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ORIGINAL ARTICLE
Year : 2014  |  Volume : 27  |  Issue : 2  |  Page : 347-352

Knowledge and attitude of students in Menoufia University, Shebin Elkom city toward premarital care in 2012


1 Faculty of Medicine, Menoufia University, Al-Menoufia, Egypt
2 Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Al-Menoufia, Egypt

Date of Submission01-Jun-2013
Date of Acceptance03-Oct-2013
Date of Web Publication26-Sep-2014

Correspondence Address:
Marwa Mohamed Mahmoud Mohaseb
MBBCh, Department of Family Medicine, Faculty of Medicine, Menoufia University, Al-Bajur, Al-Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.141706

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  Abstract 

Objective
The aim of the study was to assess the knowledge and attitude of Menoufia University students toward premarital care (PMC).
Background
PMC is a worthwhile activity to prevent reproductive health hazards, sexual dysfunction, marital distress, divorce, and family breakdown; hence, it will save the society and allow people to enjoy life.
Patients and methods
The study was a cross-sectional study conducted in Menoufia University faculties in Shebin Elkom city during the period from October 2012 to May 2013; the sample size was 345 students selected through stratified random sample by the proportional allocation method through predesigned questionnaire used for assessment of students' knowledge and attitude toward PMC services using SPSS for data analysis.
Results
Students from practical faculties showed more proper knowledge about items of PMC services, examination, and investigation components than students from theoretical faculties, with statistically significant difference. Students from practical faculties showed more positive attitude toward the usefulness and necessity of the service than students from theoretical faculties, with statistically significant difference between the two groups. There was nonsignificant difference in the overall knowledge among students of practical and theoretical faculties regarding PMC (c2 = 1.49 and P = 0.83), but there was significant difference in their overall attitude (c2 = 30.76 and P = 0.000). There was nonsignificant difference between male and female students regarding their overall knowledge (c2 = 3.86 and P = 0.43) and their overall attitude (c2 = 5.22 and P = 0.27) regarding PMC. There was nonsignificant difference between urban and rural students regarding their overall knowledge (c2 = 8.47 and P = 0.99) toward PMC, but there was significant difference in their overall attitude (c2 = 10.91 and P = 0.03) regarding PMC.
Conclusion
PMC is a multidimensional issue that plays a very important role in minimizing marital difficulties; although the majority of participants had favorable and positive attitude about PMC services, they showed no sufficient knowledge in some aspects of PMC services.

Keywords: Attitude, knowledge, premarital care, premarital care service


How to cite this article:
Farahat TM, Shaheen HM, Mohamed HM, Mohaseb MM. Knowledge and attitude of students in Menoufia University, Shebin Elkom city toward premarital care in 2012. Menoufia Med J 2014;27:347-52

How to cite this URL:
Farahat TM, Shaheen HM, Mohamed HM, Mohaseb MM. Knowledge and attitude of students in Menoufia University, Shebin Elkom city toward premarital care in 2012. Menoufia Med J [serial online] 2014 [cited 2019 Dec 10];27:347-52. Available from: http://www.mmj.eg.net/text.asp?2014/27/2/347/141706


  Introduction Top


Premarital care (PMC) is a worldwide activity aiming to diagnose, treat unrecognized disorders, and reduce transmission of diseases to couples. It is the promotion of the health and well-being of a woman and her partner before pregnancy; it is considered as the primary preventive approach for couples planning for conception [1]. From public health view, it provides health education as well as a convenient means of collecting information on population health for planning purposes [2]. PMC can identify and modify behavioral, medical, and other health risk factors known to impact pregnancy outcomes through prevention and management [3]. It is considered a step toward saving the society and allowing people to enjoy life [4]. Components of the premarital package according to integrated standards of practice, settled by Ministry of Health and Population (MOHP) [5] are premarital counseling, premarital history taking and examination, premarital investigations, and premarital immunization. However, there is a big lack in knowledge related to reproductive health even among educated persons, about the term PMC [6].

PMC is considered a component of preconception care, which is a primary approach used to address various health issues and emerging national challenges. A healthy baby and a healthy mother are valued hopes and dreams of families and cultural heritages across the world [7].

Preconception health is widely recognized as a critical component of domestic and international maternal and child health promotion. It is broadly defined as the provision of biomedical and behavioral interventions before conception to optimize women's wellness and subsequent pregnancy outcomes [8].

According to Beamish [9], youth in Egypt need more information on reproductive health and access to services before they have their first child. However, PMC should be an essential part of primary and preventive care, rather than an isolated visit [10]. Hence, this study was conducted to assess knowledge and attitude toward PMC services among students in Menoufia University during the period of the study.


  Patients and methods Top


The study was a cross-sectional study conducted in Menoufia University faculties in Shebin Elkom city during the period from September 2012 to May 2013 through stratified random proportionally allocated sampling technique. The sample was collected after calculating the sample size using EPI - INFO program version 7; 345 students were enrolled in this study after exclusion of nonrespondents (4), sample of pilot study (20), and 55 students who did not know anything about the presence of PMC services. The study included 129 students from practical faculties (Medicine, Nursing, Engineering, Science, Computer Science, Agriculture, and Home Economics) and 216 students from theoretical faculties (Law, Commerce, Education, and Arts). From each faculty, number of students was chosen equal from each grade by simple random technique. Students from faculties of Medicine and Engineering were chosen from the first four grades to be equally matched to their peers in the other faculties.

Human rights and ethical considerations were followed during the study, with total confidentiality of any obtained data. The study was approved by the Menoufia Faculty of Medicine Committee for Medical Research Ethics. A written consent form was taken from teaching authorities in the studied faculties. Each student was personally interviewed for 20 min through a predesigned questionnaire.

The questionnaire included personal data including name, age, sex, faculty, the place of residence; the second part included questions about knowledge of students about source of knowledge about PMC services and components of PMC in addition to examination, investigations, immunizations, and counseling. The third part included questions about attitude of students toward usefulness and necessity of PMC services, willing to provide service through male or female doctor, presence of their partner during consultation, concepts of Islam toward PMC service, confidentiality of investigation results, change of the marital decision according to the results of consultation, and preference to have the service in public health center or private clinic. There were 12 questions that assess the knowledge. The overall knowledge score was calculated on the basis of the number of questions answered correctly: more than 75% of the questions if correctly answered was considered good knowledge; 60-75% of the questions if correctly answered was considered fair knowledge; and less than 60% of the questions if correctly answered was considered bad knowledge. There were 16 questions that assess the attitude. The overall attitude score was calculated on the basis of the number of questions answered correctly: more than 75% of the questions if correctly answered was considered positive attitude; 60-75% of the questions if correctly answered was considered equivalent attitude; and less than 60% of the questions if correctly answered was considered negative attitude.


  Results Top


Age of the studied students ranged from 18 to 24 years, with X ± SD of 21 ± 1 years. Male students were 52.8% and female students were 47.2%. Regarding the students residency, 42.2 and 47.8% were from urban and rural area, respectively. Media was the main source of knowledge about PMC among the two groups [Figure 1] Students from practical faculties showed more proper knowledge about item of PMC services, examination, and investigation components than students from theoretical faculties, with statistically significant difference [Table 1]. Students from practical faculties agreed about the usefulness and necessity of the service by 86 and 74.4%, respectively, whereas students from theoretical faculties agreed by 66.6 and 67.2%, respectively, about the usefulness and necessity of the services, with statistically significant difference between the two groups [Table 2]. Students needed confidentiality about their result, changed the decision about marriage due to susceptibility to genetic diseases, the services acceptance by Islamic point of view, and preferred female doctor for service providing and providing the service through the primary healthcare in their locality or private clinics, with no statistically significant difference between the two groups [Table 2]. Students from practical faculties preferred consultation alone (37.2%) without the presence of their partners, whereas students from theoretical faculties preferred the presence of their partners during consultation (40.3%), with no significant difference [Table 2]. There was no significant difference in the overall knowledge about PMC services regarding the type of faculties [Table 3], sex of participants [Table 4], and their residency [Table 5]. However, there was significant positive attitude toward PMC services regarding the type of faculties and residence of the participants.
Figure 1:

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Table 1: Distribution of students of practical and theoretical faculties regarding their knowledge about different components of premarital care services

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Table 2: Distribution of students of practical and theoretical faculties regarding their attitude toward premarital care services

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Table 3: Difference in the overall knowledge and attitude toward the premarital care services between students from practical and theoretical faculties

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Table 4: Difference in the overall knowledge and attitude toward the premarital care services according to the sex of the participants

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Table 5: Difference in the overall knowledge and attitude toward the premarital care services according to residence of the participants

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  Discussion Top


Many young women and men enter into marriage with insufficient information on sexuality, reproduction, and family planning [11]. This study focused mainly on unmarried university students because their beliefs and attitudes will affect their choices in life.

The results of this study clearly showed that 75.1% of the participants were aware of the presence of PMC services. These results were similar to those conducted in Syria (57%) [12], Oman (73.1%) [13], and Saudi Arabia (62.3%) [14]. This could be due to the participants' young age (X ± SD = 21 ± 1 years) where they lack the ability to appreciate the seriousness of the genetic blood disorders and its huge impact on the emotional and financial status of the affected families.

Low knowledge level (43.6%) was detected by Eshra et al. [15], which could be attributed to discrepancy in educational level between our participants who are students and their participants who were villagers, most of whom were illiterates. Lack of knowledge was also reported by Sobhy et al. [16] and Inandi et al. [17] in their studies involving Egyptian nurses (45.3%) and Turkish university students (47.4%), respectively. Differences from our study could be related to difference in education level of study participants.

The result of this study showed that female students had more knowledge (77.3%) than male students (71.3%). This agreed with the study by Al-Aama et al. [18] on knowledge regarding the national premarital screening program among university students in western Saudi Arabia (67.4%). The study of Al-Aama [19] on attitudes toward mandatory national premarital screening for hereditary hemolytic disorders discovered that women also had better knowledge (56.7%) and stronger attitudes toward the implementation of screening (73.6%). Arulogun and Adefioye [20] found out that women tend to have more knowledge (61.3%) about issues relating to reproductive and sexual health than their male counterparts. Similar studies such as those by Khater and El Ghazaly [21] and Abd Al-Azeem et al. [1] demonstrated that women were more oriented and more knowledgeable (67.4 and 62.3%, respectively) with important health issues related to premarital genetic screening than men (53 and 47%, respectively), which reflected on their better attitude. In contrast, the findings of Ganczak et al. [22] showed that men (57%) scored higher on knowledge than their female counterparts (44%).

Lack of experience in social negotiation, ignorance about where to seek care, social stigma, and poor treatment by providers often limit young people's access to the services they need. This explained that 24.1% of students did not care where to go to have the service. These results were similar to those in the study by Creel and Perry [23].

In this study, most frequent source of knowledge was media (46% of students of theoretical faculties and 40.7% of students of practical faculties) followed by friends and relatives (29.6% of students of theoretical faculties and 34% students of practical faculties). This is similar to the result of Ibrahim et al. [14] and Al-Kindi et al. [13] that family and friends (47.7 and 46.3%, respectively) are the main source of knowledge followed by media (39.3 and 37.3%, respectively).

In this study, the participants' attitudes toward PMC were favorable (53.9%). About 74% believed that PMC is useful; 86% of practical students and 66.6% of theoretical students believed it is useful. This agreed with the study by Ibrahim et al. [14] who found that the majority of participants agreed on the importance of PMC (82.3%). In addition, an educational program conducted among female students in King Saud University, Riyadh found that students' attitude was positive (81.8% of students in the pretest and 85.9% in the post-test approved the importance of PMC) [24]. Al-Sulaiman et al. [25] found that there was positive attitude of Saudi population toward the program (65.5%). A study conducted to explore the attitude of the students of Health Sciences College in Abha toward PMC illustrated that 70% of the participants accepted PMC services [26]. A study conducted among nursing students in Alexandria University showed that 65.5% of them had a positive attitude toward premarital counseling [27]. This is similar to what has been reported in many studies such as those by Al-Kahtani [28], Al-Aama et al. [18], and Al-Kindi [13]. In contrast, the Syrian study reported that, although students had some positive attitude, they still had negative attitude and perceptions toward other aspects of PMC [10].


  Conclusion Top


This study highlights that, although the majority of participants were aware of the presence of PMC services and their availability in primary healthcare centers, they were not aware of many aspects of the service. The attitude of the participants was favorable and positive. This reflects the importance of health education as a keystone in improving knowledge toward PMC. The study recommends the development of health education programs to increase the population awareness and influence their attitudes toward PMC services.


  Acknowledgements Top


Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.Abd Al-Azeem ST, Elsayed ET, El-Sherbiny NA, Ahmed LA. Promotion of knowledge and attitude towards premarital care: an interventional study among medical student in Fayoum University 2011. Available at: http://www.academicjournals.org/jphe. [Last accessed on 2011 Jun 10].  Back to cited text no. 1
    
2. Hesketh T. Getting married in China: pass the medical first. Br Med J 2003; 326:277-279.  Back to cited text no. 2
    
3. Chuaung CH, Chen PC. Preconception care. Hu Li Za Zhi 2008; 55:5-10.  Back to cited text no. 3
    
4. Stanely SM, Markman HI, Jenkins NH. Marriage, education and government policy 2001; helping couples who chose marriage to achieve success. Available at: www.healthymarriageinfo.org  Back to cited text no. 4
    
5. Ministry of Health and Population [MOHP]. Standards of practice for integrated MCH/RH services. 1st ed. (2005). Available at: http://www.drguide.mohp.gov.eg/newsite/E-Learning  Back to cited text no. 5
    
6. Mahaini R. Improving maternal health to achieve the Millennium Development Goals in the Eastern Mediterranean Region: a youth lens. East Mediterr Health J 2009; 14:97-105.  Back to cited text no. 6
    
7. Atrash H, Adams M, Cordero J, Howse J. Time to act on missed opportunities to improve perinatal outcomes. Matern Child Health J 2006; 8:S7-S10.  Back to cited text no. 7
    
8. Agrey N, Crowe KM, Levitt C, MacDonald J, MacLean D, Polomeno V. Hanvey L editor. Preconception care in family centred maternity and newborn care. National guidelines. Ottawa: Health Canada, Minister of Public Works and Government Services;2005. 301-329.  Back to cited text no. 8
    
9. Beamish J. Adolescent and youth reproductive health in Egypt, status, issues, policies, and programmes. Policy Project 2003. Retrieved 10 June 2011 Available at: http://www.usaid.gov/pdf_docs/PNACT788.pdf. Journal of Research in Education and Society, Volume 2, Number 3, Dec. 2011  Back to cited text no. 9
    
10.Moos MK. Preconceptional health promotion: progress in changing a prevention paradigm. J Perinat Neonatal Nurs 2004; 18:12-15.  Back to cited text no. 10
    
11.Bastani F, Hashemi S, Bastani N Haghani H. Impact of preconception health education on health locus of control and self-efficacy in women. East Mediterr Health J 2010; 16:17. Available at: http://www.emro.who.int/publications/emhj/1604/article9.htm  Back to cited text no. 11
    
12.Gharaibeh H, Mater FK. Young Syrian adults′ knowledge, perceptions and attitudes to premarital testing. Int Nurs Rev 2009; 56:450-455.  Back to cited text no. 12
    
13.Al-Kindi R, Al-rujaibi S, Al-Kendi M. Knowledge and attitude of university students towards premarital screening program. Oman Med J 2012; 7:291-296.  Back to cited text no. 13
    
14.Ibrahim NKR, Al-Bar H, Al-Fakeeh A, Al-Ahmadi J, Qadi M, Al-Bar A, Milaat W. An educational programme about pre-marital screening for unmarried female students in King Abdul-Aziz University, Jeddah. J Infect Public Health 2012. Available at: http://www.elsevier.com/locate/jiph. [Last accessed on 2012 Apr 3].  Back to cited text no. 14
    
15.Eshra DK, Dongham LS, El-Sherbini AF. Knowledge and attitude towards premarital counseling and examination. J Egypt Public Health Assoc 1989; 64:1-5.  Back to cited text no. 15
    
16.Sobhy SI, Shoeib FM, Zaki NH. Assessment and upgrading of Alexandria University nursing students′ knowledge and attitude about genetic counseling. J Egypt Public Health Assoc 2001; 76:205-222.  Back to cited text no. 16
    
17.Inandi T, Tosun A, Guraksin A. Reproductive health: knowledge and opinions of university students in Erzurum, Turkey Eur J Contracept Reprod Health Care 2003; 8:177-184.  Back to cited text no. 17
    
18.Al-Aama J, Al-Nabulsi B, Alyousef M, Asiri N, Al-Blewi S. Knowledge regarding the national premarital screening program among university students in western Saudi Arabia. Saudi Med J 2008; 11:1649-1653.  Back to cited text no. 18
    
19.Al-Aama JY. Attitudes towards mandatory national premarital screening for hereditary hemolytic disorders. Health Policy 2010; 97:32-37. Available at: www.elsevier.com/locate/healthpol. [Last accessed on 2011 Jun 11].  Back to cited text no. 19
    
20.Arulogun OS, Adefioye OA. Attitude towards mandatory pre-marital HIV testing among unmarried youths in Ibadan Northwest Local Government Area, Nigeria. Afr J Reprod Health 2010. Available at: www.ajol.info/index.php/ajrh/article/view/55781/44243. [Last accessed on 2011 Jun 10].  Back to cited text no. 20
    
21.Khater TR, El-Ghazaly HS. Pre-marriage checkup in Egypt. BMJ 2003; 4:111-118.  Back to cited text no. 21
    
22.Ganczak M, Barss P, Alfaresi F, Almazrouei S, Muraddad A, Al-Maskari F. Break the silence: ′HIV/AIDS knowledge, attitudes, and educational needs among Arab University students in United Arab Emirates′. J Adolesc Health 2007; 40:572e1-572e8. Available at: http://www.sciencedirect.com/science/article/  Back to cited text no. 22
    
23.Creel L, Perry R. Improving the quality of reproductive health care for young people. Population Council and Population Reference Bureau: Amman 2003.  Back to cited text no. 23
    
24.Al-Aama JY. Perception of female students of King Saud University towards premarital screening. J Family Community Med 2006; 13:83-88.  Back to cited text no. 24
    
25.Al-Sulaiman A, Saeedi M, Brook D, Morojele N, Zhang C, Brook J. South African adolescents: pathways to risky sexual behavior. AIDS Educ Prev 2008; 18:259-272.  Back to cited text no. 25
    
26.Balck F, Berth H, Meyer W. Attitude toward genetic testing in a German population. Genet Test Mol Biomarkers 2009; 13:743-750.  Back to cited text no. 26
    
27.Al-Khaldi YM, Al-Sharif AI, Sadiq AA, Ziady HH. Attitudes to premarital counseling among students of Abha Health Sciences College. Saudi Med J 2002; 23:986-990.  Back to cited text no. 27
    
28.Al-Kahtani NH. Acceptance of premarital health counseling in Riyadh city. J Family Community Med 2000; 7:27-34.  Back to cited text no. 28
    


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