KNOWLEDGE AND PREDICTORS OF DELAYED EMERGENCY CONTRACEPTION UTILIZATION AMONG SEXUALLY ACTIVE FEMALE UNDERGRADUATE STUDENTS IN NORTHWEST, NIGERIA

Abstract

Unintended pregnancies and unsafe abortions among sexually active female undergraduates remain major public health concerns in Nigeria. Although emergency contraception (EC) is an effective method for preventing pregnancy after unprotected sexual intercourse, its utilization remains low and is often delayed. This study assessed the knowledge and predictors of delay in emergency contraception utilization among sexually active female undergraduate students of the Federal University of Education, Zaria, Kaduna State, Nigeria. A descriptive cross-sectional survey design with a mixed-method approach was employed. Using a four-stage sampling technique, 400 consenting respondents were selected from various faculties and departments. Data were collected through a structured self-administered questionnaire that assessed socio-demographic characteristics, knowledge, utilization, and factors associated with delayed EC use. Quantitative data were analyzed using descriptive statistics, Chi-square tests, Spearman correlation, and logistic regression at a 0.05 level of significance, while qualitative data were analyzed thematically. The findings showed that most respondents were aged 20–24 years (50.0%) and single (80.0%), while 42.5% had no income. Although awareness of emergency contraception was high (90.0%), utilization was relatively low (45.0%), and more than half (52.5%) reported delayed use after unprotected intercourse. Respondents generally demonstrated fair-to-good knowledge, though misconceptions persisted. Significant predictors of delayed utilization included stigma and embarrassment, inadequate knowledge, fear of side effects, partner influence, cost, and poor access to health facilities. Financial dependence on partners also emerged as an important factor influencing delays. The study concluded that despite high awareness and moderate knowledge, EC utilization remains inadequate due to psychosocial, economic, and structural barriers. Strengthened reproductive health education, youth-friendly services, and stigma-reduction interventions are recommended.