Article_parm 101_2013

Pinnacle Medicine & Medical Sciences
http:/www.pjpub.org Author(s) 2014. CC Attribution 3.0 License.
Research Article
Volume 2014 (2014)
Knowledge Regarding Emergency Contraceptives among Women of Tanahu, Nepal
Singh Sakun¹, Shrestha Sandhya² & Gurung Nirsuba³ Manipal College of Medical Sciences(Nursing program) Manipal College of Medical Sciences(Nursing program) Manipal College of Medical Sciences(Nursing program) ABSTRACT
To assess the knowledge of emergency contraceptives among the women of Tahanu District, Nepal. A descriptive cross sectionalstudy was conducted in Tanahu district, Nepal. The ethical requirement was fulfilled before data collection. Total 100 womenof reproductive age group were included in the study and interview technique was used to collect data. Out of 49 VillageDevelopment Committee, One VDC was selected by Simple Random Sampling and further Convenience sampling was done fordata collection among the women of VDC. After the collection of data they were coded and entered into Microsoft Excel andstatistical analysis was done in SPSS (Statistical Package for the Social Studies). Chi-square test was applied to find out theassociation between knowledge and selected demo-graphic variables of respondents. A total of 100 women aged 15-45 yearswere interviewed for the study. The mean ages of the respondents were found to be 31.87 ± 9.60 years and the mode age groupwas 20-24 years (24%). Majority of the respondents were Magar. Among 100 respondents 88% of them were literate. Almostthree-fourth (73%) respondents were housewives. Among 95 married respondents 31% of them admitted that their lastpregnancy was unplanned. And 14% had history of induced abortion. The most common source of information was radio. 46%of respondents had poor knowledge of Emergency contraceptives. There was a significant association of knowledge with Ageand educational level of women. The knowledge regarding emergency contraceptives is poor among the women of Tanahudistrict, Nepal. Various awareness programs should be organized by governmental and non-governmental organization to raisethe awareness of emergency contraceptives so that it will help to reduce maternal morbidity and mortality rate.
Keywords: knowledge, emergency contraceptives, women, reproductive age
INTRODUCTION
prevalence rate is 48% in which there is no documentationof utilization of emergency contraception.
Every 90 second one women dies from complications duringpregnancy or childbirth 86% of them in sub-Saharan Africa or Unintended pregnancy poses a major challenge to the reproductive health of young adults in developing countries.
With decreasing age of menarche and early onset of sexual Among the worldwide maternal deaths, 99% occur in the activity; young people are exposed early to unplanned and developing countries. The majority (80%) of these deaths are unprotected sexual intercourse leading to unwanted preventable. Goal 5 of millennium development goals is to pregnancy and, subsequently, abortions.
improve maternal health. Ministry of health and population,Nepal has targeted to reduce maternal mortality ratio by three In Nepal, the ratio of chances of death of women caused by quarters between 1990 to 2015 i.e. 515 to 134 per 1000 live pregnancy or childbirth is 1:32 whereas in developed birth² . One of the way to reduce maternal mortality is avoiding countries it is only 1:1000². At present approximately unplanned pregnancy which can be controlled by appropriate 4000-6000 women die because of pregnancy and child birth². In Nepal, out of total pregnancy 40% are set to behigh risk pregnancy⁴.
According to annual health report ,2066/67 total fertility rateis 3.1 which is reduced to 2.5 by 2015³.In Nepal contraceptive Corresponding Author: Singh Sakun
Principal, Manipal College of Medical Sciences(Nursing program), Pokhara, Nepal.
Email address: [email protected]
Pinnacle Medicine & Medical Sciences Emergency contraception (EC), also known as post-coital in SPSS (Statistical Package for the Social Studies)version contraception or the morning after pill, refers to a group of birth 16. Chi-square test was applied to find out the association control modalities that, when used within defined time limits between knowledge and selected demo-graphic variables of after unprotected intercourse, can prevent an unwanted pregnancy⁵. Emergency Contraceptive Pills (ECPs) are effectiveand cost effective contraceptive methods that can be used after unprotected sexual intercourse, or a contraceptive methodfailure. When used within 72 hours of unprotected intercourse, Socio-demographic condition of respondents
ECPs can prevent 75 to 85% of un-expected pregnancies. Theeffectiveness of ECPs declines with time; however recent A total of 100 women aged 15-45 years were interviewed research has shown that ECPs are effective when taken up to for the study. The mean age of the respondents was found five days after unprotected intercourse.
to be 31.87 ± 9.606 years and the modal age group was 2024 years(24%). Majority of the respondents were Magar Emergency contraception (EC) was incorporated in the National which covered 34 % of total 100 samples followed by the Medical Standard (NMS) for Contraceptive Services and in Aryans and Gurung who were 26 and 17 respectively.
Clinical Protocols for Health Providers in Nepal in 2003. The Among all 89% of respondents were Hindu. Nearly one- Emergency contraception pill (ECP) was included in the fourth (22%)of respondents were illiterate and 88% of Comprehensive Family Planning Training Package (COFPTP) them were literate. 16% of them had informal education and available to paramedics, and in 2004 was registered by the 28% had secondary education. Almost three- fourth (73%) Department of Drug Authority (DDA) and introduced to the respondents were housewives. The majority (95%)of respondents were married . More than two-third(69%) ofthem lived in a nuclear family. The mean income of the Despite the fact that different modern contraceptives exist family of the respondents were found to be NPR 3,009.14± worldwide, the problem of unintended pregnancy still exists, which could be due to gaps in awareness, negative attitudestowards contraception, low accessibility or as a result of sexual Reproductive health status of respondents
assault. At times, the knowledge and practice might be therebut no contraceptive is 100% effective, and it is always very Among 95 married women mean age of marriage and mean vital to have EC as a backup method. In a study conducted by age of first pregnancy was found to be 18.83 and 19.88 years Gurung NS,Gupta SK, Hyas B to investigate the level of respectively. 69% of respondents reported that their last pregnancy was planned and 31% of them admitted that their Contraception in a rural female population of reproductive age last pregnancy was unplanned. Among 95 married women of Nepal⁷ it was found that 97% have some knowledge about 14% had a history of induced abortion. Regarding the use family planning; only 3% have no knowledge about Family of family planning methods 52% of the total 95 respondents Planning; 98% don't know about Emergency Contraception; were currently using methods of family planning . Among only 2% who have formal family planning training know about them 21% were using OCP, 22% were using depo-provera Emergency Contraception; 92% want to know about Emergency 5% were using IUCD and only 4% were using Norplant.
Knowledge regarding emergency contraceptives
Considering the importance of EC in preventing unintendedpregnancy, this study aimed to assess the knowledge of EC and Among 100 respondents 68% had got information about to further elucidate the relationship between these factors and emergency contraceptives . The most common source of socioeconomic and demographic characteristics among Tanahu information was radio which was 50% and the least District, Nepal. The findings from this research will be used to common source of information was books and magazines develop more focused behavior change strategies for programs which was only 7.4%. 38.3% had got information regarding that seek to improve maternal health and survival in Nepal.
EC by health workers. Among all 51 % of women knowsabout the purposes of emergency contraceptive devices. And MATERIAL AND METHOD
regarding the use of emergency contraceptive in varioussituations 36% women gave correct answer that it should A descriptive cross sectional study was conducted in Tanahu district, Nepal. All the ethical requirement were fulfilled beforedata collection. A pre-tested semi structured questionnaire was Almost two-third i.e 30% women answered that female used to assess knowledge of women regarding emergency partner should use emergency contraceptive to prevent contraceptives, which included questions regarding socio- fertilization after unprotected sex. 17% of women had demography, reproductive health and knowledge of emergency knowledge about unsafe period during the menstrual cycle.
contraceptives. Out of 49 Village Development Committee OneVDC was selected by Simple Random Sampling and further 38% of women had knowledge regarding emergency Convenence sampling was done for data collection among the contraceptive pill,but very few i.e only 5% women knew women of VDC. Total 100 women of reproductive age group about the use of IUCD as an emergency contraceptive device.
were included in the study and interview technique was used Almost one-fourth (24%)women knew regarding the correct to collect data. After the collection of data they were coded and timing for initiation of emergency contraceptive pills. None entered into Microsoft Excel and statistical analysis was done of the respondents knew about the commercially available How to Cite this Article: Singh Sakun, Shrestha Sandhya & Gurung Nirsuba "Knowledge Regarding Emergency Contraceptives among Women of Tanahu,
Nepal" Pinnacle Medicine & Medical Sciences , Volume 2014, Article ID pmms_111, 4 Pages, 2014.
form of ECP in Nepal. 40 % women gave correct answer Regarding the knowledge of women regarding common side effects of emergency contraceptives. More than half(54%)women knew about breast tenderness as side effects Almost one- fourth (22% )women answered that pregnancy of emergency contraceptive pills. Among the 100 women test shouldn't be done before use of emergency contraceptives.
who were interviewed three- fourth of them knew the Only 8% women answered correctly about the time for discomfort in early days of insertion as the side effects of initiation of IUCD for EC. And more than one -third of women IUCD ,almost half of them i.e 49% had knowledge of gave correct answer regarding mechanism of action of IUCD.
menstrual spotting as side effects of IUCD.
Table 1: Characteristics of Knowledge Score of Respondents
Total obtainable score
Minimum score
Maximum score
Mean± SD
Mean -1.96SD to Mean +1.96SD
Note: There were total 17 questions and total score was 29.
Table 2: Knowledge Score of the Respondents
Knowledge score
Frequency
Percentage
Table 3: Association of women's knowledge with selected socio-demographic variables
Knowledge
Variables
Category
Age of mother
Ethnicity
Religion
Education
Occupation
Marital status
Per capita income
Family type
How to Cite this Article: Singh Sakun, Shrestha Sandhya & Gurung Nirsuba "Knowledge Regarding Emergency Contraceptives among Women of Tanahu,
Nepal" Pinnacle Medicine & Medical Sciences , Volume 2014, Article ID pmms_111, 4 Pages, 2014.
Pinnacle Medicine & Medical Sciences Chi-square test is applied ,the test shows that age of women Jamieson MA, Hertweck SP, Sanfilippo JS. (1999)Emergency and educational level of women was associated significantly contraception: lack of awareness among patients presenting with the knowledge of mothers at 5% significance(p< 0.05).
Management of Emergencies in family planning services in DISCUSSION
NC Chavuma DO Chanda B Vwalika (2010);Emergency Each year there are about 250 Million pregnancies globally and contraceptives among women with abortion at University one third of these are unintended and 20% of these undergo Teaching Hospital, Lusaka, Zambia; Medical journal of induced  abortion⁹.  In  Low  income  countries,  more  that  one third of the 182 million pregnancies is unintended; the fate of Park K.( 2011)Park’s textbook of Preventive and Social 19%  will  be  induced  abortion  and  11%  of  this  is  unsafe⁸.
Medicine. 21st edition Jabalpur. Banarasidas Bhanot.:463 Knowledge of Emergency Contraception is crucial, since women Robert AH, Felicia G, Felicia S, James T, Erica T.
must know they can prevent pregnancy after intercourse in (1983)Contraceptive Technology. In:Robert AH editor,Contraceptive technology & family planning. 12th Ed.; 98-100.
order to seek out treatment, while rates of unwanted pregnancy Ramesh Adhikari. (2009)Factors affecting awareness of very in different countries and population group, the need for emergency contraception among college students in Emergency contraception in critical worldwide.
Kathmandu, Nepal. BMC Women's Health, 9:27.
10. WHO. Maternal mortality in (2005): estimates developed by This study shows that 46% of the respondents obtained <27.58% (poor)of knowledge score. Among total respondent, 53% had average knowledge i.e. they had knowledge score 11. WHO and Gutmacher Institute(2005): Facts on induced between 27.58-58.62%. only 1% of the respondents had knowledge above 58.62%(good). In a similar study conducted in Karachi by F. Irfan et al it was revealed that 88% ofrespondents were not aware of emergency contraceptives⁹.
In an another study conducted by NS Gurung et al in Gorkhadistrict ,Nepal to assess knowledge of family planning andemergency  contraceptives  in  rural  female  population⁷  it  wasfound that 97% of respondents had some knowledge aboutfamily planning. 98%of total respondents don't know aboutemergency contraceptives. In a similar study done by Adhikariit was revealed that awareness of emergency contraceptives islow  among  the  college  students  of  Nepal¹⁰.  Only  about  two‐thirds of college students (68%) had ever heard about EC.
In our study the knowledge of respondents was significantlyassociated with the age and the educational level of therespondents which is supported by the result of a similar studydone in Zambia¹¹ in which level of education was significantlyassociated with the knowledge of women regarding emergencycontraceptives.
CONCLUSION
The knowledge regarding emergency contraceptives is pooramong the women of Tahanu district, Nepal. Radio and healthworkers are the most common source of information. Variousawareness programs should be organized by governmental andnon-governmental organization to raise the awareness ofemergency contraceptives.
REFERENCE
Department of Health Services, Management Division Nepal (2009/2010).Annual report. Department of Health services.
Ministry of health.
Gurung NS, Gupta SK, Hays B(2009)Knowledge of family planningand emergency contraceptives in a rural female population;Journal of GMC-Nepal; Vol 2,Issue 3,p.45-50 I Farhana et al(2009) knowledge of emergency contraceptivesamong women of childbearing age at a teaching hospital ofKarachi Journal of Pakistan medical association Volume. 59, AprilP:236-240 How to Cite this Article: Singh Sakun, Shrestha Sandhya & Gurung Nirsuba "Knowledge Regarding Emergency Contraceptives among Women of Tanahu,
Nepal" Pinnacle Medicine & Medical Sciences , Volume 2014, Article ID pmms_111, 4 Pages, 2014.

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