 39°14′E with
an elevation of 2215 meters above sea level. It is the administrative center of Hitosa woreda.

According to the Oromia Regional government, this town currently has telephone and postal
service, and is supplied with electricity from a nearby hydroelectric source. Records at the Nordic Africa
Institute website provide details of a junior secondary school in Iteya in 1968. & since 2001the junior
secondary school also begin to give preparatory lectures.

Iteya has an estimated total population of 12,979 of whom 6,418 are men and 6,561 are
women. The 1994 national census reported this town had a total population of 7260 of whom
3,481 were men and 3,779 were women. (30)

The study will be conducted in Iteya sec. & prep. School, Iteya, Arsi, Oromia, Ethiopia. The study will be
conducted to determine the knowledge, attitude & practice on utilization of EC methods among the
school female students.

Iteya sec. & prep. School is found 150 km from A.A .it is established in 6 hector Km compound & has a
total number of 2683 students in this academic year.

In 2001, it began teaching preparatory students in the same compound and named as Iteya sec. and
prep. School.

• There are 21 teachers in prep. , From these 18 are males & 3 females.

• In high school, there are 65 teachers (56 males & 9 females).

4.2.2 Study period

From December 2012- January 2013

4.3 Determination of the population

4.3.1 Reference/Source/Target population

High school female students in Oromia region in 2012/13

4.3.2 Sampling population

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 Iteya secondary & preparatory school female students in 2012/13,

4.3.3 Study population (sample)

Selected female students of all the Four Grades in Iteya secondary & preparatory school
currently found in class at the time of data collection within the study period

4.3.4 Sampling unit

Individual based

4.3.5 Study unit

Selected Individual female students in Iteya secondary & preparatory school in 2012/13

4.4 Sample size & sampling technique

4.4.1 Sample size determination

Since the population proportion of Iteya secondary & preparatory school toward knowledge,
attitude & practice of emergency contraceptive methods is not known, We took 50% proportion
rate (p=0.5) to determine maximum sample size. The sample size is determined by using single
population proportion statistical formula.

The total female students in Iteya secondary & preparatory school in the year 2012/13 is 965
out of 2683 students

n= z2p(1-p)

d2

Where:

• n=sample size

• N= source of study population which are 965

• Z= standard deviations corresponding to 95% confidence interval =1.96

• P= proportion among the study population = 0.5

• d= degree of accuracy required or desired precision (maximum allowable error of the estimate)
=0.05

n= z2p(1-p) =384

d2

• Since, n/N >0.05 the finite population correction is used to determine the final sample size.

6
 n=nо/ (1+nо/N)

= 384/ (1+384/965)

=274.692365

=275

Adding 5% for non- respondent rate give as a final sample size to be 288.75=289

Interval of individual female student selection is (K=N/n) =where N is 965 & n is 289 making
k=3.339 =3

Iteya secondary & preparatory school have 4 grades 9th, 10th, 11th & 12th these four (4) sections
will be the four strata…which mean we are using stratified sampling technique from probability
sampling methods…

Each grade have different no of female students

12th -50/965 female students

11th- 75/965 female students

10th- 305/965 female students

9th – 535/965 female students

Since the number of female students in each grade is different the distribution of the sample
size which is 289 will be distributed using proportional stratified sampling.

Proportionating the sample size in each stratum

nj= (n/N).Nj

nj- is sample size of jth stratum

Nj- is population size of jth stratum

n= n1+n2+…+nk is total sample size

N=N1+N2+…+Nk is total population size

Using the above formula with simple mathematical calculation makes the sample size in each
stratum like this

12th-15 female students

11th-23 female students

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 10th-91 female students

9th- 160 female students

Which will add up…15+23+91+160=289 total sample size?

We have already calculated the interval k as k=N/n…making 965/289…around 3

So will arrange female students in each class alphabetically n we will choose one no from (1-k)
which is from (1-3) randomly and continue picking the sample every kth or every 3rd number

• If there is more than one section in each grade we will proceed from the beginning till we get
the proportionate sample size. there will not bias since we are using the k th unit in selecting in all
the 4 strata

4.4.3 Exclusion & Inclusion criteria

A. Inclusion criteria

*All female students in the school already registered & currently attending class in this
academic year.

*being selected according to the sampling technique used

B. Exclusion criteria

*For any reason students no longer a member of the school

*male students

*all students who are not able to give verbal or written response related to their health
problem such as deaf, blind etc.

*all students who are absent during study period

*all students who are available during the study period but not willing to respond the
questioner.

4.5 Data collection & measurements

4.5.1 Data collection instruments

The data collection instrument will be structured questioner which contains both open &
closed ended questions.

Structured questionnaire, which is developed in English, will be translated to the local

language and then back translated to English by different individuals to ensure validity and keep
its conceptual equivalence

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 The structured questionnaire, which is developed in local language, will be used to collect
the required information.

The questionnaire will be pre tested on similar setting which are not included in the actual
data collection process and appropriate modification will be made to have the final version. In
average about 30 minutes is needed to complete a questionnaire

4.5.2 Data collection technique and data collectors

After giving short description on how to fill the questioner for the study units, the questioner
will be distributed to the students by the researchers grouping our 6 students in 3 groups

We will make sure the confidentiality issue that they shouldn’t write their names & no one will
know it is theirs.

The questioner will be given for students, we could give in one day probably coordinating with
the school principal’s & arranging time possibly break time to be collected the next day in the
school office.

4.6 Data processing

4.6.1 Data handling.

The collected data will enter cleaned, stored and checked for its completeness and internal
consistency. The soft copies of the data will be stored on hard drive and back up copy will be
stored on separate drive. Latter both hard copy and soft copy will be stored by flash disks and
CD too.

4.6.2 Data analysis

Code will be given to completed questionnaire. The data will be cleaned and entered in to and
processed using statistical package for social science program version 20. Descriptive summary
measures including, mean, median, relative frequency and standard deviation will be used to
analysis the first three consecutive specific objectives. Chi-square test is used to analyze the
presence or absence of association among and between variables.

4.6.3 Data presentation.

The analyzed data will be described using tables, bar charts and graphs. Narrative will be used
to more elaborate more as per necessity.

4.7 Quality control measure

To control the quality of the study, pre testing of the questionnaire

The pre test will be made on 5- % of the sample size out of the actual data collection area.
Rechecking will be made before the analysis of the data

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 4.8 Ethical consideration

An ethical clearance will be obtained from the public health department of AUSOHH

Secondly, permission letter will be taken from the school admistration of Iteya sec.

& prep. School

Thirdly, a written approval will be obtained from Iteya health office & other responsible

Bodies of the town. Finally, the objective of the study and the procedure will explain to the study
participants that no harm will happen on them when the study will be conducted. Moreover, the issues
of confidentiality will be explained

4.9 Dissemination of result

Based on the findings, after conclusion and recommendation will be made, one copy of the
research paper will be submitted to AUSOHH department of public health, Iteya health office &
other responsible bodies and stakeholders who are working on the issue of EC around Iteya
town

4.10 Limitation of the study

1) Scarcity of literature review

2) In availability of internationally accepted or tested instrument to measure the result.

3) Excluding male students

4) The short time we are doing the research

5) Other duties of us expected during the time of data collection

6) Language barrier

4.11 Operational definitions

*Knowledge: -is the information that Iteya secondary & preparatory school female students
have about EC methods & its utilization

*Attitude: - is the perception that Iteya secondary & preparatory school female student to
utilize the service with favorable or unfavorable manner towards EC

*Practice: - is an overall behavior and habit of Iteya secondary & preparatory school female
students to utilize EC methods

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 *Emergency contraception: -

Postcoital or emergency contraception is a therapy used to prevent unwanted pregnancy after

unprotected intercourse or after a failure to use a contraceptive method appropriately.

4.12 Study variables

4.12.1 Dependent variables

*Knowledge

*Attitude and

*Practice

4.12.2 Independent variables

Age, Religion, Marital status, Ethnicity, grade level,

Exposure to mass media, exposure to sex education,

Participation in school clubs, living condition

Partner & peer related characteristics, habits,

Family educational level, sexual debut

CHAPTER FIVE

WORK PLAN, DUMMY TABLES, ANNEX

5.1 Project work plan

Work plan for the assessment of KAP of high school female students towards Emergency
contraceptives at Iteya

No. Tasks to be done Responsible place

person Time(Dec. 2012- Jan 2013)
1st 2nd 3rd 4t 5th 6th
h
1 Topic selection RT and AUSOH X

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 advisor H
2 Proposal RT ‘’ X
preparation
3 Submission of the ‘’ ‘’ X
1st draft
4 Submission of the ‘’ Iteya X
final draft
5 Proposal ‘’ ‘’ X
defending
6 Discuss RT with ‘’ X
arrangements advisor and
with advisor and school
school director director
7 Preparation of RT ‘’ X
study tool
8 Travel to data ‘’ ‘’ X
collection site
9 Select data ‘’ ‘’ X
collectors and
assistants
10 Data collection ‘’ ‘’ X
11 Data collocation ‘’ ‘’ X
12 Data entry and “ ‘’ X
cleaning
13 Data analysis and “ ‘’ X
write up
14 Discussion ‘’ ‘’ X
conclusion
recommendation
writing
15 Discuss RT with ‘’ X
recommendations local
with local authority
authority
16 Submission of RT AUSOH X
final research H
paper
17 Monitoring RT and ‘’ X x x x x X
evaluation of advisor
research project

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5.2 budget section
Budget section showing personnel, materials and equipment needed for the
assessment of KAP of High school female students towards emergency
contraception at Iteya

Budget item Unit cost Multiplying factor Total cost

Advisor
Health
Personnel professionals
School
director/teachers
Printed
Supplies questioners
Papers
Pencil
Pen
Bag
CD
Flash disk
Eraser
Laptop

5.3 budget summery

S. no Budget item Total cost Remark

1 Material cost
2 Personal cost
Grand total

5.4 Dummy tables

Table – 1: -socio-demographic characteristics of Iteya high school female
students, 2012/13

13
S. No Characteristics Number %

1.1 Age

=<14

15-19

=>19

Total

1.2 Religion

Orthodox

Muslim

Protestant

Others

Total

1.3 Marital status

Married

Single

others

Total

1.4 Ethnicity

Oromo

Amhara

Tigray

Others

1.5 Grade level

9 th

10 th

11 th

14
 12 th

Total

1.6 Living condition

with family

alone/dormitory

with other person

Total

Table – 2: - Family back ground factors

S. No Characteristics Number %

2.1 Fathers educational level

Illiterate

10 education

20 education

above 20 education

Total

2.2 Mother educational level

Illiterate

10 education

20 education

above 20 education

Total

2.3 presences of siblings

Yes

No

Total

15
 If yes, his/her age

Younger

Older

Same (?)

Total

2.4 Does your parents discuss about RH at home with you?

Yes

No

Total

If No, why do you think?

Table – 3: -respondents report to sexual experience

S. No Characteristics Number %

3.1 Have you ever had sexual intercourse?

Yes

No

Total

If yes age at sexual debut

<12

12-15

15-19

>19

Total

3.2 Number of sexual partners

One

16
 two or above

Total

3.3 Have you ever been pregnant?

yes

No

Total

3.4 Number of pregnancies

one time

two times and above

Total

3.5 Was the pregnancy planned?

yes

No

Total

if no, reasons for unwanted pregnancy

contraceptive failure

abundant (pressure) by partner

Rape

forgot to take contraceptive

lack of knowledge about emergency contraceptives

Total

3.6 Have you ever had induced abortion?

Yes

No

Total

If yes, reasons for abortion

17
 fear of parents and family

fear of discontinuing school

economic problem

Table – 4:-– Partner and peer related characteristics

Sr. No Characteristics Number %

4.1 Do you discuss about reproductive health with boyfriend

(husband)?

yes

No

Total

4.2 Peer discussion about reproductive health with friends

yes

No

Total

Table – 5:-– Habits

Sr. No Characteristics Number %

5.1 Currently chewing khat

Yes

No

Total

5.2 Currently consuming alcohol

Yes

No

Total

18
 Table 6:-- Knowledge & attitude assessment
Sr. No Characteristics Number %

6.1 Exposure to Mass media

Radio

Television

Others

No exposure

Total

6.2 Exposure to sex education

Yes

No

Total

If yes, source of exposure

Family member

School friends

Mass media

Others

Total

6.3 Participation in school clubs?

Yes

No

Total

If yes which club?

Girls club

Anti-HIV & Red cross club

Mini media

Others

Total

19
6.4 Have you ever heard about modern contraceptives

Yes

No

Total

6.5 have you ever heard about emergency contraceptive

yes

No

Total

6.6 Method reported as EC

OCPs

IUCD

Other methods

I don’t know

Total

6.7 Indications/circumstances in which EC is used

after unprotected sex

when unwanted pregnancy occurs

I don’t know

Total

6.8 time EC can work

6.8.1 OCPs

within 72hrs

within 5 days

I don’t know

Total

20
6.8.2 IUCDs

within 72hrs

within 5 days

I don’t know

Total

6.9 source of EC

Pharmacy

private clinic/youth centre

government institution

Shop

I don’t know

Total

6.10 should we take it after we had already confirmed pregnancy

yes

No

Total

6.11 Have you ever used EC?

yes

No

Total

7 Attitude towards using ECs

Positive

Negative

Total

21
 ANNEXES

Annex one- Reference

1. Tadesse E, Yoseph S, Gossa A. Illegal abortion in five hospitals in Addis Ababa. EMJ; Oct 1994;
32 (4):283-84.

2. Barbara E.K, Rogers W. Rochal and Widad Kidanemariam. Maternal mortality in Addis Ababa.
Ethiopia studies in family planning.1986; 17(6/1): 288-301.

3. World Bank. Investing in health. World development report, World Bank; 1993

4. Hassen F. Analysis of factors for unwanted pregnancy among women in the reproductive age
group attending health institutes in Jimma town; Feb. 2000; Report

6. Manena-Netshikweta Ml. Knowledge, perception and attitude regarding contraceptives

among secondary school learners in the Limpopo province. South Africa: 2007. Nov, (PHD thesis)

7. Byamugisha Josaphat Kayogoza. User and provider perspectives emergency contraception

among young people in Uganda. Kampala and Stockholm: 2007. (PHD thesis)

8. Seife M, Fikre E. Assessment of level of awareness and utilization of emergency

contraception, among college female students in Oromia Regional state, Arsi Zone, Asella,
South-East Ethiopia. 2007. Jun, (Master thesis)

9. Consortium for Emergency Contraception. Emergency contraceptive pills Medical and Service
Delivery Guidelines; October 2000.

10. FGAE. Base line survey of the coital dependant methods project of the Family Guidance
Association of Ethiopia and Population Council; 2002.

11. Friedman S, McQuaid, Grendell J. Current obstetric & gynecology diagnosis & treatment: 9th
Edition; 2003.

12. Sorhaindo A, Becker D, Fletcher H, Garcia SG. Contraception emergency contraception

among university students in Kingston, Jamaica: A survey of knowledge, attitude and practice.
2002; 66(4):261-8.

13. Ethiopian Society of Obstetricians and Gynecologists (ESOG), Ministry of Health (FMOH) and
ECafrique, author. News letter. II. I. Addis Ababa, Ethiopia: 2005. May, a training curriculum for
mid-level health workers in Ethiopia.

22
 14. Tadesse E, Yoseph S, Gossa A. Illegal abortion in five hospitals in Addis Ababa. Ethiop Med J.
1994; 32(4):283–284.

15. World Health Organization: A Tabulation of Available Data on the Frequency and Mortality of
Unsafe abortion. 2nd edition. WHO Division of Family Health, Maternal Health and Safe Motherhood
Program, Geneva; 1994.

16.Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH: Unsafe abortion:
the preventable pandemic; 2005

17. World Health Organization: Complications of abortion: Technical and managerial guidelines
for prevention and treatment. Guidelines. Geneva; 1995.

18.Henshaw SK, Morrow E: Induced Abortion: A World Review. The Alan Guttmacher Institute
Review 1990

19. Popov AA: Family planning and induced abortion in the USSR: Basic health and demographic
characteristics; 2007

20. Gal SJ. LaGuardia, Termination of Pregnancy a global View. Ballier's Clinical Obstetrics and
Gynecology. 1990; 4(2):235–247.

21.Tadesse E, Yoseph S, Gossa A. Illegal abortion in five hospitals in Addis Ababa. Ethiopian Med
Journal.

1994; 32(4):283–284.

22.Mabatho M, Jomifier A, Margaret LM, Magos B, Cathyc KZ, Chelsea M. Emergency

contraception utilization by young south African women. Social Science and Medicine. 2004;
8(2):137–144.

23.Josaphat B, Florence M, Elisabeth F, Kristin G. Emergency contraception and fertility

awareness among University students in Kampala, Uganda. East African Medical Journal. 2006;
6(4):194–200.

24. (Sedgh G et al, 2007)

25.Hassen F. Analysis of factors for unwanted pregnancy among women in the
Reproductive age group attending health institutes in Jimma town. Report.
2000. Feb,
26. Kebede S, Jirra C, W/Mariam D. A survey of illegal abortion in Jimma Hospital; South West

Ethiopia. Ethiop Med J. 2000; 38:35–42.

27. Tefera N, Mingistu G, George M. National population policy of Ethiopia, women in Ethiopia

23
 UNFPA in Ethiopia. 1994:9–13. 35–38.

28. Nasir Tajure. Ethiopian journal of health sciences. 2010 July; 20(2): 91–97.

29. Wegene Tamire, Fikre Enqueselassie. Ethiopian journal of health sciences. 2007; 21(2)

30. Central stastical agency (2005).

ANNEX TWO

DATA COLLECTION FORMAT

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS

EMERGENCY CONTRACEPTIVE METHODS AMONG FEMALE HIGH SCHOOL(9-
12) STUDENTS IN ITEYA TOWN,ARSI ZONE, OROMIYA REGION, ETHIOPIA

This format consists of 7 parts

Part one- Socio-demographic characteristics

Part two – Family background factors

Part three – Respondents reported sexual experience

Part four –partner & peer related factors

Part five – Habit

Part six – Assessment of knowledge

Part seven – Assessment of attitude

NB: - Confidentiality will be kept!

Questionnaire

24
Interviewers Name ___________________________________

 Supervisor’s Name __________________________________________

 Date of interview ___________ / ___________ / _______ dd/mm/yy
 Questionnaire No ___________________________
 Woreda __________________ Kebele ________________

1. Socio demographic factors

1.1 Age
a. =<14 b.15-19 c. =>19

1.2 Religion

a. Orthodox b. Muslim c. Protestant d. others

1.3 Marital status

a. married b. single c. others

1.4 Ethnicity

a. Oromo b. Amhara c.Tigray d.others

1.5 Grade level

a. 9 Th b. 10 Th c. 11 Th d.12 Th

1.6 Living condition

a. with family b. alone/dormitoryc. with other person

2. Family back ground factors

2.1 Fathers educational level

a. Illiterate b.10 education c.20 education

d. above 20 educations

2.2 Mother educational level

a. Illiterate b.10 education c.20 education

d. above 20 educations

2.3 presences of siblings

25
 a. Yes b. No

If yes, his/ser age

a. younger b. older c. same

2.3 Dose your parents discuss about RH issues at home with you?

a. Yes b. No

If No, why do you think?

3. respondents reported sexual experience

3.1 have you ever had sexual intercourse

a. Yes b. no
If yes age at sexual debut

a. <12 b.12-15 c. 15-19 d.>19

3.2 number of sexual partners

a. One b. two or above

3.3 have you ever been pregnant

a. yes b. no
3.4 number of pregnancies

a. one time b. two times and above

3.5 was the pregnancy planned
a. yes b, no

If no reasons for unwanted pregnancy

a. contraceptive failure

b. abounded (pressure) by partner

c .rape

d. .forgot to take contraceptive

f. lack of knowledge about emergency contraceptives

3.6 have you ever had induced abortion

a. Yes b. no
If yes, reasons for abortion

a. Fear of parents and family

b. Fear of discontinuing school

26
 c. Economic problem

4. Partner and peer related characteristics

4.1 do you discuss about reproductive health with boyfriend (husband)

a. yes b. no

4.2 peer discussion about reproductive health with friends\

a. yes b, no

5. Habits

5.1 Currently chewing chat

a. yes b. no

5.2 currently consuming alcohol

a. Yes b. no

6. Knowledge & attitude assessment about EC methods

6.1 Exposure to Mass media

a. Radio b. Television c. Others d. No

6.2 Exposure to sex Education

a. Yes b. No

If yes, source of exposure

a. Family member b. school friends’ c. mass media

d.others

6.3 participation in school clubs

a. Yes b. No

If yes, which club?

a. Girls club

b .Anti-HIV & Red cross

c. Mini media

d. others’

6.4 have you ever heard about modern contraceptives

a. yes b. no

27
 If yes, what type?

6.5 have you ever heard about emergency contraceptive

a. yes b. no

6.6 methods reported as EC

a. OCPs b. IUCDs c. I don’t know d.others

6.7 indications/circumstances in which EC is used

a. after unprotected sex

b. when unwanted pregnancy occurs

c .I don’t know

6.8 times EC can work

6.8.1 OCPs

a. within 72hrs

b. within 5 days

c. I don’t know

6.8.2 IUCDs

a. within 72hrs

b. within 5 days

c. I don’t know

6.9 source of EC

a. pharmacy

b. private clinic/youth centre

c. government institution

d. shop

e. I don’t know

6.10 should we take it after we had already confirmed pregnancy

a. yes b. no

28
 6.11 have you ever use EC

a. yes b. no

7. Attitude towards EC

7.1 do u think u will use EC methods as a method if you have unplanned exposure

a) Yes b) no

CONSENT FORM (ENGLISH VERSION)

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS EMERGENCY CONTRACEPTIVE

METHODS AMONG FEMALE HIGH SCHOOL(9-12) STUDENTS IN ITEYA TOWN,ARSI ZONE, OROMIYA
REGION, ETHIOPIA

Good morning!

Or

Good afternoon!

We are students of Adama University Assela School of health & hospital, clinical two medical students, going to
conduct survey.

We would like to give u questioners for you containing few questions about Emergency contraceptives methods &
associated issues.

The objective of the study is to assess Knowledge, Attitude and Practice of Emergency contraceptives among high
school female students in Iteya. We think! Your cooperation and willingness for filling the questioners will be very
help full in identifying the problem related to the issue.

We would like to assure you that the study is confidential. We will not keep a record of your name and address.
You have the right to stop the interview at any time or to jump any question that you don’t want to answer.

Are you willing to participate in the questioner?

 yes, go to the next page

 No, thank them.

29
30