title: Factors associated with utilization of emergency contraception among female students in Mizan-Tepi University, South West Ethiopia.
abstract: BACKGROUND
  Unintended pregnancy poses a major health problem on female students in higher educations. One of the key interventions to reduce unintended pregnancy and unsafe abortion as outlined in the national youth strategy is making emergency contraception (EC) available for these risky population. However, despite its availability in many countries, EC has failed to have the desired impact on unintended pregnancy rates and its utilization is limited in colleges and universities. The objective of this study was to assess factors associated with utilization of emergency contraception among female students in Mizan-Tepi University (MTU), south west Ethiopia.
  
  
  METHODS
  A cross-sectional, institution based study was conducted from March 10-30, 2014. Multistage sampling technique was used to select the participants for the quantitative method whereas; purposive and volunteer sampling techniques were used for the qualitative study. Quantitative data were cleaned, coded and entered into Epi-data 3.1 and analyzed using SPSS version 20:00. Binary and multiple logistic regression analysis were done to determine the association between the use of EC and the predicator variables. Data from focus group discussion were transcribed and translated to English then coded, and categorized into similar themes.
  
  
  RESULTS
  A total of 489 female students were participated in the quantitative study making a response rate of 90.6%. The finding shows that 46.3% of them have used EC following unprotected sex. Female students' knowledge about EC [AOR: 3.24; 95% CI 1.32, 7.98], age at first sexual intercourse (i.e. ≥20 years) [AOR: 4.04; 95% CI 1.72, 9.52], history of pregnancy [AOR: 3.12; 95% CI 1.34, 7.24] and previous use of regular contraceptives [AOR: 5.01; 95% CI 2.23, 11.27] were found to be significant predictors of EC utilization. In the focused group discussion, a total of 32 female students were participated and the result shows that lack of knowledge about EC and fear of being seen by others (information disclosure) were reported as main factors for not using EC.
  
  
  CONCLUSIONS
  The study shows that the level of EC use was low. Female students' level of knowledge about EC, age at first sexual intercourse, previous use of regular contraceptives and history of pregnancy were major predictors of EC utilization. Therefore, designing strategies to enhance EC utilization by increasing female students' level of awareness on EC is recommended.
authors.affiliation: Department of Midwifery, Wolkite University College of Medicine and Health Sciences, PO Box 07, Wolkite, Ethiopia. basfendaz@gmail.com.
authors.forename: Bisrat Zeleke
authors.initials: BZ
authors.lastname: Shiferaw
authors.affiliation: Department of Nursing and Midwifery, Jimma University College of Public Health and Medical Sciences, PO Box 1355, Jimma, Ethiopia. bosenatebeje@yahoo.co.uk.
authors.forename: Bosena Tebeje
authors.initials: BT
authors.lastname: Gashaw
authors.affiliation: Department of Nursing and Midwifery, Jimma University College of Public Health and Medical Sciences, PO Box 1355, Jimma, Ethiopia. fekaduyadassa@yahoo.com.
authors.forename: Fekadu Yadassa
authors.initials: FY
authors.lastname: Tesso
mesh_terms: D000293:Adolescent; D000328:Adult; D044363:Contraception, Postcoital / Q000523:psychology / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014495:Universities; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female