KNOWLEDGE OF HORMONAL CONTRACEPTIVE USE AND NUTRIENT BIOAVAILABILITY AMONG WOMEN OF REPRODUCTIVE AGE IN IBADAN NORTH LOCAL GOVERNMENT AREA, NIGERIA

Abstract

Hormonal Contraceptives (HC) use among women of the reproductive age is an established method of Family Planning (FP). Hormonal contraceptives are known to affect Nutrient Bioavailability (NB) but this knowledge among users has not been well documented. This study was designed to assess effects of training on knowledge of HC use and nutrient bioavailability among women of reproductive age in Ibadan North Local Government Area, Nigeria. A quasi-experimental study was conducted among FP clinic attendees at two tertiary hospitals: Adeoyo Maternity Hospital (AMH) and University College Hospital (UCH). A semi-structured questionnaire was used to collect data on socio-demographic characteristics, types of HC used, knowledge of the effects of contraceptives on NB and the need for nutrition counseling of 300 women attending the FP clinic of AMH. Knowledge score (KS) of FP, nutrients, and effects of HC on NB were assessed on 18-item, 25-item and 25item scales respectively. The KS below 9, 13 and 13 were considered poor for FP, nutrients and effects of HC on NB, respectively. Data were used to identify knowledge gaps and develop training manual detailing types of contraceptives, side effects, nutrients, and effects of HC on nutrients for the intervention. A oneday training intervention was subsequently conducted for a purposively selected consenting 23 out of 300 women surveyed at AMH (experimental) and 30 women from UCH (control) participants. Data were analysed using descriptive statistics and t-test at p=0.05. Mean age of participants was 32.8±6.2 years (experimental) and 31.6±4.5 years (control). All participants were married and 56.5% (experimental) and 63.3% (control) had secondary education. Types of HC used by respondents included: Injectibles (43.5%; 36.7%), Intra Uterine Device (47.8%; 26.7%) and oral contraceptives (8.7%; 36.7%) for experimental and control groups respectively. Before training, mean KS for FP, nutrients and effects of HC for experimental group were 6.8±4.1, 15.4±6.9 and 1.96±4.0 compared with 9.53±3.3, 14.5±7.8 and 1.8±4.0 among control, respectively. After training, mean KS for experimental was 8.52±2.2, 16.9±5.4 and 8.3±4.7 as compared with 9.53±3.3, 14.5±7.8 and 1.8±4.0 among control respectively. A significant difference existed between experimental groups’ pre-training and postraining scores but not in the controls. At pre-training, 21.7% each of the experimental group and control group perceived that HC affects NB. At post-training, there was increase in knowledge of vii the experimental group from 21% to 73.9%. Pre-training test showed 87.0% of the experimental and 78.3% of the control groups admitted to the need for nutrition counseling while posttraining, 1000.0% and 78.3% did so respectively. At post-training, 73.9% and 60.9% of experimental and control groups stated eating adequately was required when using contraceptives, while 100.0% and 60.9%agreed to this after training respectively. Training intervention was effective in improving women’s on the effects of hormonal contraceptives on nutrient-bioavailability. Nutrition counseling should constitute part of family planning counseling to improve knowledge on hormonal contraceptives interaction with nutrient bioavailability.