CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Sexual and reproductive health is an important issue to every stakeholder in the global health sector particularly with regard to the youth and adolescents (Tien, 2006). A number of factors are responsible for the high level of importance attached to adolescents/youth’s sexual and reproductive health. Various authors indicate that adolescent/youth’s sexual and reproductive health for most countries is in bad shape. Attahir, Sufiyan, Abdukadir and Haruna (2010) found out that the health risk faced by adolescent girls during pregnancy is very high, accounting for 15% of the Global Burden of Disease (GBD) for maternal conditions and 13% of all maternal deaths. The cause of this degenerating health condition of adolescent girls, according to Tien (2006), is lack of knowledge and access to contraception. Consequently, Tayo, Akinola, Babatunde, Adewumi, Osinusi and Shittu (2010) suggested active and intensive promotion of sexuality education, and contraceptive use among the youth in the Sub-Saharan Africa as a way of addressing this anomaly. In Nigeria, Harrison (2009) observed that the countries high maternal mortality ratio (MMR) is attributed to her youth’s sexuality. The later is characterized by low contraceptive usage by the youth, high incidence of illegal abortion amongst the youth, ignorance of contraception among the youth, and lack of sex education from parents and teachers. The situation in Nigeria is likely to a reflection of the situation in the entire Africa. Such a situation made the World Health Organization Report (2010) to show that Africa’s progress in meeting the number 5 Millennium Development Goals (MDG5), in which the target is 75% reduction in the maternal mortality ratio from the year 2000, to the year 2015 remains a major challenge to health systems worldwide. Moreover, NPC and ICF Macro Report (2009), indicate that Nigeria is remarkably slow in its progress towards the MDGs set to be attained in 2015. As we move close to 2015, MMR in Nigeria is put at over 545 per 100,000 live births, compared with other societies that have made significant progress towards the MDGs goal 5, such as U.K with about 8 per 100,000 live births, Germany and Spain 7 per 100,000 live births and France with about 10 per 100,000 live births. Also, NPC and ICF Macro (2009) have attributed the high MMR in Nigeria to poor contraceptive usage and high rates of unwanted pregnancies, which invariably give rise to illegal and clandestine abortions. World Health Organization Report (2010) on the statistics of contraceptive prevalence in 53 African countries, shows that Nigeria has 14.1% contraceptive prevalence rate, unlike other African countries like Mauritius with 75.8%, Morocco 63.0%, Algeria 61.4%, Cape Verde 61.3%, Egypt 60.3%, South Africa 60.3%, Tunisia 60.2%, Zimbabwe 60.2%, Namibia and Swaziland with 55.1% and 50.6% respectively. The concern here is that since the MDG were set in 2000, there have been steps deliberately taken by Nigerian government to reduce incidences of unwanted pregnancies, particularly among the youth. Promotion of contraceptive practices has also intensified yet with 14.1% contraceptive prevalence in Nigeria, it shows low usage of contraceptives among the youth necessitating enquiring into factors that could explain the trend. According to Indongo (2007), one of the major factors is that youth often lack basic reproductive information on the consequences of sexual intercourse. In addition to the above mentioned information, youth also lack skills in negotiating sexual relationship, and knowledge about affordable confidential reproductive health services. Again many do not feel comfortable discussing sexual issues with parents or other key adults with whom they can talk about their reproductive health concerns. Likewise, parents, healthcare workers, and educators frequently are unwilling or unable to provide complete and accurate age-appropriate reproductive health information to young people. This is often due to discomfort in discussing the subject or the false belief that providing the information will encourage increased sexual activity. This is because most youth enter into sexual relationships with very little knowledge on the consequences. The little knowledge they have is either got from their peers or from the media. The question then is why teenage pregnancy, maternal mortality ratio and premarital childbirth is on the increase in Nigeria despite efforts made by both private and public agencies in providing youth-friendly centers in public and private hospitals where contraceptive services could be accessed. This study is therefore designed to study the knowledge of contraception and use of contraceptives among sexually active youth in Abuja-Federal Capital Territory (FCT).