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THE KNOWLEDGE AND PRACTICE OF CONTRACEPTION AMONG MALE ADOLESCENTS
Abstract:
This research aims to explore the knowledge and practice of contraception among male adolescents, recognizing the significance of their involvement in reproductive health decision-making. The study will employ a mixed-methods approach, utilizing surveys and in-depth interviews to gather comprehensive data. Key objectives include assessing the level of awareness among male adolescents regarding various contraceptive methods, exploring their attitudes towards contraception, and investigating the factors influencing their contraceptive choices and practices. The findings from this study are expected to contribute valuable insights to public health initiatives, educational programs, and policy development aimed at promoting responsible sexual behavior, reducing unintended pregnancies, and fostering the overall reproductive health and well-being of male adolescents.
CHAPTER ONE:
INTRODUCTION
- Background of the Study
The Oxford Advanced Learners’ Dictionary of Current English defines “Contraceptives as a drug, device of practice used to prevent a woman becoming pregnant.”1 This definition though well embracing but does not include its utilization as a preventive measure against the spread of sexually transmitted diseases; such as AIDS/HIV. The act of contraception has been an old practice even from our forefathers who designed the timing of mating with their wives or not depending on whether they want to make babies. They have a mental picture of when the monthly menstrual flow of their wives takes place or how long their wives have to breast feed their babies to avoid unwanted pregnancies. Some traditional women even go through the extra-mile of wearing contraceptive bands on their waist to prevent unwanted pregnancies.
Each year, women around the world experience 75 million unwanted pregnancies. Unwanted pregnancy can occur for two main reasons; either the couple was not using contraceptives, or the method they were using failed. There are many reasons why people do not use contraceptives to prevent unwanted pregnancy, including lack of access to family planning information and services; incest or rape; personal or religious beliefs; inadequate knowledge about the risks of pregnancy following unprotected sexual relations; and women’s limited decision-making ability with regard to sexual relations and contraceptive use.2 Many women are deprived of family planning services.
The use of contraceptives by both males and females has been accepted and widely practiced in the developed world. This has not been the case in the developing world where the male chauvinistic cultural belief that women should protect themselves from unwanted pregnancies; instead of the men also making it possible to use contraceptives. The act of child bearing is the combined effort of both males and females, but in the developing world; it is seen as a primary function of the female gender. This is the reason why the usage of contraceptives among men in these areas has not been encouraged as the female contraceptives. The patriarchal nature of the African society does not seem to help or encourage male contraception rather it makes men to believe that they do not have any role to play in reproductive health.
In the developed world, the populace has overgrown the persistent myths and negative attitude of men towards contraception. However, the fact that male contraception in the underdeveloped countries has not been encouraged has led to the paucity of information about it and also reduced the quest for knowledge in this area. Studies show that men want access to better contraceptives. In a recent study of British men, 80% placed a hypothetical male pill as one of their top three contraceptive choices (Brooks, 1988)3. Another study found that over 60% of men in Germany, Spain, Brazil and Mexico were willing to use a new method of male contraception (Heinemaan, 2006).4 In another study on “why Nigeria adolescent seek abortion rather than contraception: Evidence from focus group discussions” where youths were asked about contraceptive availability, perceived advantages of method used, side effects and young people’s reasons for using or not using contraceptives? It was found that the fear of future infertility was an overriding factor in adolescent decisions to rely on induced abortion rather than contraception.5
Methods of Contraception – are more in the female gender than the male.
Those of the female include:
The Combined Pill: These are oral contraceptives which are eniphasic and biphasic pills, Everyday /Ed pills. They are 99% effective when properly taken. They contain two hormones – estrogen and progistogen, and acts by preventing ovulation when taken regularly.
Mini Pill: Progestogen pill only. Its 98% effective when taken properly and regularly any day at the same time. It causes changes in the womb which makes it difficult for the sperm to enter the womb.
Injectable Contraceptives: They include Depo-provera and Noristerat. Its effective to 99% of cases. It also stops ovulation by acting in a similar way to the mini pill. It provides protection for up to 3 months longer. It may cause irregularity in her periods and break through bleeding.
Intra Uterine Device: Its 96 – 99% effective. It’s a plastic device or with copper inserted into the womb by the doctor and it prevents the ovum or egg from settling in the womb.
Diaphragm or Cap: Its 85-97% effective with careful use. It is a soft rubber device put into the vagina before intercourse, to cover the cervix, and form a barrier which prevents sperm from meeting the egg. It must be used with a spermicide and left in place for six hours after intercourse.
Sponge: It is 75 – 91% effective, with careful use. It’s a soft circular polyenthrane foam sponge, put into the vagina up to 24 hours before intercourse, to cover the cervix. It already contains a spermicide.
Female Sterilization: It’s a permanent method of birth control in which the fallopian tubes are closed so that the egg cannot travel down than to meet the sperm. Its effective for life but has occasional failure rate of 1:300 where the tube rejion and fertility returns.
Natural Methods (‘Safe Period’ ‘Rhythm method’). Its 85 – 95% effective. It aims to predict ovulation when the woman is most fertile intercourse is avoided at this time. This symptom-thermal method requires daily recording of body temperature, noting changes in vaginal nuclear and other signs of ovulation.
The male contraceptive measures include:
a. Condom: It is effective in 85 – 98% of cases with careful use. Its made up of a thin rubber and worn on an erect penis. It prevents sperm from entering the woman. It protects both partners against sexually transmitted diseases and also protects the woman against cancer of the cervix.
b. Male Sterilization (Vasectomy): It’s a permanent method which involves the cutting or blocking of the tubes that carry sperm from the testes (vas deferens) to the penis. It is a permanent method of contraception like the tubal ligation in females. Another method of contraception needs to be used for about 3 months after vasectomy so as to clear the whole sperm from the tube. Occasional failure of this method occurs in 1:100 cases.
c. Withdrawal Method: This method is usually not effective but its practiced by some own. They withdraw the penis before ejaculation takes place during orgasm. Its not effective because it does not take care of sperm which are passed into the vagina before orgasm takes place.
Emergency Contraception: This is method of preventing pregnancy after having unprotected sexual intercourse or if you had a contraceptive accident or misuse (such as condom breakage, failed coitus interruptus) and in case of rape. There are two common methods which can be used in emergency contraception:
a. Emergency contraceptive pills (ECPs)
b. Copper intra-uterine device (IUDs).
These two methods must be used within few days of unprotected sexual intercourse. They are safe for most women. The ECPs contain the same hormones used in family planning pills but are used differently. They either stop the release of the egg or prevent fertilization of an egg. The IUDs immobilize sperms, slow down sperm movement, prevent fertilization of the egg and cause changes in the uterine lining which prevent pregnancy.
The reproductive health of adolescents is a critical aspect of public health, and comprehensive understanding and utilization of contraception play a pivotal role in shaping the well-being of this demographic group. While extensive research has focused on female adolescents’ knowledge and practices regarding contraception, there is a notable gap in understanding the knowledge and practices of contraception among male adolescents. As adolescents transition through a period of physical, emotional, and social development, their awareness and utilization of contraception become crucial in preventing unintended pregnancies, reducing the risk of sexually transmitted infections (STIs), and promoting responsible sexual behavior.
Adolescence marks a crucial phase in the life course characterized by rapid physical, emotional, and social development. During this transformative period, adolescents encounter various challenges, including navigating their evolving sexuality. Reproductive health is a vital component of adolescents’ well-being, and understanding their knowledge and practices regarding contraception is essential for addressing the complexities associated with sexual health.
While the discourse on contraception often centers around females, the role of male adolescents in reproductive health decisions and practices remains underexplored. The prevailing emphasis on female contraception has inadvertently marginalized the significance of involving male adolescents in discussions about family planning and responsible sexual behavior. As such, there is a growing need to examine the knowledge and practices of contraception among male adolescents, recognizing their agency and the potential impact on their reproductive health outcomes.
Adolescents globally face challenges related to early and unintended pregnancies, sexually transmitted infections (STIs), and insufficient access to comprehensive sexual education. Efforts to address these issues have traditionally focused on females, but there is an emerging recognition that male adolescents’ awareness and involvement in contraception are pivotal for fostering responsible sexual behavior and preventing adverse reproductive health outcomes.
The dynamic nature of contemporary societies, coupled with evolving gender norms and expectations, necessitates a more inclusive approach to reproductive health discussions. Male adolescents, like their female counterparts, should be equipped with the knowledge and skills to make informed decisions about contraception, contributing to a shared responsibility in family planning and sexual health.
The rationale for this study lies in the acknowledgment of the unique perspectives and experiences of male adolescents in the realm of reproductive health. By delving into their knowledge and practices of contraception, we aim to uncover the factors that shape their attitudes, decisions, and behaviors in this crucial aspect of their lives. This research is driven by the belief that understanding the dynamics of male adolescents’ engagement with contraception is vital for designing effective sexual education programs, interventions, and policies that promote a holistic and inclusive approach to reproductive health.
1.2 Statement of the problem
The importance of male adolescents’ involvement in reproductive health discussions and decision-making processes is increasingly recognized. Understanding their knowledge and practices related to contraception is essential for tailoring effective sexual education programs, developing targeted interventions, and creating policies that address the unique needs of this demographic group. The study aims to shed light on the factors influencing the contraceptive behavior of male adolescents, contributing to a more comprehensive and gender-inclusive approach to reproductive health promotion.
1.3 Objectives of the Research
The primary objectives of this research are:
To assess the level of knowledge among male adolescents regarding various contraceptive methods.
To explore the attitudes of male adolescents towards contraception.
To investigate the factors influencing the contraceptive choices and practices of male adolescents.
To identify barriers and facilitators affecting the utilization of contraception among male adolescents.
To provide insights for the development of targeted interventions and educational programs to enhance the reproductive health of male adolescents.
1.4 Significance of the Study
This study holds significant implications for public health, education, and policy development. Understanding the knowledge and practices of contraception among male adolescents can inform the design of educational programs that address specific gaps in awareness and encourage responsible sexual behavior. Additionally, the findings can contribute to the development of policies that promote gender equality in reproductive health decisions and reduce the rates of unintended pregnancies and STIs among adolescents.
1.5 Scope and Limitations
The study will focus on male adolescents aged 15 to 19 years, recognizing this age range as a critical period in the development of sexual and reproductive health behaviors. The research will be conducted in [Specify the geographic area] to provide context-specific insights. However, limitations may include the potential for social desirability bias in self-reported data, and the generalizability of findings to different cultural contexts.
1.6 Research Questions
To guide the investigation, the research will address the following questions:
What is the level of knowledge among male adolescents regarding various contraceptive methods?
What are the attitudes of male adolescents towards contraception?
What factors influence the contraceptive choices and practices of male adolescents?
What are the barriers and facilitators affecting the utilization of contraception among male adolescents?
1.7 Conceptual Framework
The conceptual framework for this study integrates individual, interpersonal, and societal factors influencing the knowledge and practices of contraception among male adolescents. It considers elements such as educational background, cultural influences, peer relationships, and access to reproductive health information.
1.8 Research Methodology
A mixed-methods approach will be employed, combining quantitative surveys and qualitative in-depth interviews. Surveys will provide quantitative data on knowledge and practices, while interviews will offer a deeper understanding of the factors influencing contraceptive behavior among male adolescents.
In subsequent chapters, this study will delve into the findings and analysis, providing insights into the knowledge and practices of contraception among male adolescents, and offering recommendations for educational and policy interventions.
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