1. What do you think are the reasons of high unmet need of FP in the Philippines?
One in every four pregnancies in the Philippines is unwanted, and 610 000 unsafe abortions are conducted each year. An “unmet need of family planning” refers to the gap between reproductive intentions and contraceptive behaviors wherein fertile and sexually active women who want no more children or want to delay the next child are not using any method of contraception (Argel & Germar, 2020). Access to family planning services is hampered by several barriers which include the social norms and conservative nature of Filipino beliefs, partner’s approval on the use of family planning, fear of health concerns, and accessibility to FP services.
Even while 14 percent of 15–19 year-olds and 49 percent of those aged 20–24 years had their first sexual intercourse before marriage, according to a 2013 survey, maintaining virginity until marriage was important to 83 percent of women aged 15–24. Contrary to popular belief, this societal norm discourages unmarried women from using contraception, and non-users reported less approval of contraceptives themselves and on the part of their relatives and friends (Nagai et.al.,2019). In a survey of more than 6,500 households, one-fourth of the women said they did not want more children, but did not use family planning because of their husband's disapproval. In addition, infrequent sex and viewing themselves as being “too old to conceive easily” was commonly stated as a reason why women with an unintended pregnancy did not use contraception (Casterline, Perez, & Biddlecom, 1997). Users and providers trying to understand the chemical and biological processes that make contraceptives function often convey inaccurate information regarding contraception. Many contemporary contraceptives contain hormones that can cause some women to experience unwanted side effects such as breast soreness, headaches, weight gain, irregular menstrual bleeding, nausea, and/or loss of bone density that may occur as a result of long-term use. These possible side effects are frequently the source of a variety of misconceptions that discourage women to use FP and should be addressed in health education. Finally, the accessibility issues that pose a challenge to boosting contraceptive use in the Philippines, include geographic isolation, poverty, and contraceptive supply limitations in the community (Guttmacher Institute, 2010).
Thus, government policies and programs focusing to reduce the unmet need for family planning in our setting should be based on a clear understanding of the causes of unmet needs for family planning. The programs should include adequate information about family planning along with the importance of inter-spousal dialogue and how they can support their wives in choosing the best family planning method and providing free FP resources that the public can utilize.
2. What are ways you can suggest to increase the practice of FP in the country? Give least 1-2 suggestions.
Making FP more accessible by improving family planning counseling in all clinic contacts and reducing costs. The World Health Organization (2016) recommends providing routine family planning counseling at antenatal care, postnatal care, and other contact points, and integrating it in both immunization clinics and general primary care clinic settings. Providing information and training in basic counseling skills to community health workers is also important to address their lack of knowledge, training, and comfort, assumptions about patient pregnancy risk, negative beliefs about contraceptive methods and to ensure the quality of education they are providing clients. Higher rates of contraceptive continuation and use are reported by women who report receiving better care in their local linics. Current users can address developing or ongoing concerns about methods with ongoing counseling at every encounter, and prior users who have stopped using these methods can be targeted, if appropriate, to resume usage by identifying reasons for discontinuation. Furthermore, in order to lower costs for the recipients, family planning programs will require government assistance and funding allocation. Budget cuts to these programs will result in long-term financial expenses in the form of prenatal care, problematic pregnancies, and facility births with a high number of unplanned pregnancies. (National Economic and Development Authority, 2019).
Intensify information dissemination and educational campaigns on FP through broadcast and social media. Information on a variety of topics and concerns of couples and individuals who want to plan their families by spacing pregnancies properly or limiting their number of children should be widely disseminated through television, radios, and social media platforms to reach more people. Emphasis should also be given on debunking myths and misconceptions on family planning and reproductive health such as the fear of side effects (Lamberte et. al., 2000) This will spark casual educational conversations among families and friends on family planning and remove the stigma of discussing reproductive health concerns. This is the first step in challenging social norms and beliefs that discourage couples from accessing FP services and using effective contraceptive methods.
References:
Argel, J.I. & Germar, M.J. (2020). Contraceptive use and factors associated with unmet need for family planning among postpartum women admitted in a tertiary hospital. Philippine Journal of Obstetrics and Gynecology. http://pjog.org/article-detail.php?id=201
Casterline, J. B., Perez, A. E., & Biddlecom, A. E. (1997). Factors Underlying Unmet Need for Family Planning in the Philippines. Studies in Family Planning, 28(3), 173–191. https://doi.org/10.2307/2137886
Guttmacher Institute. (2010). Facts on barriers to contraceptive use in the Philippines. https://editor.guttmacher.org/sites/default/files/factsheet/fb-contraceptives-philippines.pdf
Lamberte, E., Lee, N. Garganian, D.C. & Kantne, A. (2000, October). Family planning service utilization and market segmentation in the Philippines. Social Development Research Center De La Salle University-Manila. https://dhsprogram.com/pubs/pdf/FA34/FA34.pdf
Nagai, M., Bellizzi, S., Murray, J., Kitong, J., Cabral, E. I., & Sobel, H. L. (2019). Opportunities lost: Barriers to increasing the use of effective contraception in the Philippines. PLOS ONE. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0218187#:~:text=The unmet need for family,to 22%25 [3].
National Economic and Development Authority (2019, March 6). Gov’t to strengthen population, family planning program. https://neda.gov.ph/govt-to-strengthen-population-family-planning-program/
World Health Organization (2016). WHO recommendations on antenatal care for a positive pregnancy experience. https://www.who.int/publications/i/item/9789241549912