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Health Care Providers' Knowledge, Attitude, Competency and Provision of Emergency Contraception: a Comparative Study of Oyo and Kaduna State, Nigeria

Osinowo, K. A, Atibioke, O.P, Adako. O. P, Okunfulure, F., Atoloye, O. A, Ladipo, O.A, Nigeria

Nigeria has a low contraceptive prevalence rate, a large number of women have unintended pregnancies, many of which are reported to be terminated through covert abortion usually perpetuated by quacks and frequently unsafe, despite the country's restrictive abortion law, thus contributing to the high maternal mortality rate in Nigeria, particularly in the rural areas. Emergency Contraception is proven to be safe and effective in preventing unplanned pregnancy. Health care providers' knowledge, attitude, competency and provision of Emergency contraception as part of Family Planning method mix are important determinants of improved access as well as quality and outcome of care and service. The study determined and compared Knowledge, Competency, Attitude and Provision of EC among health care providers in Oyo State, South Nigeria and Kaduna State, North Nigeria. The study was descriptive and cross sectional. Purposive sampling technique was used. A self-administered questionnaire was used to obtain relevant information from 165 healthcare workers comprising doctors, nurse/midwives and CHEWs. SPSS Version 20 was used for data analysis. Respondents from both states are majorly nurses/midwives and Community Health Extension Workers. Findings showed poor knowledge in both states with mean scores of (8.5+-4.0) Oyo and (8.3+-3.6) Kaduna, out of 20 points knowledge and competency score. (Only 6%) and (4%) had good knowledge and competency in Emergency Contraception in Oyo and Kaduna state respectively. Only (9.4%) Kaduna and (6.3%) Oyo identified Copper T as the maximum effective EC method. Findings revealed positive disposition towards Emergency Contraception in both states. Majority of respondents affirmed that EC is beneficial (95%) Oyo, (91%) Kaduna and would encourage others to use if they need it (89%) Oyo and (88%) Kaduna. Majority from both states, (85%) Oyo and (89%) Kaduna, agreed that ECP is important in Post Rape care as well as an important component of Reproductive Health. (69%) Oyo and (51%) Kaduna declared that they have been recommending Emergency Contraceptives while only 20% and 17% reported that there are no barriers in recommending and prescribing Emergency contraceptives from Oyo and Kaduna respectively. Only (41.3%) Oyo and (30%) Kaduna reported that they have adequate knowledge in Emergency contraceptives. Only (56%) and (48%) in Oyo and Kaduna respectively felt that EC would not promote sexual promiscuity while about (45%) Kaduna said they have ethical and religious concern to EC provision as against (15%) in Oyo state. There is urgent need for training and re-training programmes on Emergency Contraception among different cadres of health professionals in Nigeria to enable them serve clients who need it better. Educational efforts to address myths and misconceptions about EC are also recommended.

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