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(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
FigureFigureFigure1Trends <strong>in</strong> current use of modern methods by married women aged 15-49602010 Target2020504030160 years to reach 60%201001968 1973 1978 1983 1988 1993 1998 2003 2008 2013 2018 2023times more likely to use modern contraception than those<strong>in</strong> <strong>the</strong> lowest qu<strong>in</strong>tile. Fifteen years later <strong>in</strong> 2008, <strong>the</strong>ratio had gone down to just 1.3. Over <strong>the</strong> past 15 years,<strong>the</strong> two poorest qu<strong>in</strong>tiles had larger <strong>and</strong> more consistentCPR growth rates, averag<strong>in</strong>g close to 3-4 per cent annually.In contrast, those <strong>in</strong> <strong>the</strong> highest qu<strong>in</strong>tile <strong>in</strong>creased CPRby less than 1 per cent annually <strong>and</strong> <strong>the</strong>re were even twoperiods of decl<strong>in</strong>e <strong>in</strong> contraceptive use (see Figure 5). CPRuse <strong>in</strong> <strong>the</strong> middle qu<strong>in</strong>tile grew at <strong>the</strong> same rate as <strong>the</strong>average for all married women.Summary of growth trendsFrom <strong>the</strong> preced<strong>in</strong>g <strong>in</strong>formation, it appears that, from1993 to 2008, growth <strong>in</strong> contraceptive use among marriedwomen was led by those who were poor but not <strong>in</strong>agricultural work, <strong>in</strong> <strong>the</strong>ir twenties <strong>and</strong> hav<strong>in</strong>g one or twochildren. These are <strong>the</strong> segments of <strong>the</strong> population thathad lower rates of use <strong>in</strong> <strong>the</strong> past <strong>and</strong> caught up to someextent <strong>in</strong> <strong>the</strong> last 15 years. However, <strong>the</strong> rates of CPRgrowth achieved by <strong>the</strong>se best-perform<strong>in</strong>g segments arestill slow <strong>in</strong> absolute terms. For example, <strong>the</strong> 2008 NDHSshows that women <strong>in</strong> <strong>the</strong> poorest wealth qu<strong>in</strong>tile needto <strong>in</strong>crease CPR from <strong>the</strong> current 26 per cent to 68 percent <strong>in</strong> order to elim<strong>in</strong>ate <strong>the</strong>ir unmet need <strong>and</strong> <strong>the</strong> use ofunreliable, traditional methods. At <strong>the</strong> 3.9 per cent annualgrowth rate that <strong>the</strong> poorest women have achieved – <strong>the</strong>fastest among all qu<strong>in</strong>tiles – it will still take 25 years toreach 68 per cent.Modern contraceptive method mixFrom 1993 to 2008, <strong>the</strong> top two methods – pills <strong>and</strong> femalesterilization (tubal ligation) – have consistently accountedfor 71 per cent or more of all modern method use (see Figure6). Both methods are, however, undergo<strong>in</strong>g substantialchanges. Tubal ligation has gone down from first to secondFigure240%30%Use of modern contraception by age group, married women2008200319981993Annual Growth20%10%2.7%3.7% 2.8% 2.0% 2.0% 1.9% 1.3%0%15-19 20-24 25-29 30-34 35-39 40-44 45-49Age Group301
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Family Pla
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ForewordThe Asia <
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Part 1Part 1Asia <
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Ensuring that <str
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of methods for all, in</str
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and undertake <str
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Report on the Regi
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SESSION 1: Changin
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that improving <st
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at a hospital would be offered post
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Bounkoung Phichit, Deputy M
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medicines
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Thus, while knowledge of modern met
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Hon. Mr. Malakai Tabar, Chairman, P
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curricula. If the
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dialogue as well as regional <stron
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BackgroundGlobal development effort
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TableTable1EventNational policyYear
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A third observation is that reporte
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TableTable2Current Contraceptive Pr
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Figure(-1.2), Cook Island</
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FigureTableTable3Trends in<
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Nam. Nearly all economies i
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2008 2009% Bilateral % Multilateral
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family planning wi
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IntroductionFamily
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The advent of the
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FigureFigure1Oceania and</s
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next 25 years, however, TFR fluctua
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FigureFigureFigure2Total fertility
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family planning pr
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esponsible for the
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that estimates of CPR for earlier p
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Figuremarried at an older age compa
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As previously mentioned most <stron
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FigureFigure945Relationship between
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The concept of “unmet need” has
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TableTable8Percentage of th
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TableTable9Percentage of reasons fo
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family planning pr
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As far as the supp
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Socio-cultural challenges tofamily
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likely to use contraception than yo
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15 Tests of statistical significanc
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of the South <stro
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104
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Figurewill exceed the</stro
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in urban (67%) tha
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ased service delivery poin<
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Most FWAs who were recruited two to
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are considered, unmet need for effe
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Households pay the
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Effective public-private partnershi
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ConclusionThe Bangladesh Fa
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the Family
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National Institute for Population R
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IndiaIndiaFamily <
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IntroductionThe use of contraceptiv
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TableTable2Indicators of tra<strong
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FigureFigureFigure1Contraceptive pr
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TableTable5Indicators of contracept
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TableTable6Adjusted odds ratios for
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FigureFigure3Contraceptive prevalen
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TableTable7Adjusted and</st
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the north
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TableTable10Differences between nor
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TableTable11 Total fertility rate <
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End Note1The first camp was success
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152
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154
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Figure1980s and ex
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health care and ed
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assistance from UNFPA and</
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in CPR. Likewise,
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International supp
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in development has
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__________ (2007). Population <stro
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170
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TableTable2What has the</st
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174
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per cent of women reported us<stron
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is provider bias that such methods
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TableTable7skewed distribution of h
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TableTable8TableTable9182
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that of the nation
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TableTable12 7some policies that ex
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The system guides the</stro
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FigureFigure4Total donor expenditur
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FigureFigureagain
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Impact of family plannin</s
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marketing of contr
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United States Agency for In
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200
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acceptable. From an NGO perspective
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FigureThis trend of limited donor f
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Figureto have the
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FigureFigure5Percentage change <str
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FigureFigure6Desire to limit childb
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coordination betwe
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the 1980s
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Policy Management.__________ (n.d.,
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218
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Population Activities (UNFPA) for a
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where family plannin</stron
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Thus an objective assessment of <st
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226
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Figureeconomic growth durin
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TableTable1TableTable2For spac<stro
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eflect a provider bias (e.g., <stro
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The Indonesian delegation was very
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than in ensur<stro
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in-country <strong
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(Ministry of Healt
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242
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FigureTrends and p
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TableTable3Unmet need for contracep
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Page 270 and 271: ReferencesAng, Eng Suan (2007). Stu
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Page 290 and 291: FigureHIV/AIDS. An HIV-positive wom
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Guinea case by <st
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The establishment of provin
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provide family plannin</str
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Figurelegal requirement nor a condi
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FigureTableTable5TableTable6Figure4
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modern method and
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married or in unio
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Figureolder. Both the</stro
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TableTable15The immediate past Nati
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out that the “ne
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Commodity securitySupply cha<strong
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is able to achieve. In Papua New Gu
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Qualitative assessments by a number
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increasin<
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service delivery poin</stro
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Population: Views from Men
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1545-1730Day 2: December 9Session 2
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Day 3, December 10Session 50830-100
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15Mr. Tong Sithen1
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54Ms. Shadiya IbrahimAssistant Repr
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93Mr. Melkie AntonProject OfficerUn
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131Dr. John P. SkibiakDirectorRepro
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International <str
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