Assessment of Knowledge, Attitude and Practice Towards Reproductive Health Service among Mizan Tepi Universtiy Tepi Campus Students, Sheka Zone, South Nations Nationalities and Peoples Regional State, South West Ethiopia, 2017

Background: Reproductive health (RH) is defined as “A state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity, in all matters related to the reproductive system and to its functions and process”. It addresses the human sexuality and reproductive processes, functions and system at all stages of life and implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Objective: The objective of the study is to assess the Knowledge, Attitude and Practice of Mizan-Tepi University Students, Tepi campus towards Reproductive Health Service Sheka Zone SNNPRs South West, Ethiopia, 2017. Methodology: Institution Based Cross sectional quantitative Study was conducted among MTU in Tepi campus students with the sample size of 392 and a total population of 5116 from February to March. The Study subject was randomly selected students in each class in MTU, Tepi campus student’s. In the Study period Random sampling technique was used in each class select their ID number. The data was collected by structured self-administered quesionariy. After the data was collected it was analyzed by SPSS version 16. Result: Total of 375 students complete the questioner with response rate of 96.2%. From the total of 375 students 75 (20%) were knowledgeable about Reproductive health service. 175 (46.6%) know about component of Reproductive health. Among those 12.5% were known about family planning and STI, 7.7% only family planning and 6.7% access to health service. 347 (92.5%) know about ways of pregnancy prevention among those 40% oral pills and 18% injectable types of contraception were most popular in the study area. Only 158 (42.1%) were favorable Attitude towards Reproductive health service Majority of the respondents strongly agree about the importance of RH service for youths. Out of the total respondents only 132 (35.2%) had practice of RH services. Conclusion: Most of the study participants were not knowledgeable about reproductive health service and, unfavorable Attitude about RH services and also had poor attitude.


Introduction
Reproductive health (RH) is defined as "A state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity, in all matters related to the reproductive system and to its functions and process". It addresses the human sexuality and reproductive processes, functions and system at all stages of life and implies that people are able to have "a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so [1] Reproductive health is a universal concern, but is a special importance for women particularly during reproductive year. However, men also demands specific reproductive health needs and have power in some reproductive health matters [2].
Adolescents and youths people are defined by WHO as at age group 10-19 years and 15-24 years respectively. The onset of adolescence which is more or less coinciding with puberty is often influenced by manifestation of puberty [3].
Young people make up over one-quarter of the world's population. Among those, 1.4 Billion young people live in developing countries today [4]. Population censuses and projections conducted in Ethiopia in different years show that youth and adolescents constitute a high proportion of Ethiopian population. According to the 2012 population projection, the population was reach 83.75 million and the youth population was reached to 8.3 million (9.9%). Similarly the adolescent population was reach 20.19 million (24.1%) and in 2011 secondary school age population were 7.4 million [5].
As group adolescents and youth have sexual and reproductive health needs that differ from those adults in many ways and which remain poorly understood or served in much of the world. Neglecting this population has a major implication for the future. Since sexual and reproductive behaviors during adolescence have far reaching consequences for people's lives as they develop into adult [6]. Over 500,000 adolescents contract gonorrhea each year, and (25%) of Acquired Immune deficiency Syndrome cases involve young adults who probably become infected with HIV during adolescence [7].
Every year 2.5-3 million teenagers acquire a STI of one kind or another. This means that approximately one out of every teen adolescent even in developed countries becomes STD-infected each year [8].
The rapid spread of the HIV/AIDS epidemic in the country is posing very serious threats of overall socio-economic and human development prospects in the country, a recent report of the MOH on HIV/AIDS situation in Ethiopia, reports the highest prevalence of HIV infection in the age group 15 to 24 (12.1%). High rates of adolescent pregnancy mean that HIV infection will affect the next generation as well, putting babies at risk of vertical transmission and creating a generation of AIDS orphans [9] It is estimated that each year, worldwide, 15 million girls aged 15-19 years give birth and that about (11%) of children are born to adolescents [10].

Methodology Study area and period
The study was conducted at Mizan-Tepi university Tepi campus in Sheka zone SNNPRs from March 02/03/2017 to March 23/03//17. Mizan Tepi University is one among 33 universities which was establish 1998 E.C which has two branches Mizan and Tepi Campus each is 50 km apart. Tepi campus is located 611 km southwest of Addis Ababa and 899 from the regional city Hawassa. According to information obtained administrative registered office, it was start by one college which is computational science and by four departments (Biology, Chemistry, Maths, Physics) in 2000 e.c. know it has three colleges and15 department with the total of 5169 students among this 1666 are females [11].
Study design: An institution based Descriptive cross sectional study was conducted.
Source population: All regular Mizan-Tepi University students attending in Tepi campus.
Study population: All regular students who were randomly selected from each class in Tepi campus.
Inclusion criteria: All students who were regular and attending at the time of data collection in Tepi campus.
Exclusion criteria: Those were seriously ill to the extent of unable to respond during data collection period.

Sample size determination and sampling technique
Sample size determination: The sample size was determined by using single population proportion formula. The following assumptions were made, marginal error (w) that was tolerated either side of the true proportion to be 5%, and using 95%confidence level and adding 10% to compensate for nonresponse rate. Assuming the proportion of students who have KAP on reproductive health is 50% [12]. P=0.5, w=0.05 (margin of error) Q=0.5, 95%confidence interval=1.96, P=Proportion of students, None response rate=10%,

Sampling technique
Random sampling Technique Was used to conduct this study.

Sampling procedure
The required sample size was proportionally allocated to each class and we collect the data randomly by using lottery method in each class when they enter and live the class. All colleges and departments in each year were including in the sampling procedure. There are 68 regular classes in the campus; different numbers of students were attending in each class [13].
The number of students in each college was given in Table 1.

Data collection technique and tools
Data was collected using self-administered questionnaires with closed ended questions. The questionnaires were prepared in English and were pretested in students, other than the study area, one week before the start of data collection. The data was collected through structured self-administered questionnaires with close ended questions. Fourth year midwifery Students were the data collector who were principal investigators they were responsible to lead the whole situation of the data collection process to check the data consistency, completeness and editing, Discussion was done by all data collectors [14].

Data quality assurance
Data consistency and completeness was checked throughout the data collection and analysis. The data collectors were discussed on method of data collection and the Questionnaire was checked on daily basis for completeness during data collection. Data was checked in the field to ensure that all the information will properly collected. The questionnaires were pre-tested before data collection on Mizan campus.

Data processing and analysis
Data was entered by SPSS version 16 and processing, analysis was done. After we collect the data we were checked for its completeness and accuracy before analyzing it. Then mainly frequency and percent were used to summarize and present major findings to all variables of study population by using charts and graphs [15].

Ethical consideration's
The study was carried out after getting permission from the ethical review committee of Mizan-Tepi University and then a letter of support which indicates the objective of the study was written, from MTU University Tepi campus student den after that the purpose and importance of the study was explained to the participants. Data was collected after full informed verbal consent was obtained from individuals and confidentiality of the information was also maintained by omitting their names and personal identification or privacy [16].  Table 2 showed below majority of respondent's parent educational status was can read and write [17].

Knowledge of students in Tepi campus
Respondents were asked whether they know what reproductive health means and 175 (46.66%) acknowledge that they know about it, Out of 175 they gave answer that it is family planning and STI 47 (26.9%) followed by Family planning only 29 (16.5%), access to health service and information 25 (14.3%), Maternal and child health 21 (12%), STI/HIV 20 (11.4%) the right to choose when and with whom to have sex 15 (8.6%) and the rests 10.3% list three and more. A considerable proportion about 201 (53.6%) of the respondents did not know or did not responds to the question concerning components of reproductive health ( Table  3) [18].
Out of the study subjects only 63 (16.8%) of them answered that a woman is most likely to Become pregnant halfway between two periods, whereas the majority, 125 (33.3)% were from during her menstrual cycle. Out of the total study subjects, 347 (92.5%) of them had reported that they know at least one means of avoiding pregnancy. Among these Oral pills, Inject able and condoms were the most recognized contraceptive methods that were Reported by 40%%, 18% and 9.22% respectively and also 61 (17.57%) know both OCP and Injectable, the other thing while 28 (7.5%) of respondents don't know about it [19].

Journal of Hospital & Medical Management ISSN 2471-9781
abstinence followed by 75 (22.5%), mentioned condom, whereas 54 (16%) and 26 (7.8%) avoid casual sex and remain faithful to a partner respectively to be ways that a person should follow to avoid getting these diseases while the rest 41 (10.9) didn't know about it (Tables 4 and 5) [26].
As a table showed above 219 (56.8%) of the respondents had VCT information and 198 (52.8%) That, its main advantage is to maintain health and 21 (5.6%) understand it is to limit HIV/ AIDS transmission. In the contrast, 10 (2.7%) of the respondents claimed it could enable to take revenge is the test become HIV positive. In general, 220 (58.7%) of the respondents reported they need to have VCT (Table 5) [27].

Attitude towards reproductive health service
Respondents strongly agree about the importance of Reproductive health services for youth (    [28][29][30].
As the Table 6 above showed most of respondents have good attitude about reproductive health.

Journal of Hospital & Medical Management ISSN 2471-9781
Out of one hundred respondents who ever had sexual intercourse, 30 (37.8%) students were use contraceptive in the survey period as showed below among those the type of the contraceptive most of used were Emergency contraceptive which is 18 (60%) followed by emergency contraceptive 5 (16.7%) ( Table 9 and Figure 1).
Contraceptive method used by MTU students, Sheka, SNNPRs, Ethiopia, 2017.  Condome Emergency contraceptive Injectible Implants no answer Among study participants who had sex, 10 (6.7) ever hade STI that is genital ulcer, abnormal genital discharge or swelling. Among those who had such condition 3 (10%) of them side that thy go to traditional healer and the other 10% were by self-healer only 1 (10%) of respondents were went top privet health institution. Among the study participants who ever had sex, 13 (8.72%) ever been pregnant, out of this 8 (61.5%) ever had abortion but they abort by ingesting different drugs 3 (37.5%), only 2 (25%) were at privet clinic (Table 10)