The Determinants of Current Contraceptive Method Choice in the Philippines

by Anna Liza Calleja Po, Master of Arts in Demography (2001)

The challenge to policymakers does not end in encouraging more couples to use contraceptives rather extends to the selection of appropriate methods that suit client needs. It is in this light that an analysis focusing on the determinants of method choice is useful in order to better guide policy and program directions.

Guided by the framework developed by Bulatao in 1989, a total of 8,336 currently married women of reproductive age were analyzed using multinomial logistic regression. In general, older women who want to stop childbearing are more likely to choose sterilization while younger women, who more often want to space rather than limit fertility, usually prefer reversible methods (especially pills). Higher parity women, who are more likely to have the number of children they want, tend to favor more modern methods (especially pills, IUD and rhythm) compared to women living in consensual unions.

Catholic women are more likely to be using IUD and less likely to be using injectables and withdrawal compared to non-Catholic women. The likelihood of using pills tends to be greater in the National Capital Region. IUDs are more favored in Mindanao, while women in Mindanao, the rest of Luzon, and Visayas are more likely to choose injectables. Reasons why injectable use is low in NCR relative to other regions should receive further attention by program managers and service providers. Sterilization is less favored in Mindanao compared to other regions, which may partly reflect differences in accessibility and cultural/religious practice.

Women who are currently working and who reside in wealthier households are more likely to use modern methods. The poorest 20% of households is significantly less likely to use pills, sterilization, and rhythm method, but are more likely to use any modern reversible method over sterilization compared to the richest 20% of households.

Mass media and interpersonal communication are often considered to be powerful tools for information dissemination. Results generally show that hearing/viewing a message about family planning through mass media channels such as radio, TV, newspapers has little systematic impact on modern method use. These findings suggest that the content and efficacy of mass media messages designed to enhance the knowledge and use of family planning and other reproductive health services should be reassessed.

More personal forms of interaction have more influence on contraceptive method choice. Modern method use tends to be higher with more frequent spousal communication about family planning. The only exception is sterilization, where more frequent spousal communication tends to discourage use, male involvement and couple decision-making in family planning are clearly areas that need further programmatic exploration.

Fieldworker contact and visits health facilities tend to promote greater use of moderns contraception, particularly reversible contraception. Medical personnel and health workers should take greater advantage of such opportunities to impart information about available contraceptive options. Facilities that are more accessible to clients also tend to promote greater use. Source of supply (public versus non-public source) is important in predicting the use of injectables over other methods. Women who obtain care from public sector facilities are much more likely to use injectables, which implies that private sector providers are not promoting this method effectively. Recommendations are presented accordingly in light of these findings.