CHAPTER ONE

INTRODUCTION

1.1 Background

Contraceptive is any process or agent designed to prevents contraception (Farlex,2012). Modern contraception refers to technological advances designed to overcome biology. This includes methods like pills, condoms, intrauterine devices, injectables etc, which prevent pregnancy by interfering with the normal processes of ovulation, fertilization and implantation (Hubacher et al., 2015).

In 2019, there were approximately 21 million pregnancies among adolescents aged 15-19 in Low And Medium Income Countries (LMICs) with approximately 50% were due to unintended causes. This resulted in an estimated 12 million births (World health organization (WHO)., 2022).

Adolescent birth rate (ABR) has decreased from 64.5 births per 100 women in the year 2000 to 42.5 births in 2021 globally. However, rates of change have been uneven in different regions of the world with the sharpest decline in Southern Asia (SA) and even slower declines in Latin America (LAC), Carribean and sub-Saharan Africa (SSA). Although decline have been observed in all regions, SSA and LAC, continue to have the highest rates globally at 101 and 53.2 births per 100 women respectively in 2021. (World Population Prospects., 2019).

Based on 2019 data, 55% of unintended pregnancies among adolescent’s girls aged 15-19 years end in abortions, which are often unsafe in LMIC (WHO,2022). Preventing pregnancy among adolescent, pregnancy related mortality and morbidity are foundational to achieving positive health outcomes across the life course. This are also vital to achieving the Sustainable Development Goals (SDGs) related to maternal and newborn health (WHO,2022)

These SDGs 3.1 and 3.2 respectively states that; by 2030, reduce the global maternal ratio to less than 70 per 100.000 live births and by 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 25 per 1000 live births (United Nations (UN), 2022) .

Several factors contribute to adolescent and births. A major factor includes no accessibility of nor knowledge of where to obtain contraceptives and how to correctly use them. Correct use of modern contraceptives remains the best preventive measure to reduce induced non-therapeutic abortions and limit maternal and neonatal morbidity (Esambe et al., 2018).

It is important to consider all the cultural and noncultural factors that may influence the use and decision making of contraceptives among adolescents (journal of Pediatric Health Care., 2009).

According to United Nation Population Fund (UNFPA) Sub-Saharan Africa has the lowest demand (30% and use (20%) of contraceptives among 15-19 years old (Lutut et al., 2011).

In Cameroon, adolescent pregnancy is still a major public health challenges with a national prevalence of 14.2 %. According to the U.S President’s Emergency Plan for AIDS Relief (PEPFAR), the HIV prevalence in Cameroon among people 14-19years in 2018 was 3.4% with about 2% of young people between 15-24years living with HIV (Fubam et al., 2022).

Given the amount of sexual related activities students are known to engage in and the wide spreading of sexually transmitted infections, teenage pregnancies provide the need to study the behavior and attitude towards the use of contraceptives (Ugoji., 2013).

Based on personal observation Buea, a town in the South West Region of Cameroon which is heavily populated with students and other adolescent groups, is a good case study on the adoption of sexual behavior among adolescents.

This research aims to study and determine the gaps in the knowledge and use of contraceptives among adolescent females aged 15-19years in the Buea Municipality.

1.2 Problem Statement

 Pregnancies are at greater risk of poor outcomes amongst teenagers (Black et al., 2012). Cameroon has recorded the highest fertility among teenagers in the entire Central African region as of 2017. Notably, there are limited data available on assessing the awareness and prevention of teenage pregnancies among secondary and high school students in Cameroon (Elonge et al., 2020).

 According to the World Health Organization (WHO), Cameroon’s maternal mortality rate stands at 529 deaths per 100.000 live births which is significantly higher than the African average of 381 deaths per 100.000 live birth and the percentage of female adolescents (aged 15-19) in Cameroon with an unmet need for modern methods of contraception are 26.4% and 40.8% married and unmarried respectively.

Based on personal observation, there are limited data on the knowledge and use of contraceptives among adolescent females (15-19) in Buea municipality. 

1.3 Rationale

In evaluating the knowledge and use of contraceptives by adolescent females in Buea, this study will provide data in order to develop health programs for the achievement of the SDGs related to maternal and newborn health. These SDGs 3.1 and 3.2 respectively states that; by 2030, reduce the global maternal ratio to less than 70 per 100.000 live births and by 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 25 per 1000 live births (UN sustainable development, 2022). Hence justifies this study.

1.4 Research Questions

1. What is the knowledge level on contraceptives amongst female Adolescent aged 15-19 in the Buea municipality?
2. What is the level of usage of contraceptives amongst adolescent females aged 15-19 in Buea municipality?

1.5 Objectives

1.5.1 General Objective

To assess the knowledge and use on contraceptives among adolescent females age 15-19years in the Buea municipality.

1.5.2   Specific Objectives

1. To assess the knowledge level of contraceptives amongst female adolescents aged 15-19 years in Buea municipality
2. To investigate the level of usage of contraceptives amongst adolescents (15-19) in Buea municipality.