Family Planning in Asia and the Pacific - International Council on ...

(1) I am aga<strong>in</strong>st abortion; (2) I am <strong>in</strong>favor of giv<strong>in</strong>g couples <strong>the</strong> right to choosehow best to manage <strong>the</strong> families so that<strong>in</strong> <strong>the</strong> end <strong>the</strong>ir welfare <strong>and</strong> that of <strong>the</strong>irchildren are best served; (3) <strong>the</strong> state mustrespect each <strong>in</strong>dividual’s right to follow hisor her conscience <strong>and</strong> religious convictionon matters <strong>and</strong> issues perta<strong>in</strong><strong>in</strong>g to <strong>the</strong>unity of <strong>the</strong> family <strong>and</strong> <strong>the</strong> sacredness ofhuman life from conception to naturaldeath; (4) <strong>in</strong> a situation where couples,especially <strong>the</strong> poor <strong>and</strong> <strong>the</strong> disadvantagedones are <strong>in</strong> no position to make an<strong>in</strong>formed judgment, <strong>the</strong> state has aresponsibility to so provide; <strong>and</strong> lastly, (5)<strong>in</strong> <strong>the</strong> range of options <strong>and</strong> <strong>in</strong>formationprovided to couples, natural familyplann<strong>in</strong>g <strong>and</strong> modern method shall bepresented as equally available. 26The new Secretary of Health has <strong>in</strong>cluded a requestfor 400 million pesos to purchase contraceptives <strong>in</strong><strong>the</strong> regular budget of <strong>the</strong> Department of Healthfor 2011. The new Speaker of <strong>the</strong> House ofRepresentatives has pledged that <strong>the</strong> RH Bill willf<strong>in</strong>ally be put to a vote.Current issues <strong>in</strong> <strong>the</strong> familyplann<strong>in</strong>g programmeModern contraceptive useModern contraceptive use is low to moderate, with steadybut slow growth s<strong>in</strong>ce 1978. The latest survey shows thatonly a third of married women of reproductive age areus<strong>in</strong>g any modern method. The average annual growth was19 per cent from 1968 to 1978 <strong>and</strong> 2-3 per cent from 1978to 2003. The fastest annual growth <strong>in</strong> <strong>the</strong> last 30 years was3.4 per cent from 1998 to 2003. Even if this peak growthrate is susta<strong>in</strong>ed, it would take <strong>the</strong> country until 2020 toreach a contraceptive prevalence rate (CPR) of 60 per centfor modern methods, a decade beh<strong>in</strong>d <strong>the</strong> government's2010 target27 (see Figure 1). From 2003 to 2008, <strong>the</strong>growth rate dropped steeply to 0.36 per cent which, if leftunchanged, would mean that a CPR of 60 per cent formodern methods could be reached only after 160 years.Modern method CPR was 34 per cent <strong>in</strong> 2008, while <strong>the</strong>total dem<strong>and</strong> for family plann<strong>in</strong>g was 73 per cent, whichmeans that less than half of <strong>the</strong> dem<strong>and</strong> was met throughmodern methods.(Note for all figures: <strong>the</strong> support<strong>in</strong>g data <strong>and</strong> sources areavailable at <strong>the</strong> Appendix – Data Tables.)Trends <strong>in</strong> modern contraceptiveuseBy age groupS<strong>in</strong>ce 1993, contraceptive use by age had an <strong>in</strong>verted Ushape, with peak use by women <strong>in</strong> <strong>the</strong>ir 30s for any modernmethod (see Figure 2). All age groups had an <strong>in</strong>crease <strong>in</strong>percentage use from 1993 to 2008, but at different rates of<strong>in</strong>crease. The largest ga<strong>in</strong>s came from <strong>the</strong> three youngestage groups, led by those aged 20-24, hav<strong>in</strong>g <strong>in</strong>creased atan average of 3.7 per cent per year for 15 years. The oldest,those aged 45-49, had <strong>the</strong> smallest ga<strong>in</strong> at 1.3 per cent peryear. It is <strong>the</strong> only age group that had a reversal <strong>in</strong> currentuse dur<strong>in</strong>g <strong>the</strong> 15-year period, dipp<strong>in</strong>g from 26.4 per centmodern methods CPR <strong>in</strong> <strong>the</strong> 2003 survey to 22.4 per cent<strong>in</strong> 2008.By number of liv<strong>in</strong>g childrenS<strong>in</strong>ce 1993, <strong>the</strong> use of modern contraception <strong>in</strong>creasedsteadily as <strong>the</strong> number of liv<strong>in</strong>g children <strong>in</strong>creased fromzero to three; <strong>and</strong> went down <strong>the</strong>reafter (see Figure 3).Over <strong>the</strong> past 15 years, those with one child showed <strong>the</strong>most significant annual average rate of growth at 5 percent, almost 2½ times <strong>the</strong> average for all. Those with nochildren had a 6 per cent growth rate, but this generatedlittle impact as <strong>the</strong> basel<strong>in</strong>e figure was near zero. Thosewith three or more children had below average growthrates; those with three children even registered a slightdrop <strong>in</strong> use from 2003 to 2008.Women employed <strong>in</strong> agriculture tend to have more childrenthan those employed <strong>in</strong> o<strong>the</strong>r sectors (see Figure 4). Thosewith only one to two children tend to be employed <strong>in</strong>professional, technical <strong>and</strong> managerial work (31%) <strong>and</strong><strong>in</strong> sales <strong>and</strong> services (31%), while those with five or morechildren work <strong>in</strong> agriculture (33%) <strong>and</strong>, slightly less butstill substantial, <strong>in</strong> sales <strong>and</strong> service (26%). It is also worthnot<strong>in</strong>g that, among women with children, domestic service(household help) is <strong>the</strong> only o<strong>the</strong>r occupation that stillrises as <strong>the</strong> number of children <strong>in</strong>creases.By wealth qu<strong>in</strong>tileIn 1993, women <strong>in</strong> <strong>the</strong> highest wealth qu<strong>in</strong>tile were 2.1300