Emergency Contraceptive Use Among Female Senior High School Students in the La Dade- Kotopon Municipal Area, Accra-Ghana

Abstract

Background: Access to reliable and secure birth control methods is necessary to improve the reproductive health of young women in developing countries. The use of contraception is crucial in preventing unwanted pregnancy and unsafe abortions given the increase in teenage sexual activity and the decline in the age of first sex in low-income countries. In Ghana, younger women between the ages of 15 to 19 are more likely to die from complications relating to abortion. Unsafe abortion accounts for 20.7% of all pregnancy-related deaths, making them the second most common cause of mortality overall. With most teenagers engaging in sexual activity before the age of 17, adolescent reproductive health and family planning services that meet the needs of this population are critical. Emergency contraceptives use among sexually active young women offers potential solutions by providing convenient, on-demand, and confidential method of preventing unintended pregnancy after unprotected sex, contraceptive failure, or sexual assault. However, there are challenges surrounding its use with significant ramifications for young adolescents. Objective: The aim of this study was to determine the knowledge, prevalence and factors influencing emergency contraceptives use among female Senior High School students in the La Dade- Kotopon Municipality of the Greater Accra region of Ghana. Methods: A quantitative cross-sectional study was conducted at La Dade-Kotopon Municipal Area with 269 randomly selected Female Senior High School (SHS) students. Factors contributing to emergency contraceptive use were assessed using multiple binary logistic regression model with generated odds ratios and their respective confidence intervals and a p-value of less than 0.05. This was considered to be statistically significant. All statistical analyses were conducted using Stata version 17 (StataCorp, College Station, Texas). Ethical clearance was obtained from GHS-ERC with reference number GHE-ERC-080/04/24. Results: The study considered 269 respondents (all female SHS students) in the final analysis. The findings showed that a majority of the respondents 84.4%; 95% CI: 79.5, 88.3 were aware of emergency contraceptives, and 31.5% (95% CI: 25.7, 38.0) had ever used EC while 47.5% (95% CI: 35.2, 60.2) of those who had ever used EC were still using it. The odds of ECs utilisation was found to be 3.2 times among young adults (20-24) compared to adolescents (10-19) [aOR: 3.2 (1.1, 9.3); p-value=0.036]. Also, the odds of using ECs is 2.3 times among respondents in SHS 3 compared to those in SHS 2 [OR: 2.3 (1.3, 4.1); p-value=0.005]. Furthermore, the odds of utilizing EC is 2.6 and 2.8 times among those with moderate and good knowledge of EC respectively compared to those with poor knowledge. Conclusion: There is high level of awareness of emergency contraceptive use among female students in the La Dade-Kotopon Municipal Area coupled with high prevalence of use but showed knowledge gaps. The factors that influence the utilisation of ECs among adolescent girls include age, education level, and level of knowledge of ECs. It is therefore recommended that education on emergency contraceptive usage among female senior high students should be strengthened.