A COMPARATIVE STUDY OF THE REPRODUCTIVE HEALTH RISKS AND SEXUAL BEHAVIOUR AMONG PUBLIC SENIOR SECONDARY SCHOOL STUDENTS IN RURAL AND URBAN AREAS IN LAGOS STATE.

A COMPARATIVE STUDY OF THE REPRODUCTIVE HEALTH RISKS AND SEXUAL BEHAVIOUR AMONG PUBLIC SENIOR SECONDARY SCHOOL STUDENTS IN RURAL AND URBAN AREAS IN LAGOS STATE.

Abstract

Introduction: During adolescence most people begin to explore their sexuality and have sexual relationships which increase their vulnerability to reproductive health risks which are unintended and too-early pregnancy, unsafe abortion, sexually transmitted infections (STIs) including HIV, and sexual coercion. Different factors have been found to affect the reproductive health needs of young people including place of residence.
Objective: The aim of this study was to determine and compare the reproductive health risk and sexual behaviour among public senior secondary school students in rural and urban areas in Lagos State, and to explore the factors that affect their sexual behaviour and outcome.
Methods: A comparative cross-sectional design was used. The sample size was calculated using the formula for comparison of proportions of two independent groups and respondents were selected using the multistage sampling technique. Data was collected using both quantitative and qualitative methods in co-educational public senior secondary schools in rural and urban areas of Lagos State from February 20th to March 29th 2012 amongst 860 young people. Quantitative data collection was done by use of a self-administered semi-structured questionnaire adapted from ‘Asking young people about sexual and reproductive behaviours: illustrative core instruments developed by WHO/UNDP/UNFPA and World Bank. Qualitative data collection was done by Focus Group Discussions using a guide adapted from the same instrument above. Data analysis was done using Epi-info software. The Chi-square and Fisher’s exact tests were used for comparison of proportions. An association with P-value of <0.05 was considered statistically significant. Analyses of the focus group discussions were done using themes.
Result: Risky sexual behaviour was more common among respondents in rural than in urban areas as a higher percentage were sexually active (34.7% versus 21.9%). More rural than
urban respondents had more than one sexual partner with an average of 3 partners and a lower proportion had ever used condoms (57.2% versus 61.7%). Mean age at sexual debut was 14.8 and 13.8 years in rural and urban areas respectively. Rural respondents were therefore exposed to greater reproductive health risks as reflected by a higher prevalence of unwanted pregnancies (18.1% versus 11.7%) and sexually transmitted infections (34.2% versus 20.2%). However, fewer abortions (59.3% versus 81.9 %) occurred among respondents with unwanted pregnancies in rural as compared with urban areas. Non-consensual sex was also more common in rural as compared with urban areas (5.3% versus 2.8%). Knowledge of sexual and reproductive health was fair in both rural and urban areas with a mean score of 47.8% and 48.4% respectively, with teachers and friends being major sources of information on sexual health issues. Many of the sexually active respondents perceived themselves as low risk of getting pregnant (54.5% versus 37.9%) and of contracting HIV (63.6% versus 41.4%) in both rural and urban areas respectively. However, correct perception of risk was associated with protective behaviour such as use of the condom. There was no statistically significant difference in level of knowledge of sexual and reproductive health and their perception of risk among respondents in rural and urban areas. Factors associated with risky sexual behaviour were: age, sex, working for pay, parent-child-communication on sex-related issues, the person the respondent resided with and family type. Discussing sex with friends, friend’s sexual behaviour and contextual factors such as attending clubs, taking alcohol, dating and watching pornographic videos were also significantly associated with risky sexual behaviour in both rural and urban areas.
Conclusion and recommendation: Place of residence affects the sexual behaviour and reproductive health risks of young people with respondents in rural areas facing greater risks. Appropriate multi-dimensional interventions including provision of welfare support to reduce
the need for children to work, improvement of sexuality education to make them understand their risks, as well as supportive environment must be instituted to address their needs.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

A COMPARATIVE STUDY OF THE REPRODUCTIVE HEALTH RISKS AND SEXUAL BEHAVIOUR AMONG PUBLIC SENIOR SECONDARY SCHOOL STUDENTS IN RURAL AND URBAN AREAS IN LAGOS STATE.