A Brief Educational Intervention Changes Knowledge and Attitudes about Contraception for Adolescents in Rural Ghana
ESC Congress Library. Perry R. May 28, 2014; 50470; A-053
Dr. Rachel Perry
Dr. Rachel Perry
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Abstract
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Objectives
The primary aim was to assess knowledge and attitudes about contraception among female adolescents and parents of adolescents in rural Ghana, before and after a brief educational intervention. The secondary aim was to measure knowledge and attitudes toward education for females, particularly in the setting of pregnancy.


Methods
We administered a 26-item survey to 52 adolescent females aged 13-19 years and 48 parents of adolescent females in Manso Nkwanta, Ghana before and after an educational intervention. The survey was designed to evaluate knowledge and attitudes toward adolescent pregnancy, contraception, and education of women during and after pregnancy. The 30-minute intervention addressed the safety and effectiveness of contraception for teens, with emphasis on the intrauterine contraceptive device (IUD) and implant. It also addressed the importance of delayed pregnancy in women's ability to continue education. Pre- and post-intervention knowledge and attitudes were compared using descriptive, chi-square, and t-test statistics.


Results


Knowledge
At baseline, 58% of participants knew contraception is safe for teens. Most did not know whether IUDs and implants are safe (90% and 71% respectively). The majority knew teens are more likely to die in childbirth than other women (81%), most teen pregnancies are unintended (79%), and teen mothers are less likely to finish education (90%). After the intervention, more participants knew that contraception in general (84%), IUDs (54%), and implants (77%) are safe for teens compared to baseline (p<0.001 for each). Parents answered more post-intervention knowledge questions correctly compared to teens (7.2 versus 5.8 out of 9, p<0.001).


Attitudes
At baseline, 94% thought adolescents should have access to contraception. Most had no opinion whether the IUD (93%) or implant (69%) was a good option for themselves or their daughters. Half (52%) of adolescents and 23% of parents thought a pregnant adolescent should stop school, though the majority of both groups (92% and 96%) thought she should return to school after birth. After the intervention, more participants had positive attitudes toward IUDs (54%) and implants (72%) compared to baseline (p<0.001 for each).

Conclusions
Although knowledge was high regarding the medical and social risks of teen pregnancy, knowledge of contraceptive methods and their safety for teens was low. An educational intervention improved contraception knowledge and created favorable attitudes toward the most effective methods. Existing programs should be modified to include evidence-based information about contraception. Larger issues of educational parity for Ghanaian women emerged and should be addressed by future interventions.


 

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