Highlights of 2004 Family Planning Survey: SOCCSKSARGEN Region About the Survey Since 1995, the NSO has been conducting the family planning survey every year, except in 1998 and 2003 when the National Demographic and Health Survey was conducted, which collected more comprehensive information on family planning. The 2004 Family Planning Survey is the eighth family planning survey. It covered a national sample of some 17 thousand households with some 24 thousand women aged 15 to 49 years. For Region XII, there were 924 sample households interviewed with 1211 women aged 15 to 49 years. The data collection was carried out from April 12 to April 30, 2004. Characteristics of Respondents The respondents in the FPS were women of reproductive ages, irrespective of marital status. One in five respondents was in the age group 15 to 19. The oldest age group 45-49 comprised 9 percent. About 55 percent of the respondents were below 30 years old. The median age is about 28 years old. Almost four in 10 respondents were never married; the married comprised 58 percent. FIGURE 1. Percent distribution of women by age group, Philippines: 2004 Source: National Statistics Office, 2004 FPS FIGURE 2. Percent distribution of women by marital status, Philippines: 2004 Source: National Statistics Office, 2004 FPS Fifty-four percent of them were residents of urban areas, and about three in 10 respondents belonged to households classified as poor. The classification is based on the information on ownership of vehicles and presence in the household of housing amenities like electricity, radio, TV set, landline telephone, mobile phone, washing machine, refrigerator or freezer, computer, and CD or DVD player. FIGURE 3. Percent distribution of women by residence and socio-economic status Philippines: 2004 Source: National Statistics Office, 2004 FPS Contraceptive Prevalence Rate The CPR, based on the 2004 FPS, is 49.3 percent, which means that one in two married women in the country is using a family planning method. This slide which shows the CPR and the prevalence rates for modern and traditional methods, from 1968 to 2004, shows that the CPR reached around 50 percent in 1995 and appears to have remained at that level since then. The prevalence rate of modern methods in 2004 is 35 percent. This percentage is similar to the levels in 2002 and 2003. The computed 95 percent confidence intervals of the prevalence rates for modern methods from 2002 FPS, 2003 NDHS and the 2004 FPS, which you will find in the reports on these surveys, overlap. This means that there was no significant increase nor decline in the use of modern methods in the last 3 years. FIGURE 4. Percent of currently married women using contraceptive methods Philippines: 1968-2004 Source: National Statistics Office, 2004 FPS Contraceptive Method Mix If one in two women is using a contraceptive method, then the other one is not using any method at all, that is what this large pie on No Method is telling us. Contraceptive pills is the leading method, followed by female sterilization. These rankings have been the same since the 1995 FPS, except in the 1998 NDHS when it was ligation which ranked first. The percentage of women using female sterilization declined from 2002 and 2004 from 11 percent to 9 percent. For the other methods, the differences that you see are not significant based on the computed 95 percent confidence intervals for these percentages. Meaning there could just be a leveling off in the prevalence rates for the other methods, including injectables. FIGURE 5. Percent distribution of married women by current contraceptive method used Philippines: 2004 Source: National Statistics Office, 2004 FPS SOCCSKSARGEN’s prevalence rate for modern method in 2004 is 2.4% higher than the level recorded nationally. On the other hand, it is 2.5% lower for traditional methods. And among the provinces in SOCCSKSARGEN, the proportion of currently married women who used any method of contraception is highest in Gen Santos City with 58.% and lowest in Cotabato City with 15.5%. FIGURE 6. Percentage of Currently Married Women Using Modern and Traditional Method; Philippines and Mindanao Regions: 2004 Source: National Statistics Office, 2004 FPS FIGURE 7. Percentage of Currently Married Women Using Any Method of Contraception by Province; Region XII : 2004 Source: National Statistics Office, 2004 FPS The most commonly used modern Family Planning Methods in Region XII are Pills with 17.5% and IUD with 9.0%. With respect to traditional method, 7.0% used Calendar or Rhythm Method. FIGURE 8. Percentage of Currently Married Women 15-49 Years Old by Current Contraceptive Method Used; Region XII: 2004 Source: National Statistics Office, 2004 FPS Contraceptive Use for All Methods by Characteristics of Married Women The CPR differs by age of the woman. It is lowest for the age group 15 to 19, and is next lowest among women aged 45-49 years because a significant percentage of the 45-49 age group may no longer need an FP method as they are less at risk or no longer at risk of getting pregnant. The CPR is highest for age groups 30-34 and 35-39. FIGURE 9. Percent of currently married women using any contraceptive method by age group, Philippines: 2004 Source: National Statistics Office, 2004 FPS The CPR varies by level of education of the woman. Women with no education are the least likely to use contraception. Among the educated women, the use in contraception differs only between women who completed at most some elementary education and those who graduated from elementary school or completed a higher level of education. About four in 10 women who have some elementary education but did not graduate from elementary are practicing family planning. The corresponding proportion among the elementary graduates or those with a higher level of education is five out of 10. On the CPR by occupation, there is no significant difference in contraceptive use between the two broad occupation groups, the gainful workers and those not engaged in a gainful occupation like the housewives. But the more detailed tabulation in the FPS report will show that women in service related jobs and women who are officials and managers of public offices have higher CPR than other women. But in terms of modern contraceptive use, they are no different than the other women, except for women engaged in agricultural activities who are the least likely to use modern methods among the different occupation groups. FIGURE 10. Percent of currently married women using any contraceptive method by highest grade completed and occupation, Philippines: 2004 Source: National Statistics Office, 2004 FPS The CPR is strongly related to the type of residence and socio-economic status. It is higher among urban women than rural women, and among non-poor women than poor women. About four in 10 poor women are practicing family planning, while five in 10 non-poor women are doing so. FIGURE 11. Percent of currently married women using any contraceptive method by residence and socio- economic status, Philippines: 2004 Source: National Statistics Office, 2004 FPS The CPR also varies by the number of births a woman has had. It is only about 3 percent among childless married women, and more than 50 percent among married women who have from 2 to 5 children. FIGURE 12. Percent of currently married women using any contraceptive method by number of children ever born, Philippines: 2004 Source: National Statistics Office, 2004 FPS Use of modern methods is not significantly different between urban and rural women. However, it is higher among non-poor women than poor women. FIGURE 13. Percent of currently married women using modern contraceptive methods, Philippines: 2004 Source: National Statistics Office, 2004 FPS Timing of Sterilization The median age is 29.5 years, which is similar to the median age reported in the past family planning surveys. Surprisingly, about 14 percent of the women who had been ligated had the operation when they were below 25 years of age. FIGURE 14. Percent distribution of sterilized women by age at time of sterilization, Philippines: 2004 Source: National Statistics Office, 2004 FPS Source of Modern Method In the survey, the women using a supply method were asked where they obtained their most recent supply for their current method, while those ligated where asked in what facility the sterilization took place. The results of the survey show that three out four women who had ligation had the operation in a public health facility. The public sector is also the major provider of the supplies of pills, IUD, and injectables. FIGURE 15. Percent distribution of current users of selected modern contraceptive methods by most recent source of supply Philippines: 2004 Source: National Statistics Office, 2004 FPS Contraceptive Use Dynamics In the 2004 FPS, information were also collected about the family planning method the women were using in April 2003. Using the data on the method used in April 2003 and in the method used in April 2004, 12-month change of status discontinuation rates were computed. The change-of-status discontinuation rates answer the question: what percentage of users of a specific method will no longer be using that method 12 months later. Figure 16 shows estimates of discontinuation rates for selected methods shows that one in 10 users of a family planning method in April 2003 stopped using any method 12 months later. The discontinuation rate is lowest for IUD and seem to be highest for injectables and condoms. The discontinuation rate for injectables and pills tend to be higher among women with high school or college level of education. FIGURE 16. Twelve-month change-of-status discontinuation rates by highest grade completed, Philippines: 2004 Source: National Statistics Office, 2004 FPS The discontinuation rate for pills and condom do not differ by urban-rural residence, but for injectables and IUD this tends to be higher among urban than rural women. In contrary, the discontinuation rate for injectables and IUD tends to be higher among non-poor women; the reverse is true for pills and condoms. FIGURE 17. Twelve-month change-of-status discontinuation rates by residence and socio-economic status, Philippines: 2004 Source: National Statistics Office, 2004 FPS Response for Non-use In the survey, respondents who were not using a family planning method were asked why they were not practicing family planning. Methods related to exposure to conception like infecundity due to age or hysterectomy, being sexually inactive were cited by three in 10 non users. Method-related reasons like side effects and health concerns, as well as the desire for a child or more children were also the other most commonly cited reasons for non-use. Inaccessibility of FP methods was cited by 3 percent and lack of knowledge by another 3 percent of non-users. Prohibition by religion was mentioned by only 2 percent of non-users. FIGURE 18. Percent distribution of married women not using contraceptive methods by reason for non-use, Philippines: 2004 Source: National Statistics Office, 2004 FPS Currently married women in Region XII cited factors relating to exposure to conception as the main reasons for their non-use of family planning methods with 28% and 20.8% mentioned method-related reasons. FIGURE 19. Percentage of Currently Married Women opted not to avoid or delay pregnancy, by Reason for Not Using Any Contraceptive Method; Region XII: 2004 Source: National Statistics Office, 2004 FPS Unmet Need for Family Planning by Socio-Economic Status and Residence According the 2004 FPS, two in 10 married women have an unmet need for family planning. This translates into approximately 2.6 million women today assuming that the projected number of women 15 to 49 years for July this year, which is 22 million, is correct and assuming that 58 percent of these women are married. Unmet need for family planning is higher among rural women than urban women, and among poor women than non-poor women. One in five poor women has an unmet need for family planning. This proportion translates into approximately 1 million women in poor households, with unmet need for family planning. FIGURE 20. Percent of currently married women with unmet need for family planning, Philippines: 2004 Source: National Statistics Office, 2004 FPS In the Philippines, the unmet need for spacing is 10.8% and for Region XII, it is 9.7%; and unmet need for limiting is 12.7% and 8.1% respectively. FIGURE 21. Percentage of Currently Married Women With Unmet Need for Family Planning; Philippines and Region XII: 2004 Source: National Statistics Office, 2004 FPS High Risk Fertility The 2004 FPS data also generates an estimate of the percentage of married women who have high-risk fertility, or who are at risk of conceiving a child with an elevated mortality risk if they become pregnant. This slide indicates that six in 10 married women aged 15 to 49 years maybe considered at risk if they become pregnant because they are less than 18 years of age, or older than 34, have four or more previous births and would have an acceptably short birth interval of less than 24 months. FIGURE 22. Percent distribution of currently married women at risk of conceiving a child with an elevated risk of mortality by category of increased risk, Philippines: 2004 Source: National Statistics Office, 2004 FPS FPS Summary of Findings The 2004 FPS is the 8th in a series of family planning surveys conducted nationwide since 1995. The following are the 2004 FPS nationwide major keyfindings and highlights: One in two married women in the country is using a family planning method. The CPR reached around 50 percent in 1995 and appears to have remained at that level since then. The prevalence rate of modern methods in 2004 is 35 percent. This percentage is similar to the levels in 2002 and 2003. Contraceptive pills is the leading method, followed by female sterilization. The CPR varies by level of education of the woman. Women with no education are the least likely to use contraception. Women in service related jobs have higher CPR than women in other occupation groups. CPR is higher among urban women than rural women, and among non-poor women than poor women. Use of modern methods is not significantly different between urban and rural women, but it is higher among non-poor women than poor women. The median age at time of sterilization is 29.5 years, which is similar to the median age reported in the past family planning surveys. The public sector is the major provider of the supplies of pills, IUD, and injectables, and of the service for ligation. There has been a shift in the source of pills from the public to the private sector, particularly from BHUs and RHUs to the pharmacies . The discontinuation rate is lowest for IUD and seem to be highest for injectables and condoms. Methods related to exposure to conception and method-related reasons like side effects and health concerns, as well as the desire for a child or for more children were the most commonly cited reasons for non-use of family planning. Two in 10 married women have an unmet need for family planning. This translates into approximately 2.6 million women with unmet need for FP today. One in four non-users of FP will practice family planning. One in five non-users intend to use a modern method. The poor are willing to pay lower amounts for their contraceptive supplies compared with women classified as non-poor. Half of the poor women who intend to use pills in the future are willing to pay up to 25 pesos only or even less, while it is 30 pesos or less for the non-poor. Six in 10 married women aged 15 to 49 years maybe considered at risk of conceiving a child with an elevated mortality risk, if they become pregnant, because they are less than 18 years of age, or older than 34, have four or more previous births and would have an acceptably short birth interval of less than 24 months. For more information or data request on the final report of the 2004 Family Planning Survey, send us email or visit NSO SOCCSKSARGEN Regional and its Provincial Offices near you.