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Impact of Adolescent Reproductive Health Education on Contraceptive Use among Female University Students in Nigeria

Abstract

Adolescent and young adult reproductive health remains an important public health concern in Nigeria, particularly among female university students who may face challenges related to unintended pregnancy, sexually transmitted infections, unsafe abortion, and limited access to accurate reproductive health information and services. Reproductive health education provides young women with accurate information about sexual and reproductive health, fertility, pregnancy prevention, contraceptive methods, effectiveness, correct use, possible side effects, sexually transmitted infection prevention, informed decision-making, and access to appropriate reproductive health services. Contraceptive use refers to the adoption and appropriate use of methods intended to prevent unintended pregnancy, including condoms, oral contraceptive pills, injectables, implants, intrauterine devices, emergency contraception, and other approved methods. In Nigeria, inadequate reproductive health knowledge, misconceptions about contraceptive methods, fear of side effects, concerns about infertility, partner influence, stigma, cost, and limited access to youth-friendly reproductive health services may affect contraceptive use among female university students. Effective adolescent reproductive health education may improve knowledge, attitudes, self-efficacy, decision-making, and utilization of appropriate contraceptive methods. Against this background, this study investigates the impact of adolescent reproductive health education on contraceptive use among female university students in Nigeria. The study is anchored on the Health Belief Model, Theory of Planned Behavior, and Social Cognitive Theory. The Health Belief Model explains preventive reproductive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding students' decisions regarding contraceptive use. The Theory of Planned Behavior explains how attitudes, subjective norms, and perceived behavioural control influence intentions and subsequent contraceptive practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping reproductive health behaviour. Collectively, these theoretical perspectives provide a suitable framework for explaining how reproductive health education may influence contraceptive use among female university students in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from female undergraduate students in selected universities in Nigeria using a structured anonymous self-administered questionnaire. A multistage sampling technique will be employed to select states, universities, faculties or departments, academic levels, and eligible participants. Where feasible, selected student groups will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured adolescent reproductive health education covering reproductive anatomy and physiology, fertility and conception, prevention of unintended pregnancy, available contraceptive methods, effectiveness and correct use, possible side effects and their management, prevention of sexually transmitted infections, dual protection, emergency contraception, myths and misconceptions, informed reproductive decision-making, and access to confidential reproductive health services. Contraceptive use will be assessed using indicators such as current contraceptive use, use of modern contraceptive methods, consistency of use, method choice, correct use, and utilization of appropriate reproductive health services. Descriptive statistics will be used to summarize participants' sociodemographic and reproductive characteristics, reproductive health knowledge, exposure to education, and contraceptive use. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the impact of adolescent reproductive health education on contraceptive use. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that adolescent reproductive health education has a significant positive impact on contraceptive use among female university students in Nigeria. Students exposed to structured reproductive health education are expected to demonstrate improved knowledge of contraceptive methods, greater confidence in making informed reproductive health decisions, reduced misconceptions, and increased utilization of appropriate contraceptive methods. Education may encourage consistent contraceptive use, improve awareness of dual protection against unintended pregnancy and sexually transmitted infections, and increase utilization of youth-friendly reproductive health services. However, education alone may not guarantee consistent contraceptive use because female university students may continue to experience barriers such as fear of side effects, concerns about infertility, partner influence, stigma, cost, lack of privacy, and limited availability of youth-friendly services. Consequently, reproductive health education is expected to be most effective when supported by confidential, accessible, affordable, and youth-friendly contraceptive services. The study is expected to contribute to the literature on adolescent reproductive health, contraceptive use, reproductive health education, unintended pregnancy prevention, sexual health, and public health in Nigeria by providing empirical evidence on the impact of reproductive health education on contraceptive use among female university students. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), Federal Ministry of Education, National Universities Commission, university health services, reproductive health organizations, healthcare providers, development partners, and policymakers regarding strategies for improving contraceptive use among young women. The study will also provide evidence-based recommendations for strengthening reproductive health education in universities, improving access to youth-friendly contraceptive services, addressing contraceptive misconceptions, strengthening confidential counselling services, promoting informed reproductive decision-making, and reducing unintended pregnancies among female university students across Nigeria.

Keywords: Adolescent reproductive health education, contraceptive use, female university students, reproductive health, contraception, unintended pregnancy, sexual health, health education, youth-friendly services, reproductive health practices, public health, Nigeria.