INFLUENCE OF SOCIAL RELATION ON CONTRACEPTIVE UTILIZATION AMONG UNIVERSITY STUDENTS

of [OR=1.79: 95%CI=1.96-3.24, p=0.049]. Odds ratio show that the probability of using contraceptive for female respondents who discussed sexuality with their partner increased by 1.79 times more than those who discussed.


ISSN: 2320-5407
Int. J. Adv. Res. 8(07), 646-651 647 wish to become pregnant at a young age or, if they have already had a child, wish to delay a second pregnancy. Studies show that the prevalence of regular contraceptive use in undergraduate university students in countries of the Sub-Saharan Africa like Ethiopia is very low (Tessema & Bayu, 2013). Generally, contraceptive prevalence rate in Sub Saharan Africa is reported to be at only 21 percent, which is interpreted to be very low (Tessema et al., 2013).
Young women can therefore benefit from contraceptive uptake to prevent unwanted pregnancies that are known to have negative effects on their relationships, ambitions, and on the baby. Among determinants of contraceptive uptake is social relations which has been mentioned in some studies, for instance, a study done in China by Chi, Yu & Winter (2012) revealed that most students (75.6%) were free to discuss sexuality with peers, whereas, very few (13.7%) discussed sexuality and contraceptives with their parents. This paper sought to establish the Influence of social relation on contraceptive utilization among undergraduate students at MMUST. It is anticipated that the knowledge gained from this study will contribute to the existing body of knowledge in the area of family planning among the youths in Kenya. The findings will also form a basis for policy formulation as well serve as a point of reference and stimulate more research in the field of reproductive health in Kenya.

Literature Review:-
A study by Lebese (2013) showed that friends contributed to access to sexuality information. However, this was often insufficient to help girls adjust their sexual behavior. Since male adolescents are perceived as having more decision-making power than their female counterparts. The study concluded that it is important to encourage male involvement in reproductive health programs, as this may contribute to the reduction of the HIV pandemic, sexually transmitted infections and unwanted pregnancies. According to Velasco (2016), women in Bolivia who were often too shy to discuss contraceptive use with their husbands, expressed even greater fear about talking to a male provider. Purvis et al. (2014) carried out a study on Parental Involvement and Contraceptive Use Frequency during College and found that the frequency of contraceptive use during college and parental involvement during adolescents indicated a positive correlation between contraceptive use frequency among females and their father's involvement. Females who reported higher rates of father involvement reported higher frequency of contraceptive use. In addition, frequency of hormonal contraceptive use among females was positively related to mother's involvement during adolescents. The study further reported that African American females most frequently reported that their fathers were "never" in their lives 19.8% of the time compared to White females who reported only 3.2% of the time that their fathers were never involved. Racial differences were statistically significant when examining the reported father involvement by both males (p=.007) and females (p=.000). No statistically significant differences existed between mothers' involvement and racial differences. One very interesting finding within the study is the lack of a statistically significant relationship between female sexual behaviors, contraceptive use, and mothers' involvement. Research has continued to indicate that adolescent and emerging adult females desire male attention and when they do not receive the attention from a father figure they will look elsewhere for said attention. One final possibility is that females may participate in safer sexual behaviors through the use of contraceptives as a result of respect for their fathers and potentially fear of their father's reaction to an unplanned pregnancy.
A study by Iyoke (2014) found that an overwhelming proportion of university students obtained the information that enabled them to make choices about contraception from peers. This is similar to the findings of studies in some parts of Nigeria. For instance, in the study by Ezebialu and Eke (2013), 51% of students obtained contraceptive information from friends, whereas in the study by Abiodun and Balogun (2009) in Ilorin, approximately 74% obtained contraceptive information from friends. It would appear, therefore, that contraceptive information among students in tertiary institutions of learning in Nigeria is largely peer-driven. It was therefore concluded that with an apparent low level of knowledge of contraceptives among the youth, a high dependency on peer information by young people could result in the poor uptake of modern methods of contraception or the use of nonpharmacological agents or off-label drug use with unproven contraceptive efficacy. Sexual behavior is thus one of the many areas in which teenagers are influenced by their best friends and peers. If young people believe their friends support condom use or actually use condoms, chances are greater that they will use condoms themselves.

Methodology:-
This study employed a descriptive survey design to establish the respondent's social relation and contraceptives uptake among undergraduate students at MMUST. The universe of the study comprised undergraduate students at 648 the main campus who were in there first, second, third and fourth year of study. Sample size for the survey was determined using Fischer formula at a standard error margin of 5%, a confidence level of 95%, and a 22% response distribution, a sample size of 453 was then derived. The population was stratified by the year of study to reflect the distribution of undergraduate at the university to participate in the study. Undergraduate students studying from campuses and learning centers outside the main campus were excluded from the study. Primary and secondary data was collected through the questionnaires, in-depth interviews and document analysis. The selection of these tools was informed by the nature of the data to be collected, time available as well as the objective of the study. The respondents were asked about their social demographic factors that included age, sex and marital status. Other items included the uptake of family planning, religion, family status and, nature and type of school attended. To inquire about factors associated with social relation on contraceptive utilization, respondents were asked if they had discussed sexuality with their father, mother, peers, partners or university employees.
To estimate the reliability of the instrument, a pilot survey involving sixty (60) undergraduate students was carried out at MMUST, Cronbach alpha was then established from the responses using statistical package for social science (SPSS). The Cronbach's alpha was 0.822 hence reliability was considered to be good. The 60 undergraduate students who participated in the pilot survey were not included in the main study. The researcher also determined the content validity of the questionnaires as a way of ensuring that the data collected using the instrument represent adequately the domain of the variables measured. Data from the completed questionnaires was analyzed using Statistical Package for Social Science (SPSS) to provide frequencies, means and percentages to describe the population.

Results:-
The result in table 1 revealed that majority (68%) of male respondents who discussed sexuality with their father used contraceptive compared to 36.1 % who reported non-use. Similarly, 58.6% of male respondents who did not discuss sexuality with their father used contraceptive as opposed to 41.4% who did not use. On the side of female respondents, 61.0% who discussed sexuality with their father indicated that they had used contraceptives compared to 39% who reported non-use.
Regarding discussing sexuality with the mother, 56.4% of male respondents reported that they had used contraceptives compared to 43.6% who said the contrary. On the other hand, 68.4% of male respondents who had not discussed sexuality with mother reported the use of contraceptives as opposed to 31.6% who reported non-use. Consequently, majority (56.5%) of female respondent who discussed sexuality with mother had used contraceptives compared to 43.6% who reported non-use. In contrast, 66.5% of female respondent who had not discussed sexuality had used contraceptives while 30.5% did not.
The findings of the study further show that majority (66.7%) of male respondents who discussed sexuality with their father used contraceptives in contrast to 33.3% who reported non-use. Likewise, 62.3% of male respondents who had not discussed sexuality with their partner used contraceptives and 37.7% had not used. On the other hand, majority (66.1%) of female respondents who discussed sexuality used contraceptives compared to 33.9% who did not. Further, 50.8 % of female respondents who did not discuss sexuality with their partner used contraceptives as opposed to 49.2% who did not.
As regards to discussing sexuality with peers, the study found that 54.5% of male respondents who discussed sexuality with peers used contraceptives as opposed to 45.5% who reported non-use. Consequently, 69.8% of male respondents who had not discussed sexuality with peers had used contraceptives while 37.7% did not. Regarding female respondents, of those who had discussed sexuality with their peers, 63.2% indicated that they had used contraceptives while 36.8% reported in the negative. Only 43.8% of female respondents who had not discussed sexuality with their peers used contraceptives and majority 56.2% did not use contraceptives.
The results of the study further reveal that 64.2% of male respondents who had discussed sexuality with university employees used contraceptives and 35.8% had not. Also, 63.0% of male respondents had used contraceptives though they had not discussed sexuality with university employees compared to 35.8% who reported non-use. Likewise, 59.7% of female respondents who had discussed sexuality with university employees said that they had used contraceptives and 40.3% indicated the contrary. In addition, 64.2% of female respondents used contraceptives though they had not discussed sexuality with university employees while 35.8% did not use contraceptives. In order to establish the influence of social relationship on contraceptives uptake, logistic regression analysis was carried out. Social factors that were compared with utilization included discussing sexuality with parents, partner, peers, and university employees. The results of logistic regression in table 1 suggest that there was statistical significant association between male respondents who discussed sexuality with their father and use of contraceptives [OR=1.56: 95%CI=1.05-2.35, p=0.027]. Further, odds analysis show that male respondents who discussed sexuality with their father increased the probability of using contraceptives by 1.56 times more compared to those who had not discussed sexuality with their father. Similarly, there was significant association between female respondents who discussed sexuality with their mother [OR=0.54: 95%CI=0.31-0.95, p=0.032]. However, Odds analysis revealed that the probability of using contraceptives reduced by 54% for female respondents who discussed sexuality with their mother compared to those who did not. Similarly, female respondents discussing sexuality with their peers was significantly associated with contraceptives usage [OR=2.47: 95%CI=1.01-6.05, p=0.042]. Likewise, the probability of using contraceptives for female students who discussed sexuality with their peers increased by 2.47 time more compared to those who did not discuss sexuality with their peers.

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Also, male respondents who discussed sexuality with their peers were significantly associated with contraceptives utilization [OR=0.47: 95%CI=0.29-0.78, p=0.003]. However, odds ratio reveal that male respondents who had discussed sexuality with their peers reduced the probability of using contraceptive by 0.47% compared to those who had not discussed sexuality with their peers. Female respondents who discussed sexuality with their partners were significantly associated with the use of contraceptives [OR=1.79: 95%CI=1.96-3.24, p=0.049]. Odds ratio show that the probability of using contraceptive for female respondents who discussed sexuality with their partner increased by 1.79 times more than those who had not discussed.

Discussion:-
The study aimed at establishing the respondent's social relation and contraceptives uptake in public universities. An analysis of social relations revealed a statistical significant association between male respondents who discussed sexuality with their father and use of contraceptives [p<0.027]. Male respondents who discussed sexuality with their father were found to increase the probability of using contraceptives. Similarly, there was significant association between female respondents who discussed sexuality with their mother [p<0.032] however, their probability contraceptives reduced. In addition, male [p<0.003] and female [p<0.042] respondents discussing sexuality with their peers was significantly associated with contraceptives usage. Nevertheless, the probability of using contraceptives was found to be higher in female who discussed sexuality with peers compared to their male counterparts who discussed sexuality with peers. Female respondents who discussed sexuality with their partners were significantly associated with the use of contraceptives [p<0.049] and their probability of using contraceptive to increase.  (2014) in their study found a positive correlation between contraceptive use among females and their parent's involvement. In addition, females who reported higher rates of mother and father involvement reported higher frequency of contraceptive use. On the other hand, the study found the mother's involvement by African Americans male not to be statistically significantly associated to contraceptive uptake. This may be attributed to low level of intimidation from their mothers.
The result of this study concur with the findings of a study by Iyoke, et al., (2014) on peer-driven contraceptive choice and preference which show that contraceptive usage among students in tertiary institution in Nigeria was peer driven. Consequently the study indicated that a huge percentage of males and females made their contraceptive choice based on information from peers.

Conclusions:-
The study concludes that there is an association between discussing sexuality with parents and peers, and contraceptive utilization. However, factors such as discussing sexuality with partners and university employees had no much bearing when it comes to contraceptive utilization. This demonstrates that majority of students make their contraceptive choices based on influence from parents and peers.