This study interviewed Egyptian 15-19 year olds about their knowledge and beliefs concerning reproductive health, sex education, and contraceptives.

Egypt

Young women face a variety of reproductive health risks, including sexually transmitted diseases (STDs); too-early pregnancy and childbearing; and unintended pregnancy, often leading to unsafe abortion and its complications. In Egypt, approximately 10 percent of women marry before age 20. However, young people know little about reproductive health, and most services are directed at women in their late twenties or older.

Research Findings

More than 1,600 young people were interviewed for this study. Sixty percent were ages 15 to 19, while the remainder were ages 20 to 24. Findings should not be generalized beyond Assiut Governorate.

• Approximately one-fourth of the study participants were familiar with the term "reproductive health." Those who were educated, older, not married and living in urban areas were more likely to have heard the term.

• Adolescents' ideal age at marriage varied according to sex. The mean ideal age was 21.2 years for females and 25.6 for males. Urban residents had higher ideal ages at marriage for boys than did rural residents, but not higher ideal ages for girls. One participant advocated early marriage because "the female is able to have children and raise them up properly while she is still young and of good health."

• Almost all respondents knew the importance of antenatal care; this varied little by sex, education, marital status or residence. Nearly all respondents thought a physician should provide antenatal care, although they were evenly split with regard to whether they preferred a female or male physician.

• When asked about their attitudes toward the appropriate place for childbirth, more than 80 percent preferred the government hospital, although actual delivery was split between the government hospital and home.

• More than 95 percent of the sample knew the term "family planning" and had favorable attitudes toward contraception. Knowledge of specific methods varied by sociodemographic characteristics and sex. For example, 21 percent of older study participants knew about injectables, compared with 53 percent of younger participants. Ninety-two percent of women knew about intrauterine devices, compared with 79 percent of males. Nearly 95 percent of study participants approved of family planning; attitudes about family planning did not vary by sex or sociodemographic characteristics. "Life became very expensive, and many children need a lot of money, and from where can we get money in this hard time?" one study participant asked.

• Twenty-seven percent of those who were married were using contraceptives at the time of the study. The percentage increased as the number of children increased. Fifteen percent of those with one child were using contraception, compared with 79 percent of those with four or more children.

• Forty-eight percent of less educated respondents had heard of STDs. Of these, 90 percent had heard of AIDS, but only 2 percent of syphilis. Sixty percent of those said "following religious teaching" was the best way to protect oneself, while 17 percent said premarital exams and 17 percent said periodic checkups.

• Seventy-nine percent of study participants approved of female circumcision. This varied from 89 percent among less-educated respondents to 69 percent among more-educated respondents.

• Ninety-five percent of educated men approved of helping care for children, compared with 79 percent of less-educated men. The differences were less pronounced among urban and rural men (91 and 89 percent respectively).

Recommendations

This study -- one of the first in Egypt to examine the reproductive health knowledge, attitudes and practices of women and men ages 25 years and younger -- could be used to improve reproductive services for young adults.

• Additional research on adolescents is needed, especially in the rural areas where the majority of young people will marry and begin families while in their teens. Collecting data on desired age at marriage, birth intervals, desired and optimal family size and sources of information can guide health providers and policy-makers in meeting the needs of this target population

• A variety of traditional, institutional and political barriers and myths about sexuality make it difficult to change health policies for adolescents. Many Egyptians believe that providing family planning services to youth will promote promiscuity. However, it is essential to explore adolescents' sources of information on reproductive health, since incorrect information is difficult to correct.

• Reproductive health programs should provide young people with accurate information, to enable them to make responsible decisions. Successful programs should reach out to adolescents and youth in their own environment -- schools, recreation centers and work sites.

Study Design

This study was conducted by Dr. Mohammad Qayed of the Community Medicine Department at Assiut University. Dr. Cynthia Waszak of FHI served as technical monitor. A final report in English will be posted on FHI's web site when available. This study was supported by the Women's Studies Project at FHI, through a Cooperative Agreement funded by the U.S. Agency for International Development.