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When a
woman wants to space or limit childbirth but is not using
a family planning method, she is said to have an "unmet
need." This concept reflects a shift in the thinking
of family planning programs from population control to reproductive
health. Unintended pregnancies and induced abortions are other
indicators of unmet need.
In theory,
fertile women can choose from a menu of artificial and natural
contraceptive methods; but the reality points to the fact
that many couples do not realize their desired family size.
They may have limited information about various family planning
methods.
The poor
especially are not fortunate in spacing births and realizing
the number of desired children. Because they lack education,
are underemployed and have no access to safe contraceptives,
they end up with unintended births while some undergo induced
abortions.
The first
State of the Philippine Population Report (SPPR),
published by the Commission on Population (Popcom) with financial
assistance from the United Nations Population Fund (UNFPA),
cautioned that the lack of success in meeting planned family
size has unfavorable, sometimes tragic, results. Frequent
pregnancies keep the wife out of work. Her long absences from
the work force means she gives up skills that are rewarded.
Unplanned
births may also sour family relationships. The husband and
the wife may find themselves in conflict because their emotional
and physical needs are misaligned. She may need his company
to go through the pains of pregnancy and birth while he may
not be able to shift easily from market work to housework.
The problem
of unmet need is worsened if a household's income is below
the subsistence level. Money goes to food and other basic
needs; none is left for family planning.
As a result,
the older children may be forced to work for small pay to
augment the family income. They miss out on education and
health which they ought to be accumulating as they mature.
The overall
cost, according to the SPPR, is "the country's social
capital, which is crucial for making labor and physical capital
attain their most productive combinations, languishes at a
low level. Overall development gravitates to a low resting
point."
The Report
said that in the Philippines, 26 percent of married women
of reproductive age have an unmet need for family planning.
A major factor explaining unmet need is the husband's objection
to family planning and the wife's acquiescence to this. The
husband's view usually prevails even over an educated wife's
preference.
Recent
studies show that "men tend to be the ultimate decision-makers
in sexual relations, childbearing and child-rearing decisions
among most couples." Disagreements over the number of
children and timing of pregnancy end often with the husband's
decision overruling that of his wife. Wives are believed to
submit to their husbands' decision to maintain marital harmony,
"part of a deeply ingrained cultural value and expectation
about women's role."
It was
observed that women resort to subterfuges and various forms
of resistance and accommodations when negotiating for their
rights and entitlements. The belief that women should accommodate
their husbands'
sexual
need even if it is against their own wishes lessens female
control over their fertility.
Unmet
need also reflects the face of poverty. It has been shown
that 70 percent of the world's poor are women. They tend to
bear the burden of making ends meet, of feeding the children
and taking on paid world to make sure that their offspring
survive an economic crisis. What's more, because of their
ability to bear children, women are expected by society to
engage in child care far beyond the nine months of pregnancy.
Another
problem is violence against women (VAW), a human rights violation
and a threat to women's health, their reproductive rights
and, in some cases, their need to control their fertility.
VAW destroys a woman's self-esteem and undermines their full
involvement in society.
In the
Philippines, violence can occur right in the home; women are
the more likely victims and men the perpetrators of violence.
Some husbands become violent when denied their "marital
rights." The 1993 Philippine Safe Motherhood Survey shows
that one out of 10 respondents had been physically harmed
by someone close to them. A third reported that the violence
occurred during pregnancy.
The World
Bank stated that rape and domestic violence are significant
causes of disability and death of women of reproductive age.
Women lose nearly one in five healthy years of life age 15-44
in both developing and industrialized countries as a result
of VAW.
To address
this problem the Philippines has produced policy and program
proposals that focus on gender awareness and education, legislation,
support services for victims, establishment of crisis and
counseling services, empowerment of women, a media campaign,
training in self-defense, legal reforms, among others. There
emerges a need to address structural violence and systematic
forms of violence and link them to interpersonal violence.
Another
way of dealing with unmet need is enlisting the support of
the men who have been pretty much left out of the picture
in population programs. The new advocacy puts men back into
the picture in partnership with women and emphasizing male
participation and responsibility in reproductive health.
In the
Philippines, men have been found to have a strong pronatalist
stance, which is a major problem. The pressure to have children
is greater on the husband than on the wife. Children are seen
as proof of a man's virility. Since a man is acknowledged
as the head of the family, he decides on important matters
like how many children to have and when to have them.
The SSPR
noted that there is "a higher latent demand for family
planning services among men, given more knowledge of contraception.
Expansion and improvement of family planning services currently
available to men is needed to convert potential demand to
effective demand for services."
The report,
titled "Time to Act: Needs, Options, Decisions,"
saw the need for intervention strategies aimed at men who
perpetrate VAW, so as to break the cycle of violence. Counseling,
rehabilitation and livelihood support are some steps in this
direction. Gender-sensitive and peaceful men can also be tapped
to help abusers stop their aggressive behavior and find other
ways of handling their problem.
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