Knowledge on contraceptive methods
This study aimed at determining knowledge about contraceptive methods and associated factors among teenage girls in secondary schools in Wanging’ombe district – Njombe region. The study revealed that a considerable number of secondary school girls had knowledge on contraceptive methods but it was not sufficient as it was reported to be 60.2%. These findings vary slightly from the study conducted by Mung’ong’o et al, in Dar es Salaam Tanzania which reported that the level of knowledge on contraceptive methods among students in secondary schools was 75% (16). There are other studies reported lower percentage of knowledge on contraceptives among teenage school girls than this study,
for instance, the study conducted in Oyo State – South West Nigeria reported that female secondary school students had a high knowledge on contraceptive knowledge, but only 58.1% of all students had a good knowledge (17). Moreover, there are numerous studies conducted in different parts of the world which revealed similar findings as this study, for example studies conducted in Rural Pakistan by Mustafa (2008) in Bangladesh (18), a study by (Kabir, 2008)(19), in Tanzania by Dangat & Njau, (2013) (20), as well as in Nigeria by Idonije et al, (2011) (21) revealed that the level of knowledge on contraceptive methods among teenage girls in secondary schools is still low and unsatisfactory. The variations in the level of knowledge on contraceptive methods reported by various studies might be due to differences in socio – economic and demographic characteristics of study populations.
Contraceptive use and access among secondary school girls
The study found that use of contraceptives among interviewed sexually active school girls is still very low. The prevalent reasons for non-use of contraceptives reported was poor knowledge on contraceptives and lack of access to contraceptives. There are other studies that found the similar findings and some different findings, for instance studies done in Tanzania, Kenya, Ethiopia, Ghana, Nigeria, Uganda and India revealed almost the same findings (Mngodo, 2013; Somba et al., 2014; Sweya et al., 2016; Mung’ong’o et al., 2010a; Adeyinka et al., 2009; Ahmed et al., 2017; Asekun-Olarinmoye and Adebimpe, 2013; Fantahun et al., 1995; Mwambete and Mtaturu, 2006; Mung’ong’o et al., 2010b; Renjhen et al., 2010; Kagashe and Honest, 2013; Olajide et al., 2014; Nsubuga et al., 2016).
The most common mentioned type of contraceptive method used within the past six months was a male condom. This finding is consistent with findings from a study done among secondary school students in Dar es Salaam, Tanzania (16). The study done among secondary school students in Ekpoma, Nigeria found that condom was the major available contraceptive for the males (21). Another study among physically challenged in-school adolescents in Osun State, Nigeria found the same findings (22). Male condoms are preferably used by school girls with their sexual partners mainly because it is convenient to apply and has dual effects namely prevention of unintended pregnancies and protection against sexual transmitted infections including HIV infection. Moreover, the majority of sexually active girls in this study reported that it is very difficult to access contraceptive methods and the most prevalent reason was fear of stigma.
The main mentioned sources of information about contraceptive methods were media. There are other studies that found similar findings while other studies found different findings. For instance, in the study conducted among secondary school girls in Calabar, Nigeria it was found the main sources of contraceptive information were books/magazines and friends (28). Also, the study among senior high school students in Ahmedabad in India reported the prevalent sources of information mentioned were schools, books, friends, mass media and sexual partners (23).
Tanzanian Demographic Health survey 2016 found almost the same findings: the students reported hearing a family planning message on the radio (62% of females and 75% of males) (29). Teenagers were also exposed to family planning messages via television (31% of females and 47% of males) and newspapers/magazines (25% of females and 35% of males) (9). In almost all studies media has been the most prevalent source of information.
Attitudes towards Contraceptive use
Overall, the attitudes towards contraceptive methods among school girls in this study is positive as majority of students perceived that contraceptives are beneficial (99.7%) and also students were in favor of contraceptive methods (65.5%), however there are some students who perceived that contraceptive methods are harmful (99.7%) while others reported that contraceptive methods are associated with promiscuity (9.1%). This study is consistent with the study of Opundo, 1998 in his study in Kisumu, Kenya found that over 77% of teenage school girls indicated positive attitude as they are in favour of contraceptive methods In Oyo-state in Nigeria Idowu et al., (2017) found that 55.3% of teenage school girls had positive attitudes towards family planning (17). A majority of secondary school girls are not taking any precaution to prevent teenage pregnancies for fearing side effects and perceived promiscuity. The girls need to be knowledgeable about side effects as far as contraceptives are concerned. Perceived promiscuity is a wrong perception that can be mitigated by educating the community
Factors associated with knowledge on contraceptive methods
The univariate and multivariate models of this study revealed that factors that were significantly associated with knowledge on contraceptive methods among teenage girls in secondary schools in Wanging’ombe District were older age, higher class level, type of school, religion, residence, school ownership and economic condition of parents at home. These findings differ from other studies such as the study conducted by Bugsa et al, (2014) in secondary schools in Ethiopia which revealed that factors associated with knowledge on contraceptive methods are age of respondents, marital status, primary source of information, and previous contraceptive use. Moreover, another study conducted in Ethiopia by Habitu et al (2015) reported that information about contraceptives, cultural acceptance, sexual intercourse, and attitudes towards contraceptive methods were associated with knowledge on contraceptive methods among teenage secondary school girls. Also, the study conducted by Sweya et al (2016) (24), Aghoja et al (2009) (25) as well as by Hossain et al (2018) (26) revealed several factors associated with knowledge on contraceptive methods such as education level, cultural factors, attitudes, religion, marital status, sexual active, beliefs, socio economic status, women age, low literacy levels and ineffective conveyance of health information by health care providers. The possible reasons behind these differences in findings might be differences in geographical settings and differences in socio demographic characteristics of study populations.
Knowledge on the consequences of teenage pregnancy on health and education
The study reveals that knowledge on the consequences of teenage pregnancy on adolescent health and education is relatively high (64%). This finding is consistent with various studies which reported similar findings for example the study of Achema, Emmanuel, & Moses, (2015) (27), Bhandari, (2015) (28), Kunene, (2014) (29) and Kanku & Mash, (2014) (30). However, the reported knowledge is unsatisfactory as it is below 80%, therefore it is worthy to introduce interventions in order to raise knowledge on the consequences of teenage pregnancy to the students.