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

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modern method <strong>and</strong> 94 per cent of rural women also fell<strong>in</strong>to this category.So far as <strong>the</strong> use of any method of contraception isconcerned, <strong>the</strong> Isl<strong>and</strong>s region had <strong>the</strong> highest overallprevalence rate both <strong>in</strong> 1996 <strong>and</strong> 2006, while <strong>the</strong> Highl<strong>and</strong>shad <strong>the</strong> lowest rate, with <strong>the</strong> o<strong>the</strong>r regions hav<strong>in</strong>g been <strong>in</strong>between (see Table 8). In 2006 this pattern rema<strong>in</strong>ed <strong>the</strong>same, although CPR rose <strong>in</strong> all regions. So far as modernmethods are concerned, <strong>the</strong> Sou<strong>the</strong>rn region (with<strong>in</strong>which is located <strong>the</strong> nation’s capital city) had <strong>the</strong> highestprevalence rate <strong>in</strong> both 1996 <strong>and</strong> 2006. Between 1996<strong>and</strong> 2006, <strong>the</strong> prevalence rate for modern methods rose at<strong>the</strong> national level (from 19.6 to 24.4%) <strong>and</strong> <strong>in</strong> all regionso<strong>the</strong>r than <strong>the</strong> Isl<strong>and</strong>s (Table 8). In <strong>the</strong> Isl<strong>and</strong>s region,however, CPR for modern methods essentially rema<strong>in</strong>edstatic between 1996 <strong>and</strong> 2006 (a decl<strong>in</strong>e from 27 to 26%would not be statistically significant) <strong>and</strong> <strong>the</strong> proportionof all users who were us<strong>in</strong>g modern methods fell from 68per cent to only 57 per cent. The proportion of marriedwomen <strong>in</strong> <strong>the</strong> Isl<strong>and</strong>s region us<strong>in</strong>g “traditional” methods,particularly periodic abst<strong>in</strong>ence, was highest of all regions<strong>in</strong> 1996 but was even higher <strong>in</strong> 2006. It is likely that thispattern is associated with religion, as <strong>the</strong> “rhythm” methodcan also be described as a form of periodic abst<strong>in</strong>ence <strong>and</strong><strong>the</strong> use of this method is highest <strong>in</strong> <strong>the</strong> Isl<strong>and</strong>s region.It is possible that <strong>the</strong> decl<strong>in</strong>e <strong>in</strong> CPR for modern methodsof contraception <strong>in</strong> <strong>the</strong> Isl<strong>and</strong>s region, accompanied by arise <strong>in</strong> <strong>the</strong> use of any method, was a function of a religiousrevival over <strong>the</strong> period. Although 26 per cent of <strong>the</strong> 2006DHS sample population identified <strong>the</strong>mselves as RomanCatholic, published DHS tables do not provide anyevidence on contraceptive use by different religious groupsthat could be cross-classified by region. 9The use of contraception, like knowledge, is higher <strong>in</strong>urban than rural areas, with <strong>the</strong> proportion of currentlyTableTable10360
married women us<strong>in</strong>g any form of contraception reach<strong>in</strong>g44 per cent <strong>in</strong> 2006 compared with 36 per cent <strong>in</strong> 2006(see Table 9). The use of modern family plann<strong>in</strong>g <strong>in</strong>creased<strong>in</strong> both rural <strong>and</strong> urban areas between 1996 <strong>and</strong> 2006but <strong>the</strong> rate of <strong>in</strong>crease was higher <strong>in</strong> rural areas. CPR formodern methods <strong>in</strong> rural areas <strong>in</strong>creased by 32 per centbetween 1996 <strong>and</strong> 2006 compared with an <strong>in</strong>crease of only19 per cent <strong>in</strong> urban areas.The proportion of all currently married urban women us<strong>in</strong>gcontraception who were us<strong>in</strong>g a modern method decl<strong>in</strong>edbetween <strong>the</strong> last two DHS (from 86 to 83%) suggest<strong>in</strong>gthat more urban women were us<strong>in</strong>g “traditional” methods<strong>in</strong> 2006 relative to a decade earlier. This is an unexpectedresult that may be associated with a more active campaignaga<strong>in</strong>st modern contraception by <strong>the</strong> Catholic Church. Inrural areas <strong>the</strong> use of modern contraception among thoseus<strong>in</strong>g any form of family plann<strong>in</strong>g has <strong>in</strong>creased, but notby much. In 2006, 27 per cent of all rural women us<strong>in</strong>g anyform of contraception were us<strong>in</strong>g a “traditional” method.Age patternsIn Papua New Gu<strong>in</strong>ea, knowledge of modern contraception,which tends to be relatively low among young people (65%of 15-19-year-old females knew of a modern method),rose with age to a maximum of 85 per cent at ages 30-34<strong>and</strong> <strong>the</strong>n fell away among older women aged 35 <strong>and</strong> older(70%). The actual use of contraception showed a similarpattern but reached its maximum (30.4%) among womenaged 40-44 (see Table 10). Trends over <strong>the</strong> 1996-2006decade show <strong>in</strong>creas<strong>in</strong>g contraceptive use among youngerwomen, with somewhat slower <strong>in</strong>creases among womenaged 35 <strong>and</strong> older.Parity is also a significant determ<strong>in</strong>ant of contraceptiveuse, with higher parity women be<strong>in</strong>g more likely to usecontraception. However, even among women of parity4 <strong>and</strong> over, modern contraceptive use was only 34 percent (Table 10). The use of any form of contraception(traditional <strong>and</strong> modern) reached a peak (41%) amongwomen aged 40-44, <strong>and</strong> 10 per cent of this group wereus<strong>in</strong>g a traditional method <strong>in</strong> 2006.Unmet need for family plann<strong>in</strong>gThe ICPD Programme of Action recommends that“Government goals for family plann<strong>in</strong>g should be def<strong>in</strong>ed <strong>in</strong>terms of unmet need for <strong>in</strong>formation <strong>and</strong> services” (UnitedNations, 1995). Subsequently, ICPD+5 recommendedthat “Where <strong>the</strong>re is a gap between contraceptive use <strong>and</strong><strong>the</strong> proportion of <strong>in</strong>dividuals express<strong>in</strong>g a desire to spaceor limit <strong>the</strong>ir families, countries should attempt to closethis gap by at least 50 per cent by 2005, 75 per cent by2010 <strong>and</strong> 100 per cent by 2015” (United Nations, 1999).The concept of “gap” comes from early generation KAP(knowledge, attitude <strong>and</strong> practice) studies from which wasco<strong>in</strong>ed <strong>the</strong> term “KAP-gap” to refer to a situation <strong>in</strong> whicha woman expressed a desire to limit or space births but wasnot us<strong>in</strong>g any form of contraception. Clos<strong>in</strong>g this gap by2015 would be an extremely ambitious goal <strong>in</strong> <strong>the</strong> case ofPapua New Gu<strong>in</strong>ea.The concept of “unmet need” has undergone fur<strong>the</strong>rref<strong>in</strong>ement <strong>in</strong> recent years with <strong>in</strong>creas<strong>in</strong>gly encompass<strong>in</strong>gdef<strong>in</strong>itions of <strong>the</strong> categories of women who can beconsidered as hav<strong>in</strong>g an unmet need. The current def<strong>in</strong>itionof unmet need accord<strong>in</strong>g to <strong>the</strong> United Nations PopulationDivision is:Unmet need for family plann<strong>in</strong>g is <strong>the</strong>number of women with unmet need forfamily plann<strong>in</strong>g expressed as a percentageof women of reproductive age who areTableTable11361
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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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244
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FigureTrends and p
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TableTable3Unmet need for contracep
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TableTable5TableTable6TableTable725
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TableTable8TableTable9Malaysia, abo
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previously mentioned is based on fo
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TableTable16births and</str
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FigureFigure3TRF54.5Scatter plots o
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ReferencesAng, Eng Suan (2007). Stu
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Demographic data sheet: population
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population size, with just 336,000
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NuptialityIn Myanmar nuptiality is
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FigureIn Myanmar, birth-spac<strong
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Scope of coverage and</stro
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FigureIn Myanmar, out of six select
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equirements. The Min</stron
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according to <stro
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Adolescent sexual and</stro
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FigureHIV/AIDS. An HIV-positive wom
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National Population PolicyMyanmar i
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Linkages with o<st
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TableTable4Achievements of Myanmar
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monitoring <strong
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Nay Pyi Taw, 26 October 2010.53 Sit
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292
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294
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TableTableA296
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dispense and adm<s
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(1) I am against a
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FigureFigureFigure3Use of modern co
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FigureFigure7Traditional method use
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Figureprojection, and</stro
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Figure 11 summarizes the</s
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Page 348 and 349: includin</
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Page 358 and 359: FigureThe existence of traditional
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Page 382 and 383: is able to achieve. In Papua New Gu
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Page 390 and 391: Population: Views from Men
Page 392 and 393: 1545-1730Day 2: December 9Session 2
Page 394 and 395: Day 3, December 10Session 50830-100
Page 396 and 397: 15Mr. Tong Sithen1
Page 398 and 399: 54Ms. Shadiya IbrahimAssistant Repr
Page 400 and 401: 93Mr. Melkie AntonProject OfficerUn
Page 402 and 403: 131Dr. John P. SkibiakDirectorRepro
Page 404: International <str
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