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CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

The Oxford Advanced Learners’ Dictionary of Current English defines “Contraceptives as a drug, device of practice used to prevent a woman becoming pregnant.” This definition though well embracing but does not include its utilization as a preventive measure against the spread of sexually transmitted diseases; such as AIDS/HIV.  The act of contraception has been an old practice even from our forefathers who designed the timing of mating with their wives or not depending on whether they want to make babies.  They have a mental picture of when the monthly menstrual flow of their wives takes place or how long their wives have to breast feed their babies to avoid unwanted pregnancies.  Some traditional women even go through the extra-mile of wearing contraceptive bands on their waist to prevent unwanted pregnancies.            
Each year, women around the world experience 75 million unwanted pregnancies.  Unwanted pregnancy can occur for two main reasons; either the couple was not using contraceptives, or the method they were using failed.  There are many reasons why people do not use contraceptives to prevent unwanted pregnancy, including lack of access to family planning information and services; incest or rape; personal or religious beliefs; inadequate knowledge about the risks of pregnancy following unprotected sexual relations; and women’s limited decision-making ability with regard to sexual relations and contraceptive use.2 Many women are deprived of family planning services.            
The use of contraceptives by both males and females has been accepted and widely practiced in the developed world.  This has not been the case in the developing world where the male chauvinistic cultural belief that women should protect themselves from unwanted pregnancies; instead of the men also making it possible to use contraceptives.  The act of child bearing is the combined effort of both males and females, but in the developing world; it is seen as a primary function of the female gender.  This is the reason why the usage of contraceptives among men in these areas has not been encouraged as the female contraceptives.  The patriarchal nature of the African society does not seem to help or encourage male contraception rather it makes men to believe that they do not have any role to play in reproductive health.            
In the developed world, the populace has overgrown the persistent myths and negative attitude of men towards contraception.  However, the fact that male contraception in the underdeveloped countries has not been encouraged has led to the paucity of information about it and also reduced the quest for knowledge in this area.  Studies show that men want access to better contraceptives.  In a recent study of British men, 80% placed a hypothetical male pill as one of their top three contraceptive choices (Brooks, 1988)3.  Another study found that over 60% of men in Germany, Spain, Brazil and Mexico were willing to use a new method of male contraception (Heinemaan, 2006).4  In another study on “why Nigeria adolescent seek abortion rather than contraception:  Evidence from focus group discussions” where youths were asked about contraceptive availability, perceived advantages of method used, side effects and young people’s reasons for using or not using contraceptives?  It was found that the fear of future infertility was an overriding factor in adolescent decisions to rely on induced abortion rather than contraception.
Methods of Contraception -  are more in the female gender than the male.
Those of the female include:
The Combined Pill:  These are oral contraceptives which are eniphasic and biphasic pills, Everyday /Ed pills.  They are 99% effective when properly taken.  They contain two hormones – estrogen and progistogen, and acts by preventing ovulation when taken regularly.
Mini Pill:  Progestogen pill only.  Its 98% effective when taken properly and regularly any day at the same time.  It causes changes in the womb which makes it difficult for the sperm to enter the womb.
Injectable Contraceptives:  They include Depo-provera and Noristerat.  Its effective to 99% of cases.  It also stops ovulation by acting in a similar way to the mini pill.  It provides protection for up to 3 months longer.  It may cause irregularity in her periods and break through bleeding.
Intra Uterine Device:  Its 96 – 99% effective.  It’s a plastic device or with copper inserted into the womb by the doctor and it prevents the ovum or egg from settling in the womb.
Diaphragm or Cap:  Its 85-97% effective with careful use.  It is a soft rubber device put into the vagina before intercourse, to cover the cervix, and form a barrier which prevents sperm from meeting the egg.  It must be used with a spermicide and left in place for six hours after intercourse.
Sponge:  It is 75 – 91% effective, with careful use.  It’s a soft circular polyenthrane foam sponge, put into the vagina up to 24 hours before intercourse, to cover the cervix.  It already contains a spermicide.
Female Sterilization:  It’s a permanent method of birth control in which the fallopian tubes are closed so that the egg cannot travel down than to meet the sperm.  Its effective for life but has occasional failure rate of 1:300 where the tube rejion and fertility returns.
Natural Methods (‘Safe Period’ ‘Rhythm method’).  Its 85 – 95% effective.  It aims to predict ovulation when the woman is most fertile intercourse is avoided at this time.  This symptom-thermal method requires daily recording of body temperature, noting changes in vaginal nuclear and other signs of ovulation.
The male contraceptive measures include:
a. Condom:  It is effective in 85 – 98% of cases with careful use.  Its made up of a thin rubber and worn on an erect penis.  It prevents sperm from entering the woman.  It protects both partners against sexually transmitted diseases and also protects the woman against cancer of the cervix.
b. Male Sterilization (Vasectomy): It’s a permanent method which involves the cutting or blocking of the tubes that carry sperm from the testes (vas deferens) to the penis.  It is a permanent method of contraception like the tubal ligation in females.  Another method of contraception needs to be used for about 3 months after vasectomy so as to clear the whole sperm from the tube.  Occasional failure of this method occurs in 1:100 cases.
c. Withdrawal Method: This method is usually not effective but its practiced by some own.  They withdraw the penis before ejaculation takes place during orgasm.  Its not effective because it does not take care of sperm which are passed into the vagina before orgasm takes place.
Emergency Contraception:  This is method of preventing pregnancy after having unprotected sexual intercourse or if you had a contraceptive accident or misuse (such as condom breakage, failed coitus interruptus) and in case of rape.  There are two common methods which can be used in emergency contraception:
a.  Emergency contraceptive pills (ECPs)
b.  Copper intra-uterine device (IUDs). These two methods must be used within few days of unprotected sexual intercourse.  They are safe for most women.  The ECPs contain the same hormones used in family planning pills but are used differently.  They either stop the release of the egg or prevent fertilization of an egg.  The IUDs immobilize sperms, slow down sperm movement, prevent fertilization of the egg and cause changes in the uterine lining which prevent pregnancy.
1.2   PROBLEM STATEMENT            
It is true that sexual education in most of our homes are poor, with the belief that being sexually educated will make the student to be promiscuous or to test what they have learnt.  But we all know that our society have overgrown such belief, and they will always have coitus, whether they are educated or not.  They will always be influenced by their peer groups and those who are not yet exposed will learn the act in a negative way.  This being the case, the onus now rests on adults to educate the teenage or early adult group on what the reproductive organs stand for, the usage of contraceptives to reduce the incidence of unwanted pregnancies or even infections in the reproductive system.            
The need for this study is to stimulate parents and school authorities to educate our younger generations to be well equipped with the knowledge of family planning.  Failure of this taking place will lead to an increase in the number of unwanted pregnancies, sexually transmitted diseases and undue population rise in the society.
1.3       JUSTIFICATION FOR THE STUDY            
Over the years, especially in Africa, the need for contraception and control of population using female methods of the pill, injectables etc have been adapted.  Before now only the condom and withdrawal method has been used by men. The increasing need for male contraception cannot be over-emphasized as humans are more aware of the fact that, there need to be a greater co-operation between spouses for family and reproductive health to grow and blossom; with greater understanding that everyone involved will contribute their quota to the success of the family. 
To this extent therefore, there is the dire need for the study of this nature to identify the contraceptive devices possibly of use now, the knowledge of their use, how well adolescent comply with their use, in order to educate them so that they could have a good beginning in their understanding of choosing when to have children and when not to.  This is done with the wisdom that a good beginning when well nurtured will bring about a good end. This study will give us an overview of the perception or knowledge, the usage or practice of contraception among these adolescent which will again enable us to educate them on what good practice of family or reproductive health should be.  This will translate into a better moral upbringing of the society around us.
On-Going Research: There are many ongoing research projects into different methods of male contraception.  Researchers are optimistic that a safe, effective method of male contraceptive will eventually become a reality, although this is still several years away.
The two main areas of research into male contraception include:
a.  Hormonal Contraception – where synthetic hormones are used to temporarily stop the development of healthy sperm.
b.  Non-Hormonal Methods – where other techniques are used to stop healthy sperm from entering a women’s vagina.
1.4       GENERAL OBJECTIVE            
The objective of this study was to determine the level of awareness of male on contraceptive measures with a view to improving this knowledge and increasing their compliance to the usage.  This will help us in educating them on how to prevent early pregnancies and its negative effects and or infections to their young reproductive organs which may lead to secondary infertility in later life.  
1.5       SPECIFIC OBJECTIVE
1.  To assess the knowledge of male students of Federal College of Education Technical Asaba on male contraception.
2.  To determine the practice of male contraception among the students.
3.  To assess the factors that influence the use of these contraceptives in this age group of students.