Abstract

Birth control or Contraceptives are measures put in place to prevent the occurrence of pregnancy despite regular sexual intercourse with a man. The options if birth control ranges between natural and modern. Natural method includes methods such as Calendar method, Observation of cervical mucus, Coitus interrupts, Temperature method and lactation amenorrhea method.

Modern method on the other hand is divided into Barrier method, Hormonal method and surgical method. Birth control has advantages such as prevention of pregnancy, helps in preventing the transmission of STIs (condoms) and regulation of an irregular menstrual cycle (pills). It equally has disadvantages such as continuous spotted bleeding in between period, heavy menstrual flow, delay in the return of menses and pain/discomfort upon insertion (implants). Factors such as traditional beliefs, religious beliefs, stigmatization and ignorance on birth control can hinder the practice of birth control.

Through proper and continuous education and availability of the different birth control methods, these barriers can be taken care of as awareness will be created and its practice enhanced. This research was conducted in Mutengene Health Area in the Tiko health district, with 20 quarters and 6 out of the 20 selected for the study using a clustered sampling method. 381 female youth employed into the study by a convenient sampling method.

The findings from this research show that majority of the female in Mutengene health area (88.2%) have knowledge on contraceptives but only (53.8%) of them practice contraceptives. One can then conclude that these female youth have some ideas about birth control but the facts are not known. So, education remains the key solution.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Birth control method are well documented in ancient Egypt. The Ebers Papyrus from 1550BC and the Kahun Papyrus from 1850BC have within them some of the earliest documented descriptions of birth control, the use of honey, acacia leaves and lint to be place in the vagina to block sperm. Another early document explicit referring to birth control methods is the Kahun Gynecological Papyrus from about 1850 BC.

It describes various contraceptive pessaries, including acacia gum, which recent research has confirmed and is still used in contraceptive.  Other birth control methods mentioned in the papyrus include the application of gummy substances to cover the “mouth of the womb” (that is the cervix), a mixture of honey and sodium carbonate applied to the inside of the vagina, and a pessary made from dung. Lactation (breast-feeding) of up to three years was also used for birth control purposes in ancient Egypt. (Richard G, et al, 2005) withdrawal, or coitus interruptus, was also a method of contraception.

Birth control also known as fertility control or contraceptive are methods or devices used in preventing pregnancy (According to Collins English Dictionary). It forms an integral part of maternal and child health. It is a concept many couples or single mothers use in preventing pregnancy. It can also be used in preventing pregnancy before marriage or for educational purpose until life’s goal are attained (MedlinePlus, 28 December 2021).

The act of contraceptives began centuries ago as early as1850BC by the use of primitive ways like herbs to prevent pregnancy until WHO saw the need to integrate it into the activities of maternal and child health (Sophia Yen, 2022). Today, we can talk of family planning as not only a family issue but a national or international issue because its practice affects WHO statistics either negatively or positively: negatively in that failure to practice or poor application can lead to consequences such as maternal and infant morbidity and mortality, increased child delinquency, etc. On the other hand, correct practice may go a long way to reduce infant morbidity and mortality, and decreased child delinquency, etc. (Dr Jean Wong, 2nd March 2021).

Despite the global acceptance of birth control method, some people still reject its practice due to religious for example the catholic who look at its an act of disobedience to God command ,some for cultural reasons especially in cultures where children are regarded as an increase in work force and for defiance and also a sign of sexual strength. That notwithstanding, birth control still remains an acceptable global concern and is a tool use in checking an increase in world`s population according to Malthus who says the population is increasing in a geometric rate while food supply is increasing in an arithmetic rate (Malthus 1826).

Imogene King’s Interaction System Framework and Theory of Goal Attainment

This theory focuses on three levels of dynamic interaction systems in which an individual exist which are the personal system (individual), interpersonal system (group) and the social system (society). The investigator chose this theory because the effective implementation of birth control method(s) depends on the individual, group and society at large.

It depends on individual in the sense that looking at the society, most of the women especially the young commit abortion due to body image especially the unmarried; what the pregnancy is going to do to their shape, the desire to remain young and the perception of aging due to pregnancy and the thought that it’s not yet time for procreation. It depends on group in that people tend to value their relationship with peer, fear of rejection and/or avoidance by friends and the limitation of interactions among peers so they decide to abort the unwanted pregnancy. It depends on society because of issues like rejection by society and stigmatization, exclusion from religious groups as a result of pregnancy from wedlock, disruption in education, etc. (King 1981 and Sieloff, 2006)

If all these three systems are targeted and proper education given, their understanding of birth control and practice enhanced, it may go a long way to limit this malpractice of abortion due to unwanted pregnancy and its numerous consequences, limiting maternal morbidity and mortality.

According to King 1981 and Sieloff, 2006, if an understanding of the social system including the authority, decision makers, organization (such as churches), powers and status is made through proper assessment, and proper education given, it may go a long way to intergrate the practice of birth control by individuals, groups and the society at large as some of the things that prevent its practice will be ascertain and taken care of (King 1981 and Sieloff, 2006).

It is assumed that a person with proper knowledge on the importance of something, the advantages and disadvantages of the thing in question, that person will stand a better chance of making the right decisions on the subject matter than when the knowledge is absent. Hence assessing the knowledge of these mothers will directly or indirectly enhance its practice by individuals, groups and society at large.

In this aspect, the effectiveness of nursing care will be measured in terms of patient’s behavior (King 1989, page 156), so a positive or negative change in patient’s behavior will determine the level of goal attainment.

According to a study conducted by Philip Nana Njotang and co in Yaoundé, the center region of Cameroon, as of November 2014 to April 2015, it was reviled that there is generally a low practice of contraceptive despite the much effort put in by the government. From their study, it shows that the continuous increase in maternal mortality has a link with the implementation of birth control.

In their study, it was discovered that some women do not practice birth control due to religious reasons, some (singles) because parent never approve of it, some because their spouse never approved of it and still others due to lack of knowledge. It was concluded in this study that if the knowledge of the population on contraceptive can be increased, there will likely be an increase in its practice which may lead to a reduction in maternal mortality (Philip Nana Njotang et al, 2015).

According to another study conducted by Dickson Shey and co in the Cameroon Development Corporation camps in the South West Region of Cameroon as of 2021, it was proven that the use of contraceptives has a significant positive impact in the reduction of maternal mortality of these population (in Tiko and Pendamboko precisely). Equally, it was also reviled by DicksonShey and co after their study that the practice of birth control methods was very low in their area of study giving the impression that the high maternal morbidity and mortality was linked to this poor practice of contraceptives. (Dickson Shey et al, February 2021)

Mutengene health area may also have a direct link with the usage of contraceptive and the prevalence of maternal morbidity and mortality. This gives more reasons to indulge in this research so as to ascertain its cause. Following this revelation and the situation in Mutengene health area, it is possible that assessing the knowledge and practice of birth control in this health area can equally create a positive impact in the lives of the women here.

In the subsequent analysis, this study will be highlighting facts based on the findings of other researchers in the country. This information is collected and deemed necessary to back up the bases of this current study. To begin with, in the study of Philip Nana Njotang and co in Yaounde Cameroon, it was discovered that poor or no practice of birth control is cause by factors such as religious beliefs, unwillingness of spouse, poor knowledge on contraceptives, etc. This poor practice has a very negative impact in the maternal morbidity and mortality and an enhancement in its practice (Philip Nana et al, 2015)

Another related study carried by Dickson Shey and co in the CDC camps in the south west region of Cameroon equally shows that poor practice of contraceptive especially among women of low socioeconomic status is linked to poor knowledge on contraceptives, religious beliefs, traditional beliefs, refusal of spouse, etc (Dickson Shey et al, February 2021).

It is then with high optimism that the rise in maternal mortality in this health area should have a link with the knowledge and practice of birth control. By assessing the knowledge and practice of birth control in this health area, it will be possible to come with some (if not all) of the hindrances to the practice of birth control in the population.

The researcher is highly optimistic that if these barriers to the practice of contraceptive are carefully and well addressed, there will be a positive impact in the maternal morbidity and mortality in this health area as people (men and women, married and single, low and high socioeconomic status, rich and poor) will be able to make informed decisions and take responsible actions toward their sexual lives that will positively influence their health, the health of the group to which they belong and the health of the community at large.

1.2 Problem Statement

The rate of criminal abortion has become very rampant in the society today (25% in Cameroon) (DHS 2012). Something that was regarded as a tabor to be mentioned is gradually becoming a normal thing nowadays.

Despite that the government of Cameroon has added birth control method as part of the minimum package of health in all primary health care (DHS 2O12), criminal abortion is still rampart.

A critical look at the situation reveals during my internship at regional pacis hospital where one girl was rush to the hospital for committing a criminal abortion. For her it was normal since she did not see her menses the last month of which she flows for two weeks heavily which is very abnormal. Before rushing with her to the hospital she had already lost a lot of blood due to the bleeding and with all the effort from health personnel’s she still dies. Despite all the effort put in place by health personnel’s and the government the rate of criminal abortion still increases which has push me to ask this question.

1.3 Research Questions

1. Do these women know about birth control methods or contraceptives at all?
2. If they know, are they practicing it?
3. If they are not practicing what could be the possible reasons for not practicing? Assessing their knowledge and practice of contraceptives may go a long way to prevent unwanted pregnancies and limit criminal abortion.

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