SURVEYS SHOW
Couples have one child more than they intended to have

Fertility surveys reveal that married couples in the Philippines exceed their "wanted fertility" by one birth. Rural couples have an unintended fertility as high as 1.4 births compared to 0.7 for couples in urban areas.

Many Filipino women have an unmet need for family planning. About 9 percent of currently married women who want to space births and 11 percent of women who want no more children do not practice contraception.

Loaded with policy implications, these findings are among those presented in 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).

There is an unmet need when a woman in her childbearing years wants to space or limit her children but is not practicing family planning.

Data show that the problem of unmet need is brought about by a number of factors. These include lack of information and access to high-quality family planning services. This is suggested by the "fear of side effects" as among the reasons for not using contraception.

As presented in the report, which is titled "Time to Act: Needs, Options, Decisions," the main findings concerning unmet need are:

l Unmet needs for contraception (for limiting and spacing births) are high;

l Non-use of contraception is related to concerns about adverse health effects and husband's objection;

l Husbands generally want more children than their wives.

The reasons currently married women do not use a contraceptive method are: they want children (20.1 percent); lack of knowledge (6 percent); they are opposed to family planning (3.2 percent); religion (4.8 percent); costs too much (0.4 percent); hard to get methods (0.4 percent); side effects (21.6 percent); health concerns (10 percent); inconvenient (2.1 percent); old, difficult to get pregnant, infrequent sex or husband away (18.6 percent); menopausal or had hysterectomy (10.7 percent).

Data from the fertility surveys mentioned earlier also show that about half of currently married women want no more children. Moreover, not all those who say so are able to meet their fertility preferences. Of the births during the last five years before the National Demographic and Health Survey, 27 percent were to mothers who wanted the births later, and 18 percent were to mothers who did not want any more children.

The same survey also showed that couples have one child more than they intended to have. Mothers with no education have a total wanted fertility rate of four compared with their total fertility rate of five. Those with elementary education have a total wanted fertility rate of three and a total fertility rate of five.

Those who reached high school have a total wanted fertility rate of three and a total fertility rate of four, while those who went to college or higher have a total wanted fertility rate of 2.5 and a total fertility rate of three.

From these figures, one can infer that mothers with lower education have a higher desired and actual fertility.

Unmet need cuts across place of residence. Women in urban areas have a total wanted fertility rate of 2.3 , and a total fertility rate of three. Those residing in rural areas have a total wanted fertility rate of 3.3, and a total fertility rate of 4.7.

There are also marked differences in unmet need by region. Unmet need is high in Eastern Visayas (Region 8), Central Mindanao (Region 12) and the Cordillera Autonomous Region (CAR), and lower or declining in Central Luzon (Region 3), Southern Tagalog (Region 4), Bicol (Region 5), Southern Mindanao (Region 11) and the National Capital Region (NCR). The Autonomous Region of Muslim Mindanao (ARMM) and the newly constituted region of Caraga also have substantial unmet needs based on the 1998 survey.

The ARMM had the lowest percentage of currently married women using any contraceptive method at 15.8 percent, compared to 54.8 percent for Central Luzon and 48.3 percent for Cagayan Valley and the national level of 46.7 percent. The ARMM also had the highest percentage (29.4 percent) of married women having unmet need for family planning, as against 19.8 percent for the total sample.

Contraceptive use is related to some characteristics of the women surveyed, particularly their age, residence, and educational attainment.

For instance, younger women (aged 15-19) have the highest unmet need for family planning (32.1 percent) compared to women aged 20-24 (29.4 percent), 25-29 (23.9 percent), 30-34 (19.1 percent), 35-39 (19.8 percent), 40-44 (15.8 percent), and 45-49 (6.3 percent).

Women in rural areas also have a greater unmet need (23.3 percent) compared to urban women (16.3 percent). The government is addressing this problem. The Department of Health (DOH) has been carrying out the Family Planning and Maternal Health Program, with help from the United States Agency for International Development (USAID). Its main goal is to raise the health status of women and children by reducing the unmet need for family planning services and implementing selected child survival program.

The United Nations Population Fund (UNFPA), through its 5^th Country Country Programme of Assistance, is implementing the Reproductive Health Subprogram and Advocacy Subprogram in nine selected provinces in four regions (2,6,12 and ARMM).

By 2004, the RH subprogram is expected to have contributed to increased use of: integrated and quality health services by women, men and adolescents; and gender-sensitive RH information, knowledge and counselling services to bring about behavioral changes toward healthy reproductive and sexual practices.

The Advocacy Subprogram, on the other hand, aims to increase the support for population and RH activities among various influential groups, including policymakers, administrators, religious leaders, community leaders, and media producers and practitioners.

The DOH has also carried out, with help from USAID, the Management Sciences for Health and the Population Council, the Matching Grant Program which assists local government units in expanding service delivery coverage for four program areas: child immunization, vitamin A supplementation, tetanus toxoid immunization for women, and family planning.

In terms of education, women with no education have the highest unmet need (28.4) compared with those who went to elementary school (23.9 percent), high school (18.7 percent) and college or higher (15.6 percent).

There is also a difference between poor and non-poor women in their preference for contraceptive methods. In the use of female sterilization, 38.7 percent of the non-poor preferred it to 19.1 percent of the poor.

For the pill, 50.2 percent among the non-poor preferred it to 37.9 percent of the poor while injectables are preferred by 12.3 percent of the poor and 7.3 percent by the non-poor. It seemed that more poor women tend to use the temporary family planning methods. These findings, however, did not take into consideration the differences in ages of respondents and income status.
top