1. What do you think are the reasons of high unmet need of FP in the Philippines?
In the past years, there is an estimated 222 million women in low- and middle-income countries including the Philippines which have an unmet need for modern contraception and family planning. And even with this fact, there has been very little studies during the last fifteen years on the causes for this widespread failure to implement childbearing desires in contraceptive practice. There are some demographic survey data in women’s self-reported reasons for non-use, but these days provide limited insight on the full set of possible obstacles to use. And even with the recent laws regarding reproductive health like the R.A. No. 10354 or the Philippine Reproductive Health Law, the unmet need for family planning and contraceptive use still remains undeniably high for some regions in the country. One study says that there are possible four explanations for an unmet family planning need in the Philippines. First, an unmet need as an artifact of inaccurate measurement of fertility preferences and contraceptive practice. Second, due to a weakly held fertility preferences. Third, a result of a women’s perceiving themselves to be at low risk of conceiving. And lastly, due to costs of contraception. As much as I support the four explanations identified in the article as the vast reasons for high unmet need of family planning in the Philippines, I want to talk something that is more timely and relevant to our situation today.
The covid-19 pandemic has disrupted many aspects of living in the society such as education, work, and most especially health care services which include family planning services. Because of intermittent lock downs on rural and urban areas, many of those who are subscribing to family planning services missed their follow-up check ups with their health care provider. This is the same scenario that goes to pregnant women during the early phases of the pandemic. And of course, people of this time do not go to the clinics not because the restrictions are not allowing them to, but the fact that Covid-19 is easily transmissible, these women subscribed or wanting to have family planning services were scared of going out especially before where hospitals are exhausted with Covid patients and even rural clinics were fully occupied solely for these patients. The result, of course women were forced to stay at home and be safe neglecting the fact that stopping the contraceptive use or the inconsistency of the family planning services increases the possibility of conception. Although staying at home for safety is a reasonable excuse, without the government stepping up the family planning services to address the issue, the unmet need of family planning will continue to rise.
Because of the recent global health challenge, the Covid-19 pandemic, there is a need to strengthen more of the family planning services and aid the disruptions caused by the social and economic impacts of Covid-19. And although, the Covid-patient numbers are declining, and people are given more access outdoors for services and even for leisure activities, the Covid scare is still present in some communities and people may not be as willing as before to go to the clinics and hospitals again for health services including family planning. Efforts must be put on both how to strengthen the policies and how to reach out more people. Education, further counseling, and consistent monitoring are also expected to be included should the adjustments be made.
2. What are ways you can suggest to increase the practice of FP in the county? Give at least 1-2 suggestions
Like I said from my previous discussion on the reasons why there is still high unmet need of family planning in the Philippines, which my answer mostly delved on the disruptions caused by the Covid-19 pandemic, I suggested to have the policies regarding family planning services adjusted based on the current situation in the communities that are still or even not anymore facing other community health concerns. This not just by readjusting to strengthen the goal of the services, but also finding new interactive ways to reach out to people with the assurance of safety and low cost service. For example, many hospitals and clinics were used and still being occupied by Covid-19 patients, even if some of these hospitals are supposedly for let’s say women and their spouses seeking for family planning and contraceptive services. Because of this, people may still have fear of visiting the health facility; in their community, there may still be some restrictions of movement; there is a lack of access to health care providers; and lastly, the drug or chemist stores still remain closed. This will lead to the women or men not having an access to the contraceptive methods. But I’m only speaking about people who are willing to actually go to these health centers and have an access to family planning services. I haven’t mentioned yet those people who are uninformed but can still be educated to seek and know more about family planning and its services, and those people who are educated but are uninterested or do not believe to the good outcomes of the service. Speaking of these people, they are the ones least expected to come to the health centers or to their health care providers given with the current situation.
So, in order to address this, I suggest that the government should step up in making these family plannings services more accessible than before. They can start by increasing the staff available for consultation whether it be online or onsite. If onsite, I think of doing more community visits that are not near the hospitals or clinics where Covid scare is possible. If online, it can be done even to the most accessible social media sites like facebook or messenger, so some old people won’t find it hard to make an appointment or do follow-ups. It will also help if the family planning devices or products like male and female condoms be made available in many places for free. Furthermore, it would also help if more and more people become aware of the importance of family planning most especially in today’s situation. So, aside from strengthening government services on healthcare facilities, finding ways to reach out more to people is a must. I suggest that the LGUs implement programs like seminars, talks, and counseling to their barangays or community villages to educate more people about reproductive health. This sounds so easy to say but honestly, thinking about it, people may not be ‘encouraged’ enough so it is important to find ways that people will be engaged or somehow interested. One way LGUs can do that for example is having a seminar/talk about reproductive family health planning on Covid vaccination sites where there is an expected huge number of people. There should be staff and counselors ready for individual counseling and education.
Summing up, there are actually many ways to promote reproductive family health and its services even in this time of pandemic. But, the question relies really on how effectively the government will address these problems, and how people will cooperate. However, I see more of a system problem than the people actually needing the family planning services. I’m not saying that the government are not doing good enough, but the outcomes and current situation on reproductive health really show that there is indeed, a need to step up, so unmet needs for family planning may at least stop in rising, and hopefully, eventually recede.
References:
Casterline JB, Perez AE, Biddlecom AE. Factors underlying unmet need for family planning in the Philippines. Stud Fam Plann. 1997 Sep;28(3):173-91. PMID: 9322334.
Machiyama, K., Casterline, J.B., Mumah, J.N. et al. Reasons for unmet need for family planning, with attention to the measurement of fertility preferences: protocol for a multi-site cohort study. Reprod Health 14, 23 (2017). https://doi.org/10.1186/s12978-016-0268-z.