Improving the reproductive health of the student community - the case of the Kwame Nkrumah University of Science and Technology, Kumasi , Ghana

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Reproductive health (RH) of the youth (individuals of the age group of 15-24 years) includes their physical, mental and social well being and not merely the absence of disease (WHO, 2001 & 2002). RH therefore encompasses the ability to remain free from unwanted pregnancy, unsafe abortion, sexually transmitted infections including HIV/AIDS and all forms of sexual violence and coercion. The youth today form the largest cohort ever of that age group, have half all incidences of HIV/AIDS and there is a great gap between their RH/FP needs and services (Senderowitz, 2002). The objective of the study: To evaluate the RH needs of students and the RH services available to them at Kwame Nkrumah University of Science and Technology in order to improve on the delivery of such services. The state of RH and RH care service delivery to the youth of KNUST is so far not documented. A sample of 300 students aged between 15 and 24 years was targeted at the Kumasi Campus of the University, 30 health workers from the University and Bomso Hospitals were also sampled as well as 20 administrators of the University. Questionnaires were administered to each target group. The study was a non-interventional, descriptive type with a current cross sectional design. Stratified followed by systematic sampling was used to select student, whereas health workers and administrators were sampled purposively. Findings: Of the respondents, 30.2% were sexually experienced and of that proportion 7% had more than one sexual partner. The median age of sexual debut was 18.0 years. 60.4% of respondents lived with both parents. The knowledge of fertile periods in a woman’s menstrual cycle was poor (29.3%). Awareness of the risk of pregnancy at sexual debut (88.7%) and after unprotected sex on just one occasion (89.3%) was good. Awareness that a girl could get pregnant after unprotected sex on attaining puberty (85.1%) was good. The concept of safe sex (using condoms for sex) was known by 44.1% of respondents. HIVIAIDS could not be cured was the view of 88.2% respondents, and 94% of them thought that an individual could have HIV or STI and still look physically healthy. Respondents would consult health workers (54.1%) for information on RH issues than they would their parents and peers (43.7% for mothers, 27.5% for fathers and 10.8% for peers). Females would speak to their mothers (62.7% for females and 35.7% for males) and health workers (61.8% females and 50.6% males) than would their male counterparts on RH issues. Males (14.4%) would confer with their peers than would females (2.9%). Knowledge of modes of acquisition of HIVIAIDS was as follows; 90.5% at first unprotected sexual contact, 96.8°/o at birth and 92.8% via circumcision with unsterilized equipments. Condoms do not protect against HIV/AIDS was the opinion of 25.7% of respondents. Teenage pregnancy was seen as negative by 91.9% of respondents. Condom use was perceived as easy by 50.5% of respondents, though 14.4% knew the 6 main steps involved in usage. Five out of six students with STI sought treatment and 7(87.5%) of the 8(100%) who got pregnant aborted the foetus at a health facility. Carrying of condoms was perceived as being ‘ever ready’ for sex by 62.9% of respondents. Students were against premarital sex males (74.0%) and females (78.8%). 95.6% of respondents thought religion shaped sexuality. 12.5% of University administrators said RH policy guidelines or protocols were available in their outfit. 12.5% of them had ever interacted with students who had RH problems. in the University Hospital, 37.5% of respondents said RH policies and protocols did exist. 50.0% of respondents said students did patronize RH services in the hospital. 25.0% of respondents said there were facilities available for RH service provision. At Bomso Hospital, 22.2% of respondents said RH policies and protocols did exist. 55.6% of respondents said students did patronize RH services. 55.6% of respondents said there were facilities for delivery of RH services. Conclusions: Knowledge of fertile periods was poor, concept of safe sex was fair, risk of pregnancy, transmission and cure of HTV/AIDS and STI was good. Health workers and parents were considered better providers of RH information than peers. Females would get more information on RH issues from mothers and health workers than from peers. Teenage pregnancy and premarital sex were seen as negative, giving abstinence a chance. Though condom use was perceived as easy, knowledge of the steps in its use was poor. good proportion of STIs and abortions were managed at health facilities. Carrying condoms was seen as being prepared for sex. Parents would talk more about premarital sex, less approved of contraceptive use and least of abortion. Religion was seen to shape sexuality. University Administrators, Health workers at the Hospitals were barely aware of RH policies and protocols, had minimal interaction with students on RH issues and had few facilities for RH service delivery. Recommendations were made to the University Administration, the Management of the University and Bomso Hospitals, the Student Leadership, the University Community, the Student Community, the University System and Stakeholders and Civil Society. Recommendations were also made for further research.
A thesis submitted to the Department of Community Health, School of Medical Sciences in fulfilment of the requirements for the degree of Masters of Science, 2004