The Effect of Health Eduction and Advocacy on Male Knowledge and Attitude on Sexual and Reproductive Health in Urban and Rural Communities of Enugu State

Abstract

Knowledge, attitude and involvement (KAI) of men in sexual and reproductive health issues is central to the attainment of health benefits centered on MDG 3(promoting gender equality and empowering women), MDG 4 and 5(improving maternal and child health). Due to poor exposure to KAI, current studi es states that Nig eria contributes 10% of the global burden of maternal mortality with millions of unintended pregnancies and HIV/AIDS infections. The importance of determining and intervening on the KAI is crucial to improving maternal and child health. The objectives of this study were to determ ine the knowledge of male towards contraception, sex negotiation and other reproductive health issues , to determine the attitude of males towards prevention of domestic violence and having multiple sex partners, to institute health education to encourage men to become more involved and supportive of reproductive health issues such as women's needs, choices, and rights in sexual and reproductive health and to evaluate the effect of the health education on the knowledge, attitude and involvement of men in reproductive health issues. The study was undertaken in Enugu South and Udi Local Government Areas in Enugu State . It was an interventional study with health education components involving married males aged 30 to 50 years in the selected communities in Enugu State . Four communities, 2 from each of the LGAs participated in this study. One in each of the two LGAs was used as controls while the other as an intervention group. Data were collected from 224 married men aged between 30-50 years on their knowledge, attitude and involvement in reproductive health issues. A pre invention and post intervention ques tionnaire was used to evaluate the effects of health education on the intervention group. Data were analyzed electronically using Microsoft Excel software 2007 for the graphics only and Stat istical Package for Social Sciences (SPSS) computer software for windows, version 15.0. Statistica l differences between the pre and post intervention data were determined using chi squared test at p- value j; 0.05. Majority of the men 36 (67.9%) in the urban area at the pre-intervention stage had a good knowledge on when to confirm a woman is pregnant. After the intervention, most 47 (89.9%) of their knowledge was improved. This knowledge was also improved from 66.1% in the rural at pre-intervention to 85.7% at post-intervention. They equally showed knowledge 39 (73.5%) in condom use as a family planning method which was increased 56 (100%) after the intervention showing a statistical difference in their knowledge. Also, in the rural area , this knowledge was also increased from after a health education intervention. Most respondents in the control group both in the urban and the rural area had some general knowledge on reproductive health but there was no statistical difference in their knowledge at the beginning and at the end of the study. The highe st attitude among the respondents 50 (89.3%) on reproductive health issues was shown in the study group in the urban area after the intervention. This was also high among the respondents 48 (85.7%) in the control group in the urban area. Most of the respondents 53 (94.6%) in the urban area would actively be involved in reproductive health more than those in the rural area in the study group .There was a statistically difference in men 's involvement in reproductive health in the study group. The knowledge, attitude and involved of men in reprodu ct ive health issues were improved as a result of health education intervention although some of the evaluation results were statistically insign ificance showing more encouragement to improve their knowledge , attitude and involvement. Public enlightenment campaign should be used to Increase awareness on importance of men involvement in reproduct ive health issues.