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Effect of Contraceptive Counselling on Contraceptive Decision-Making among Female Undergraduates in Nigeria

Abstract

Contraceptive decision-making is an important component of reproductive health among female undergraduates because informed contraceptive choices can contribute to the prevention of unintended pregnancies and support reproductive planning. Female university students may face challenges when making contraceptive decisions due to inadequate knowledge, misconceptions about contraceptive methods, concerns about side effects, partner influence, social and cultural expectations, cost, accessibility, and exposure to unreliable reproductive health information. Contraceptive counselling provides an opportunity for healthcare providers to offer accurate, confidential, and individualized information about available contraceptive methods, effectiveness, benefits, possible side effects, contraindications, duration of protection, and appropriate method selection. Against this background, this study investigates the effect of contraceptive counselling on contraceptive decision-making among female undergraduates in Nigeria. The study will be anchored on the Health Belief Model, Theory of Planned Behavior, and Social Cognitive Theory. The Health Belief Model explains how female undergraduates' perceptions of their susceptibility to unintended pregnancy, perceived severity, perceived benefits of contraception, perceived barriers, and cues to action may influence their contraceptive decisions. The Theory of Planned Behavior emphasizes attitudes toward contraceptive methods, subjective norms, perceived behavioural control, and behavioural intentions in shaping contraceptive decision-making. Social Cognitive Theory emphasizes knowledge, self-efficacy, observational learning, interpersonal influences, and social support in the development of reproductive health behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how contraceptive counselling may influence contraceptive decision-making among female undergraduates in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise female undergraduate students enrolled in selected universities and other tertiary institutions across Nigeria. A multistage sampling technique will be used to select states, institutions, faculties, departments, and eligible female undergraduates. Contraceptive counselling will be assessed using indicators such as exposure to professional contraceptive counselling, frequency and duration of counselling sessions, individualized method information, discussion of contraceptive effectiveness, benefits, limitations, possible side effects, eligibility considerations, method availability, dual protection, follow-up arrangements, and opportunities for questions and clarification. Contraceptive decision-making will be assessed using indicators such as ability to identify suitable contraceptive options, informed consideration of benefits and risks, confidence in choosing a preferred method, intention to use contraception, consistency between chosen method and individual reproductive goals, voluntary decision-making, and ability to discuss contraceptive choices with a healthcare provider or partner where appropriate. Data will be collected using structured questionnaires and appropriate validated contraceptive knowledge or decision-making assessment instruments where available. Descriptive statistics will be used to summarize participants' characteristics, exposure to contraceptive counselling, and patterns of contraceptive decision-making. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of contraceptive counselling on contraceptive decision-making. Where a quasi-experimental design is adopted, contraceptive decision-making scores before and after structured counselling may be compared, while relevant demographic, socioeconomic, reproductive, relationship, educational, and healthcare-access factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that contraceptive counselling has a significant positive effect on contraceptive decision-making among female undergraduates in Nigeria. Female undergraduates who receive structured, confidential, and client-centred contraceptive counselling are expected to demonstrate greater confidence and capacity to make informed contraceptive decisions than those with limited exposure to counselling. Counselling may improve students' understanding of contraceptive options, effectiveness, benefits, limitations, possible side effects, and appropriate use, thereby reducing misconceptions and fear surrounding contraceptive methods. Individualized counselling may also enable women to consider their reproductive goals, preferences, health circumstances, and lifestyle when making contraceptive choices. However, stigma, cultural and religious beliefs, partner influence, financial constraints, limited access to confidential contraceptive services, fear of side effects, and misinformation may continue to affect contraceptive decision-making. The study therefore expects accessible, confidential, non-judgmental, evidence-based, and client-centred contraceptive counselling to contribute significantly to improved contraceptive decision-making among female undergraduates in Nigeria. The study is expected to contribute to the literature on contraceptive counselling, contraceptive decision-making, reproductive health, family planning, contraceptive choice, unintended pregnancy prevention, women's health, university health services, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, universities, tertiary health services, reproductive health clinics, healthcare providers, family planning programmes, development partners, and policymakers regarding strategies for improving informed contraceptive choices among young women. The study will also provide evidence-based recommendations for strengthening contraceptive counselling within university health services, training healthcare providers in youth-friendly and client-centred family planning counselling, improving confidentiality and accessibility of contraceptive services, developing culturally appropriate reproductive health education materials, addressing contraceptive misconceptions, and promoting informed and voluntary contraceptive decision-making among female undergraduates across Nigeria.

Keywords: Contraceptive counselling, contraceptive decision-making, female undergraduates, reproductive health, contraceptive choice, family planning, unintended pregnancy prevention, women's health, university health services, Nigeria, public health.