This study interviewed married women in the Philippines about the changes family planning use had on their family and work lives, as well as social status.

Philippines

The Philippine family planning program began in the 1970s and reflected a concern with rapid population growth and inadequate maternal and child health (MCH). Over the past two decades, the program has had varying degrees of political support and, consequently, somewhat erratic implementation. In the past six years, there has been an attempt to revive training of MCH and family planning workers and increase the choice of contraceptive methods. For example, injectables have been introduced.

Among the benefits of family planning often cited by contraceptive users are improvements in women's health and the family's economic status. In research conducted in Western Visayas, the Philippines, women said family planning allowed them more freedom to participate in the work force and more time to participate in community activities. Women who used family planning were generally more satisfied with their lives and more likely to share in household decision-making. Domestic violence was a concern for many women in this region of the Philippines.

Research Findings

Researchers interviewed 1,100 married women of reproductive age, plus 50 key informants. Investigators also conducted nine pre-survey and 27 post-survey focus group discussions with women, men, community leaders, members of women's groups, and family planning service providers. Both rural and urban residents took part in the study.

• More than half of the women interviewed currently used contraception or had used family planning at some point. Thirty seven percent are current users. The most popular methods are the pill, tubal ligation, and injections while the most unpopular are male-oriented methods -- condoms and vasectomy. The most common reason for choice of family planning methods was effectiveness, while the most often cited side effect was dizziness. In focus group discussions, men and women expressed fears about contraceptive side effects and gave this concern as a reason for not using family planning.

• Family planning users were more likely to engage in paid work than were non-users. Family planning use provided increased economic opportunities for women, including opportunities to earn a living and to become more efficient workers.

• Women who used family planning were more likely to participate in community activities, such as Parent-Teacher Associations, religious organizations and beautification projects. Women found community activities relaxing, and said these activities allowed them to socialize and interact with their peers. Women reported that social participation gave them satisfaction and increased their sense of self-worth.

• More family planning users than nonusers shared decision-making with their husbands in four areas: the woman's work outside the home; the woman's travel outside the community; use of family planning; and plans for future births. Nonusers were more likely to report that their husbands made decisions independently in these four areas.

• More than one-third of the women reported they had been victims of physical abuse, psychological abuse, or both. Most domestic violence happened when the perpetrator (usually the husband) had been drinking. Among the perceived causes of violence were jealousy, quarrels due to suspected infidelity, and arguments over financial and other family matters. The most common reported acts of physical abuse were beating, boxing, slapping, and kicking. Contraceptive use did not reduce women's risks of violence, nor did work status.

Recommendations

There should be continuous efforts to improve the family planning program, including an effort to provide integrated reproductive health. Special attention needs to be given to helping women deal with side effects. Because of demands on women's time at home and in the work place, health services should be offered at times (and places) convenient to women; for example, on weekends or after normal business hours. Policy-makers should be concerned about the need for more employment opportunities for women, and should encourage women to take on greater leadership roles in the community. Community leaders should develop strategies to minimize and eliminate domestic violence and should develop referral systems to respond to victim's needs in a timely manner.

Study Details

This research was conducted by the Social Science Research Institute, Central Philippines University, in collaboration with the Women's Resource Center and the Family Planning Organization of the Philippines. The principal investigators were Dr. Fely David and Dr. Fely Chin. Research was supported by the Women's Studies Project at Family Health International, through a cooperative agreement funded by the U.S. Agency for International Development. Technical assistance was provided by Dr. Eilene Bisgrove.