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

FigureFigure7Traditional method use <strong>in</strong> <strong>the</strong> Philipp<strong>in</strong>es <strong>and</strong> neighbour<strong>in</strong>g <strong>Asia</strong>n countrieswoman's fertile period – from 26 per cent to 48 per cent<strong>in</strong> <strong>the</strong> four surveys from 1993 to 2008. This <strong>in</strong>dicates thatmost users have not had any formal orientation, much lesstra<strong>in</strong><strong>in</strong>g, about <strong>the</strong> method.The Department's goal 30 of 80 per cent total CPR <strong>and</strong> 60per cent modern-method CPR by 2010 implies a target of20 per cent use rate for traditional methods, which meansthat <strong>the</strong> current high levels will be raised fur<strong>the</strong>r. Thiscontradicts <strong>the</strong> Department's own family plann<strong>in</strong>g methodmix. Policy clarification is needed <strong>in</strong> this area.Unmet need for modern methodsUnmet need measures <strong>the</strong> proportion of married womenwho are able to get pregnant (fecund), want to space <strong>the</strong>next pregnancy by two years or more or stop childbear<strong>in</strong>galtoge<strong>the</strong>r, but are not us<strong>in</strong>g any method of contraception.Accord<strong>in</strong>g to this def<strong>in</strong>ition, users of traditional methodsare classified as hav<strong>in</strong>g “met” <strong>the</strong>ir need for prevent<strong>in</strong>gpregnancy. Ow<strong>in</strong>g to <strong>the</strong> large risks posed by traditionalmethods <strong>in</strong> lead<strong>in</strong>g to un<strong>in</strong>tended pregnancies <strong>and</strong> <strong>the</strong>exclusion of <strong>the</strong>se methods <strong>in</strong> official family plann<strong>in</strong>gprogrammes, organizations such as <strong>the</strong> GuttmacherInstitute (“unmet need for effective contraception” 31 ) <strong>and</strong>ICF Macro of <strong>the</strong> MEASURE DHS project (“unmet needfor modern methods” 32 ) have began releas<strong>in</strong>g comb<strong>in</strong>edcounts of women with unmet need toge<strong>the</strong>r with thoseus<strong>in</strong>g traditional methods. This is especially useful forcountries such as <strong>the</strong> Philipp<strong>in</strong>es with high levels oftraditional method use. These comb<strong>in</strong>ed counts will beused <strong>in</strong> <strong>the</strong> present report.Unmet need for modern methods provides a simple basisfor target<strong>in</strong>g levels of contraceptive use that is groundedon <strong>the</strong> expressed desires of women to regulate <strong>the</strong>irchildbear<strong>in</strong>g. With <strong>the</strong> unmet need approach, however,a problem occurs if women <strong>and</strong> couples desire a largenumber of children that, when aggregated, would lead tounsusta<strong>in</strong>able population growth. This desire may havebeen true for <strong>the</strong> Philipp<strong>in</strong>es <strong>in</strong> <strong>the</strong> earlier decades, but <strong>the</strong>latest studies show a different picture.Westoff 33 calculated <strong>in</strong> a 2006 multi-country study that<strong>the</strong> Philipp<strong>in</strong>es would have a total fertility rate (TFR) of2.4 to 2.8 children per woman if <strong>the</strong> unmet need based on2003 DHS data were elim<strong>in</strong>ated or substantially reduced.Shift<strong>in</strong>g <strong>the</strong> large number of traditional method usersto modern methods would fur<strong>the</strong>r reduce <strong>the</strong> predictedTFR.In a 2006 study us<strong>in</strong>g cross-tabulations <strong>and</strong> multivariateanalyses of socio-economic status <strong>and</strong> demographicbehaviour, Orbeta 34 concluded that “it is not <strong>the</strong> dem<strong>and</strong>for more children that is <strong>the</strong> reason for [<strong>the</strong> poor's] largefamily size but <strong>the</strong>ir use of <strong>in</strong>effective fertility controlmeasures”. He proposed three factors or mechanisms thatcould expla<strong>in</strong> this outcome: “(a) <strong>the</strong> crowd<strong>in</strong>g out of womenfrom poor households by a significant percentage of womenfrom richer households that are gett<strong>in</strong>g <strong>the</strong>ir supplies ofmodern contraception also from public sources, (b) <strong>the</strong>lower education of women from poorer households, <strong>and</strong>(c) <strong>the</strong> lower capacity of women from poorer householdsto pay for private supplies”.Proportion of women withunmet needThe Philipp<strong>in</strong>e government does not have a target forreduction of unmet need but gave a CPR target of 80 percent for all methods <strong>and</strong> 60 per cent for modern methodsby 2010, <strong>and</strong> a CPR of 100 per cent by 2015. 35 The 100per cent CPR target is likely a mistake because <strong>the</strong>re willalways be women who do want to get pregnant. This is anarea that needs policy clarification from <strong>the</strong> government.304