CHAPTER ONE

INTRODUCTION
Contraceptive use helps couples and individuals realize their basic rights to decide freely and
responsibly if, when and how many children to have. The growing use of contraceptive
methods has resulted in not only improvement in health-related outcomes such as reduced
maternal mortality and infant morbidity (Admed et al 2012) but also improvement in
schooling and economic outcomes, especially for girls and women (Canning et al
2012).Contraceptives are used by the majority of married or in union women in almost all
regions in the world. In 2015, 64% of married or in union women of reproductive age
worldwide were using some form of contraception .However; Contraceptive use was much
lower in the least developing countries (40%) and was particularly low in Africa (33%) for
reasons such as inadequate knowledge, accessibility, among others. Modern Contraceptive
methods constitute most contraceptive use.
According to Lule et al in 2007, Contraceptives also known as Birth control is the intentional
prevention of Contraception through the use of various devices, sexual practices, chemicals,
drugs or surgical procedure , Also Singh et al 2014 defined contraceptives as a product or
medical procedure that interferes with reproduction from acts of sexual intercourse.
Contraceptives are aimed at spacing out deliveries and preventing unwanted pregnancies.
There are different methods of contraceptives with each having its side effects and risk with
some being more reliable than others. These methods of Contraceptives can be classified
broadly into; Natural methods, Hormonal methods, Barrier methods and Permanent
sterilization

1. 1 Background
According to Adinma, 2012 the rate of modern contraceptive use worldwide has resulted in
the reduction of maternal and infant mortality rates and other adverse outcome.
Over the past five decades, the use of contraceptive methods has markedly increased such that
nearly two in three married or in union women globally in 2015 were using some form of
contraception. The growth in contraceptive use was especially rapid in Asia and Latin
America and the Caribbean while it has increased at a much slower pace in several regions of
Sub Saharan Africa. The use of Modern Contraceptive method Accounts for the vast majority
of use, although the mix of methods used varies widely across regions and countries. Despite
the development of a range of effective methods, in at least one in four countries just one
1
method account for 50% or more of all contraceptive use among married or in union
women(Admed,2012)
Contraceptive prevalence almost doubled in the world between 1970 and 2015 from 36% in
1970 to 64% in 2015 with most of the increase occurring prior to the mid 1990 (Admed et al
2012)
In India a study was carried out to access the knowledge and use of contraceptives among
currently married adolescent women (CMAW), a very high proportion of girls get married at
a very young age and immediately are exposed to the risk of bearing children. Women often
shy away from using contraception mainly because they lack knowledge and are afraid of
sterilization; or pills; or injection is not available, thereby have to carry the burden of
unwanted pregnancy or go for abortion which is mainly unsafe (Jejeebhoy, 2000).
In Africa, the annual rates of changes in modern contraceptive prevalence among women of
reproductive age varied from as low as 0.77% in Lagos Nigeria to 8.64% in Ghana. The rate
of change was also high in Burkina Faso, Kaduna and Uganda. These changes were due to
improvement in knowledge and accessibility (Ahmed et al 2012).
According to a research carried out in Ibadan Nigeria 2002, it was accessed that in developing
countries especially Africa, Reproductive ill health that have been a great concern to many
stakeholders as maternal mortality and morbidity are very high compared to the developed
world .Also, reproductive health knowledge and access to quality of care, maternal health
services in Africa are poor with significant health consequences (Adinma, 2002).
Despite the benefits of contraceptives to reproductive health, contraceptive use has been
found to be limited among many displaced persons in the world, some of whom face
difficulties having access to reproductive health care services (Ngum, 2014)
Moving to Cameroon, general contraceptive use has increased from 16% in 1991 to 32% in
2011 and is still unsatisfactory. Main reasons for nonuse or poor use of contraceptives in
Cameroon by those in need include health concerns, infrequent sex, opposition from others
and lack of knowledge. According to Ajong et al, Reasons for use of a particular
contraceptive method in Cameroon include the effectiveness of the method, its financial and
geographical accessibility, its ability to prevent STIs and whether or not it is prescribed by
medical personnel. The promotion of family planning or contraception has shown to reduce
hunger, reduce poverty, infant and maternal mortality rates, it also contributes to women
empowerment.

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1.2 Statement of Problem
In Cameroon, general contraceptive use has increased but there are still cases of unwanted
pregnancies (Nchinda 2015).No or low use of contraceptives leads to increase house hold
populations, with Cameroon as a developing country the rate of unemployment is high , some
families might not have enough finance to support children and give them proper education,
this may lead to hunger, school drop outs, homeless children and subsequently high crime
rates among the community, also high cases of unwanted pregnancy, Infant and maternal
mortality, STIs may increase as well. This study is to find out the level of knowledge women
of child bearing age in koweit Community have on contraceptives, reasons for the choice of
contraceptive they use and challenges faced in using it.
1.3 Rationale of Study
The promotion of family planning or Contraception will reduce hunger and poverty as
families will be able to limit spacing between children and unwanted children, thus they will
be able to properly educate their children and improve their living conditions, this will
contributes to women empowerment and reduction in abortion, infant and maternal mortality
and morbidity
1.4 Research Questions
1) What knowledge do women of child bearing age have about contraceptives?
2) What are the Reasons for the use of contraceptives among women of child bearing age?
3) What are the challenges faced by women of child bearing age using it in koweit?
1.5 Objectives
1.5.1 General Objective
Investigating knowledge among women of child bearing age (19-49) on the use of
contraceptives in koweit Community, Douala
1.5.2 Specific Objectives
1) To investigate Knowledge on contraceptives among women of child bearing age in koweit
community
2) To find out reasons for the use of contraceptives among women of child bearing age koweit
in Douala
3)To Investigate challenges faced by women of child bearing age in use contraceptives within
koweit.

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1.6 Significance of Study
Women are an integral part of the health, community and societal building of a nation. Their
knowledge on contraceptives and use is vital in preventing abortion, infant and maternal
mortality, sexually transmitted infections and optimization of health. Assessing their
knowledge on contraceptives will help determine their level of understanding and practice,
which will further improve on Health strategies towards awareness of contraceptive.
1.7 Definition of Terms
Contraceptives: refers to the use of various methods devices, drugs, sexual practices or
surgical procedure to prevent pregnancy by interfering with the normal process of ovulation,
fertilization and implantation (Cates, 2012)
Knowledge: According to Webster’s dictionary, knowledge is the fact or condition of
knowing something with familiarity gained through experience or association (Stephen 2000)
Investigation; According to Random house, INC, 2022 An Investigation is a systematic,
minute and thorough attempt to learn the facts about something complex or hidden
Challenges; something or Situation that needs great mental or physical effort under to be
done successfully or the situation that requires great effort (online Cambridge dictionary
2021)
Age; length of time that a person has lived or a thing has existed. (Webster dictionary 2022)
Conception or fertilization: Fusion of gametes to give rise to new individual or offspring
and initiate its development.
STIs; Sexually Transmitted Infections
IUDs; Intrauterine Devices
Vasectomy: Removal of the vas deference in males.
Participant; A person who will take part in activity

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 CHAPTER TWO

LITERATURE REVIEW
2.1 Definition
Cates in 2012 defined contraceptives as use of various agents’ drugs, sexual practices or
procedures to prevent conception or pregnancy by interfering with the process of ovulation,
fertilization or implantation. Also according to Singh et al 2014, contraceptives are products
or medical procedure that interferes with reproduction from acts of sexual intercourse. They
are excellent strategies to prevent pregnancy in all women not desiring a future pregnancy and
not wanting a permanent contraception procedure. The most appropriate method of birth
control depends on individual’s overall health, age, frequency of sexual activity, number of
sexual partners, desire to have children in the future and family history of certain diseases
These methods of Contraceptives can be classified broadly into; Natural methods, Hormonal
methods, Barrier methods and Permanent sterilization .Natural methods such as breast
feeding, calendar(rhythmic) method, abstinence or celibacy, withdrawal method or coitus
interrupts.(Moreira et al 2019), Hormonal methods in which medications which are
hormones are used to prevent ovulation. These methods include, birth control pills known as
oral contraception, Depovera injections, jadelle implants. Also, barrier methods which work
by preventing the sperm from getting to the egg and fertilizing the egg such as (Cates, 2012)
male and female condoms which are very important because the use of condoms among
sexually active women is effective in fighting against sexually transmitted infections and HIV
.Other methods are the diaphragm and cervical cap, intrauterine devices (IUD) which are
inserted into the uterus to prevent the fertilized egg from implanting in the wall of the uterus,
Lastly Tubal ligation where the fallopian tube is tied and cut to prevent fertilization with
vasectomy are methods of permanent contraception(Cates, 2012).

2.1.1 Trends in Contraceptive use worldwide

Contraceptives are used by majority of women in almost all regions of the world. In 2015,
64% of married women or union women of reproductive age worldwide were using some
form of contraception. However, contraceptive use was much lower in the least developed
countries (40%) and was particularly low in Africa (33%).Among the other major geographic
areas, contraceptive use was much higher ranging from 59% in Oceania to 75% in Northern

5
America. Within these major areas there are large differences by region and across countries.
(Ahmed et al 2012)
At least 1 in 10 married or in union women in most regions of the world have an unmet need
of family planning. Worldwide in 2015, 12% of married or in union women are estimated to
have had an unmet need for family planning; that is, they wanted to stop or delay child
bearing but were not using any method of contraception. The level was much higher, 22%, in
the least developed countries. Many of the latter countries are in sub-Sahara Africa, which is
also the region were unmet need highest (24%) doubled the world average in 2015. (Ali et al
2013)
Modern contraceptive methods constitute most contraceptive use. Globally in 2015, 57% of
married or in union women of productive age used a modern method of family planning,
constituting 90% of contraceptive users. When users of traditional methods are counted as
having an unmet need for family planning, 18% of married or in union women worldwide are
estimated to have had an unmet need for modern methods in 2016. (Alkema et al 2013)
Substantial gabs still persist in the use of modern methods among couples or singles who want
to prevent pregnancy. Large gabs remain in the proportion of total demand for family
planning satisfied with modern methods in countries where over all contraceptive use is low
or where many couples rely on traditional methods of contraception. In 2015, less than half of
total demand for family planning was being with modern methods in 54 countries (34 of
which are in Africa). (Betrand, 2014) In an additional 76 countries, less than 75% of total
demand was met by use of modern methods.
Growth in contraceptive prevalence until 2030 is expected mainly in the regions of sub-
Saharan Africa an Oceania. Between 2015 and 2030, the time period of the 2030 agenda for
sustainable development, contraceptive use is projected to grow particularly in regions where
less than half of married or in union women of reproductive age currently use contraception.
Contraceptive prevalence is projected to increase from 17 to 27% in Western Africa, from 23
to 345 in middle Africa, from 40 to 55% in Eastern Africa, and from 39 to 45% in Melanesia,
Micronesia and Polynesia. Yet unmet need for family planning is still projected to remain
high in 2030, above 20% in all these regions, except in Eastern Africa where it is projected to
decrease from 24% to 18% between 2015 and 2030.
Nearly 800 million married or union women are projected to be using contraception in 2030,
and growth in the number of contraceptive users will be uneven across regions. The global
number of married or in union women using contraception is projected to rise by 20 million,
from 758 million in 2015 to 778 million in 2030.Growth in number of contraceptive users is
6
projected to be high for all regions of Africa and in Southern Asia. Globally, the number of
women with an unmet need for family planning is projected to change little, from 142 million
in 2015 to 143 million in 2030, due to growth in women of reproductive age in Sub-Saharan
Africa and growth in the demand for family planning (Bertrand et al 2014)
2.1.2 The benefits of Contraceptives
 Preventing maternal morbidity and mortality
Contraception has clear health benefits, since the prevention of unwanted pregnancies results
in subsequent decrease in maternal morbidity and mortality. Contraceptives allow spacing of
pregnancies, delaying pregnancies in young girls who are at risk of health problems and death
from early child bearing; preventing pregnancy among older women who face increased risk.
Contraceptives enable women who wish to limit the size of their families to do so. By
reducing rates of unintended pregnancies; contraception also reduces the need for unsafe
abortion. It is a low cost and effective way to save life (Darroch 2012).
 Reducing unsafe abortion from unintended pregnancies
An estimated 20 million unsafe abortions take place each year, resulting in 6700 deaths
annually, mostly in developing countries. Contraception can prevent many of these tragic
deaths by reducing the number of unintended pregnancies with a higher risk of pregnancy
complications and unsafe abortions (Cates, 2012)
 Reducing infant mortality
Contraception can prevent closely spaced and ill-timed pregnancies and birth, which
contribute to some of the world’s highest infant mortality rates. Closely spaced births in
higher infant mortality: international survey data show that babies born less than two years
after their next oldest brother or sister are twice as likely in the first year, as those born after
an interval of three years. Infants of mothers who die as a result of giving birth also have a
greater risk of death and poor health. (Singh 2007)

 Helping to prevent HIV/AIDS

Contraception reduces the risk of unintended pregnancies among women living with HIV,
resulting in fewer infected babies and orphans. In addition, male and female condoms provide
dual protection against sexually transmitted infections (STIs) including HIV. Contraceptive
use prevent more than 577,000 unintended pregnancies to HIV infected women each year in
sub-Sahara Africa.
 Empowering people and enhancing education

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 Contraceptives enable women to make informed choices about their sexual and reproductive
health, and create an opportunity for enhanced education and participation in society,
including paid employment. Additionally, having smaller families allow parents to invest
more in each child. (Cates 2011)

 Reducing adolescent pregnancies

Pregnant adolescent are more likely to have preterm and low birth weight babies. Babies born
to adolescents have higher rates of neonatal mortality. Many adolescent girls who become
pregnant have to leave school. This has long term implications on them as individuals, their
families and communities.
 Slowing population growth
Contraception is key to slowing unsustainable population growth and the resulting negative
impacts on the economy, environment, and national development efforts (Singh, 2012)

2.1.3 Types and Classification of Contraceptives

Table 1: Contraceptives are known to be in various types.
The most commonly used one are;

Type of contraceptives Advantages Disadvantages

1)Natural methods

 Abstinence(Celibacy) No risk of pregnancy, easy to Might be hard to stay abstinent for

handle, no cost involved, no some people, Alcohol, Cannabis
risk of STIs or HIV and other drugs can affect decision
making

 Rhythmic method

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Also called Calendar method. It
works by a woman monitoring when
Have no side effects, Its Doesn’t protect against sexually
she is fertile and avoiding sexual
appealing to women who transmitted infections, least
activity or using other birth control
have religious objectives to effective as it doesn’t completely
such as condoms at the time she is
use medical forms of birth prevent pregnancy because of
fertile
control period variation, needs consistent
timing in order to avoid mistakes

 Withdrawal method
Also known as coitus interrupts;
is when a man removes the penis
from the vagina prior to Takes a lot of control for the man to
ejaculation. This prevents the pull out before ejaculation, does not
sperm from being deposited in No cost involved, universally protect against STIs, risk of pre
the vagina. acceptable, no side effects ejaculate may contain spermatozoa
presenting the possibility of
conception

2) Hormonal Methods

Contain either estrogen or Protects against pregnancy Does not protect against STIs,
progesterone only. These methods for 5-10 years, doesn’t expensive, menstrual irregularities,
include; interrupt with sexual infection of the IUD
intercourse, safe if a woman
can lead to pelvic infection,
is breast feeding
mood swings

Does not interrupt with sex,

 Intrauterine Device (IUD); a Does not protect against STIS,
cheap, easy to manage
coil or small flexible T shaped inconsistence use may increase
device that is placed in the failure, needs timing. Mood swings
uterus. There is copper IUD that and menstrual irregularities
releases spermicide that kill

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 sperm and Hormonal IUD which
contain progestin that prevents
the sperm from reaching the egg
by thickening he cervical mucus.
Examples; Paragad

 Pills
Combined contraceptive having
two hormones; estrogen and
progestin, Loestrin 20 is an
example

Does not interrupt with sex, Doesn’t protect against STIs and
safe for breast feeding, are HIV, mood swings and menstrual
affected by other methods. irregularities,

 Injections
Has a high chance of
Liquids that are injected into the effectiveness, easy
body; containing synthetic convenient and not
progesterone and estrogen expensive
preventing ovulation. Depot
Provera and Neristerat are
examples

weight gain, does not protect

against STIs, abdominal pain and
mood changes

 Implants
Does not interrupt with sex, Irregular periods, must be used
Rod shaped plastic about the
easily removed, long term alongside condom to prevent
shape of a match stick placed
protection against pregnancy STIs ,headaches, moods swings
under the skin of the upper arm
and weight gain

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Barrier Methods Are safe for breast feeding, May interrupt with sex, incorrect
does not affect a woman’s removal and disposal may cause
These methods prevent sperm from
menstrual cycle, less costly, unintended pregnancy, prevent
getting to the egg. Include;
Condoms prevent against pregnancy only when used every
Condoms(male and
STIs and HIV time of sexual intercourse, excess
female),Spermicide ,Diaphragm and
friction during sex can cause the
cervical cap
condom to burst

Permanent or Sterilization
Method

These are ways of completely and

Permanently prevent Difficult to reverse, does not
permanently stopping conception
pregnancy, may decrease risk protect against STIs and HIV; need
 Tubal Ligation of ovarian cancer if the to use condom during sex,
A method of female ovaries are removed, Does Infections may occur if aseptic
sterilization performed by not affect sex drive or techniques were not maintained
cutting the fallopian tubes interrupt with sex during the procedure
and sealing them to prevent
fertilization

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Figure 1: Types/ Methods of Contraceptives
2.2 Concepts of Knowledge on Contraceptives
A number of studies have identified the knowledge of contraception linked to its usage. In
2018 a study of knowledge and practice of contraceptive use among female of child bearing
age Mosul, Iraq disclosed and acceptable level of knowledge and positive practices among
Iraqi women seeking health care in respect to birth control method. Because contraception
and family planning decision making are almost always the responsibility of both partners.
Females with lower levels of education require continued education and regular
communication about the importance of fertility control (Omran, 2012)
Studies carried out to access the knowledge, attitude and practice of emergency contraceptives
among women Adama university female students showed that higher education students’
unwanted pregnancy pose a major public health problem in the developed and developing
countries (Josaphat, 2007) including Ethiopia and are associated with far reaching effects such
as jeopardizing students’ educational progress and future careers. These pregnancies are
mostly unplanned and unintended, and many are terminated either legally or illegally. Around
30% to 50% of women presenting for choice of termination of pregnancy were not using
contraceptives at the time of contraception and similar numbers of pregnancies were
unplanned. In about half of all pregnancies, conception occurs due to inadequate guidance to
use contraception effectively, including the user’s inability to address their feelings, poor
attitude towards contraceptives and lack of motivations. Despite the Ethiopians government’s

12
effort to prevent unwanted pregnancies and abortion among youths of age less than 24 years,
the number of youths requesting termination of pregnancy is increasing annually. Despite the
availability of contraceptives with available cost, there is a large number of youths with
unwanted pregnancies and unsafe abortion. (Margarenta, 2016).A total of 660 students
completed the questionnaire making a response rate of 100% though nearly half of the
respondents have heard about emergency contraceptives in this study, only 15% of them had
identified the correct timing of administration of the pill after unprotected sexual contact. Less
than one-third of the respondents had good knowledge about emergency contraceptives on
overall summary index for knowledge in this study. This finding reveals that comprehensive
knowledge about emergency contraceptive method is lacking.
Another study sought to determine the prevalence of use, level of knowledge, and predictors
of modern contraceptive use among reproductive-aged women in the Ledzokuku Krowor
Municipality, a densely populated residential part of the Greater Accra Region 2011. The
findings revealed that although there was a high level of knowledge and awareness of modern
contraceptives, only a small number of women actually use them. A number of factors,
including partners’ approval, marital status, and employment status were associated with use
of modern contraceptives while only religious beliefs and attitude significantly predicted use
of modern contraceptives (Taylor, 2011)

In Cameroon studies were conducted targeting women of child bearing age Biyem-Assi health
district to evaluate the knowledge and determine the future desires to use contraceptives
among women in urban Cameroon. Among the 212 women included in the survey, a good
proportion 95.6% identified contraceptives as used to prevent unwanted pregnancy and this
showed and increasing strength in increasing the level of education. Also, 77.5% thought that
contraception should be used by all sexually active women. The most sited contraceptive
method were: condom 689(96.8%), oral pills, and implants. Their main source of information
was family members, friends, the health personnel (47.7%) and the school (47.7%).The
knowledge of women of child bearing age in the Biyem-Assi health district was relatively
high but still unsatisfactory. The proportion of contraceptive non users who have no desire of
adopting any contraceptive method in future is still unacceptably high. The rate of use of
family planning services in the developing world and more particularly in Cameroon remains
unsatisfactory. The number of women with and unsatisfied potential demand for
contraception is still very high in Cameroon. Meeting targets of sustainable development
goals in maternal and neonatal health requires a good and consistent use of family planning

13
services. With abortion not legalized in Cameroon, the effective use of family planning
methods remains the main stay in the fight of high rates of induced abortion and its
complication.
In 2011, a study to access contraceptive use among adolescent was done in Kintampo area of
Ghana. A cross sectional survey carried in Kintampo North municipality and Kintampo South
District communities which are mostly rural area using both quantitative and qualitative
methods was conducted among 793 adolescent aged 15 to 19 years. The population has a
typical developing county structure. The percentage of educated people in the study was low.
There was a school dropout rate of 17.3% with adolescents abandoning school to support
family in farming and selling. The results showed that knowledge of at least one contraceptive
method was high, with knowledge of male condoms being used and it was the highest most
common contraceptive method used (82%).The use of other methods such as; pills injections
and foam among others were low. Adolescents who discussed contraceptive use before their
first sexual encounter were more likely to use contraceptive consistently when compared to
those who had never discussed contraceptive use. Though a high number of adolescent knew
at least one contraceptive method, this knowledge did not influence them to consistently use
contraceptive .Only a small percentage of the sexually active adolescent used a contraceptive
method consistently (Yen et al 2013)
A study on the Relationship of female literacy to contraceptive use in urban slums of Khushab
Punjab-Pakistan in 2010 was to determine the effect of education on contraceptive use among
married women of reproductive age. It was argued that education typically delays the age of
cohabitation, secondly literate women can learn about and use contraceptive efficiently than
uneducated women, thus reducing the number of unanticipated pregnancies. Thirdly, highly
educated women are likely to be more effective in producing healthy children. A cross
sectional design was used with a sample of 150 married women of reproductive age (15-
49years) were randomly selected and intensively interviewed, their most commonly used
contraceptive methods were female sterilization, condom, IUD, contraceptive injections, and
pills. Traditional methods like withdrawal and periodic abstinence were also used. The results
revealed that education has appositive impact on contraceptive use and in turn reduces the
family size along with other factors like socio economic status. Female literacy level in the
area was low, only 30.6% women were literates. Contraceptive use was higher among the
literate women 61%.As female educational level increased, contraceptive use also increased,
an inverse relationship between female educational level and number of children was

14
observed. The results revealed that education has a positive impact on contraceptive use and
in turn reduces the family size along with other factors like socio economic status.
2.3 Reasons for the use of Contraceptives
A study on Factors influencing the use of modern contraception among reproductive aged
women in Bangka Belitung Province, Indonesia revealed that the rate of women in Bangka
Belitung who actually used modern family planning was 44.1%.Most women who used
family planning were 30-34years and above and have graduated from high school. They also
had careers, 1-2 children, and lived in Urban and Rural areas. The 3 month family planning
injection was the main contraceptive used in Belitung. Factors such as woman’s age,
education, number of children, areas of residence and visits to health facilities were
considered significant issues in determining contraceptives use among reproductive aged
women in Bangka Province (Amraeni et al 2020)
In 2020, a work on Modern contraceptive use among reproductive aged women in Ghana:
Prevalence, Predictors and policy implications in Ledzokuku Krowor municipality showed
that although there was a high level of knowledge and awareness of modern contraceptives,
only a small number of women actually used them. A number of factors including partner’s
approval, marital status and employment status were associated with reasons for the use of
modern contraceptives while only religious beliefs and attitude significantly predicted use of
modern contraceptives (Taylor et al 2011)
Another research conducted to determine the factors that influence the use of modern
contraceptive methods in Minembwe, in Congo among women of child bearing age. At the
time of the study, only 14.3% of the women were using modern. The prevalence of the use of
modern was a bit lower than 18.0% reported by Apanga et al. in Ghana and 19.0% reported
by the Demographic and Health Survey in the Democratic republic of The Congo [DHS-
DRC].However, if only modern contraceptive prevalence is considered, this study shows that
it is higher in MINEMBWE (11.6%), compared to those observed in the last three DHS-RDC
reports in 2003, 2010, and 2014 where the prevalence was 6.5%, 5.4%, and 8%, respectively.
Among the few women that used modern contraceptives, the main motivations for using
contraceptive methods were births spacing, avoiding unplanned pregnancy while only very
few use contraceptive methods to limit birth. Major challenge identified in this study is the
access to adequate family planning services. Over 30% of the women walk for over 30
minutes to the nearest health facility. This might be an important reason for the low usage of
FP among Minembwe women. Difficulty in accessing family planning service due to the long
distance between health facilities and homes has also been reported in other studies
15
Some women were of the opinion that healthcare workers usually display a discriminatory
attitude towards women who express the desire to use contraception and others said that there
were no suitable shelters in healthcare facilities to ensure confidentiality of PF service
delivery (Karim 2010)

2.4 Challenges faced in Using Contraceptives

In Ghana, a study was carried out to access the knowledge, perception and ever use of modern
contraceptives among women in GA East District, Ghana. Surveys of 332 women of child
bearing age were used. They were sexually active women with ages between 20 1nd 40 years
and most of the women were married at the time of the survey. Respondents expressed almost
universal awareness 99.7% of at least one method of contraception, about 55% had heard of
more than one method. The male condom and injectable were the most commonly mentioned
methods. Among respondents, 76% indicated that they felt comfortable using them. A
majority of the respondents indicated that both partners should be involved in the decision to
use any contraceptive, while only 18% indicated that the decision should be made exclusively
by the woman. Most women indicated that having adequate privacy is important to access
family planning; only 12% of the women who had ever used contraceptives indicated privacy
while accessing family planning services. The main side effects indicated were those affecting
menstrual periods 82% and problems with the heart.8% indicated the use could lead to
barrenness; there was fear of contraceptive failure, non -supportive influence off male
partners and religious utilization of family planning services. Although most women
considered contraception as an important action, they lacked motivation to use it because of
their perception of barriers
A study was carried out to access knowledge, attitude and practice of porous women in
Kerachi, Pakistan regarding contraception in March 2009.It showed that of the 100 women
interviewed, 57% had used barrier methods as contraception at some time in their life
Injectable contraceptives were used by 43% of the women, pills were used by 33% of the
women while 30% had intra uterine device (IUD).Only 6 women had used safe period as a
method of contraception. Majority of the women received information about family planning
were from health personnel 9%, from media while 33% from family members and friends.
More than half 57% of the women thought contraceptives had effects on their health. Weight
gain was experienced by 41% of the women mostly on injectable progesterone, menstrual
irregularities were observed by 60% of the women, out of whom 31% experienced
menorrhagia and 30% experienced amenorrhea. Some experienced subfertility. Majority
16
(67%) of the women believed that it is the responsibility of the woman to practice
contraception, (Ali et al, 2004)

CHAPTER THREE
MATERIALS AND METHODS
3.1 Research Design
A descriptive cross sectional study design will be use. The women of koweit will be assess
on knowledge on contraceptives, its uses, reasons for use and challenges faced using it with
the help of a questionnaire.

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3.2 Study Area
This study will be carry out in Douala, Wouri division in the Littoral Region of Cameroon
specifically in the koweit community. The koweit community is made up of people of
different works of life like ; civil servants, farmers, drivers, lawyers, with majority being
business people and tribes such as; Sawa, Muslim, Graffis, Bangwans, Bakossi, Noni and lots
more with females toping the population. The community has health facilities like health
centers, private and state owned hospitals which offer health services to the inhabitants living
in koweit.
Majority of the population in this community are women of reproductive age who might be
sexually active and may turn to use contraceptives to prevent unwanted pregnancies, Secondly
households observations will be make in this community to have a number of children which
might be an indication of low use of contraceptives hence the need to access these women’s
knowledge and use of contraceptives

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