Factors associated with the use of emergencycontraception among female students at the university of rwanda

Abstract

Objective: Emergency contraception (EC) is an effective method to reduce unintended pregnancies. Despite the notable gains in contraceptive use and decrease in the unmet need for contraception over the past decade, nearly half (47%) of pregnancies in Rwanda are unintended. Unintended pregnancy increases the risk of unsafe abortion and thus maternal mortality and morbidity. The objective of the study was to examine the knowledge and use of EC among female students at the University of Rwanda. Methods: A cross-sectional survey of female students from 7 urban and rural colleges of the University of Rwanda was conducted from December 2019 through January 2020. Informed written consent was obtained. Correlation analysis were done using alpha value at 0.05 and 95% confidence interval. Results: A total of 386 female students were recruited. Most of the students (84%) were less than 24 years old with one third between 18 - 20 years. Most were single (96%), 54% were in relationship and 44% had had sex at least once. The mean age at first sexual intercourse was 18.7 + 3.2 years. Of the 170 women who had sexual intercourse, 62% were still sexually active, 51% had had more than one sexual partner and 52% had had unprotected sexual experience at least once. Sixty five percent of the cohort did not use any contraception. Most students (81%) knew what EC was, but 53% stated EC was not accessible, 65% didn’t know the correct timing and 52% did not plan to use it in the future. Women with prior sexual experience were significantly more likely to have knowledge of EC (87.6%, p=0.003) and had intent to use it (57.1%, p=0.002) but were not more knowledgeable about types of EC. Among students who used other methods of family planning, were currently sexually active or had had unprotected sex, knowledge of EC was not higher than students without the exposure. Conclusion: Female students at the University of Rwanda had limited knowledge or intent to use EC despite being sexually active. This represents a significant gap in public health. Knowledge of EC and access within the educational system are necessary as this can significantly impact continuing education and human resource potential for a developing country.