PERCEIVED INFLUENCE OF SEXUAL HEALTH EDUCATION AS A PREDICTOR FOR REDUCING UNPROTECTED SEXUAL INTERCOURSE AMONG FEMALE STUDENTS
ABSTRACT
This study investigated the Perceived Influence of Sexual Health Education as a Predictor for Reducing Unprotected Sexual Intercourse among Female Students in Lagos Mainland LGA Four purpose of the study, research questions and hypotheses were formulated for this study. The study comprised 300 students spread across three secondary schools and three tertiary institutions in Lagos mainland Local Government Area, using multistage sampling technique of simple random and purposive sampling for participant’s selection. Data was collected using a self-developed questionnaire titled Sexual Health Education and Unprotected Sexual Intercourse Questionnaire (SHEUSQ). The validity of the instrument was scrutinized by the supervisor and two other experts in the department of Human Kinetics, Sports and Health Education. The reliability of the study was achieved using the test- retest method. Data collected were correlated using frequency counts, percentage and measure of central tendencies for the demographic characteristics, while Chronbach Alpha test and r-value of 0.86 analytical tool was used to test all stated hypotheses at 0.05 level of significance and considered appropriate for the adoption of instrument in the study. The significant value of (F=5.735, F=3.519, F=7.843, T=1.563) was obtained for hypotheses one to four respectively. The finding of this study revealed that there was significant relationship between health education and unwanted pregnancy, sexually transmitted diseases, abortion and contraceptives among female students in Lagos Mainland Local Government Area. It was recommended that more sensitization and education should be organized to educate female students in Lagos Mainland Local Government Area on sexual intercourse. The Government should fund evidence-based sex education interventions of female students in secondary schools and tertiary institutions. Mass media should also be used as a channel on reducing sexual intercourse among female students. Ministry of health and social development Lagos State can partner with the millennium development goals providers (UNICEF, WHO) to curb unprotected sexual intercourse through sexual education among female students.
Keywords: Abortion, Contraceptives, Female students, Influence, Sexual Health Education, Sexual intercourse, unwanted pregnancy, Lagos Mainland.
Word count: 325
TABLE OF CONTENTS
CONTENT PAGES
Title i
Personal Ethics ii
Certification iii
Dedication iv
Acknowledgements v
Abstract vi
Table of contents vii
CHAPTER ONE: INTRODUCTION
Background to the Study 1
Statement of the Problem 5
Purpose of the Study 5
Research Questions 6
Research Hypotheses 6
Significance of the study 6
Scope of the Study 7
Operational definition of terms 8
CHAPTER TWO: LITERATURE REVIEW
Concept of Sexuality 9
Concept of Sexual Health Education 10
Concept of Sexual Intercourse 15
Unprotected Sexual Intercourse and it’s dangers 24
Sexually Transmitted diseases 25
Unwanted pregnancy 29
Abortion 30
Factors influencing sexual intercourse among students 32
Influence of Sexual Health Education on reducing unprotected Sexual Intercourse34
Empirical Studies on sexual Health Education and Unprotected sexual intercourse36
Appraisal of Literature Review 40
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Research Design 41
3.2 Population of the study 41
3.3 Sample and sampling technique 41
3.4 Research instrument 41
3.4.1 Validity of the instrument 42
3.5 Reliability of the instrument 42
3.6 Method of data collection 42
CHAPTER FOUR: DATA ANALYSIS AND
PRESENTATION OF RESULTS
4.1 Data Presentation 43
4.2 Test of hypotheses 44
4.3 Discussion of the findings 47
CHAPTER FIVE: SUMMARY, CONCLUSION
AND RECOMMENDATIONS
5.1 Summary 53
5.2 Findings 53
5.2 Conclusion 54
5.3 Recommendations 54
REFERENCES 56
APPENDIX
CHAPTER ONE
INTRODUCTION
Background to the study
One of the pivotal responsibilities of women is procreation as ordained by God (Dei & Osei-Bonsu, 2015). However there are conditions to be met before a woman could start procreating. The sexual and reproductive health of young adults is one that demands an immediate attention as the world has more young adults than ever before (Chandra-Mouli, Catherine & Sylvia, 2015). Nigeria’s population is estimated to be 183.5 million with an annual growth rate of 3.2% (Nigeria Demographic & Health Survey, 2013; Integrated Biological Behavioural Surveillance Survey, 2014). About one-third (36.5 million) of Nigeria’s total population are youth between the ages of 10 and 24 and it is estimated that by 2025, the number of Nigerian youth will exceed 57 million (Santhya & Jejeebhoy, 2015; National Bureau of Statistics, 2015; Envuladu, Anke, Zwanikken & Zoakah, 2017). Nigeria has the highest rates of adolescent fertility in sub-Saharan Africa and over Nine hundred thousand (900,000) births to adolescents occur annually and One hundred and fifty out of every One thousand women who give birth in Nigeria are 19 years old or under (Abiodun, Maharaj, Witbooi, Peter & Kazeem, 2016).
Globally, unintended births among unmarried adolescent girls are a major contributor to maternal and childhood mortality, the vicious cycle of ill-health, poverty, and truncated educational opportunities (Izugbara, 2015). Health is a perceived state of complete well being of an individual and should encompass all dimensions of health with prudent attention given to his morphology and his environment” (Ogunbamowo & Oladipupo, 2021). Sexual health is a field of research, healthcare, and social activism that explores the health of an individual’s reproductive system and sexual wellbeing during all stages of their life (Mitchell, Lewis, O’Sullivan & Fortenberry, 2021). The term can also be further defined more broadly within the framework of the World Health Organization’s (WHO) definition of health as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity” to denote sexual wellbeing, encompassing the ability of an individual to have responsible, satisfying and safe sex and the freedom to decide if, when and how often to do so (World Health Organization, 2018). United Nations agencies in particular define sexual and reproductive health as including both physical and psychological well-being vis-à-vis sexuality (Hall, Moreau & Trussell, 2012). A further interpretation includes access to sex education, access to safe, effective, affordable and acceptable methods of birth control, as well as access to appropriate health care services, as the ability of women to go safely through pregnancy and childbirth could provide couples with the best chance of having a healthy infant (Morris & Rushwan, 2015). Risky changes lead students to adopt high-risk behaviours, such as the use of psycho-active substances, dangerous behaviours and initiation to sexual intercourse, which have important consequences on adulthood health and also on that of future generations (Raj, Jackson & Dunham, 2018).
Sexual activities among students are on the increase all over the world with a trend towards early onset. Many of the young students have initiated their first sexual activity in their adolescent age (Yolaine, Charles, Ghislain, Makilioubè & Toyi, 2018). In Nigeria, up to 6% of all sexually active adolescent girls may have been pregnant and engaged in induced abortion (Aderibigbe, Araoye, Akande, Monehin, Musa & Babatunde, 2011). Sexual intercourse (or coitus or copulation) is a sexual activity typically involving the insertion and thrusting of the penis into the vagina for sexual pleasure or reproduction (Carroll, 2018). According to Rathus, Nevid & Rathus, (2010) other forms of penetrative sexual intercourse include anal sex (penetration of the anus by the penis), oral sex (penetration of the mouth by the penis or oral penetration of the female genitalia), fingering (sexual penetration by the fingers) and penetration by use of a dildo (especially a strap-on dildo). These activities involve physical intimacy between two or more individuals and are usually used among humans solely for physical or emotional pleasure and can contribute to human bonding (Freberg, 2010).
Sexual intercourse or other sexual activity can encompass various sexually stimulating factors (physiological stimulation or psychological stimulation), including different sex positions (such as the missionary position, the most common human sex position or the use of sex toys (Wayne, Dana & Elizabeth, 2011). Sexual intercourse among undergraduate students increases the risk of acquiring HIV infections, sexually transmitted infections (STIs) and unintended pregnancy (Shrestha, Karki, Copenhaver, 2016). Unprotected sexual intercourse is the immediate common underlying behavioural factor for HIV and other sexually transmitted diseases as well as unplanned pregnancy. Several studies have documented low rates of use of condom as well as other forms of modern contraceptives among young people in Nigeria (Adedini, Babalola, Ibeawuchi, Omotoso, Akiode & Odeku, 2018). It has been deduced that unmarried adolescents are at higher risk of having unmet need for contraception than the older population due to social pressure, contraceptive access barriers arising from providers bias, and gender-based violence among others and the adverse consequences of unmet need among young people such as unintended pregnancies, maternal mortality, and sexually transmitted infections, including HIV/AIDS (Sánchez-Páez & Ortega, 2018).
Sexuality Education is an education that aims to develop and strengthen the ability of children and young people to make conscious satisfying, healthy and respectful choices regarding relationships, sexuality and emotional and physical health (Makoro, 2017). Good quality sexuality education according to Apter, (2011) has a positive impact on attitudes and values and can even increase the power of dynamics in intimate relationships, this contributing to the prevention of abuse and fostering mutually respectful and consensual partnerships. Comprehensive sexuality deals with not only human anatomy and disease prevention but also human rights, gender equality, communication skills and respectful relationships. Access to information about sexual development, sexual and reproductive health, interpersonal relationships, affection, intimacy, body image, gender role and sex roles are very key in enabling people form positive health attitudes, beliefs and values (Christensen, 2016).
Sex education also refers to formal programs of instruction on a wide range of issues relating to human sexuality, including human anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, contraception and other aspects of some human sexual behaviour. Common avenues for sex education are parents or caregivers, school programs and public health Campaigns. Sexuality is a fundamental aspect of human life: it has psychological, spiritual, social, economic, political and cultural dimension. Preparing children and young people for the transition to adulthood has always been one of humanity’s great challenges, with human today in a world with AIDS, how we meet this challenge is our most important opportunity in breaking the trajectory of the epidemic (UNESCO, 2019).
Research shows that effective comprehensive risk reduction programs such as sexuality education that focuses on specific behaviours, provide basic and accurate information regarding the risks and methods of protection, and include opportunities to address peer norms and practice communication, negotiation, and refusal skills within the program (Denford, Abraham, Campbell & Busse, 2017). The purpose of any Sexuality Education (SE) program is to develop proper regard for the mastery of life and to promote a mature acceptance of self in the young person (especially the unmarried) and of his fellow man. People, especially students are exposed to cultures where sex and sexual imagery sell almost everything (Harmanci, 2020). The consequences for unwanted pregnancies, sexually transmitted diseases, and rape are, therefore, much greater now than ever. There is no doubt that students are exposed to sex-related education from different sources outside the family who are supposed to educate their young ones on sexual mores. They are exposed to magazines that sell sex on their front pages, films that depict sex, musicals that portray sex as normal human life as well as commercial adverts which portray sex. Most secondary school students are students who need proper education (information) about human sexuality. This is because students have problems with self-control, delay of gratification, and risk analysis. Thus, students may not think about the consequences of their sexual behaviour (Harmanci, 2020).
Sometimes, peer group values and norms conflict with those of parents. In traditional Nigerian cultures, where the adult society restricts sexual experimentation by youths, the expectation might be that adolescents, in their membership in the peer group, would question the cultural definitions of sexual standards and codes. While in our educational systems the adolescents, are involve in some of the following permissible sexual activities kissing, breast/genital fondling, embracing, holding hands and sexual intercourse‖ in their mode of dressing and clothing, the adolescents appear to be veering from the past mode of dressing brought first by our tradition and later by colonization (Oluyole, 2018). For most adolescent’s way of dressing has departed totally from the past. They dress in clothes that appeal to them but which to adults are weird and embarrassing. The female adolescents mostly dresses half nude; they prefer to wear trousers and skimpy shirts or tee-shirts that reveals their tummy, body hug which shows all the contours in their body frames or mini-skirt with a see-through tops while the boys although still wears shirt and trousers but which are always in various bigger sizes compared to their normal sizes. They also wear low waist trousers. This observed clothing habit is not limited to a specific class of adolescents. It cut-across the entire socio-economic status, irrespective of their educational level and status (Amu & Adegun, 2015). Therefore what used to be regarded as fashion which is described to be a period desired appearance is being turned to clothing which is regarded as an established pattern of dressing. This shows that Nigerian youths are absorbing foreign culture and they no longer adhere strictly to local cultural regulation concerning sex(reference) Therefore this study seeks to examine the perceived influence of sexual health education on mitigation of unprotected sexual intercourse among female students in Lagos Mainland L.G.A.
Statement of the problem
It has been observed that most students of the university don’t have the right sexual health information to want to not indulge in reckless sexual activity. Many students in the university get first-hand information from social media and conversations from their colleagues which is doing more harm than good to them. It has been realized that many undergraduates have turned the school to an institution of promiscuity as there is no sexual education from the parents. Young female students have turned unprotected sexual intercourse to a norm without taking into consideration the risks involved.
It was also observed that the media has become a major means to popularizing the notion of the different types of sexual intercourse mutual or intimate relationships develop from.
Therefore this study will assess the influence of sexual health education on the reduction of u protected sexual intercourse among female students in Lagos mainland L.G.A.
Purpose of the study
The main purpose of the study is to assess the perceived influence of sexual health education on unprotected sexual intercourse among female students in Lagos mainland L.G.A.
The specific purpose of this study are:
- To examine the influence of sexual health education and unwanted pregnancy among female students in Lagos Mainland L.G.A.
- To examine the influence of sexual health education and sexual transmitted infection among female students in Lagos Mainland L.G.A.
- To examine the influence of sexual health education and Abortion among female students in Lagos Mainland L.G.A.
- To examine the influence sexual health education and use of contraceptive among young students in Lagos Mainland L.G.A.
Research Questions
The following research questions will be answered for the study:
- Will sexual health education significantly influence unwanted pregnancy among female students of Lagos Mainland L.G.A?
- Will sexual health education significantly influence sexual transmitted infection among female students of Lagos Mainland L.G.A?
- Will sexual health education significantly influence Abortion among female students of Lagos Mainland L.G.A?
- Will sexual health education significantly influence use of contraceptive among female students of Lagos Mainland L.G.A?
Research Hypotheses
The following research hypotheses will be postulated for the study:
- There will be no significant influence of sexual health education and unwanted pregnancy among female students of Lagos Mainland L.G.A.
- There will be no significant influence of sexual health education and sexual transmitted infection among female students of Lagos Mainland L.G.A.
- There will be no significant influence of sexual health education and Abortion among female students of Lagos Mainland L.G.A..
- There will be no significant influence of sexual health education and use of contraceptives among female students of Lagos Mainland L.G.A.
Significance of the Study
The research will be of great significance to parents, the Government, Non-governmental organization (NGOs), Researchers, Lecturers and Students.
The findings of this study will be of great relevance to the parents as it will help them to teach their young adults about unprotected sexual intercourse and the risks involve which would increase their knowledge among their peers. This study will also provide the parents with greater knowledge on the level of involvement of students in sexual activities. Such organized information will enhance their good monitoring of the students as well as knowing the consequences involved in their children’s involvement in risky sexual intercourse. Therefore, parents will become more united with the university to monitor and manage the students’ unpleasant sexual intercourse in school and at home.
The findings of this study will be of significance to government as it serve as And also to provide qualified lecturers that will teach students on the areas of sexuality education.
It would also be of significance to Non-governmental organizations as it will give them the opportunity to curb unprotected sexual intercourse through sexual education among female students. Consequently,getting involved will serve as a means of conveying to the government to come to the aid of the school administrators to equip the school with qualified personnel like counselors, that will help to counsel the students in the areas of sexual education without being embarrassed. This would enable them sensitize the female students.
The findings of this study will also be significant to female students because it will enable them to be aware of the fact that the sexual problems they are facing is as a result of changes in their development with sexual education. It will also enable them to understand the implication of getting involved with unprotected sexual intercourse. It will also increase their knowledge and be able to stay away from negative peer groups in school. The students will be better informed on the risks they are to face if they involved with the act.
Finally, the findings of this study will contribute more knowledge most especially to the researchers who may want to go into studies in the area of youths and the impact of sexual education in sexual intercourse among them.
Delimitation of the study
This study is delimited to the following;
- Descriptive research design
- Female studentswill be selected by using multistage sampling technique of simple random and purposive sampling in Lagos Mainland L.G.A
- Use of a self-developed and validated questionnaire titled sexual health education and unprotected sexual intercourse (SHEUSI).
- The sample population of Three hundred (300) Participants in Lagos Mainland L.G.A.
- The use of descriptive statistics of frequency counts and percentage to describe data
- The use of Chi-Square for inferential statistics at a 0.05 level of significance.
Limitation of Study
Some of the respondents will be reluctant to hear the researcher out at first because matters concerning sex are considered to be abominable in our society. So, it will be evident in their body language which speaks that they don’t want the researcher to approach them. The researcher will ease their mind by telling them the purpose of why he/she came and allow them give him/her a listening ear.
The respondents will be unwilling to give accurate information regarding this topic under the consideration that giving correct information might make others see them as a bad/spoilt child which can cause depression, guilt and negative attitudes of self isolation in them. However a brief talk will be given to them so they can talk more openly about it and they recognize consequences of some sexual actions. There will also be hesitations of respondents to complete questionnaires administered to them. A non-disclosure mandate will be made available to ensure respondents of the information provided. Finally, many of the students will be stressed from classes and preparation of examinations. The students will mostly be tired from the day’s workload. A lot of convincing and pleading will be done by the researcherfor them to fill the questionnaires.
Operational Definition of Terms
Sexual Health: Sexual and reproductive health is a field of research, healthcare, and social activism that explores the health of an individual’s reproductive system and sexual well-being during all stages of their life.
Sexual Health Education: Sexuality education aims to develop and strengthen the ability of children and young people to make conscious, satisfying, healthy, and respectful choices regarding relationships, sexuality, and emotional and physical health.
Unprotected Intercourse: Unprotected sex (also referred to as condom-less sex) is defined as sexual intercourse without contraception.
Students: A person who is studying at a university or other place of higher education.
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