DEPATMENT OF NURSING

KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS MODERN

CONTRACEPTIVE METHODS AMONG FEMALE STUDENTES IN AKESTA
PREPARATORY SCHOOL, NORTHEAST ETHIOPIA, 2015.
RESEARCHERS
1. HUSSEN MULUGETA
2. MITAW GIRMA
3. TIROWERKE GETENET
4. TESHAGER HUKA
5. GURMU NEGEWO
ADVISOR; YEMIMAREW GETACHEW (BSC, MSC IN CLINICAL AND
COMMUNITY MENTAL HEALTH)
A RESEARCHPROPOSAL SUBMITTED TO COLLAGE OF MEDICEN AND
HEALTH SCIENCE DEPARTEMENT OF NURSING, WOLLO UNIVERSITY,
IN PARTIAL FULFILLMENT FOR THE REQUIRMENT OF BACHELOR OF
SCIENCE DEGREE IN NURSING.

APRILE; 2015
NORTH EAST, ETHIOPIA

I
 ABSTRACT
Background: Despite the availability of highly effective methods of contraception, many pregnancies
are unplanned and unwanted. These pregnancies carry a higher risk of morbidity and mortality, often
due to unsafe abortion. Many of these unplanned pregnancies can be avoided using modern
contraception. Literature reveals that there is existence of knowledge attitude and practice gaps on
modern contraceptive in the world including Ethiopia.
Objective: - To assess knowledge, attitude and practice towards modern contraceptive use
among female students in Akesta preparatory school.

Methods and materials: A descriptive cross-sectional study design was carried out among 90 of
female students in Akesta preparatory school by using simple survey data collection method.
Data was collected using structured questionnaire and analyzed using computer and presented
with tables.

Result: - Information was collected from 90 reproductive age group of Akesta preparatory
school female students giving a response rate of 100%. From a total of 90 Akesta female
reproductive age grope students 239(97.95%) of students have information or knowledge of
contraceptive. But only 119(48.77%) of women were used contraceptives. of the 244
respondents, 128(52.45%) and 116(47.55%) had positive and negative attitudes respectively. The
result showed that positive attitude of the respondents were higher among who had good
knowledge and who were practicing contraceptive methods. Some of the study variables are
statically significant. But Ethnicity, religion and occupation of women have no statically
significant. The study also found that most women used contraceptive method for the purpose of
child spacing. Desire to have mare children was the main reason for none users.

Conclusion and recommendation: - The study showed that, most students have
information of contraception. Even though, the importance of contraceptive are well accepted by
majorities, a large number of study population were not using contraceptive. Therefore, intensive
effort should be made to educate the public about FP methods, and to bring positive attitude
toward modern contraceptive method.

II
 ACKNOWLEDGEMENT
First of all, we would like to thank almightily “God” the most gracious and the most
merciful for his kindness, love and help for our success and achievement.
Next, we would like to thank our dear advisor, Mr.YemimrewGetachew (BSC, MSc in
clinical and community health) their constructive advice as well as comments and suggestions.
We also would like to thank our families who have great place in our achievements from the
beginning.
Lastly we would like to thank our friends and Akesta hospital health workers as well as
Akesta preparatory school directors for their cooperation in providing us with necessary advice,
references and literatures.

III
 TABLE OF CONTENT

TITLE PAGE
Abstract .........................................................….. .. . .… .. .. .. . ..... … I
Acknowledgement .........................................................................……….………..II
Table of contents………………………………………………………………III-IV
Abbreviation ..................................................................................................…. ....V
List of figures……………………………………………………………………...V
List of tables ...........................................................................................................VI
CHAPTER ONE- INTRODUCTION
1.1. Background information.............................................................................. 1
1.2. Statement of problem…………………………………………………….2-3
CHAPTER –TWO
2.0. Literature review……………………………………….…………………4-7
2.1 Significance of the Study…………………………………………………...8

CHAPTER THRE OBJUCTIVE

3.1. General Objective ……………………………………………………………..9
3.2. Specific Objectives .............................................................................................9

CHAPTER FOUR- METHOD AND MATERIALS…………………………….…..10

4.1. Study area and period……………………………………………………….…...10
4.2. Study design ……….……………………………………………………………10
4.3.Population ……………………………………………………….………………10
4.3.1. Source population………………………………………………..…………...10
4.3.2. Study population …………………………………………………………..…10

IV
4.4 Eligible Criteria……………………………………………………………….…11
4.4.1 Inclusion Criteria……………………………………………….………..……11
4.4.2 Exclusion Criteria……………………………………………………….……..11
4.5 Sample size determination and sampling technique …………………………11
4.5.1 Sampling size determination ………………………………………………11
4.5.2 Sampling technique………………………………………………………….11
4.6. Study Variable………………………………………………………………….11
4.6.1. Dependent variables………………………………………………………….11
4.6.2. Independent variable…………………………………………………………11
4.7. Data collection procedures……………………………………………………….12
4.7.1 Instruments…………………………………………………………………...12
4.7.2 Data collectors selection and training…………………………………………12
4.7.3 Data collection method and collectors………………………………………..12
4.8. Data quality management………………………………………………………..12
4.9. Data processing, analysis, interpretation and presentation………………………..12
4.10. Operational definition of concepts………………………………………………13
4.11. Ethical consideration……………………………………………………………...13
4.12 Dissemination plan……………………………………………………………..14

CHAPTER –V – WORK PLAN…………………………………………………………..15

CHAPTER VI- BUDGET ……………………………………………………………...16
References ………………………..……………………………………………………..17

CHAPTER VII
RESULT……………………………………………………………………..15-24

V
CHAPTER –VIII
DESCUSSION………………………………………………………………25-27
CHAPTER- IX
CONCLUSION AND RECOMMENDATION……………………………28-29

Annexes

Annex I- References ...........................................................………………… 30-31

Annex III – Questionnaire………………………………………………………32-33

LIST OF TABLES

CONTENT PAGE

Table-1 work plan…………………………………………………………………..15

Table2 . Stationary and personal cost………………………………………………….….16

Table 3. Socio demographic characteristics of the female students study population in Akesta
preparatory school…………………………………………………………………….19

Table4. Distribution of Akesta preparatory school reproductive age group female students

Of their contraceptive knowledge, attitude and practice…………………..…………20

Table5. Source of information for use of contraception in the study area…..............21

VI
Table -6. Method of contraceptive use reason for use and nonuse in the study
population………………………………………………………………………...21

Table7. Distribution of attitude towards modern contraceptive method

in the study area………………………………………………………….......22

LIST OF FIGURES

Content page

Figure1. Distribution of type of contraceptive known by reproductive age group Buture Gebissa
Kebele, Manna Woreda, 2013…………………………………………………………………...18

Figure2.Type of contraceptive method used by the study population in Buture Gebissa Kebele,
Manna Woreda, 2013…………………………………………………………………………….19

ABREVATION

ANC-ante natal care

EDHS -EthiopianDemography andHealth Survey

FP- Family planning

IUCD – Intra uterine contraceptive Device

KAP- Knowledge Attitude and Practice

LB- Live birth

STD- Sexually Transmitted Disease

VII
UK- United Kingdom

USCB – United states census Bureaus

WHO- World Health Organization

VIII
 CHAPTER ONE

INTRODUCTION
1.1. Background information
Contraceptive refers to ways or methods by which pregnancy is spaced, limited or
prevented. The practice of contraceptive is as old as human existence. For centuries,
human have relied on their imagination to avoid pregnancy. During the second century
in Rome, serums and Ephesus created a highly acidic concoction of fruits, nuts and
wool that was placed at cervical as to a spermicidal barrier (1).

The currently available methods of contraceptive may be classified in to tradition or

folk method and modern contraceptive method. The traditional methods are coitus
interrupts, post vital douche, vocational amenorrhea, and periodic abstinence (rhythm;
the modern methods are Barrier methods (male and female condoms), diaphragm,
cervical cap, vaginal sponge, and spermicidal, Hormonal methods (oral contraceptives,
injectable, implantable, long acting progestines, the IUDs) and sterilization methods
(Tubal ligation and vasectomy ( 2).

Effective control of reproduction can be essential to women ability to achieve her

individual goals and contribute to her sense of well being. In other words, use of
contraceptive could prevent as many in every maternal risk and death by allowing
women to space birth, avoid un intended pregnancy and abortion and stop child bearing
when reaching their desired family size (1).

1
 1.2 Statement of the problem

As of today, world population is estimated to a number 7.071 billion, by the United

States census Bureau (USCB). Africa is the second most populated continent which
accounts 1billion that covers 15% of the world population. Ethiopia is one of the most
populated countries in Africa next to Nigeria (3). The November 2007 Ethiopian
population was 77milion while it was 60million in 1999 and 11.8million in 1900 (4).
Today, Germany and Ethiopia have roughly the same number of population around
83million but, unless something changes, by 2050 Ethiopia is projected to more than
double its population to 174million. Because Ethiopian total fertility rate, 5.4 is four
times greater than Germany rate (5).
According to a joint report of joint WHO/ UNICEF/UNFPA in 2008, every day, about
1000 women die due to preventable complications of pregnancy. Of these, 570 lived in
sub-Sahara Africa, 300 in south Asia and only five in high income countries. The risk
of a woman in a developing country dying from a pregnancy related causes during her
life time is about 36 times higher compared to a woman living in a developed country
(6).

According to EDHS 2011, maternal mortality ration in Ethiopia was 676 deaths per
100,000live birth. In other words, for every 1,000 live birth in Ethiopia during the
seven year preceding the survey 2011, about seven (6.76) women died during
pregnancy, during child birth or within two months of child birth (7 ). In contrast, in
developed nations, maternal mortality ration was 14 deaths per 100,000 live births in
the same year (6). Not only this, but also infant mortality ratio. Nonmetal mortality
ration and under five mortality ratio is high which account 59 death per 1000 LB,
37death per 1000 LB and 88 death per 1000 LB respectively although there is
achievement compared to EDSH of 2005( 6 ).

Various obstacles impede use of contraceptive in Africa. A qualitative study conducted

in March, 2008 in south central part of Uganda identified and classified those obstacles
into five categories that includes misconception and fears, socio cultural expectation,
short term planning and health service barriers.

2
The roles of religion and culture as fertility determinant have been the subject of
considerable discussion in fertility literatures. The culture and religious back ground of
a given community has powerful effect on health seeking behavior in general and
contraceptive use in particular.

Thus, expending contraceptive use is critical to limit women exposure to a general risk
in pregnancy and child bearing and enable to women avoiding high risk births. Besides,
it decreases infant and child mortality by investing the family for few children and used
for decrease population growth rate.

3
 CHAPTER –TWO
2. LITERATURE REVIEW
Family planning affects fertility by raising contraceptive use which is one of the most
proximate determinants of fertility rate. Decline in FR has been noted in several countries
regardless of the level of development (15).

Few sexually active women in developing countries use modern contraceptive method,
such as oral contraceptive method and condom although there is considerable variation
between countries up take. Generally developing countries use much lower contraceptive
method than developed countries. For example, 69% of adolescent women in UK study
report use of modern contraceptive method than developed countries. For example, 69% of
adolescent women in UK study report use of modern contraceptive compared with 12% in
Mali and 17% in Tanzania of 15-49 years old female (16).

In south Asian and sub Saharan Africa countries of all survey conducted from 2000 - 2008
for women’s whose reason for not using contraceptive were not related to desire to have
more children or other fertility related. The most important reasons opposition to use
contraceptives is fear of side effect and health concern. The cost of contraceptive or access
to family planning provider is not important reason in either region. Lack of knowledge
was the most important reason to the intention not to use contraceptive in Chad, where as
unimportant in Ghana whose health concern and side effect are report for non use. In
Senegal more than half of all women are who were not using contraceptive because of
opposition to family planning (4).

In developing countries, particularly in most part of Africa, modern family planning

method is still not wholly accepted by the population. Africa has the lowest rate of
contraception use. There are factors contributing for low use of family planning .As RJ.I,
like reported earlier, some of the cause to the failure of FP programs in developing
countries are the availability of only one or two contraceptive method in clinic, lack of
qualified personnel to provide the method, lack of adequate supervision and coordination,
isolated programs from other services, religious impediment in some areas, inefficient
management of FP programs, high prenatal and infant mortality in the area, insufficient
information and lack of publicity, constraints to FP in Africa, socio cultural norms that
4
govern family formation and reproductive behavior, difficulty in communicating sexual
and family life to outsider, cultural resistance to mode FP, religious constraints, lack of
awareness and education, especially in ruler areas (10).

A survey was conducted to stud knowledge attitude and Practice (KAP) of family planning
in a community located in Banteay Meanchey, where unmet contraceptive need is highest.
Structured interviews were performed with 139 married women in rural Cambodia,
selected through a simple random sampling method. The results showed that knowledge of
modern contraceptives among the respondents is universal, with 99% of women being
aware of at least one modern method of contraceptive. The respondents and stakeholders
showed a positive attitude in their support of family planning programs, and more than half
of the respondents knew where to obtain contraceptive methods. Around 56% of the
women were practicing family planning at the time the survey was conducted, with their
main reasons being fertility desire despite the side effects of some methods, and to maintain
their standard of living. (19)

There was cross sectional study carried out on assessment attitude and Practice of
contraceptive among married women Mpwapwa district in Dodoma region, Central
Tanzania, in 2012. A total of 160 married women of reproductive age (15-49 years) from
160 randomly chosen households (i.e., one individual per household) were involved in this
study. Study participants who were aware of modern contraceptives were asked to indicate
their views on whether if benefits of modern contraceptives outweigh negative effects; if
desired to know more on modern contraceptives; if would recommend use of modern
contraceptive to a friend; if not current user, if intends to use modern contraceptives in
future; if frequently discuss with husband on modern contraceptives/family planning
(spousal family planning); and if husband approve modern contraceptives with the
purpose of ascertaining their attitude as well as attitude of husband towards modern. The
results showed that half (50%) of that were aware of modern contraceptives thought that
benefits of modern contraceptives outweigh negative effects and nearly two- third (65.2%)
to know more (learn more) on modern contraceptives. Furthermore, 42% of them that is
four in every ten of respondents that were aware of admitted that they could recommend
use of modern contraceptives to a friend. In addition, for those who were non current users

5
of modern contraceptives, a quarter (25.4%) of them indicated they are intending to use in
the future (20)

There was survey conducted in Ghana in 2003 to assess discontinuation of contraceptive

use. According to the study, 15-19 years of age and 26-34 years were used contraceptive
which is 16.5% and 49% respectively. Secondary school and above were more use
contraceptive compared to illiterate which is 52.5% and 25.5% respectively. Most
Christians use as compared to Muslims. The reason for non-users was fear of side effect,
14.4%, religious opposition, 5.1% supply problem 3.2% and lack of knowledge 0.4% (11).

According to EDHS 2011, the most known modern contraceptives are injectable, male
condoms and pills. More than one in four married women (27%) currently use modern
family planning method. Another 1% is using traditional method. Injectable, 21%, followed
by implants are the most currently used methods. Unmarried sexually active women are the
most likely to use FP-over half (52%) are using a modern method with 32% using
injectable and 11% using male condoms. Use of modern FP various by residence and
region. Modern methods were used by 50% of married women in urban area, compared
with 23% of women in rural areas. Modern contraceptive use ranges from a low of 4%
among married women in Somali region to a high of 56% in Addis Ababa (7).

In Ethiopia, community based cross-sectional study was conducted in west welega, Guyi
town in 2005 on modern contraceptive use and factors determining its use among women
of child bearing age. 384 women were interviewed. Of these, 75% of them had heard about
FP. The most known source of information was health institution 63.9% followed by peers,
mass media, husband / partner which is 41%, 26.3% and 24% respectively, the most known
methods in the study area were pills (98%), injectable (90.5%), and male condom (21.3%).
Out of 325 women who had husband/ partner 35.1% have discussed about FP with their
husband /partner. And the point of discussion was on deciding to use modern contraceptive,
its advantage and side effect. injectable, pills and condom were the most widely used
method in the study population which accounts 74.8%, 21% and 1.4% respectively. 76.8%
6
of the study population use the method currently for spacing reason while 47.7% didn’t use
the method for reason of lack of awareness followed by not achieved the desire to have
children which account 17.3%. (12).

Another population based study was conducted in Mojo town in Ethiopia April 2011 about
family planning Utilization. According to the study 34% of them had practiced one form of
FP service. The study also identifies the reason for non utilization for non users. that most
women is contraceptive knowledge and practice is influenced by socio-cultural norms such
as male / husband dominance, and opposition to contraceptive and low social status of
women lack of formal education is essential for women was identified as key factor in
preventing change in the patterns of contraceptive knowledge and use by women in this
part of Ethiopia ( 14 ).

7
 CHAPTER- THREE

Significance of the study

In Ethiopia, although the knowledge of family planning is nearly universal, the use of
contraceptive is low. Assessing knowledge attitude and practices of family planning
methods will encourage users and motivate non-users. It provides related information
which could be used by policy makers. Furthermore, it is important to identify and
provide socio demographic factors influencing family planning use and nonuse. The
study is also used to recommend by concerned body according to make intervention
according to the result.

8
 CHAPTER –FOUR

OBJECTIVES
4.1. General Objective

. To assess knowledge, attitude and practice of modern contraceptive methods among reproductive
age group female students in Akesta preparatory school, Northeast Ethiopia 2015.

4.2. Specific Objectives

1. To assess knowledge of reproductive age group of female students about modern

family Planning methods.

2. To determinefamily planning practice among female students of reproductive age

groups.

3. To assess attitude of female students of reproductive age group towards modern

family Planning method.

9
CHAPTER –IV

4.0. METHODS AND MATERIALS

4.1. Study area and period

The study area is in Akesta town, south Wollo, Northeast Ethiopia which is located 514Km
far from Addis Ababa and 113.5km from Wollo University Dessie campus. The climate of
the Akesta town has cold weather condition and which has hilly and irregular topographical
land features. This town is found borderline from Genete west and toliawelia east. The
socio-economic status of most of the population living in this town is depending on
agriculture. . This Akesta town has one hospital, one preparatory school, one health center,
eight mosque and three churches, one private clinics but no drug store. This study will be
conducted on Akesta preparatory school female students. This preparatory school is the
only one which is found in Akesta town, which was built in 1945Ec as junior then it
becomes high school and it gives services along period time up to 1999, and it becomes
preparatory school after 1999. This school is built near to the town in the direction of south
west. The total students in this preparatory school are 291 students, out of which 91 are
females. Among those 91female students 60are grade 11 and 31 are grade 12 but of those
31 grade 12 students 1 is drop out. Community and governmental support are the main
sources of this preparatory school. The study will be conducted from May 1-10/2015

4.2. Study Design

Cross-sectional study design will be employed.

4.3 populations

4.3.1 Source population

All reproductive age group female students of Akesta preparatory school.

4.3.2 Study population

All reproductive age group of female students in Akesta preparatory school who fulfill the inclusion
criteria.

10
4.4 Eligibility criteria

4.4.1 Inclusion criteria

 Those female students attend their educations regularly.

 Female students whose age is between 15 and 49.

4.4.2 Exclusion Criteria

 Those female students who will not present at the time of data collection

 Those who are not continue their education.

4.5 Sample size determination: Since the source population is too small and not adequate
to take sample from this population. So we will use the source population as it is.

4.6. Sampling technique

Simple survey sampling technique will be conducted.

4.7. Variables
4.7.1. Dependent variables
- knowledge of female reproductive age group students
- practice among females students of reproductive age groups
- attitude of female students of reproductive age group
- 4.7.2. Independent variables
- Age
- Religion
- Ethnicity
- Marital status
- Income
- Number of children
- Family Educational stats
- Language
- Perceived benefit and risk of modern contraceptive
- Origen of residence
- Parents occupation

11
5.8. Data collection instruments

The data will be collected using structured questioner which will be developing in
Amharic. The data will be collected by three 4th year BSc Nursing Students who will take
training for two days about data collection procedure. After having consent from the
Akesta preparatory school directors and other concerned bodies, data will be collected for
eight days.

5.9. Data quality assurance and supervision

Data will be collected using structured questionnaire methods. Proper training will be given
for data collectors and will be supervised for their proper performance of tasks and visually
checked to ensure that all information are collected and recorded.

5.10. Data analysis and presentation

The raw data will be analyzed manually and using scientific calculator. The result will be
presented using tables.

4.12. Operational definition and term definition

5.13. Operational definition and term definition

 Family planning- couples choice when to begin haring children, how many to
have, how far apart to have them, and when to stop haring children.
 Knowledge of contraceptive method:- a women aware of at least one
contraceptive method

 . Good knowledge :-well informed and known about family panning knowledge
question and who know at least two importance of FP methods

 Poor knowledge: - Those who are informed, but know less than two importance of
FP methods
 Attitude:- The predisposition to respond in favorable or unfavorable manner
toward a target
 Positive attitude: - Given for interviewee who answered at least 60% of favorable
attitude question.(>=3/5 positive attitude statements )

12
  Negative attitude: - Given for interviewee who answered less than 60% of positive
attitude question.
 Practice:- to use contraceptive currently
 Factors:- Something, that contribute to the use or non use of contraceptive method
 Users:- those currently using contraceptive
 Non-users:- those currently not using contraceptive
 Unpleasant:- those reproductive age group women, who belief contraceptive
method is not comfortable for use

4.12. Ethical consideration

Ethical clearance will be obtained from Wollo University College of medicine and health science
and be given to the administrative Office of Akesta preparatory school. Permission will be taken
from the responsible authorities of the school. The data collector will be informed about the
purpose of data collection. Confidentiality of the information will be assured and finally, they will
be thanked for their cooperation. Informed verbal consent will be taken from the participants. At
the end of data collection the data collectors will give health Education about modern
contraceptives.

4.12. Dissemination of the plan

The final report of the study will be submitted to Wollo University college of Medicine and
health science department of nursing. The result of the study will be also disseminated to
Akesta preparatory school and other responsible body.

5.12. Limitation

-The study was conducted on reproductive age group of Akesta preparatory female
students. Therefore, generalization of the study was not reflecting the reproductive health
status of all preparatory female students throughout the country.

-Sensitivity of the question may reduce the respondent response.

13
 CHAPTER-SIX
RESULT
1. Socio-demographic characteristics of the study population, in Akesta preparatory
school 2015.

Information was collected from 90 reproductive age grope of Akesta preparatory female
students giving a response rate of 100%.

From a total 90 of reproductive age group Akesta preparatory school female students 69
(28.27%) and 73(28.27%) were found in age between20 – 24 and 25-29 respectively .In
this study most women were married which is 166(25.00%) and few women were divorced
which is 4(1.62 %). Concerning educational status, majority of women were illiterate
which was 160(65.57%) and 53(21.72%) women have completed primary and secondary
school. The women those who can read and write were 25 (10.24%). Only few of the
study population joined college and above, which was, 6 (2.45%). Of 244 women, 145
(59.42%) were house wife and 58(23.77) were farmers while student and merchant
accounted 27(11.07%) and12 (4.91%) respectively. The most dominant ethnicity and
religion were Oromo and Muslim which account 235(96.10%) and 229(93.85%)
respectively. Concerning income, most women monthly income was between 251 and 499
which accounts 94(38.52% ) and only few women get >1500 which was 3.(Table 1)

Table 1. Table 3.Socio-demographic characteristics of the study population, in Akesta

preparatory school 2015..

Demographic variables Number Percent

Age
15-19 72 80
20-24 14 16
25-29 4 4
30-34 0 0
35-39 0 0
40-44 0 0
45-49 0 0
Total 90 100
Marital status
14
Single 82 91
Married 8 9
Widowed 0 0
Divorced 0 0
Total 90 100

Fathers educational states

Illiterate 15 17

Read and write 31 34

Less than grade 5 14 16

Above grade 5-8 14 16

Grade 9-12 6 6

Above grade 12 10 11

Total 90 100

Mother educational status

Illiterate 15 15 17

Read and write31 31 34

Less than grade 5 14 18 20

Above grade 5-8 14 19 21

Grade 9-12 5 6

Above grade 12 13

12

Total 90 100

Where you come from

Rural 45 50

Akesta town 38 42

Other 7 8

15
Total 90 100

Educational status
Grade 11 30 34
Grade 12 60 66
Total 90 100
Ethnicity 2.45
Amhara 90 100
Oromo 0 0
Tegeray 0 0

Other 0 0
Total 100 100
Family occupational status
Farmer 53 59

Merchant 11 12
Other 26 29
Total 90 100
Religion
Muslim 57 64
Orthodox 33 36
Other 0 0
Total 90 100
Income per month (Birr) 0 1.23

2. Distribution of Source of information for use of contraceptive method of

in Buture Gebissa kebele Manna Woreda ,2013

The commonest source of information for modern contraceptive methods was

health personnel/ facility which account 205(85.06%). Of the respondents 10 of
them (4.15%) heard from health personnel/facility and mass media.(table 2)

16
Table 5.Source of information for use of contraception in the study area, 2015.

source of information No. %

Mass media 33 36

School 30 34

Husband/partner 4 4

Health personnel 23 26

Total 100 100

3. Knowledge of contraceptive methods among reproductive women in

Buture Gebissa kebele Manna Woreda, 2013

17
 Figure 1. Distribution of type of contraceptive known by reproductive age group
in the study area.

As shown on the above figure , the most known methods by the respondents
were pills and injectable which was, 180(43.16%)and 162(38.84%) respectively
followed by implant which was93( 22.30 ).Condom was also known by 69(16.54)
respondents. 17(4.07%) respondents had information of IUCD. Tubal ligation was
known by 2 Women. No one told vaginal methods (foam, spermicidal and diaphragm)
and vasectomy as contraceptive method. About 173 (70.90%) of the women knew
more than one contraceptives.

4. Type of contraceptive method used by the study population use among

reproductive age group women in Buture Gebissa kebele,Manna Woreda,2013

18
Figure 2. Distribution of type of contraceptive method used by female reproductive groups
in Akesta preparatory school students, 2015

The above figure shows that injectables and pills were mostly used method of
contraceptive which was53 (44.5%) and36 (30.25%) respectively. 22 (18.49) respondents
used implanon while IUCD and condom were used by 3 and 4 women respectively. Only
1(0.84% ) woman used , tubal ligation for complete family size. No one ever used vaginal
methods

4. Reasons for contraceptive use and non use among reproductive age group women
in Buture Gebissa kebele,Manna Woreda,2013

Use and more The most important reason for use of contraceptive was for spacing of child
which was 82 (68.90%) followed by financial reason 16(13.44%). Fear of side effect and
19
desire to have more children were the most known reasons for not using c/c by the
respondents which accounts 30(13.60%) and 29(23.10%) respectively(table 3 )

Table3. Distribution of reasons for contraceptive use and non use among reproductive age
group Akesta preparatory school female students, 2015.

Reasons for contraceptive use

For spacing 45 50
For limiting 16 18
For health related problem 10 11
To prevent unwanted pregnancy 19 21
Other(specify) 0 0
Total 90 100
Reason for not using contraceptive
Not achieved I have to number of children to 0 0
have
Due to cultural belief or religious opposition 7 17
Due to influence from husband 8 19
Fear of side effect 12 29
Sex preference 21 50

Others(specify) 10 24
Total 42 100

5. Attitude towards modern contraceptive methods, among reproductive age group of

Akesta preparatory school female students, 2015.

Of the 90 Akesta preparatory female students reproductive age group students

115(47.13%) women had positive attitude while128 (52.45%) women had negative
attitude toward modern contraceptive methods. Of the 244 women, 119(48.77%)
strongly agree that contraceptive method reduce rapid population growth. Most of
the women108 (44.26%) strongly disagree that using contraceptive method was
against the will of God. 111(45.49%) of the respondents strongly disagree that
contraceptive methods prevent unsafe abortion. (Table 4)

20
 Table4. Distribution of attitude towards modern contraceptive methods, among
reproductive age group students in Akesta preparatory school students 2015.

Statement SA A N DA SD Total

No. % No % No % No % No %

Modern contraceptives are 20 21 27 30 12 14 13 15 18 20 100

more important than natural

Using contraceptive 33 36 25 28 14 16 9 10 9 10 100

improves women’s life

Contraceptive is 22 25 19 21 10 11 20 22 19 21 100
against the will of God

Contraception reduce 24 27 23 26 14 15 15 17 14 15 100

rapid population
growth

Contraception prevent 20 22 25 28 14 15 15 17 16 18 100

maternal and infant
death

Contraception prevent 19 21 31 35 18 20 12 13 10 11 100

unsafe abortion

Where, SA=strongly agree (5), A=agree (4), N=neutral (3), DA=disagree (2), SD=
strongly disagree (1)

Score level <=3/6 =negative attitude & score level >3/6= positive attitude

Of the 244 respondents, 132(55.10%) and 129(52.86%) of them believe that contraceptive
method were ineffective and unpleasant respectively. Of the same respondents, 140(57.37)
and 104(42.63%) of them believed that contraceptive were good and bad. But, most of the
women, 177(72.54%) believed that contraceptive method is important. (Table5)

21
Table5. Distribution of attitude(emotional) towards modern contraceptive methods, among
reproductive age group women, in Buture Gebissa kebele , Manna Woreda, 2013.

Statement No. %

Good 140 57.37

Bad 104 42.63

Total 244 100

Pleasant 115 47.13

Unpleasant 129 52.86

Total 244 100

Effective 112 45.90

Ineffective 132 55.10

Total 244 100

Important 177 72.54

Unimportant 67 27.46

Total 244 100

Acceptable 125 51.27

Unacceptable 119 48.73

Total 244 100

In this study association between socio demographic variables and use of contraceptive was
done. Significantly associated variables were, marital status (p=0.002), age (0.000),
educational status, (0.000). But religion, ethnicity and income had no significant
association with use of contraceptive with p-value of p=0.930, p=0.538 and p=0.058
respectively (table.5)

22
Table6. Distribution of association of socio-demographic variables and modern

Contraceptive practice of reproductive age group women in Buture Gebissa, kebele, 2013.

Variable Users Non users X2 Value

No % No %

Age

15-19 72 80

20-24 14 16

25-29 4 4
30-34 0 0

35-39 0 0

40-44 0 0

45-49 0 0

Total 90 100

Marital status 90 100

Single 82 91

Married 8 9

Widowed 0 0

Divorced 0 0

Total 0 0

Father Educational 90 100

status
Illiterate 15 17

Read and write 31 35

23
Less than grade 5 14 15

Above grade 5-8 14 15

Grade 9-12 6 7

Above grade 12 10 11

Total 90 100

Mother educational
status

Illiterate 15 17

Read and write 31 34

Less than grade 5 18 20

Above grade 5-8 19 21

Grade 9-12 5 6

Above grade 12 15 17

Total 90 100

Origin of incidence

Rural 45 50

Akesta town 38 42

Other 7 8

Total 100
90

24
 Family Occupational
status
Merchant 11 13

Farmer 53 59

Other 26 28

Total 90 100

Religion

Muslim 57 63

Orthodox 33 37

Other 0 0

Total 90 100

Ethnicity

Amhara 90 100

Oromo 0 0

Tegeray 0 0

Other 0 0

0
Monthly Income
6. Association of attitude practice of modern contraceptive methods among
reproductive age group women in Buture Gebissa Kebele,Manna Woreda,2013

As shown on the table below, there was significant association between

attitude and practice of modern contraceptive methods of the reproductive age
group women with p values of p=0.000. Of the 128 respondents who had
positive attitude, 20 of them (16%) were not using contraceptive methods at
the time of the survey.
25
Table7. Distribution of association between attitude and modern contraceptive
practice among reproductive age group women in Buture Gebissa kebele,
Manna Woreda, 2013

Practice Total X2 p. value

Yes No

Attitude No. % No % No. %

Positive 108 90.1 20 16 128 52.46 137 0.000

Negative 11 9.9 105 84 116 47.54

Total 119 100 125 100 244 100

CHAPTER-SEVEN

DISCUSSION
Despite the recent increase in contraceptive use, Ethiopia, Africa's second most populous
country, is known to have a low contraceptive prevalence and high total fertility.

This study revealed that from a total of women participated in the study,239 (97.78) of
women had information about contraceptives and know at least one type of contraceptive
method. The high level of knowledge on at least one form of contraception among the
participants of this study (96%) is in line with previously reported national figures (98.4%).

From those women who had information of contraceptive, pills and inject able were the
most known by most respondent which was 180 (43.19%) and 162(38.84%) respectively
followed by implant which was 92(22.3%). This was a consistent with another study
conducted in South East Nigeria, Nalawi about prevalence and determinants of
contraceptive use and un meet need of family planning in 2008,which showed Pills and

26
injictable were the most known by most respondents which was (94.6%) and( 96.17%)
respectively( 15 )

But, of the respondents, only 175(71.72% ) of them had good knowledge meaning, those
who had information and know at least one type of contraceptive method in addition to
knowing at least 3 importance of FP methods.

Regarding contraceptive users from a total of 244 women of reproductive age 119
(48.77%) had used contraceptive. This is comparable with the finding in Jimma zone in
2013(18 ) study conducted on Family Planning Knowledge, Attitude and Practice among
Married Couples in Jimma Zone, Ethiopia where 43% of females were using modern
contraceptive method(18)

However, the CPR is higher than the regional (24.9%) as well as the national (29%)
figures (7). This might be due to repeated health information by CBTP and TTP program
in the study area. The most ever used method of contraceptive were injectables and pills
which was 53 (44.53%) and 36(30.25%) respectively. Implanon, condom and IUCD were
used by 22(18.49%), 4 and 3 women respectively. Another study conducted in Nigeria,
Nelaw: 73% of women had ever used the modern method of contraceptive. Male condom
and IUCD were the most used methods which were (71.4%) and (35.4%) respectively (15).
This difference may be due to availability and expectation towards male condom and
IUCD.

This study revealed that 125 (51.23%)) of women had never used contraceptive method.
From this, the desire of more children (24.00%) was the main reason of not used the
contraceptive method followed by fear of side effect which (23.10%) .But in Nigeria
Nalawi the reason for no use of family planning method were fear of side effect (28.9%),
against religion (18.4%), husband disapproval (36.8%) and lack of access (15.8%)(16).
This difference may be due to variation of the study subjects and year of study. Similarly in
our country Gonder Administrative Zone in Dembia district the most important reason for
non-use of contraceptive was perceived side effect of contraceptive (43%), to have more
children,34.7% (16)

In this study association between socio demographic variables and use of contraceptive was
done. Significantly associated variables were, marital status (p=0.002), age (0.000),
27
educational status,(0.000). But religion, ethnicity and income had no significant association
with use of contraceptive with p-value of p=0.930, p=0.538 and p=0.018 respectively..
Level of education and age were consistent with another study conducted in Ghana in 2003
with p-value 0.001 and 0.004 respectively where secondary school and above were more
used contraceptive compared to illiterate. In addition Nigeria, Nalawi, religion had no
statically significant on use of contraceptive with p=0.41. In contrast this study was
inconsistent with another study conducted in Dembia District, where occupation and
religion were found to be significant association with usage of contraceptive (p<0.05) (16).
Also in study conducted in Butagira District, there was appositive association between
contraceptive use and educational status of women because primary and secondary level
education were more likely to use family planning compared to illiterate (22 ). There was
also another the study conducted in Jimma town in 2006 about influence of women
autonomy and level of contraceptive use, socio demographic factors found to be had no
statically significant association(14).

In this study, there was significant association between attitude and practice of modern
contraceptive methods of the reproductive age group women with p values of, p=0.000.

Of the 128 respondents who had positive attitude, 20 of them (16%) were not using
contraceptive methods at the time of the survey. This might be due to influence from their
husband/partner because of negative attitude that they have towards modern contraceptive.

28
 CHAPTER EIGHT

8. Conclusion and Recommendation

8.1 Conclusion

The analysis of this study provides information on reproductive age group women on
knowledge attitude and practice of modern contraceptive in Buture Gebissa Kebele Manna
Woreda. The result demonstrates that good knowledge among reproductive age group was
observed, yet difference on knowledge of specific contraceptive exists. . It is evident from
this study that, high knowledge on contraceptive is not matched with high contraceptive
use. Most of the women’s knowledge is limited to short-term contraceptive methods rather
than the long-terms. Even though, the importance of contraceptive were well accepted by
majorities, a large number of study population were not using contraceptive. Among reason
for not using contraceptives want to have more children and fear of side effects were the
most common. There were different reasons for utilization of contraceptive. These reasons
were different from person to person. But spacing of children was the main reason for
utilization of contraceptive. Most of the women with positive attitude were practicing
29
modern contraceptive methods. Most of the respondent who were using c/c had positive
attitude.

8.2 Recommendation

This study revealed that, there is a huge gap between the contraceptive knowledge and the
practice. Therefore, in order to narrow this gap with aim of increasing the contraceptive
practice the following recommendations were forwarded.

 Effort must be made to greatly increase the number of contraceptive users by

educating and motivating the public that can be achieved by popularizing FP
methods, and by involving men in contraceptive education, by involving
community and religious leaders.
 As one method is not appropriate to all women, emphasis should be given to the
availability of the method to help clients to switch from one method to another
rather than terminating due to its side effect
 Clients should be informed with long term family planning and recent updated
information about contraceptive by extension health workers, Jimma media center
and JUSH health worker.


30
 ANNEX -I

REFERENCES
1. Omni M., Samra- Latif., Contraception, department of obstetrics and Gynecology,
Robert wood Johnson University, Hanilton Hospital; Sep 5, 2008. Available at
http://www.emedicine. Com
2. Alan H. Decherney, Lauren Nathan, J. Murphy Goochwin Neri Lanfer. Current
diagnosis and Treatment. Obstetrics and Gynecology, 10 th edition, USA; mc Graw Hills
companies.
3. Wikipedia, the free encyclopedia.

4. World bank. Org<……> health, nutr & … public at a G… or : http: world bank org.
(PCDPQW7Y7O

5. Family planning in Ethiopia and new UN strategy/ owned board 23 Spep. 2010 or
www.org./blog/3706/.
6. UNFPA/UNICEF/WHO, maternal death worldwide available at
www.who.int/../index.html
7. Ethiopian demographic and Health survey 2011.

31
8. Florence Miremable. BMC public health, 2010:10:530. Also available at www. Biomed
central.com/,. 2010
9. Fasil H. Assessment of factors influencing the utilization of modern contraceptive
methods ingloele and Tera district, June 2006.
10. Lete R.J.I., Fp in Africa. University of yeounodae, Cameroon, General foundation for
medical education and research, Available at http://www.gfmer.ch/ books/reproductive
health.
11. Nicholas J. parr. Discuntinauation of contraceptive use in Ghana. Journal of Health
popul. Nutr.2003, 2(21):150-151.
12. Kefalew E., modern contraceptive use in Guyi Town, Ethiopia June 2005; 20-22.
13. N. Regassa. FP utilization in Mojo town. Journal of Geography planned Jun 2011,
4161: 355-360.

14. A . Haile. Influnce of women autonomy on couple’s contraceptive use in Jimma town.
Ethiopian Journal of health Development. 2006, 20 (3) : 6 – 9

15. Emmanuel, N. Monago. Prevalance and determinants of contraceptive and unmet need
of contraceptive in Nelaw: Nigeria. International jornal of medicin and medical scince.
2009, 1(10): 325 329.

16. Y. kebede. Contraceptive prevalence and factors associated with usage of

contraceptives around Gondar town. Ethiopia Journal of health Dev. 2000; vol. 14
(3):327
17. Becker S (1999) Measuring Unmet Need: Wives, Husbands or Couples? International
Family Planning Perspectives 25: 172–180. doi: 10.2307/2991881

18. T.Tilahun, G. Coene, W. Kassahun: Family Planning Knowledge, Attitude and

practice among Married Couples IN Jimma Zone, Ethiopia, 2013.
19. V. Sreytouch: Knowledge, Attitude and Practice (KAP) of family planning among
married women, in Banteay Meanchey, Cambodia, 2011; 103-1107
20. J. Lwelamira, G. Mnyamagola and J. Lwelamira; Knowledge, Attitude and Practice
(KAP) Towards Modern Contraceptives among Married Women of Reproductive Age in
Mpwapwa District, Central Tanzania; Current Research Journal of Social Sciences 4(3):
235-245, 2012

21. Beranger. LH, Saving RE, Ferguson, Sharma U, Global proactive of sexual and
reproductive health of adolescent, prevention and potential ancent 2007, 369: 1220-
1221.

22. A. Worku, Determinants of low Family planning use and high unmet need in Butajira
Town, Journal of Reproductive health, Dec.2011, 8 (1): 37 – 41

32
 ANNEX-II

QUESTIONNAIRE
JIMMA UNIVERSITY STUDENT RESEARCH PROGRAM QUESTIONNAIRE
PREPARED TO ASSES KNOWLEDGE ATTITUDE AND PRACTICE OF
MODERN CONTRACEPTIVE METHODS AMONG REPRODUCTIVE AGE
GROUP WOMEN IN BUTURE GEBLSSA KEBELE, MANNA WOREDA, JIMMA
ZONE, SOUTHWEST ETHIOPIA, 2013.

Instruction I. Mark (  ) in the given space

II. Write appropriate words, phrases or number in the space provided

I. Socio demographic characteristics

1. Age -------------------------
2. Marital status A. single B. Married C. Widowed D.
Divorced
3. Religion A. Muslim B. Orthodox C. Protestant D. Other (specify)
33
 4. Ethnicity A. Oromo B. Amhara C. Douro D. Yem E. Other (specify)
5. Occupational status:- A. Housewife B. Government employee C. student D.
Merchant
E. farmer F.servant G. Other (specify
6. Education status A. Illiterate B. Read and write C. primary and secondary
D. college diploma and above
7. Income A. <250 B. 251 -499
C. 500-999 D. 1000-1499 E. >1500.
II. Knowledge towards family planning methods
8. Have you ever heard about family planning?
A. Yes B. No
9. If yes to question no 8. What was your source of information?
A. Mass media B. School C. Husband /partner D. Health personnel
10. Do you know any method that enables women to control pregnancy?
A. Yes B. No
11. If’ Yes ‘to question no 3. What methods do you know?
A. Pills B. Injectable C. Implant D. IUCD

E. Condom F. Others (specify)

12. What is importance of FP methods?

A. to space child B .to limits pregnancy C. to prevent unwanted pregnancy

D. To prevent STDs like HIV/AIDS.

13. Which of the following is a long term family planning method?

A. Pills. B. IUCD. C. Norplant. D. Vasectomy. E. Tubal ligation. F.

condom. G. injectable. G. none

III. Attitude towards modern family planning methods

14. What is your attitude toward contraceptive methods

Statement SA A N DA SD

5 4 3 2 1

Modern contraceptive are more important than

natural

Using contraceptive improves women’s life

Contraceptive is not against the will of” God”

Contraception reduce rapid population growth

34
Contraception prevent maternal and infant death

Contraception prevent unsafe abortion

1 .Very low 2. Low 3. Medium. 4. High 5. Very high

15. Family planning is:-

Positive Score level Negative

attitude. attitude

Very High(4) Medium Low(2) Very

high(5) low(1)
(3)

Good Bad

pleasant Unpleasant

effective Ineffective

Acceptable Unacceptable

important Unimportant

16. Have you ever used modern contraceptives

A. Yes B. No
17. If yes to question no 5 are you using currently?
A. Yes B. No
18. If yes to question no 15 what is the method?
A. Pills B. Injectable C. Implant D. Condom E. IUCD F.
Others
19. If yes to question no 15 what is the reason for using the method currently?
A. For spacing B. For limiting C. Health related problem

D. Financial problem E. To prevent, unwanted pregnancy.

20. If never used, what is your reason?

A. Fear of side effect
B. Sex preference
C. Not achieved number of children to have
D. Cultural belief /religion opposition
E. influence from husband
F. Others (Specify)

35
Thank you

36