THE COPPERBELT UNIVERSITY

MICHAEL CHILUFYA SATA

SCHOOL OF MEDICINE

NAME OF STUDENT : CHANYA RICHARD

STUDENT NUMBER : 18123267

NAME OF SUPERVISOR : Dr. David Mulenga

RESEARCH TITLE : ASSESSMENT OF KNOWLEDGE, ATTITUDE AND

PRACTICES AT CBU-SOM TOWARDS

CONTRACEPTIVE USE.

This project proposal is being submitted in partial fulfilment of the

requirements for the degree in Public Health (MBP).

DECLARATIONS

STUDENT:

I CHANYA RICHARD of student identification number 18123267 hereby declare

that the work in this proposal is my working except for quotations and summaries

that have been cited. The work in this paper has not been submitted before by

anyone at any institution of higher learning.

Date......................................

Signature.............................................

SUPERVISOR: Dr. David Mulenga

Date.................................

Signature.....................................

i
ABSTRACT

Introduction

Contraception is regarded as an important preventive measure of unintended

pregnancies (UP) and sexually transmitted diseases, including human

immunodeficiency virus infection and acquired immune deficiency syndrome

(HIV/AIDS), among youths. This study aims to assess the knowledge, attitude, and

practices of contraception use among female students at The Copperbelt University

(CBU) in Ndola.

Method

This research study will be conducted at the Copperbelt university school of

medicine. The target population for the study are all female students the
aforementioned school regardless of their age. A cross- sectional study will be
conducted on the female students at the University. Data will be collected using a
predesigned, tested and self-administered questionnaire. The questionnaire will
include specific sections to test the respondent's knowledge, attitude ad practices
towards the use of contraceptives. Data analysis will be done through descriptive
statistics.

Conclusion

Data collected from this study will highlight the status of knowledge, attitude and
practices of the respondents towards the use of contraceptives. This will allow for
appropriate measures and interventions to be put in place by relevant authorities.

ii
ACKNOWLEDGEMENT

I would like to thank the almighty God for his divine intervention in the entire

procedure of developing and writing my research proposal. My heartfelt gratitude to

Dr. David Mulenga for his input and guidance in supervising my work. I would also

like to extend my sincere thanks to the University Administration and lecturers of

the Copperbelt school of Medicine for their commitment to teaching and guiding us.

I also extend my appreciation to family and friends for their support and love all the

way.

iii
Table of Contents
DECLARATIONS......................................................................................................................i
ABSTRACT..............................................................................................................................ii
ACKNOWLEDGEMENT........................................................................................................iii
LIST OF ABBREVIATIONS..................................................................................................vi
CHAPTER ONE........................................................................................................................1
INTRODUCTION.....................................................................................................................1
PROBLEM STATEMENT........................................................................................................3
LITERATURE REVIEW..........................................................................................................4
GENERAL OBJECTIVES........................................................................................................6
SPECIFIC OBJECTIVES......................................................................................................6
RESEARCH QUESTIONS....................................................................................................6
JUSTIFICATION......................................................................................................................7
MEASUREMENTS...................................................................................................................8
CONCEPTUAL FRAMEWORK.....................................................................................................9

CHAPTER TWO: METHODOLOGY....................................................................................10

STUDY SITE.......................................................................................................................10
TARGET POPULATION....................................................................................................10
STUDY DESIGN.................................................................................................................10
SAMPLE SIZE....................................................................................................................10
SAMPLING PROCEDURE................................................................................................11
INCLUSION CRITERIA.....................................................................................................11
EXCLUSION CRITERIA....................................................................................................11
DATA COLLECTION........................................................................................................11
DATA ANALYSIS..............................................................................................................12
ETHICAL CONSIDERATION...........................................................................................12
STUDY LIMITATIONS......................................................................................................12

iv
REFERENCE LIST.................................................................................................................13
ANNEXES...............................................................................................................................18
ANNEX I: INFORMATION SHEET..................................................................................18
ANNEX II: BUDGET..........................................................................................................19
ANNEX III: QUESTIONNAIRE........................................................................................20

v
LIST OF ABBREVIATIONS

UP - UNINTENDED PREGNANCY

MCS - SOM - MICHEAL CHILUFYA SATA SCHOOL OF MEDICINE

HIV - HUMAN IMMUNEDEFICIENCY VIRUS

vi
CHAPTER ONE

INTRODUCTION

Almost 20% of the Zambia’s population is between 15 and 24 years of age (Central

Statistics Agency, 2022). This group constitutes the majority of youths who join

universities in Zambia. Although the group is the most sexually active, girls in the

group are faced with more challenges in accessing contraceptives than are married

women due to the stigma attached to their sexual activities before marriage. This

poses the risk of unwanted and teen pregnancies and unsafe abortions (Ministry of

Health, 2020). The latter is a significant public health concern in many developing

countries, with the most recent publication showing global annual incidence estimates

that suggest that 25.1 million women had undergone unsafe abortions between 2010

and 2014 (Ministry of Health,2020).

Despite being freely available at health facilities throughout the country, the

utilization of contraception among students, especially females, remains low, with

increased rates of unplanned pregnancies being reported (Ministry of

Health,2020).Previous reports in Zambia have shown the utilization of contraception

among secondary school students to be between 11.8% and 40.0% despite students

exhibiting a relatively high knowledge of contraception (Ministry of Health,2020).. In

the general population, the contraception uptake rate has been reported to vary from

19.0% to 34.4% (Ministry of Health,2020).].

1
The correct use of contraception can prevent unintended pregnancies, unsafe

abortions, and sexually transmitted infections, including HIV (Ministry of

Health,2020).. Unwanted pregnancies among students of higher learning institutions

create a major public health problem, particularly in developing countries, and may

jeopardize students' learning and potential careers. Globally, several studies have

reported on the knowledge, attitude, and practice toward the use of contraception

among various groups of students (McEwan B, Aukett R, Hills MD. N Z Med

J. 1988) but little is known about the current knowledge, attitude, and practice toward

the use of contraception among young females in this study setting.

Most previous studies have concentrated mainly on primary and secondary school

girls, and only a few have addressed the problem of the low utilization of

contraception among university students. Further, to the best of my knowledge, no

study has been conducted in this study area to assess the knowledge, attitude, and

practice of methods of contraception among female university students. This

study, therefore, aimed to assess the knowledge, attitude, and practice of

contraception use among female students on Copperbelt School of medicine, in

Ndola, Zambia.

2
PROBLEM STATEMENT

The correct use of contraception can prevent unintended pregnancies (UP), unsafe abortions,

and sexually transmitted infections, including HIV (Smith, Wong, McNamee & Fairley,

2012). Unwanted pregnancies among students of higher learning institutions create a major

public health problem, particularly in developing countries like Zambia, and may jeopardize

students’ learning and potential careers. Globally, several studies have reported on

knowledge, attitude, and practices towards the use of contraception among various students

(McEwan B, Aukett R, Hills MD, 1988) but little is known among young females in this

study setting. It is against this backdrop that this research aims at assessing the knowledge,

attitude, and practice of contraceptive use among students.

3
LITERATURE REVIEW

A number of Knowledge Attitude and Practice survey have been carried out

covering different population groups (Thapa, et al., 2015& Rao, et al., 2005). A

survey conducted in Manipur concluded that the use of modern family planning

methods increases with education, while female sterilization prevalence decline

sharply with women’s education level (Ayub, et al., 2015). Moreover, recent

analysis of Demographic Health Survey (DHS) for 25 developing countries

confirms previous findings from the World Fertility Survey (WFS) that the better

educated women are more likely to practice contraception (Lamidi, 2015). A study

conducted by Samba (2014) on the Nurses and Nursing students about Emergency

Contraceptives (EC) in Kenya mentioned that the level of knowledge of EC is poor

and more information is needed.

A study conducted in Lahore at Aitcison Hospital reveals that the level of education of

the women was 43 percent is matric however, 60 percent have the awareness related to

contraceptives. In addition 54 percent women approved the use of contraception.

Another study conducted at Lahore, Pakistan revealed the low level of education that is

70 percent illiterate followed by the low prevalence of contraception that is 27.9 percent

(Manzoor, et al., 2013).

The above studies clearly show the difference of urban and rural practices of

contraception and the relationship of education too.

A study conducted with the women having unplanned pregnancy in Nigeria revealed the

4
knowledge of contraception up to 85 percent among Nigerian women. The source of

knowledge was the health care provider followed by mass media 38.4 percent and 21.4

percent respectively. The women agreed to the usefulness of contraception that is 86

percent however, only 8.7 percent women ever used the contraception. The constraints

identified in this study were partner 54 percent, ill health 35 percent and religion

contributed to 28 percent (Ross, et al., 2013).

5
GENERAL OBJECTIVES

To assess the knowledge, attitudes and practices towards contraceptive use among female

Students at the Micheal Chilufya Sata School of Medicine.

SPECIFIC OBJECTIVES

 To assess the level of knowledge towards contraceptive

 To asses attitude towards contraception

 To assess contraceptive practices

 To assess barriers in accessing and using contraceptives

 To identify facilitators that influence contraceptives use

RESEARCH QUESTIONS

 What is the level of knowledge among female students towards use of contraceptives?

 How is the student’s attitude towards use of contraception?

 How is the practice of contraception among female students?

 What barriers do students face in accessing and using of contraceptives?

 What facilitators influence the use of contraceptives?

6
JUSTIFICATION

Unintended pregnancies (UP) are on an increase among most female youths in Zambia. This

is mainly due to the low utilization of contraception among them (youths).

Studies show that having sufficient knowledge about use of contraception and the benefits it

offers increases acceptance and uptake of available contraception services. Therefore, results

of this study will show the status of knowledge, attitude, and practices of female students at

the Micheal Chilufya Sata School of medicine towards the use of contraceptives and hence

give picture of their acceptance, willingness and uptake of the use of contraceptives.

7
MEASUREMENTS

Operational definitions

CONTRACEPTION: The deliberate us of artificial methods or other techniques to prevent

pregnancy as a consequence of sexual intercourse.

UNINTENDED PREGNANCY (UP): When a woman gets pregnant without wanting or

planning for pregnancy due to improper or lack of use of contraceptives methods.

KNOWLEDGE: Information and skills that are acquired through experience or education.

ATTITUDE: A way of thinking or feeling about something

PRACTICE: The customary, habitual, or expected procedure or way of doing something

Dependent variables; Contraception use

Independent variables; knowledge, Attitude and Practices

Type of variable Variable Indicator Scale of measurement

Dependant Contraceptive use Positive test Absent or Present

Independent Knowledge No. of responses 0- no knowledge

1-3 poor

4-6 Reasonable

7-10 Good

Independent Attitude No. of responses 0-4 negative

4-8 positive

Independent Practices No. of responses 0-4 negative

4-8 positive

8
CONCEPTUAL FRAMEWORK

Independent Variables

Knowledge Dependent Variable

Attitudes
Contraceptive Use

Practices

9
CHAPTER TWO: METHODOLOGY

STUDY SITE

This study will be conducted in Ndola at Michael Chilufya Sata School of Medicine on the

Copperbelt of Zambia. This site is appropriate because it the main campus for the female

students of the University who happen to be the respondents in this research.

TARGET POPULATION

The study will involve female students at the Micheal Chilufya Sata School of medicine of

all ages.

STUDY DESIGN

This is a descriptive cross- sectional design using quantitative methods will be used to study

knowledge, attitude, and practice among female students towards use of contraceptives. A

well-structured questionnaire will be used. This study design has been chosen for it's

simplicity to use, cost effectiveness, economical and time saving nature.

SAMPLE SIZE

The sample size will be calculated using the following formula;

n=p(1-p) (z/E)²

Where p= the proportion of successes in the population, z= a reflection of the confidence

level that will be used, E= desired margin of error.

10
 n=0.5(1-0.5) (1.96/0.05)²

n=0.25(1356.24)

n=339.06

Therefore, a sample size of 339 is needed.

SAMPLING PROCEDURE

A simple random sampling technique will be used for this study at the Micheal Chilufya Sata

School of medicine.

INCLUSION CRITERIA

All female students at the Micheal Chilufya Sata School of medicine.

EXCLUSION CRITERIA

Women and girls that are not at the Micheal Chilufya Sata School of medicine and those

refuse to take part in the study.

DATA COLLECTION

A questionnaire with closed and open questions will be given to participants. Data will only

be collected after the participants give consent.

11
DATA ANALYSIS

Qualitative data will be descriptive and quantitative data will be analysed using statistical

package for social sciences, SPSS version.

ETHICAL CONSIDERATION

Permission will be collected from CBU-SOM Management and consent from participants

before administering the questionnaires. Respondents will be made aware of the purpose,

involvement and importance of the research and their participation. The participants will be

assured of anonymity and confidentiality. It will clearly be stated that their participation is

voluntary and that they can withdraw at any time with no penalties.

STUDY LIMITATIONS

The small sample size to be used may not produce adequate results that can represent the

larger Zambian population. A larger sample size could be preferred but is not attainable due

to unlimited resources.

12
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ANNEXES

ANNEX I: INFORMATION SHEET

Figure 1: Information sheet

My name is Chanya Richard. I am a student at the Copperbelt University, School of

Medicine.

I am conducting a research on Knowledge, Attitudes, and Practices Towards Contraceptive

use among all female students at CBU-SOM. This is in partial fulfilment of the training in

Bachelor of Public Health

The research seeks to determine the status of knowledge, Attitudes, and Practices towards

use of contraceptives among female students at the University. Be informed that this study is

purely academic and any information you provide shall be used for the purpose of the study.

Participating in the study is completely voluntary; you as a participant are free to withdraw at

any. Information obtained from this study is completely confidential. No name or any other

forms of identification will appear on the research report. Your participation in the research

will be highly appreciated.

If you have any questions feel free to ask and below are my details;

Name: Chanya Richard

Contacts: 09656673891/ 0770507826

Email: richardrichanya @gmail.com

18
Figure 2: Consent form

I......................................................................................(full names), having read and

understood the information sheet, I willingly give consent to participate in the research study

as described above. Therefore, I hereby agree to be given a questionnaire and I am free to

withdraw at any time.

Signature.................................................

Date......................................

ANNEX II: BUDGET

ITEM UNIT COST DESCRIPTION TOTAL

ETHICS K600 TDRC 1 COPY K600

CLEARANCE

TRANSPORT K10 BUS FAIR TO AND 400

FROM BY 40 DAYS

PLAIN PAPERS K140 1 RIM OF A4 PAPER K140

PRINTING K2 1PROPOSAL K100

REPORT (24pages),
1QUESTIONARE (2
pages), 1 FINAL
PROJECT REPORT
(>30 pages

PHOTOCOPYNG K1 150 pages K150

OTHER BINDING OF K250

STATIONARY REPORT
PROPOSAL, FINAL
REPORT AND PENS

LUNCH RESEARCHER’S 150

ALLOWANCE for 10

19
ANNEX III: QUESTIONNAIRE

SECTION A. DEMOGRAPHICS

1. What is your age range?

a. 18-30

b. 31-44

c. ≥45

2. What is your marital status?

a. Single

b. Married

c. Divorced/separated/widowed

3. Religion

a. Christian

b. Muslim

c. Hindu

d. Atheist

e. Other

20
4. Highest education level attained?

a. No education

b. Primary education

c. Secondary education

d. Tertiary education

5. What is your occupation?

a. Employed

b. Unemployed

SECTION B. KNOWLEDGE OF CONTRACEPTIVES

1. Have you heard of contraceptives?

a. Yes

b. No

2. Are you aware of the contraception services offered at various clinics in Zambia?

a. Yes

b. No

21
3. How did you know about contraception services?

a. TV/Radio

b. Social media

c. Friends and family

d. School/workplace

e. Hospital/clinic

4. Are you aware of the age at which women are supposed to start the use of

contraceptives in Zambia?

a. Yes

b. No

5. Having unprotected sexual intercourse has a risk of getting unintended pregnancy?

a. Yes

b. No

SECTION C. ATTITUDE AND PRACTICES TOWARDS CONTRACEPTION USE

1. Do you see a need for the use of contraceptives?

a. Yes

b. No

22
2. Would you be willing to start taking contraceptives?

a. Yes

b. No

3. Would you be willing to go to any clinic/ hospital anytime you want to take

contraceptives?

a. Yes

b. No

4. Do you feel shy to ask for contraceptives from the health personnel?

a. Yes

b. No

5. Do you fear having unintended pregnancy?

a. Yes

b. No

6. Do you think use of contraceptive can prevent unwanted pregnancy?

a. Yes

b. No

7. Do you think obtaining contraceptives is expensive?

a. Yes b. No
23
8. Do you think developing a habit of taking contraceptives is good for you?

a. Yes

b. No

24