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Assessment of level of knowledge and utilization of emergency contraception among female students of Hawassa University, south Ethiopia

Introduction: Emergency contraception is used as an emergency procedure to prevent unintended pregnancy secondary to an unprotected se xual intercourse and method failure. Hence, this study assessed the level of knowledge and utilization of emergency contraception among undergraduate regular female students of Hawassa University, south Ethiopia. Methods: An institution-based cross-sectional survey was conducted among female students of Hawassa University in December 2012. Seven hundred seventy six of the students were sampled by using multistage sampling technique. Pretested structured questionnaire was used to collect the data. Results: The majority 719 (92.7%) of female university students ever had sexual intercourse and 17 (2.2%) experienced forced sex. Eight (47%) of these 17 students experienced unintended pregnancy all of which resulted in an induced abortion. Three hundred seventy nine (72.2%) of the respondents had knowledge about emergency contraceptives and only 41 (10.8%) of them had ever used emergency contraceptives;oral contraceptive pills were the most widely used form of all emergency contraceptives 41 (10.8%). Age, marital status and age at menarche were associated with knowledge of emergency contraception;moreover, residence, year of study and experience of forced sex were found to be predictors of emergency contraception utilization. Conclusion: Female university students had been experiencing high rate of unintended sexual practice and pregnancy, low knowledge level and utilization of emergency contraceptives;moreover, they had no youth-friendly access to the services. Therefore, there is a need for collaborated effort to improve service access and scale up their utilization level to prevent unwanted pregnancy.

Use of Emergency Contraception could Halve Induced Abortion Ratein Shanghai, China

Objective To investigate and estimate the proportion of the induced abortion that could have been prevented by using emergency contraception in Shanghai Method Structured interviews were conducted in 606 women (413 married and 193 unmarried) aged 18-49 years, who were attending three health care centers in Shang- hai for termination of first trimester pregnancy. Results A total of 98.2% of the pregnancies were unwanted, and 63.7% of the women recognized that they were at risk of pregnancy soon after the intercourse. It is estimated that 52.2% of the induced abortion could have been prevented if the women had used levonorgestrel-only emergency contraception. Only 28.5% of the respondents were aware of emergency contraception. The most important sources of information about emergency contraception identified by respondents were books/newspapers/periodicals (38.2%), and relatives/friends (30.6%). Family planning health education on emergency contraception was noted by 28.9% of married women but only by 5.8% of unmarried women. A portion of 85.5% of all respondents reported they would be willing to use emergency contraception when needed. Those more willing to use emergency con- traception included younger, better educated, and unmarried women experiencing their first pregnancy. Women preferred drugstores (60.1%) than hospitals (30.2%) for obtaining emergency contraception. Conclusion Women’s needs for emergency contraception were enormous. Promotion of emergency contraception by providing information and improving service could have a substantial impact on reducing the rate of induced abortion in Shanghai.

Mifepristone in Combination with Misoprostol vs. Low Dose Mifepristone Alone in Emergency Contraception: a Multi-center Double-blind Randomized Clinical Trial

To compare the effectiveness and side effects of various low dose of Mifepristone in combination with Misoprostol and low doses Mifepristone alone in emergency contraception Materials & Methods This is a multi center double blind randomized controlled clinical trial. A total of 899 healthy women were allocated into this study and were randomly divided into 3 groups. They were orally administrated with different emergency contraceptives with 120 h after unprotected intercourse. Group I (n=300) was given 25 mg Mifepristone plus 0.2 mg Misoprostol after 24 h. Group II (n=299) was given 10 mg Mifepristone plus 0.2 mg Misoprostol after 24 h. Group III (n=300) was administrated with 10 mg Mifepristone alone. The effective rates in different groups were calculated with Dixon method. Results Altogether 11 pregnancies occurred, among which 2 cases were in Group I, 2 cases in Group II, and 7 cases were in Group III. After correction with method failure, there was only one case in Group I, 0 case in Group II, and 5 cases in Group III. The contraceptive effectiveness in these groups was 95.5%, 100% and 76.9% respectively. The pregnancy rate was significantly lower in Group I and Group II than that of Group III (P<0.01). The side effects were slight and tolerable, and there was no significant difference between different groups (P>0.05). Conclusion Use of low dose Mifepristone (25 mg or 10 mg) in combination with 0.2 mg Misoprostol was an effective, low side effects and safe treatment regimen for emergency contraception.

Investigation on Knowledge of and Attitude to Emergency Contraception among Induced-Abortion Women

Based on the data from the survey of 6O6 women who went to three MCHs ofShanghai for induced abortion, women's knowledge of and attitude to emergency con-traception (EC) were analyzed. The results showed that 28.5% of the subjects wereaware of EC. Among them, 97 1% were aware of emergency pill. The main re-sources of their knowledge were from books, newspapers, magazines and relatives orfriends. Women's exact knowledge of EC was insuffcient. The younger, well-edu-cated women were more likely to be aware of EC. 85.5% of the subjects were willingto use EC when needed. Women who had knowledge EC and were in the first preg-nancy were more willing to use this method. Most women prefrred to use emergencypill and thought drug store was the most appropriate place in which to acquire it. Theresult implied that, in order to decrease the rate of induced abortion, it is urgent tocommunicate EC to the public and to produce emergency pills to be accessible for use.

Analysis on the Emergency Contraception Knowledge Level and Its Influencing Factors among Abortion Patients in Shanghai City

To evaluate the knowledge level of emergency contraception, explore the determinants of the knowledge level among women seeking abortion and give sugges- tions on how to improve the quality of emergency contraception service. Method A total of 606 women requiring abortion at three MCHs in Shanghai City were interviewed face to face with structured questionnaire. Results 63. 7% of unwanted pregnancy could use EC to prevent. Subjects got their knowledge on EC mainly from books/newspapers/magazines and relatives/friends/ parents. The proportion of the awareness of EC was 28.5%. Most subjects were aware of hormonal EC pill, but only 14.9% of them knew that the pill should be taken within 72 hours after the intercourse. Among the subjects who were aware of EC, the average score of the knowledge was lower than half of the full marks. The lower the subject's educational level was, the less likely they were aware of EC and the lower score of the knowledge of EC they had. The score of the knowledge of EC was higher among subjects who learned of EC mainly from family planning publicity. Conclusion It is urgent to popularize EC in order to reduce unwanted pregnancy and induced abortion. The information, including EC can be used in which situations, it's advantages and disadvantages as well as indication, should be given to women in an appropriate way and using plain language. The departments of family planning should play a leading role in improving women's knowledge of EC.

Use of Male Condoms among Adolescents with Free Access at Emergency Contraception—Study among Students from the Public Education System of the Sao Paulo, Brazil

The research conducted in public schools in Sao Paulo city, Brazil, studied the awareness and use of emergency contraception (EC) and its possible implications on the condoms use. Among the 4929 students, 55.6% had already had sex, 19.5% had got pregnant and 7.3% had had abortions. Condoms were used by 88.6% and were options for those who did not have a steady relationship. The EC was used by 30.3% after a faulty condom usage, and by the older ones, with a steady partner. It is needed to be given contraceptive alternatives to reduce the risk and provide access to other contraceptives.

Knowledge and Utilisation of Emergency Contraception Pills among Female Undergraduate Students at the University of Nairobi, Kenya

Background: Emergency Contraception (EC) is used after unprotected sexual intercourse, following sexual abuse, misuse of regular contraception or non-use of contraception. Seventeen percent of pregnancies in Kenya are unintended, potentially leading to unsafe abortion that contributes to the high maternal mortality rate in Country. According to 2016 Kenya Demographic and Health Survey (KDHS), the maternal mortality ratio was 362 maternal deaths per 100,000 live births. Female students in University or College are vulnerable to unplanned pregnancies and illegal abortions resulting in mortality, morbidity and psychosocial problems. Knowledge on EC is very important for students as they are not in stable relationships and not using regular contraception. Therefore, the aim of this study was to determine the knowledge and use of Emergency Contraception among female undergraduate students in the University of Nairobi. Materials and Methods: We used an institution-based cross sectional, quantitative study to sample was employed among 383 female undergraduate students at the University of Nairobi. The University of Nairobi has six colleges and systematic random sampling was used to select study participants from each college. Data were collected using self-administered questionnaires and analysed using SPSS Version 16. Bivariate analysis and logistic regression were used to determine sample characteristics significantly associated with knowledge and utilisation of Emergency Contraception. Results: Most (53%) of the respondents were sexually active, and only 20% of the sexually active female students had ever used Emergency Contraception. Emergency Contraception awareness was high at 86.4%. However, based on a predefined criterion, accurate knowledge of Emergency Contraception was low at 42.6%.The majority (82.5%) of the respondents depended on mass media as a source of information on Emergency Contraception. Factors associated with Emergency Contraception knowledge on bivariate analysis were: age 20 years and above (p = 0.001), enrolment in college of health science (p = 0.001), being in year three of study and above (p = 0.0001) and having an insurance cover (p = 0.021). Ever use of Emergency Contraception was associated with enrolment in the College of health science (p = 0.025) and age 20 years and above (p = 0.050). In multivariate analysis, older age (Aor 1.885 p = 0.003) as well as being in the College of health science (Aor 0.001) were significantly associated with increased probability of being knowledgeable about Emergency Contraception. Conclusion: Although University of Nairobi female undergraduate students are aware of the existence of Emergency Contraception, their specific knowledge on correct timing of taking EC after unprotected sex and on effectiveness is poor. EC use is also low, compounded by underutilisation of public facilities as a source of the EC and underutilisation of health workers as a source of EC information. Therefore, an educative forum may be needed to improve the knowledge of EC among University of Nairobi female students. Health education on the availability of EC in public facilities needs to be addressed. Possible use of informal sources of information such as peer education could be an area to explore in client education on EC knowledge and use. Further research is recommended to establish factors that influence utilisation of public health workers as a source of EC information.

Emergency contraception:What is new?

Unintended pregnancy rates remain high throughout the World and increase the risk of poor maternal and infant outcomes.Most of unintended pregnancies occur in women who were not using contraceptionor who became pregnant despite the reported use of contraception.Women who have had recent unprotected intercourse including those who have had another form of contraception fail are potential candidates for this intervention.Currently used em-ergency contraceptive methods are pills that contain combined estrogen-progesterone,only progestin,antiprogestins and copper intrauterine devices.The most common form of this type of contraception is oral progestin-only pills(levonorgestrel).The most effective method is copper intrauterine devices followed by anti-progestins and oral progestin-only pills.The major pathogenesis of oral emergency contraceptives is the prevention or delay of ovulation.Although conception is possible on only a few days of the cycle,emergency contraception is offered when indicated without regard to the timing of the menstrual cycle because of uncertainty in the timing of the ovulation.Levonorgestrel and E/P regimes are most effective as soon as possible after unprotected sexual intercourse.A linear relationship has been shown between ef-fectiveness and the time of dose.The effectiveness continues for 120 h,but it is recommended to be used within 72 h after intercourse.Intrauterine devices may prevent pregnancy when 5 d after ovulation.

Call to Improve Women’s Awareness Regarding Emergency Contraception in Arab Societies

Birth spacing means allowing three years or more between two children or two pregnancies.Globally,contraceptive prevalence among married women has increased from 30 percent in the early 1960s to 58 percent in 1998.In ISLAM,the Quran had clearly Indicated the proper time span which should elapse between the birth of one child and the next.The carrying of the child(pregnancy)to Fissal is(weaning)a period of thirty months.

Determinants of emergency contraceptive pill use in Bangladesh: An analysis of national survey data

Objective:To examine the determinants of emergency contraceptive pill use in Bangladesh.Methods:Data for this cross-sectional study came from 2017-2018 Bangladesh Demographic and Health Survey.Characteristics of 906 reproductive age women who were potential candidates for using emergency contraceptive pill were analysed in this study.Data were analysed using univariate and multivariate analyses.Stepwise binary logistic regression was employed as multivariate analysis.Results:Only 10.9%candidates were found to ever use emergency contraceptive pill.The odds of using emergency contraceptive pill for women visited by family planning field worker was significantly higher than that for those who were not visited by family planning field worker[odds ratio(OR)1.94;95%confidence interval(CI)1.19–3.17;P=0.008],while the odds of using emergency contraceptive pill for women with high socioeconomic status was higher than that for those with low socioeconomic status(OR 3.10;95%CI 1.61–5.97;P=0.001).Additionally,having some media access was linked to an increase in the odds of using emergency contraceptive pill(OR 3.01;95%CI 1.33–6.83;P=0.008).Women empowerment related factors did not show any significant effect on emergency contraceptive pill use.Conclusions:The findings indicate that family planning programme has a great opportunity of playing an important role in increasing emergency contraceptive pill use in Bangladesh by increasing the knowledge and awareness of women about emergency contraceptive pill.

Sexuality and Emergency Contraceptive Practice among Female Undergraduates in Lagos, Nigeria

Background: Young people, especially those in tertiary institutions are vulnerable to unplanned and unprotected sexual intercourse which predisposes them to unintended pregnancies and subsequently unsafe abortions. One of the key interventions for reduction of unwanted pregnancies and unsafe abortions is effective use of emergency contraceptives. Objectives: To assess the sexuality, perception, attitude towards and determinants of usage of emergency contraception among female undergraduates in Lagos, Nigeria. Methods: Cross-sectional survey conducted in June 2016 among 805 female students of the Lagos State University. Data were collected through structured self-administered questionnaire by obtaining information on demography, sexual and contraceptive history, perception, attitude towards and use of emergency contraceptives. Data obtained were analyzed using SPSS version 16. Chi-square and logistic regression models were applied to variables to test for significance that predicts the use of emergency contraceptives. Results: Of the 725 (90%) completed questionnaires, 334 (46%) of the respondents were sexually active with 115 (34%) having previous history of pregnancy. Eighty-two percent of those pregnancies were unintended. Eighty-eight percent of those with unintended pregnancy had them terminated by induced abortions, 54% of which was carried out by untrained persons. Only 29% of those who had unprotected sexual intercourse used emergency contraceptives. Lack of knowledge and promotion of sexual promiscuity were identified as the main reasons for not using emergency contraceptives. Previous use of contraceptives, married status, increasing age and year of study were positive predictors for the use of emergency contraceptives while poor knowledge was a significant predictor of non-use. Conclusion: There was poor knowledge and low utilization of emergency contraceptives among respondents. Information on contraceptives should be introduced in secondary schools and in general studies courses in tertiary institutions while parents and caregivers should discuss issues relating to sex and contraceptives with adolescents.

Barriers to Utilization of Modern Contraceptive Methods Used by Females Aged 15 - 24 Years: A Case Study of Moyo District in Uganda

Background: Modern contraceptives are medical procedures that interfere with reproduction or acts of sexual intercourse. Moyo district contraceptive prevalence used by females aged 15 - 24 years is 6.03%, which is far from the national target. The low contraceptive use among this age group results in high school drops, unwanted pregnancy, early child marriage, and community disputes. Purpose: To evaluate barriers associated with the utilization of modern contraceptive methods used by females aged 15 - 24 years in Moyo district in Uganda. Methods: A cross-sectional design with mixed methods of quantitative and qualitative approaches was used. The reason for using a cross-sectional design is to measure the exposure and outcome variables at the same time. It’s relatively quick and inexpensive, and findings can be used to create an in-depth research study. Multistage sampling was used to draw 423 participants for quantitative and 23 participants were purposively selected for Qualitative study based on knowledge and experience, the results were analyzed using SPSS Version 20 and open code software and presented in the form of tables, pie charts, graphs, descriptive and inferential statistics. Results: The findings indicated marital status OR 3.193, P-Value 0.000 and CI (2.002 - 5.091), Family/Community influence OR 1.644, P-Value 0.019 and CI (1.084 - 2.493) and Cultural influence OR 2.004, P-Value 0.006 and CI (1.218 - 3.298) tend to be associated with using contraceptives. Desire for children OR 0.459, P-Value 0.002 and CI (0.279 - 0.756) and long waiting time OR 0.442, P-Value 0.003 and CI (0.258 - 0.756) tend to be not associated with the use of modern contraceptives. The findings of this study have shown both individual and socio-cultural factors contribute to the low utilization of modern contraceptives among females aged 15 - 24 years, and these need to be addressed with the involvement of different stakeholders.

HPS和ECS在危重病例抢救技能培训中的应用

危重病例抢救是医学临床技能重要的组成部分,也是临床医生必须掌握的重要技能,危重病例抢救技能是各种基本临床技能的综合,也是培养医学生科学诊断思维和良好心理素质的重要手段。为了探讨临床危重病例抢救技能培训的新方法。将HPS和ECS应用在危重病例抢救技能培训中,重现了危重症抢救现场,缓解了临床教学资源不足的矛盾,提高了医学生的临床技能、沟通技巧和综合诊断技能。HPS和ECS应用于危重病例抢救技能培训顺应现代医学教育的趋势,必将成为培养医学创新型人才所必不可少的手段。

ECS模拟教学在外科休克临床教学中的应用

探讨智能型高级综合模拟人(ECS)模拟教学在外科休克临床教学中的教学方式和效果。将56名国际学院临床医学本科学生随机分为2组,一组采用ECS模拟教学,一组用传统教学法,学习结束综合评价两组学生的学习成绩和效果。结果显示ECS组的综合考试成绩、临床理论知识及临床技能明显优于传统教学组。

ECS结合PBL教学法对神经内科实习生医疗技术的影响

目的探讨模拟人(ECS)结合问题式学习(PBL)教学法对神经内科实习生医疗技术的影响。方法运用ECS结合PBL教学法对所有实习生进行教学,比较培训前后学员对疾病诊断和治疗等专业知识掌握情况,以及综合素质、考核成绩。结果培训后学员的专业知识掌握程度明显高于培训前(P<0.05)。培训后,学员思考问题的方式方法、临床思维和逻辑思维能力、归纳分析能力均明显优于培训前(P<0.05)。培训后学员的综合成绩明显优于培训前(P<0.05)。结论 ECS结合PBL教学法能有效促进学生的理论知识掌握和临床操作技能的提升,有助于全面提升学生的综合素质,教学质量显著。

Perception and Practice of Emergency Contraception among Female Undergraduates of the University of Ibadan, Nigeria

Objective To assess perception and level of proper utilization of emergency contraception （EC） among female undergraduates. Methods Cross-sectional questionnaire study was performed on 383 female undergraduates in Nigeria in June 2006. Data analysis was with Z-square test and logistic regressions （P 〈O. 05）. Results One hundred and five （48.2%） had been sexually exposed. Only 32 （30.5%） used regular contraception. Seventy-three （24.3%）female undergraduates were aware of EC. Only 29 （7.6%） had used EC before. Most would not use emergency contraceptive drugs in future due to lack of awareness （64.8%）, and fear for future fertility and of drugs being injurious to health. Use of EC was associated with awareness of correct interval for use （OR=9.1; 95%CI： 2.1-39.9）. Conclusion There is poor knowledge about EC and poor use, while significant need remains. Most knowledge was acquired from peers and inaccurate. Peer educators are important and professionals＇ knowledge needs improvement.