{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:05:50Z","timestamp":1784261150298,"version":"3.55.0"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unintended pregnancy remains a major public health concern in Sierra Leone, where stigma, misconceptions, and access barriers hinder the timely use of emergency contraception (EC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the prevalence of EC use, assess related knowledge and attitudes, and identify associated factors among female university students in Sierra Leone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study using convenience sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Conducted in 2024 among 366 female undergraduate students at Njala University, Sierra Leone, using convenience sampling and a structured, self-administered questionnaire to assess sociodemographic characteristics, EC utilisation, knowledge, and attitudes. The knowledge and attitudes were scored and categorised based on the mean scores. Descriptive statistics, logistic regression, and Pearson\u2019s and Spearman\u2019s correlations were used for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among participants, 68.3% (n=250) reported ever using EC, with 36.5% (n=91) of ever-users using it within the past four weeks and 29.5% (n=74) between one and three months prior to the survey. Of participants, 53.0% (n=194) had good knowledge, and 49.7% (n=182) had a positive attitude toward EC. Ever-use was more likely among students aged 26\u201330 years (AOR 3.58; 95% CI 1.42\u20138.90) and in year two (AOR 2.64; 95% CI 1.25\u20135.55), but less likely with poor knowledge (AOR 0.16; 95% CI 0.09\u20130.30) and negative attitudes (AOR 0.19; 95% CI 0.10\u20130.36). No prior history of EC use was associated with lower odds of both good knowledge (AOR 0.20; 95% CI 0.10\u20130.41; p &lt; 0.001) and positive attitude (AOR 0.23; 95% CI 0.11\u20130.46; p &lt; 0.001). Knowledge and attitudes were strongly correlated (r=0.659; rho=0.611; p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EC use is widespread among sampled students but is influenced by knowledge and attitudes. These exploratory findings suggest that targeted, peer- and provider-led education to address misconceptions and improve service navigation could enhance informed contraceptive choices and reduce unintended pregnancies in this context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261469462","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:34:41Z","timestamp":1784039681000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency contraception among female university students in Sierra Leone: An exploratory study of use, knowledge, attitudes, and associated factors"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-841X","authenticated-orcid":false,"given":"Augustus","family":"Osborne","sequence":"first","affiliation":[{"name":"Institute for Development"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Bangura","sequence":"additional","affiliation":[{"name":"Njala University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2603-9989","authenticated-orcid":false,"given":"Ahmed","family":"Vandy","sequence":"additional","affiliation":[{"name":"College of Medicine and Allied Health Sciences"},{"name":"University of Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1363\/4400612"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2014.00393.x"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30315-6"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.18356\/9789211073454"},{"key":"e_1_3_7_6_2","unstructured":"unfpa. Adolescents and Youth Report: West and Central Africa. https:\/\/wcaro.unfpa.org\/sites\/default\/files\/pub-pdf\/UNFPA-WCARO-YOUTH-EN-WEB.pdf (2018) accessed 26 January 2026."},{"key":"e_1_3_7_7_2","unstructured":"UNFPA. Towards Zero Unmet Need for Family Planning in West and Central Africa. https:\/\/wcaro.unfpa.org\/sites\/default\/files\/pub-pdf\/2024-08\/%233_Acceleration_Paper_Zero_unmet_need_FP_v4_(1).pdf (2024) accessed 27 January 2026."},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-025-08059-0"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","unstructured":"Paul M Gebreselassie H Samai M et al. Unsafe Abortion in Sierra Leone: An Examination of Costs and Burden of Treatment on Healthcare Resources. Epub ahead of print 2015. DOI: 10.4172\/2167-0420.1000228.","DOI":"10.4172\/2167-0420.1000228"},{"key":"e_1_3_7_10_2","unstructured":"WHO UNICEF UNFPA. Trends in maternal mortality 2000 to 2020 2023. Geneva. https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/c3957b94-cdd5-47d7-85f8-6202be229f8e\/content (accessed 2 November 2025."},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.2028"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/17290376.2013.869649"},{"key":"e_1_3_7_13_2","unstructured":"WHO. Emergency contraception. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/emergency-contraception (2021) accessed 2 November 2025."},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40834-026-00460-0"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des140"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.02.009"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181dd22ef"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002162"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2019.06.008"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(06)27231-8"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1101\/2025.04.01.25325048"},{"key":"e_1_3_7_22_2","volume-title":"ORIGINAL ARTICLES Emergency Contraception and Fertility awareness among University Students in Kampala, Uganda","author":"Byamugisha JK","year":"2006","unstructured":"Byamugisha JK, Mirembe FM, Faxelid E, et al. ORIGINAL ARTICLES Emergency Contraception and Fertility awareness among University Students in Kampala, Uganda, 2006."},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.2307\/3181062"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(02)00315-3"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","unstructured":"Tajure N. Knowledge Attitude and Practice of Emergency Contraception among Graduating Female Students of Jimma University Southwest Ethiopia. Ethiop J Health Sci; 20. DOI: 10.4314\/EJHS.V20I2.69434 Epub ahead of print 9 September 2010.","DOI":"10.4314\/EJHS.V20I2.69434"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5760-7"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110855"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40834-025-00344-9"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","unstructured":"Kgosiemang B Blitz J. Emergency contraceptive knowledge attitudes and practices among female students at the University of Botswana: A descriptive survey. Afr J Prim Health Care Fam Med; 10. DOI: 10.4102\/phcfm.v10i1.1674 Epub ahead of print 2018.","DOI":"10.4102\/phcfm.v10i1.1674"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.297"}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057261469462","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17455057261469462","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057261469462","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:48:02Z","timestamp":1784260082000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17455057261469462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":30,"alternative-id":["10.1177\/17455057261469462"],"URL":"https:\/\/doi.org\/10.1177\/17455057261469462","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"17455057261469462"}}