Research Article | | Peer-Reviewed

Knowledge, Attitude, and Intentions Regarding Modern Contraceptive Use Among Nursing and Midwifery Students at SDA NMTC, Asamang

Received: 17 September 2025     Accepted: 30 September 2025     Published: 27 October 2025
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Abstract

Background: Modern contraceptive remain vital in reducing unintended pregnancies and promoting reproductive health. However, knowledge, attitude and intentions regarding their use vary among young people, particularly students in health training institutions. Objective: This study assessed the knowledge, attitudes and intentions regarding modern contraceptive use among nursing and midwifery students at SDA NMTC, Asamang. Methods: A descriptive cross-sectional study was conducted among 293 students using a structured questionnaire. Data were analyzed using descriptive statistics and chi-square tests of association with significance set at p < 0.05. Results: The majority of respondents (69.6%) demonstrated good knowledge of modern contraceptive methods, while only 10.2% exhibited poor knowledge. Most respondents (70.5%) held positive attitudes toward contraceptive use. More than half expressed an intention to use contraceptives in the near future (53.6%) though fewer were willing to commit to consistent use (33.4%). Marital status (χ2 = 6.972, p = 0.008), academic programme (χ2 = 8.260, p = 0.004), and academic level (χ2 = 23.922, p < 0.001) were significantly associated with contraceptive intention, while age was not (p = 0.184). Conclusion: The study demonstrated generally high knowledge and positive attitudes toward modern contraceptives among respondents, yet intentions for consistent use remain low.

Published in American Journal of Health Research (Volume 13, Issue 5)
DOI 10.11648/j.ajhr.20251305.13
Page(s) 272-280
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Modern Contraceptives, Knowledge, Attitude, Intention, Nursing Students, Midwifery Students, Ghana

1. Introduction
Modern contraceptives are essential for improving sexual and reproductive health by reducing unintended pregnancies, unsafe abortions, and maternal mortality . Globally, family planning is recognized as a cornerstone of Sustainable Development Goal (SDG) 3, which seeks to ensure healthy lives and well-being for all . Despite ongoing global and regional initiatives, contraceptive uptake among young people in many low- and middle-income countries (LMICs), including Ghana, remains suboptimal . National surveys report only a modest contraceptive prevalence rate, with persistent unmet needs contributing significantly to unintended pregnancies and adverse reproductive health outcomes . Within this context, nursing and midwifery students constitute a particularly important group. As future healthcare providers, they are expected to acquire not only technical knowledge of contraceptive methods but also the skills to provide accurate counselling, dispel misconceptions, and advocate for evidence-based practices. However, studies from sub-Saharan Africa indicate that while healthcare students are generally aware of available contraceptive methods, their knowledge depth, perceptions, and willingness to recommend them are strongly influenced by cultural norms, religious beliefs, and personal values . Persistent misconceptions such as the belief that hormonal methods cause infertility, weight gain, or long-term health risks remain prevalent and shape students’ attitudes toward contraceptive use and counselling . Furthermore, stigma surrounding contraceptive use, particularly among unmarried or adolescent women, continues to undermine uptake and advocacy . These challenges create a gap between theoretical knowledge and practical readiness, which may affect the quality of reproductive health services once these students graduate into clinical practice. Addressing these barriers is crucial for strengthening reproductive health training in nursing and midwifery curricula. By assessing current levels of knowledge, attitudes, and intentions regarding contraceptive use among students, educators and policymakers can identify gaps and design interventions that foster competence, confidence, and cultural sensitivity. This, in turn, will help prepare future professionals to deliver unbiased, client-centered, and comprehensive family planning services, ultimately contributing to improved maternal and health outcomes in Ghana and beyond.
2. Methods
2.1. Study Settings
The study was conducted at SDA Nursing and Midwifery Training College (NMTC) Asamang, a health training institution in the Sekyere South municipality of Ashanti region, Ghana. The college trains nursing and midwifery students to provide quality healthcare services. It has lecture halls, skills laboratory, a library and a computer laboratory. The institution has a structured academic environment with students at different levels of study. Currently, it’s a single sex (female) school.
2.2. Study Design
The type of design for the study was a descriptive cross-sectional survey. A stratified random sampling technique was employed to ensure fair representation across different academic levels (first-year, second-year and third-year students). The proportional allocation method was used to determine the number of students selected from each level. After stratification, simple random sampling was applied to select participants from each level, ensuring that every student had an equal chance of being included.
2.3. Sampling Procedure
The Kish (1965) approach for known study populations was used to determine the appropriate sample size that adequately reflects the total research population. The Kish method is most suitable when the study population or sampling frame is known, and it is recognized as one of the most accurate ways to calculate sample size .
The generic formula for this approach is:
n = N/ [1 + N (α)2]
Where:
n = sample size,
N = sampling frame (1098 students at SDA NMTC for 2024/2025 academic year)
α = 5% margin of error or confidence level.
n = 1098/ [1 + 1098 (0.05)2]
n = 293.19
n = 293
2.4. Data Processing and Analysis
Data entry was performed using SPSS software version 26.0, where the data were cleaned and analyzed. Descriptive statistics were computed, and the results for each variable were presented as frequencies and percentages. To analyze the demographic characteristics influencing intention to use contraceptives, a logistic regression analysis was performed. A p value of < 0.05 was considered statistically significant, with 95% confidence intervals reported for all estimates.
2.5. Ethical Statement
This study received approval from the Ghana Adventist Health Services Review Board under approval number (GAHS/ERC/07/25). Informed consent was sought from the study participants in order to make free decisions about their involvement.
3. Results
3.1. Demographics Characteristics of the Study Respondents
A total of 293 respondents were sampled for the study. Almost half of the respondents (n= 144, 49.1%) were within the age of 22-25 years. The data indicates a well-balanced sample in terms of educational level (Level 100, 200 & 300) with respective proportion of 33.3% and program of study (Nursing & Midwifery) with a proportion of 50.5% and 49.5% respectively. A greater proportion of the respondents (n = 286, 97.6%) were single.
Table 1. Demographic characteristics of respondents (n = 293).

Variable

Frequency (n)

Percentage (%)

Age (years)

18-21

101

34.5

22-25

144

49.1

Above 25

48

16.4

Marital status

Single

286

97.6

Married

7

2.4

Programme

Nursing

148

50.5

Midwifery

145

49.5

Level

100

98

33.4

200

98

33.4

300

97

33.2

3.2. Respondents’ Knowledge Level on Modern Contraceptives
The study assessed respondents’ knowledge level on modern contraceptive methods. As shown in figure 1, the majority of respondents (n = 204, 69.6%) demonstrated good knowledge of modern contraceptives. About one-fifth (n = 59, 20.2%) of the respondents had fair knowledge, whereas only a small proportion (n = 30, 10.2%) exhibited poor knowledge.
Table 2. Knowledge on Modern Contraceptives (N = 293).

Variable

N

%

Formal Education on Modern Contraceptives

Yes

274

93.5%

No

19

6.5%

Source of Information on Modern Contraceptives (multiple response)

Classroom lectures

242

82.6%

Clinical practice

103

35.2%

Social media

147

50.2%

Friends/Peers

104

35.5%

Healthcare professionals

128

43.7%

Known Modern Contraceptive Methods (multiple response)

Oral contraceptive pills

221

75.4%

Condoms (male/female)

171

58.4%

Intrauterine device (IUD)

145

49.5%

Injectable contraceptives

134

45.7%

Implants

115

39.2%

Traditional/Natural methods

77

26.3%

Primary Function of Modern Contraceptives

Prevention of pregnancy

143

48.8%

Prevention of STIs

101

34.5%

Both A and B

49

16.7%

Perceived Effectiveness of Modern Contraceptives

Very effective

113

38.6%

Somewhat effective

118

40.3%

Not effective

23

7.8%

Not sure

39

13.3%

Time Frames for contraceptive effectiveness

24 hours

132

45.1%

48 hours

59

20.1%

72 hours

73

24.9%

5 days

29

9.9%

Knowledge score

Good (KS≥12)

204

69.6%

Fair (KS<12≥8)

59

20.2

Poor (KS<8)

30

10.2

Figure 1. Respondents’ knowledge level on modern contraceptive (N = 293).
3.3. Attitudes Towards Modern Contraceptives Methods
Respondents’ attitudes towards the use of modern contraceptives were assessed through a series of statements. As presented in Table 3, more than half of the respondents (n = 161, 54.9%) strongly agreed that modern contraceptives are essential for preventing unintended pregnancies, and 132 (45.1%) strongly agreed that contraceptives use should be encouraged among young people. On the other hand, mixed opinions were observed regarding the belief that contraceptive use promotes promiscuity among young adults, with 25% disagreeing and another 25% remaining neutral. A considerable proportion of respondents (n = 117, 39.9%) strongly agreed that they felt comfortable discussing contraceptive options with peers, while religious beliefs influenced the attitudes of 157 (53.6%) respondents to varying extents. Importantly, the majority (n = 137, 46.8%) strongly agreed that healthcare professionals should provide more education on modern contraceptive methods. As illustrated in figure 2, the composite measure of attitude revealed that 70.5% of respondents demonstrated a good attitude towards modern contraceptives, whereas 29.5% held poor attitudes.
Table 3. Attitudes Towards Modern Contraceptives methods.

Statement

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Modern contraceptives are essential for preventing unintended pregnancies.

161 (54.9%)

88 (30.0%)

29 (9.9%)

8 (2.7%)

7 (2.4%)

The use of contraceptives should be encouraged among young people.

132 (45.1%)

102 (34.8%)

37 (12.6%)

15 (5.1%)

7 (2.4%)

Contraceptive use promotes promiscuity among young adults.

44 (15.0%)

59 (20.0%)

73 (25.0%)

73 (25.0%)

44 (15.0%)

I feel comfortable discussing contraceptive options with my peers.

117 (39.9%)

73 (24.9%)

44 (15.0%)

31 (10.6%)

28 (9.6%)

Religious beliefs influence my opinion on contraceptive use.

96 (32.8%)

61 (20.8%)

84 (28.7%)

43 (14.7%)

9 (3.1%)

I believe healthcare professionals should provide more education on modern

137 (46.8%)

103 (35.2%)

29 (9.9%)

17 (5.8%)

7 (2.4%)

Figure 2. Respondents’ attitude towards the use of contraceptives.
3.4. Intention to Use Contraceptive Methods
Respondents intention to use contraceptive was assessed through several items (Table 4). A little over one-third of the respondents (n = 111, 37.9%) reported willingness to start using contraceptives in their next sexual intercourse, while 182 (62.1%) expressed no intention. More than half (n = 174, 59.4%) indicated they would consider using contraceptives at least once in every few sexual encounters compared to 119 (40.6%) who would not. Similarly, 157 respondents (53.6%) reported an intention to use contraceptives in the nearest future, whereas 136 (46.4%) did not. However, a lower proportion (n = 108, 36.9%) stated they were considering using contraceptives within the next six months, while 185 (63.1%) disagree. Likewise, only 98 respondents (33.4%) affirmed that they would ensure contraceptive use in every sexual encounter, compared to 195 (66.6%) who would not. Interestingly, 103 respondents (35.2%) asserted that they could not use contraceptives under any circumstances, while a larger majority (n =190, 64.8%) disagreed with this statement.
The relationship between respondents’ demographic characteristics and their intention to use contraceptives was examined using the chi-square test of association (table 5). Age did not show a statistically significant association with intention to use contraceptive (χ2 = 3.387, p = 0.184, Cramér’s V = 0.108). however, marital status was significantly associated with contraceptive use intention (χ2 = 6.972, p = 0.008, Cramér’s V = 0.154), with single respondents expressing greater intention to use compared married counterparts. Similarly, the academic programme of study was significantly related to contraceptive use intention (χ2 = 8.260, p = 0.004, Cramér’s V = 0.168). Furthermore, the respondents’ academic level showed the strongest significant association with contraceptive use intention (χ2 = 23.922, p < 0.001, Cramér’s V = 0.286).
Table 4. Intention to use contraceptive methods.

Statement

Response

Yes (%)

No (%)

Am willing to start using contraceptive in my next sexual Intercourse

111 (37.9%)

182 (62.1)

I will consider the use of contraceptive at least once in every few times I have sexual intercourse

174 (59.4%)

119 (40.6)

Am considering using contraceptive within the next 6 months

108 (36.9%)

185 (63.1%)

I will ensure the usage of contraceptive in every sexual intercourse am engaged in

98 (33.4%)

195 (66.6%)

I intend using contraceptive in the nearest future

157 (53.6%)

136 (46.4%)

I cannot use contraceptive no matter what

103 (35.2%)

190 (64.8%)

Table 5. Relationship between demographic characteristics and intention to use contraceptives.

Variables

Intention to use

Chi-square (x2)

p-value

Cramér’s V

Yes

No

Demographic Age

18-21

31

70

3.387

.184

.108

22-25

60

84

Above 25

20

28

Marital status

Single

105

181

6.972

.008

.154

Married

6

1

Programme

Nursing

68

80

8.260

.004

.168

Midwifery

43

102

Level

100

39

59

23.922

.000

.286

200

58

55

300

14

68

4. Discussions
The current study revealed that the majority of respondents (69.6%) demonstrated good knowledge of modern contraceptive methods, while only a small proportion (10.2%) had poor knowledge. This finding is consistent with studies in Ghana and Nigeria, which also reported high levels of awareness and knowledge of modern contraceptives among young adults and students . Similarly, a study from Ethiopia indicated that most university students were knowledgeable about contraceptive methods, largely due to exposure through health education and media campaigns . In contrast, studies in rural Uganda and Malawi reported lower levels of knowledge and widespread misconceptions . These differences may be attributed to variations in educational background, access to reproductive health information, and availability of youth-friendly health services. The relatively high knowledge levels in this study could reflect the influence of formal health training curricula and exposure to reproductive health education in Ghana. With respect to attitudes, this study found that most respondents (70.5%) demonstrated positive attitudes toward modern contraceptive use, while 29.5% held negative attitudes. This aligns with studies in Ghana and Ethiopia, which reported predominantly positive attitudes among students and young adults , and with a Nigerian study where the majority of adolescents supported contraceptive use to prevent unintended pregnancies . Conversely, findings from Uganda highlighted negative attitudes, largely shaped by cultural norms, stigma, and religious influences . The positive attitudes observed in this study may stem from increased access to information and gradual shifts in social norms, though the persistence of negative perceptions among a minority underscores the need for continued education and stigma reduction.
Despite high knowledge and generally positive attitudes, the study revealed hesitancy regarding contraceptive intentions. More than half of respondents expressed willingness to use contraceptives in the near future (53.6%) and at least occasionally (59.4%), yet fewer were willing to initiate immediate use (37.9%) or commit to consistent use (33.4%). This pattern mirrors studies in Nigeria and Ethiopia, where young adults, despite being well-informed, expressed reluctance toward consistent use due to cultural norms, stigma, and concerns about side effects . By contrast, a study in Kenya reported higher levels of intention for regular use , suggesting that differences in accessibility, peer acceptance, and family planning services may shape intention differently across contexts. In this study, marital status was significantly associated with contraceptive intention, with single respondents reporting higher intention than married respondents. This finding supports studies from Ghana and Uganda , where unmarried young adults often used contraception to delay childbearing. However, some African studies reported no significant association , indicating contextual variation. Academic programme and academic level also significantly influenced contraceptive intention, with nursing students and higher-level students demonstrating greater intention. This is consistent with findings from Ethiopia and Nigeria , which emphasized the role of health training in shaping reproductive health behaviors. Interestingly, age was not a significant predictor of contraceptive intention in this study, which contrasts with evidence from Tanzania and Malawi where age strongly influenced intention . This may be due to the relatively narrow age range of students in the current study, where academic exposure rather than age differences may play a greater role.
5. Limitation of the Study
The study was conducted in a single nursing and midwifery training institution, which may limit the generalizability of the results to other health training colleges across Ghana. The use of a cross-sectional design restricts the ability to establish causal relationships between sociodemographic factors and contraceptive intentions. The study was restricted to female students due to the single-sex composition of the institution.
Abbreviations

LMICs

Low- and Middle-Income Countries

NMTC

Nursing and Midwifery Training College

SDA

Seventh-Day Adventist

SDG

Sustainable Development Goal

Author Contributions
Richard Mensah: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Ellen Opoku Boamah: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Mercy Dankwah: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Setina Boahemaa Adu: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Adwoa Arkoh Boaten: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Eunice Korlekie Teye: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Gifty Manu Gyamfi: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Sampson Asiedu: Conceptualisation, Writing - original draft, Validation, Methodology, Investigation, Data curation, Formal analysis, Writing - review & editing, Software, Project administration.
Funding
The authors did not receive any money or funding for this research.
Conflicts of Interest
The authors declare that they have no competing interests.
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    Mensah, R., Boamah, E. O., Dankwah, M., Adu, S. B., Boaten, A. A., et al. (2025). Knowledge, Attitude, and Intentions Regarding Modern Contraceptive Use Among Nursing and Midwifery Students at SDA NMTC, Asamang. American Journal of Health Research, 13(5), 272-280. https://doi.org/10.11648/j.ajhr.20251305.13

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    Mensah, R.; Boamah, E. O.; Dankwah, M.; Adu, S. B.; Boaten, A. A., et al. Knowledge, Attitude, and Intentions Regarding Modern Contraceptive Use Among Nursing and Midwifery Students at SDA NMTC, Asamang. Am. J. Health Res. 2025, 13(5), 272-280. doi: 10.11648/j.ajhr.20251305.13

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    AMA Style

    Mensah R, Boamah EO, Dankwah M, Adu SB, Boaten AA, et al. Knowledge, Attitude, and Intentions Regarding Modern Contraceptive Use Among Nursing and Midwifery Students at SDA NMTC, Asamang. Am J Health Res. 2025;13(5):272-280. doi: 10.11648/j.ajhr.20251305.13

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  • @article{10.11648/j.ajhr.20251305.13,
      author = {Richard Mensah and Ellen Opoku Boamah and Mercy Dankwah and Setina Boahemaa Adu and Adwoa Arkoh Boaten and Eunice Korlekie Teye and Gifty Manu Gyamfi and Sampson Asiedu},
      title = {Knowledge, Attitude, and Intentions Regarding Modern Contraceptive Use Among Nursing and Midwifery Students at SDA NMTC, Asamang
    },
      journal = {American Journal of Health Research},
      volume = {13},
      number = {5},
      pages = {272-280},
      doi = {10.11648/j.ajhr.20251305.13},
      url = {https://doi.org/10.11648/j.ajhr.20251305.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20251305.13},
      abstract = {Background: Modern contraceptive remain vital in reducing unintended pregnancies and promoting reproductive health. However, knowledge, attitude and intentions regarding their use vary among young people, particularly students in health training institutions. Objective: This study assessed the knowledge, attitudes and intentions regarding modern contraceptive use among nursing and midwifery students at SDA NMTC, Asamang. Methods: A descriptive cross-sectional study was conducted among 293 students using a structured questionnaire. Data were analyzed using descriptive statistics and chi-square tests of association with significance set at p Results: The majority of respondents (69.6%) demonstrated good knowledge of modern contraceptive methods, while only 10.2% exhibited poor knowledge. Most respondents (70.5%) held positive attitudes toward contraceptive use. More than half expressed an intention to use contraceptives in the near future (53.6%) though fewer were willing to commit to consistent use (33.4%). Marital status (χ2 = 6.972, p = 0.008), academic programme (χ2 = 8.260, p = 0.004), and academic level (χ2 = 23.922, p p = 0.184). Conclusion: The study demonstrated generally high knowledge and positive attitudes toward modern contraceptives among respondents, yet intentions for consistent use remain low.
    },
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Knowledge, Attitude, and Intentions Regarding Modern Contraceptive Use Among Nursing and Midwifery Students at SDA NMTC, Asamang
    
    AU  - Richard Mensah
    AU  - Ellen Opoku Boamah
    AU  - Mercy Dankwah
    AU  - Setina Boahemaa Adu
    AU  - Adwoa Arkoh Boaten
    AU  - Eunice Korlekie Teye
    AU  - Gifty Manu Gyamfi
    AU  - Sampson Asiedu
    Y1  - 2025/10/27
    PY  - 2025
    N1  - https://doi.org/10.11648/j.ajhr.20251305.13
    DO  - 10.11648/j.ajhr.20251305.13
    T2  - American Journal of Health Research
    JF  - American Journal of Health Research
    JO  - American Journal of Health Research
    SP  - 272
    EP  - 280
    PB  - Science Publishing Group
    SN  - 2330-8796
    UR  - https://doi.org/10.11648/j.ajhr.20251305.13
    AB  - Background: Modern contraceptive remain vital in reducing unintended pregnancies and promoting reproductive health. However, knowledge, attitude and intentions regarding their use vary among young people, particularly students in health training institutions. Objective: This study assessed the knowledge, attitudes and intentions regarding modern contraceptive use among nursing and midwifery students at SDA NMTC, Asamang. Methods: A descriptive cross-sectional study was conducted among 293 students using a structured questionnaire. Data were analyzed using descriptive statistics and chi-square tests of association with significance set at p Results: The majority of respondents (69.6%) demonstrated good knowledge of modern contraceptive methods, while only 10.2% exhibited poor knowledge. Most respondents (70.5%) held positive attitudes toward contraceptive use. More than half expressed an intention to use contraceptives in the near future (53.6%) though fewer were willing to commit to consistent use (33.4%). Marital status (χ2 = 6.972, p = 0.008), academic programme (χ2 = 8.260, p = 0.004), and academic level (χ2 = 23.922, p p = 0.184). Conclusion: The study demonstrated generally high knowledge and positive attitudes toward modern contraceptives among respondents, yet intentions for consistent use remain low.
    
    VL  - 13
    IS  - 5
    ER  - 

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    1. 1. Introduction
    2. 2. Methods
    3. 3. Results
    4. 4. Discussions
    5. 5. Limitation of the Study
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